The Mediating Role of Emotional Regulation in the Relationship Between Traumatic Childhood Experiences and Maternal Reflective Functioning 

Subject Areas : Clinical psychology

Shahnaz Ahmadi ¹ , Mohtaram Nemattavousi ²

1 - MA in Clinical Psychology Islamic Azad University South Tehran Branch
2 - PhD Islamic Azad University South Tehran Branch

Received: 2023-03-06 Accepted : 2023-03-06 Published : 2022-09-23

Keywords: Emotional regulation, parental reflective functioning, traumatic childhood experiences,

Abstract :

This study was done with the aim of determining the mediating role of emotional regulation in the relationship between child- hood traumatic experience and maternal reflective functioning. The statistical population included the mothers who visited safe houses in the city of Tehran in 2021. By the convenient method, 312 mothers were selected using the convenience sampling method and the participants answered the Parental Reflective Functioning Questionnaire (Luyten et al., 2017), childhood trauma Questionnaire (Bernstein et al.,2003), and difficulties in emotion regulation scale (Gratz & Roemer, 2004). The results of the path analysis test indicated that traumatic childhood experiences were able to explain 63% of the variance in emotional regulation diffi- culties. Moreover, traumatic childhood experiences and difficulties in emotion regulation were respectively able to explain 65, 25, and 32% of the variance of the subscales of the pre-mentalizing modes, the certainty of mental states, interest, and curiosity mental states of maternal reflective functioning. These findings indicate that emotional regulation plays a mediating role in the relationship between traumatic childhood experiences and maternal reflective functioning.

References:

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psycho- pathology: A meta-analytic review. Clinical Psycholo- gy Review, 30(2), 217-237.

Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C. H., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. European Archives of Psychiatry & Clinical Neuroscience, 256(3), 174- .186

Berking, M., & Wupperman, P. (2012). Emotion reg- ulation and mental health: recent findings, current challenges, and future directions. Current Opinion in Psychiatry,25(2), 128-134.

Bernstein, D. P., Fink, L., Handelsman, L., Foote, J., Lovejoy, M., Wenzel, K., Sapareto, E., & Ruggeiro, J. (1994). Initial reliability and validity of a new retro- spective of child abuse and neglect. American Journal of Psychiatry, 151(8), 1132-1136.

Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., & Zule, W. (2003). Devel- opment and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse &

Neglect, 27(2), 169-190.

Berthelot, N., Ensink, K., Bernazzani, O., Normandin, L., Luyten, P., & Fonagy, P. (2015). Intergenerational transmission of attachment in abused and neglected mothers: The role of trauma‐specific reflective func- tioning.Infant Mental Health Journal,36(2), 200-212.

Besharat, M. A., & Bazzazian, S. (2014). Psychometric properties of the Cognitive Emotion Regulation Ques- tionnaire in a sample of Iranian population. Advances in Nursing & Midwifery, 24(84), 61-70. [In Persian].

Besharat, M. A., Asadi, M. M., & Tavalaeyan, F. (2015). Mediating role of ego strength in the relation- ship between attachment styles and cognitive emotion regulation strategies. Journal of Developmental Psy- chology: Iranian Psychologist, 12(46), 107-119. [In Persian].

Bowlby, J. W. (1969). Attachment and loss (Vol. 1). At- tachment (2nd ed). New York: Basic Books.

Brodsky, B. S., Mann, J. J., Stanley, B., Tin, A., Oquen- do, M., Birmaher, B., & Brent, D. (2008). Familial transmission of suicidal behavior: factors mediating the relationship between childhood abuse and off- spring suicide attempts. The Journal of Clinical Psy- chiatry,69(4), 584-596.

Danielson, C. K., Hankin, B. L., & Badanes, L. S. (2015). Youth offspring of mothers with posttraumatic stress disorder have altered stress reactivity in response to a laboratory stressor. Psychoneuroendocrinolo- gy,53, 170-178.

De Roo, M., Wong, G., Rempel, G. R., & Fraser, S. N. (2019). Advancing optimal development in children: examining the construct validity of a Parent Reflective Functioning Questionnaire. JMIR Pediatrics & Par- enting, 2(1), e11561.

Ebrahimi, H., Dejkam, M., & Seghatoleslam, T. (2014). Childhood Traumas & Suicide Attempt in adulthood. Iranian Psychiatry & Clinical Psycholo- gy, 19(4), 275-282. [In Persian].

Ensink, K., Berthelot, N., Bernazzani, O., Normandin, L., & Fonagy, P. (2014). Another step closer to mea- suring the ghosts in the nursery: preliminary validation of the Trauma Reflective Functioning Scale. Frontiers in Psychology, 5, 1471.

Ensink, K., Normandin, L., Plamondon, A., Berthel- ot, N., & Fonagy, P. (2016). Intergenerational path- ways from reflective functioning to infant attachment through parenting. Canadian Journal of Behavioural Science/ Revue Canadienne des Sciences du Compor- tement, 48(1), 9–18.

Essien, E. A., Attoe, O. R., Anake, G. A., Uwah, E. E., Aigbomian, E. J., Eleazu, F. I., & Udofia, O. (2018). The childhood trauma questionnaire: validity, reliabil- ity and factor structure among adolescents in Calabar, Nigeria.Nigerian Journal of Medicine,27(3), 252- .259

Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2002). Affect regulation, mentalization, and the de- velopment of the self. New York, NY: Other Press

Fonagy, P., Steele, M., Steele, H., Moran, G. S., & Hig- gitt, A. C. (1991). The capacity for understanding men- tal states: The reflective self in parent and child and its significance for security of attachment. Infant Mental Health Journal, 12(3), 201-218.

Garnefski, N., Kraaij, V. (2006). Cognitive emotion regulation questionnaire- development of a short 18- item version (CERQ-short). Personality & Individual Differences, 41, 1045-1053.

Garner, A. S., Shonkoff, J. P., Siegel, B. S., Dobbins, M. I., Earls, M. F., McGuinn, L., Pascoe, J., Wood, D. L., & Committee on Early Childhood, Adoption, and Dependent Care. (2012). Early childhood adversity, toxic stress, and the role of the pediatrician: Translat- ing developmental science into lifelong health. Pediat- rics, 129(1), 224-231.

Goldberg, D. P., Gater, R., Sartorius, N., Ustun, T. B., Piccinelli, M., Gureje, O., & Rutter, C. (1997). The va- lidity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine, 27(1), 191-197.

Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psy- chology & Psychiatry, 38(5), 581-586.

Goudarzi, Z., Ghanbari, S., Pakdaman, Sh., & Maza- heri, M. A. (2016). The mediating role of emotional regulation in the relationship between mothers’ reflec- tive functioning and children’s internalization and ex- ternalization problems. Master’s thesis, Faculty of Ed-

ucational Sciences and Psychology, Shahid Beheshti University. [In Persian].

Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology & Behavioral Assessment, 26(1), .41-54

Gratz, K.L., & Tull, M.T. (2010). Emotion regulation as a mechanism of change in acceptance- and mind- fulness-based treatments. In R. Baer (Ed.), Assessing mindfulness and acceptance processes in clients: Illu- minating the theory and process of change (pp. 107- 133). Oakland, CA: New Harbinger Publications.

Gratz, K.L., Rosenthal, M.Z., Tull, M.T., Lejuez, C.W., & Gunderson, J.G. (2006). An experimental investiga- tion of emotion dysregulation in borderline personality disorder. Journal of Abnormal Psychology, 115, 850- .855

Gross, J. J., & Jazaieri, H. (2014). Emotion, emotion regulation, and psychopathology: An affective science perspective. Clinical Psychological Science, 2(4), .387-401

Håkansson, U., Watten, R., Söderström, K., Skårderud, F., & Øie, M. G. (2018). Adverse and adaptive child- hood experiences are associated with parental reflec- tive functioning in mothers with substance use disor- der. Child Abuse & Neglect, 81, 259-273.

Hamilton, J. L., Shapero, B. G., Stange, J. P., Hamlat, E. J., Abramson, L. Y., & Alloy, L. B. (2013). Emo- tional maltreatment, peer victimization, and depressive versus anxiety symptoms during adolescence: Hope- lessness as a mediator. Journal of Clinical Child & Adolescent Psychology,42(3), 332-347.

Hazan, C., & Shaver, P. R. (1994). Attachment as an organizational framework for research on close rela- tionships.Psychological Inquiry,5(1), 1-22.

Karimifar, M. (2017). Effectiveness of emotion regulation training on quality of life among women with anxiety. Journal of Developmental Psychology: Irani- an Psychologist, 13(52), 407-420. [In Persian].

Kestenberg, J. S. (1980). Psychoanalyses of children of survivors from the Holocaust: Case presentations and assessment. Journal of the American Psychoanalytic

Association, 28(4), 775-804.

Kim, J., & Cicchetti, D. (2010). Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology. Journal of child psy- chology & psychiatry, 51(6), 706-716.

Kim, P., Leckman, J. F., Mayes, L. C., Newman, M. A., Feldman, R., & Swain, J. E. (2010). Perceived quality of maternal care in childhood and structure and func- tion of mothers’ brain. Developmental Science, 13(4), .662-673

Kline, R. B. (2011). Principles and practice of structur- al equation modeling. New York, NY: Guilford Press.

Luyten, P., Mayes, L. C., Nijssens, L., & Fonagy, P. (2017). The parental reflective functioning question- naire: Development and preliminary validation. Plos One, 12(5).

Morris, A. S., Silk, J. S., Steinberg, L., Myers, S. S., & Robinson, L. R. (2007). The role of the family context in the development of emotion regulation. Social De- velopment, 16(2), 361-388.

Mousawi, W., & Bahrami Ehsan, H. (2020). A prelim- inary study of psychometric properties of the Parental Reflective Functioning Questionnaire (PRFQ) on an Iranian sample. Journal of Applied Psychology Re- search,11(3),55-68.[In Persian].

Naragon-Gainey, K., McMahon, T. P., & Chacko, T. P. (2017). The structure of common emotion regulation strategies: A meta-analytic examination. Psychologi- cal Bulletin, 143(4), 384-427.

Poole, J. C., Dobson, K. S., & Pusch, D. (2018). Do adverse childhood experiences predict adult inter- personal difficulties? The role of emotion dysregula- tion. Child Abuse & Neglect, 80, 123-133.

Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002). Risky families: Family social environments and the mental and physical health of offspring. Psychological Bulletin,128(2), 330-366.

Rojas, S. (2021). Emotional regulation as a mediator of adverse childhood experiences and parental reflective functioning. Doctoral dissertation, Alliant Internation- al University.

Roy, A. (2011). Combination of family history of sui- cidal behavior and childhood trauma may represent

correlate of increased suicide risk. Journal of Affective Disorders, 130, 205-208.

San Cristobal, P. S., Santelices, M. P., & Fuenzalida, D. A. M. (2017). Manifestation of trauma: The effect of early traumatic experiences and adult attachment on parental reflective functioning. Frontiers in Psycholo- gy, 8, Article 449.

Scheeringa, M. S., & Zeanah, C. H. (2001). A relational perspective on PTSD in early childhood. Journal of Traumatic Stress: Official Publication of The Inter- national Society for Traumatic Stress Studies, 14(4), .799-815

Schultheis, A. M., Mayes, L. C., & Rutherford, H. J. (2019). Associations between emotion regulation and parental reflective functioning. Journal of Child and Family Studies,28(4), 1094-1104.

Shields, A. M., & Cicchetti, D. (1995). The development of an emotion regulation assessment battery: Reliabil- ity and validity among at-risk grade-school children. In Poster presented at the Society for Research in Child Development. IN, Indianapolis.

Slade, A. (2005). Parental reflective functioning: An in- troduction. Attachment & Human Development, 7(3), .269-281

Stacks, A. M., Muzik, M., Wong, K., Beeghly, M., Huth- Bocks, A., Irwin, J. L., & Rosenblum, K. L. (2014). Maternal reflective functioning among mothers with childhood maltreatment histories: Links to sensitive parenting and infant attachment security. Attachment & Human Development, 16(5), 515-533.

Teicher, M. H., & Samson, J. A. (2016). Annual research review: Enduring neurobiological effects of childhood abuse and neglect. Journal of Child Psychology and Psychiatry, 57(3), 241-266.

Torkashvand, F., Jafary, F., Rezaeian, M., & Sheikh Fathollahi, M. (2013). A survey on child abuse & some demographic factors affecting students of the third gradeofguidanceschoolinZanjanin2011.Journal of 

Rafsanjan University of Medical Sciences, 12(6), 447- 460. [In Persian].

van Harmelen, A. L., Hauber, K., Gunther Moor, B., Spinhoven, P., Boon, A. E., Crone, E. A., & Elzinga, B. M. (2014). Childhood emotional maltreatment sever- ity is associated with dorsal medial prefrontal cortex responsivity to social exclusion in young adults. PloS one, 9(1), e85107.

Veit, C. T. & Ware, J. E. (1983). The structure of psycho- logical distress and well-being in general population. Journal of Consulting & Clinical Psychology, 51, 730- .742

Watson, D., Clarke, L. A., & Tellegen, A. (1988). Devel- opment and validation of brief measures of positive and negative affect: The PANAS Scales. Journal of Personality & Social Psychology, 54, 1063-1070.

Widom, C. S., Czaja, S. J., Kozakowski, S. S., & Chau- han, P. (2018). Does adult attachment style mediate the relationship between childhood maltreatment and mental and physical health outcomes? Child Abuse & Neglect,76, 533-545.

Winnicott, D.W. (1967). Mirror-role of the mother and family in child development. In P. Lomas (Ed.), The predicament of the family: A psycho-analytical sym- posium (pp. 26–33). London: Hogarth and Institute of Psycho-Analysis.

World Health Organization. (2006). Preventing child mal- treatment: A guide to taking action & generating evi- dence. Geneva: World Health Organization.

Yehuda, R., & Lehrner, A. (2018). Intergenerational trans- mission of trauma effects: Putative role of epigenetic mechanisms. World Psychiatry, 17(3), 243-257.

Zimmer-Gembeck, M. J., Kerin, J. L., Webb, H. J., Gard- ner, A. A., Campbell, S. M., Swan, K., & Timmer, S. G. (2019). Improved perceptions of emotion regula- tion and reflective functioning in parents: Two addi- tional positive outcomes of parent-child interaction therapy.Behavior Therapy,50(2), 340-352.