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Neglected ghosts of contested nurseries: The role of interpersonal trauma and psychosocial adversity for caregiving among parents with intellectual disability
Stockholm University, Faculty of Social Sciences, Department of Psychology, Personality, Social and Developmental Psychology.ORCID iD: 0000-0002-2527-9357
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Research on the general parent population has established that parental exposure to interpersonal trauma and psychosocial stressors may negatively influence caregiving and children’s development. Research also suggests that parents with intellectual disability (ID) are disproportionally exposed to interpersonal trauma and psychosocial stressors, and that such exposure may contribute to the elevated risk for caregiving and child developmental problems in this population. Conflicting findings have, however, also been reported, and there is no synthesized picture of the prevalence of interpersonal trauma among these parents, or of associated caregiving-related and child developmental outcomes. There is also a scarcity of research addressing these parents’ exposure to interpersonal trauma and psychosocial stressors, in relation to developmentally informed aspects of caregiving and child development. 

This thesis aims to counter these knowledge gaps. Study I systematically reviewed extant empirical reports on interpersonal trauma among parents with ID, and links with caregiving-related and child developmental outcomes. The review indicated that > 50% of these parents have been exposed to interpersonal trauma. Findings regarding caregiving-related outcomes overall indicated that interpersonal trauma increases caregiving-related risks. Reports on links with child developmental outcomes were scant and inconsistent. Studies II and III present empirical works, focused on parental social-cognitive capacities among mothers with ID. Study II involved a sample of mothers with ID (n = 30), and comparison mothers with ADHD (n = 61), and examined the mothers’ exposure to interpersonal trauma and psychosocial adversity in relation to their capacity for parental mentalizing. Mothers with ID had a heightened risk for mentalizing difficulties, in the form of prementalizing modes of relating to their children. Cumulative interpersonal trauma uniquely predicted prementalizing across groups, whereas psychosocial adversity added to the risk for prementalizing specifically among mothers with ID. Study III involved a second sample of mothers with ID (n = 23) and their children, and socioeconomically matched mothers without ID (n = 25) and their children. This study examined the mothers’ capacity for interpreting infants’ emotions, in relation to the mothers’ exposure to interpersonal trauma, and their children’s attachment. Mothers with ID had a heightened proclivity to misinterpret infants’ emotional expressions as expressions of anger and shame. Shame misinterpretations were also linked with these mothers’ cumulative interpersonal trauma, and with child attachment insecurity and disorganization. An addendum to Study III also addressed the mothers’ psychosocial situation, in relation to maternal sensitivity and the children’s attachment. In both study groups, psychosocial adversity was linked with lower maternal sensitivity. The analysis also suggested that psychosocial adversity contributed to child attachment disorganization specifically among children of mothers with ID. Overall, the thesis points to the importance of acknowledging the parents’ relational history and psychosocial situation, when attempting to understand caregiving-related and child developmental difficulties in families headed by parents with ID. The thesis also outlines important steps for future research, and discusses implications of the findings for practitioners and policy-makers.

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University , 2023. , p. 98
Keywords [en]
Intellectual disability, Interpersonal trauma, Psychosocial Risk, Parenting, Child development, Social cognition, Parental mentalizing, Attachment
Keywords [sv]
Intellektuell funktionsnedsättning, Interpersonellt trauma, Psykosocial risk, Föräldraskap, Barns utveckling, Social kognition, Föräldramentalisering, Anknytning
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-223650ISBN: 978-91-8014-593-0 (print)ISBN: 978-91-8014-594-7 (electronic)OAI: oai:DiVA.org:su-223650DiVA, id: diva2:1811871
Public defence
2024-01-19, hörsal 7, hus 4, Albano, Albanovägen 12, Stockholm, 10:00 (English)
Opponent
Supervisors
Available from: 2023-12-14 Created: 2023-11-14 Last updated: 2024-02-01Bibliographically approved
List of papers
1. Experiences of Interpersonal Trauma Among Parents With Intellectual Disabilities: A Systematic Review
Open this publication in new window or tab >>Experiences of Interpersonal Trauma Among Parents With Intellectual Disabilities: A Systematic Review
2023 (English)In: Trauma, Violence, & Abuse, ISSN 1524-8380, E-ISSN 1552-8324, Vol. 24, no 4, p. 2843-2862Article, review/survey (Refereed) Published
Abstract [en]

Research has suggested highly elevated levels of interpersonal trauma (IPT) among parents with intellectual disabilities (ID), and that such experiences may contribute to the caregiving and child developmental problems often seen in this population. Conflicting results have however been reported, and there is no systematic review on this matter. This study therefore systematically reviewed the empirical evidence concerning (a) prevalence of IPT among parents with ID, and links with (b) caregiving-relevant and (c) child developmental outcomes, in accordance with the PRISMA 2020 guidelines. Searches were conducted in MEDLINE, CINAHL, PsycINFO, and PTSDpubs. Peer-reviewed empirical articles reporting exposure to any form of systematically assessed IPT (unspecified IPT, physical, sexual, and emotional abuse, neglect, prolonged childhood separations from caregivers, witnessing abuse in the family) among parents with ID were included, yielding a final selection of 20 studies. Findings consistently indicated markedly elevated levels of IPT among parents with ID, with a majority (>50%) having experienced some form of IPT. Estimates for both unspecified and specific forms were typically higher than corresponding estimates in other groups at elevated risk, and than meta-analytical general population estimates in comparable countries. Findings regarding caregiving-relevant outcomes were mixed but indicated links with adverse outcomes, particularly regarding parental mental health. Reports pertaining to child developmental outcomes were scant and inconsistent. We highlight important limitations in the extant literature and provide directions for future research and clinical practice. 

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
intellectual disabilities, interpersonal trauma, risk factors, abuse, maltreatment, caregiving, child development
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-209441 (URN)10.1177/15248380221119237 (DOI)000850333300001 ()36062575 (PubMedID)2-s2.0-85139405761 (Scopus ID)
Note

This research was supported by grants from the Swedish Research Council (Grant 2017-03315) and the Swedish research Council for Health, Working Life, and Welfare (Grant 2017-01182) awarded to Pehr Granqvist and Tommie Forslund.

Available from: 2022-09-19 Created: 2022-09-19 Last updated: 2024-01-11Bibliographically approved
2. Parental mentalising among mothers with intellectual disability or ADHD: Links with experiences of abuse, neglect and psychosocial risk
Open this publication in new window or tab >>Parental mentalising among mothers with intellectual disability or ADHD: Links with experiences of abuse, neglect and psychosocial risk
2023 (English)In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 36, no 6, p. 1206-1217Article in journal (Refereed) Published
Abstract [en]

Background: Parental mentalising difficulties are robustly linked to caregiving problems. Mothers with intellectual disability are at risk for caregiving problems, but knowledge on their parental mentalising abilities is lacking. The present study aimed to fill this gap.

Method: Thirty mothers with mild intellectual disability, and 61 comparison mothers with ADHD, were assessed for parental mentalising using the Parental Reflective Functioning Questionnaire. Contributions of intellectual disability, maternal exposure to childhood abuse/neglect and psychosocial risk to parental mentalising were examined through hierarchical regression analysis.

Results: Mothers with intellectual disability had a heightened risk for parental mentalising difficulties, in the form of elevated prementalising. Intellectual disability and cumulative childhood abuse/neglect uniquely predicted prementalising among the mothers, whereas cumulative psychosocial risk added to the risk for prementalising specifically among mothers with intellectual disability.

Conclusions: Our findings support contextual models of caregiving, and suggest a need for mentalisation-based support for parents with mild intellectual disability.

Keywords
ADHD, childhood abuse and neglect, intellectual disability, parental mentalising, psychosocial risk
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-220269 (URN)10.1111/jar.13118 (DOI)000988400800001 ()37194381 (PubMedID)2-s2.0-85159405130 (Scopus ID)
Funder
Swedish Research Council, 2017-03315Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-01182
Available from: 2023-08-22 Created: 2023-08-22 Last updated: 2024-01-15Bibliographically approved
3. Mothers With Mild Levels of Intellectual Disability: Emotion-Interpretation, Traumatization, and Child Attachment Representations
Open this publication in new window or tab >>Mothers With Mild Levels of Intellectual Disability: Emotion-Interpretation, Traumatization, and Child Attachment Representations
2021 (English)In: American Journal on Intellectual and Developmental Disabilities, ISSN 1944-7515, E-ISSN 1944-7558, Vol. 126, no 4, p. 341-356Article in journal (Refereed) Published
Abstract [en]

Prior research indicates links between parents' experiences of interpersonal trauma and emotion-interpretation difficulties, and between such difficulties and child attachment insecurity and disorganization. Although mothers with mild levels of intellectual disability (ID) are at heightened risk for trauma and emotion-interpretation difficulties, and their children for attachment insecurity, corresponding links in this population have not been examined. We therefore investigated emotional interpretations among mothers with mild levels of ID (n = 23) and matched comparison mothers without ID (n = 25), in relation to mothers' experiences of trauma and their children's attachment representations. Mothers with mild levels of ID were not less accurate than comparison mothers with regard to general positive and negative emotion-interpretation accuracy, but they were significantly more likely to misinterpret shame and anger. Among mothers with mild levels of ID, misinterpretations of shame were positively related to maternal experiences of trauma, and to child attachment insecurity and disorganization.

Keywords
intellectual disability, attachment, emotion interpretation, interpersonal trauma, risk factor
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-196077 (URN)10.1352/1944-7558-126.4.341 (DOI)000664856700004 ()34161561 (PubMedID)
Available from: 2021-08-31 Created: 2021-08-31 Last updated: 2023-11-14Bibliographically approved

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