Veteran parents’ posttraumatic stress disorder and harsh parenting: Parental pre-mentalization as a mediator

• In Event: Informing Prevention and Intervention Programs targeting Adverse Childhood Experiences (ACEs)

Abstract

Veteran parents pervasively suffer from posttraumatic stress disorder (PTSD), which may contribute to their harsh parenting and trauma for the next generation. However, the modifiable factors that can mediate the pathway from parental PTSD to harsh parenting are less examined. Attachment theory states that parents’ appropriate interpretation of their children’s internal states, e.g., parental mentalization, contributes to parental sensitivity and positive parenting. Unfortunately, parents’ traumatic symptoms may substantially limit their mentalizing capacities. Specifically, parents experiencing trauma can develop pre-mentalization mode – a distorted way of interpreting their child’s subjectivity as malevolent – to cause harsh parenting or child maltreatment behavior. To inform interventions to break the cycle of generational trauma in military families, this study aims to examine the associations between veteran parents’ PTSD and harsh parenting as mediated by parental pre-mentalization.
Using Qualtrics online research panel, we collected data from 509 veteran parents with young children below the age of 10. Parents’ PTSD was measured by the 17 items from the PTSD Checklist-Military Version. Parental pre-mentalization was assessed by the 6-item pre-mentalization subscale of the Parental Reflective Functioning Questionnaire. Sample questions include “The only time I’m certain my child loves me is when he or she is smiling at me.” “My child cries around strangers to embarrass me.” “When my child is fussy, he or she does that just to annoy me.” Harsh parenting included two dimensions: corporal punishment and psychological aggression. They were both assessed by 4 items from the sub-scales of the Dimensions of Discipline Inventory. Relevant covariates included parents' age, gender, education, relationship status, household income, and child age and gender. Using Mplus 8.7, we built a structural equation modeling (SEM) to test the hypothesis that the pathways from parental PTSD to harsh parenting were mediated by parental pre-mentalization. Root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI), and standardized root mean square residual (SRMR) were used to assess model fit. Nonnormality and missing data were handled by the full-information maximum likelihood estimator.
While controlling the race and household incomes, the SEM model fit was good: RMSEA = .072, CFI = .965, TIL = .962, SRMR = .07. Parental PTSD was directly associated with corporal punishment (β = 0.264, p <. 001) and psychological aggression (β = .217, p <. 001). More importantly, we found that parental pre-mentalization was a significant mediator for the pathways from parental PTSD to corporal punishment (indirect effect = 0.263, p <. 001)and parental PTSD to psychological aggression (indirect effect = 0.248, p <. 001).
This study suggested that veterans’ PTSD will significantly compromise their parental mentalization which may later increase the chance of harsh parenting. As pre-mentalization is a significant mediator, changing the way parents interpret their child’s mental state could help counteract the impacts of veterans’ PTSD on parenting. The mentalization-based intervention, originally developed for people with borderline personality disorders, can be tailored to decrease veterans’ parental pre-mentalization to break the cycle of trauma among veteran families.

Authors

• Xiafei Wang, Syracuse University
  Presenting Author

• Qingyang Liu, Syracuse University

• Gabriel J Merrin, Syracuse University