Mother-infant attachment and the intergenerational transmission of posttraumatic stress disorder

摘要

Evidence for the intergenerational transmission of posttraumatic stress disorder (PTSD) is documented in the literature, although the underlying mechanisms arepoorly understood. Attachment theory provides a framework for elucidating theways in which maternal PTSD may increase offspring PTSD vulnerability. Thecurrent study utilized two independent prospective data sets to test thehypotheses that (a) maternal PTSD increases the probability of developing aninsecure mother-infant attachment relationship and (b) an insecure mother-infant attachment relationship increases the risk of developing PTSD following traumaexposure in later life. In the first study of urban, primarily low-incomeethnic/racial minority mothers and infants (N = 45 dyads), elevated maternal PTSDsymptoms at 6 months were associated with increased risk for an insecure,particularly disorganized, mother-infant attachment relationship at 13 months. Inthe second birth cohort of urban, low-income mothers and children (N = 96 dyads),insecure (avoidant or resistant) attachment in infancy was associated in adose-response manner with increased lifetime risk for a diagnosis of PTSD byadolescence. A history of disorganized attachment in infancy predicted severityof PTSD symptoms, including reexperiencing, avoidance, hyperarousal, and totalsymptoms, at 17.5 years. In both studies, associations between attachment andPTSD were not attributable to numerous co-occurring risk factors. The findingssuggest that promoting positive mother-child relationships in early development, particularly in populations at high risk for trauma exposure, may reduce theincidence of PTSD.