39.2 PREDICTORS OF SOCIAL ENGAGEMENT AND REGULATION DIFFICULTIES IN SIX-MONTH-OLD INFANTS BORN TO MOTHERS WITH A HISTORY OF VIOLENT TRAUMA

Objectives: Research in older children and in animal studies has shown that maternal trauma increases the risk for adverse developmental and medical outcomes in the offspring. Early infancy is a particularly vulnerable period, yet it remains unclear whether maternal trauma type, associated psychiatric diagnoses, atypical parenting behavior, and/or parenting stress best predict the development of psychological and/or medical difficulties in young infants. Methods: Women (N = 198) and their infants (age 6 months) born at term and without complications were the focus of this study. A psychiatrist assessed maternal trauma history, PTSD, MDD, dissociative disorder symptoms, anxiety, and parenting stress through Life Stressor Checklist-Revised, Clinician Administered PTSD Scale, Structured Clinical Interview for DSM Disorders, Spielberger Trait Anxiety Inventory, and Parenting Stress Index- Parent Child Dysfunctional Interaction Subscale. Coders of videos recording mother-infant free play were blind to the results of interviews (Coding Interactive Behavior Scale and Atypical Maternal Behavior Instrument for Assessment and Classification). Mothers completed the Infant Toddler Symptom Checklist on infant regulation difficulties ("fussy baby"). We computed structural equation modeling to test a model assessing paths leading from trauma-related maternal measures to infant outcome. Results: The results of assessments were as follows: 48.9 percent had maternal trauma history, 17.7 percent had PTSD, 16.1 percent had MDD, and 34.4 percent showed signs of maternal fussy baby concern. Statistical analyses showed significantly more parenting stress and atypical parenting, as well as more infant regulation difficulties, but less infant social engagement in the presence of maternal trauma (p < 0.05), even if maternal psychiatric symptoms did not fully meet DSM criteria for PTSD, MDD, or both. Structural equation modeling revealed that atypical parenting and parenting stressors are important mediators in the complex interactional pattern between maternal trauma-associated symptoms and child developmental outcomes. Conclusions: From a child developmental point of view, screening and intervention tools in the context of maternal trauma need to target atypical parenting and maternal feelings of parenting stress in addition to maternal psychiatric symptoms.