Neglected ghosts of contested nurseries : The role of interpersonal trauma and psychosocial adversity for caregiving among parents with intellectual disability

Abstract: 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.