Identifying Risk and Resilience Factors in the Intergenerational Cycle of Maltreatment: Results From the TRANS-GEN Study Investigating the Effects of Maternal Attachment and Social Support on Child Attachment and Cardiovascular Stress Physiology

Anna Buchheim; Ute Ziegenhain; Heinz Kindler; Christiane Waller; Harald Gündel; Alexander Karabatsiakis; Jörg Fegert

doi:10.3389/fnhum.2022.890262

Identifying Risk and Resilience Factors in the Intergenerational Cycle of Maltreatment: Results From the TRANS-GEN Study Investigating the Effects of Maternal Attachment and Social Support on Child Attachment and Cardiovascular Stress Physiology

Front Hum Neurosci. 2022 Jul 18:16:890262. doi: 10.3389/fnhum.2022.890262. eCollection 2022.

Authors

Anna Buchheim¹, Ute Ziegenhain², Heinz Kindler³, Christiane Waller⁴, Harald Gündel⁵, Alexander Karabatsiakis¹, Jörg Fegert²

Affiliations

¹ Department of Clinical Psychology II, Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
² Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University Hospital, Ulm, Germany.
³ German Youth Institute, Munich, Germany.
⁴ Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nürnberg, Germany.
⁵ Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany.

Abstract

Introduction: Childhood maltreatment (CM) is a developmental risk factor and can negatively influence later psychological functioning, health, and development in the next generation. A comprehensive understanding of the biopsychosocial underpinnings of CM transmission would allow to identify protective factors that could disrupt the intergenerational CM risk cycle. This study examined the consequences of maternal CM and the effects of psychosocial and biological resilience factors on child attachment and stress-regulatory development using a prospective trans-disciplinary approach.

Methods: Mother-child dyads (N = 158) participated shortly after parturition (t ₀), after 3 months (t ₁), and 12 months later (t ₂). Mothers' CM experiences were assessed at t ₀, attachment representation at t ₁ and psychosocial risk and social support were assessed at t ₁ and t ₂. At t ₂, dyads participated in the Strange Situation Procedure (SSP). Children's attachmen status were classified as organized vs. disorganized, including their level of disorganized behavior, and heart rate (HR) and respiratory sinus arrhythmia (RSA) were recorded as stress response measures of the autonomic nervous system. Maternal caregiving during SSP was assessed using the AMBIANCE scale. Child's single nucleotide polymorphisms rs2254298 within the oxytocin receptor (OXTR) and rs2740210 of the oxytocin gene (OXT) were genotyped using DNA isolated from cord blood.

Results: Maternal CM experiences (CM+) were significantly associated with an unresolved attachment status, higher perceived stress and more psychological symptoms. These negative effects of CM were attenuated by social support. As expected, maternal unresolved attachment and child disorganized attachment were significantly associated. Maternal caregiving did not mediate the relationship between maternal and child attachment but influenced children's HR and RSA response and disorganized behavior. Moreover, the rs2254298 genotype of the OXTR gene moderated the stress response of children from mothers with CM. Children carrying the rs2740210 risk allele of the OXT gene showed more disorganized behavior independent from maternal CM experiences.

Conclusion: We replicated and extended existing CM and attachment models by co-examining maternal attachment, social support, and child genetic susceptibility on child attachment and cardiovascular stress regulation. The findings contribute to an extended understanding of risk and resilience factors and enable professionals to target adequate services to parents and children at risk.

Keywords: adult attachment projective picture system; attachment representation; childhood maltreatment; intergenerational cycle of attachment; maternal sensitivity; oxytocin receptor gene; respiratory sinus arrhythmia; social support.