The role of parental emotion reactivity and regulation in child maltreatment and maltreatment risk: A meta-analytic review

Maternal Emotional and Behavioral Regulation/Dysregulation and Parenting Practices: A Systematic Review

Emotional and behavioral regulations are crucial for the development of perceptive, responsive, and flexible parenting. Moreover, maternal emotional dysregulation constitutes a risk for maltreatment behaviors. The present study aimed to conduct a systematic review of empirical studies on the associations between mothers' emotional and behavioral regulations and parenting practices with their children or adolescents. A systematic review was conducted, including papers that addressed these variables, analyzing the direct effects, and moderation or mediation effects of maternal emotional and behavioral regulation on parenting practices, targeting child and adolescent samples. We identified 35 studies for analysis. Most of the studies (86%) showed significant associations between maternal emotional and behavioral regulation and parenting practices. Mothers' emotional dysregulation was related to a high risk of maltreatment and negative parenting, such as unsupportive reactions and harsh discipline. High maternal emotional dysregulation and negative parenting, in turn, were associated with children's aggressive behaviors. Conversely, when mothers exhibited high emotional regulation, they engaged in more positive and supportive parenting. Additionally, maternal behavioral regulation with inhibitory control and effortful control led to supportive and warm parenting. Individual and contextual factors, such as maternal victimization history and symptoms of inattention and hyperactivity, had effects on maternal emotional dysregulation, which, in turn, impacted their parenting practices. Consequently, emotional and behavioral regulation played a crucial role in mothers' parenting practices with their children and adolescents. The findings of the current review could contribute to planning parenting interventions, including maternal emotional and behavioral regulation skills, aimed at preventing maltreatment of their children.

A Narrative Review of the Efficacy of Interventions for Emotional Dysregulation, and Underlying Bio-Psycho-Social Factors

In this narrative, comprehensive, and updated review of the literature, we summarize evidence about the effectiveness of interventions aimed at reducing emotion dysregulation and improving emotion regulation in children, adolescents, and adults. After introducing emotion dysregulation and emotion regulation from a theoretical standpoint, we discuss the factors commonly associated with emotion regulation, including neurobiological and neuropsychological mechanisms, and the role of childhood adverse experiences and psycho-social factors in the onset of emotion dysregulation. We then present evidence about pharmacological and non-pharmacological interventions aiming at improving emotion dysregulation and promoting emotion regulation across the lifespan. Although our review was not intended as a traditional systematic review, and the search was only restricted to systematic reviews and meta-analyses, we highlighted important implications and provided recommendations for clinical practice and future research in this field.

Intergenerational cascade processes from parental childhood adversity to child emotional and behavioral problems

BACKGROUND

Parental adverse childhood experiences (ACEs) may transmit to the next generation and influence children's emotional and behavioral problems. Relatively little evidence exists on the underlying pathways of this intergenerational transmission at the family- and individual-level.

OBJECTIVE

This study examined the intergenerational cascade processes of parental ACEs on children's emotional and behavioral problems via family cohesion, children's ACEs, and children's self-control.

PARTICIPANTS AND SETTING

283 children (52 % male, Mage = 10.47 years) and their parents (61.1 % mothers, Mage = 38.62 years) were recruited for a 2-month longitudinal study with surveys administered at three time points.

METHOD

Mediation models examined the intergenerational effects of parental ACEs (T1/T3) and family cohesion (T1) as reported by parents, and children's ACEs (T1) and children's self-control (T2) as reported by children, on children's internalizing and externalizing problems (T3) as reported by parents.

RESULTS

Family cohesion, children's ACEs, and children's self-control sequentially mediated the link between parental ACEs and children's externalizing problems (indirect effect = 0.004, 95 % CI [0.001, 0.014]). Parental ACEs were directly linked with children's internalizing problems (β = 0.191, SE = 0.075, p = .011).

CONCLUSIONS

Findings demonstrated intergenerational cascades of distal and proximal risk processes from parental ACEs to children's behavioral problems. These findings have implications for future interventions on children's externalizing problems that aim at improving family cohesion and children's self-control for families exposed to childhood adversity.

The Role of Psychopathology and Emotion Regulation in the Intergenerational Transmission of Childhood Abuse: A Family Study

Previous studies have shown that parents with a history of childhood abuse are at increased risk of perpetrating child abuse. To break the cycle of childhood abuse we need to better understand the mechanisms that play a role. In a cross-sectional extended family design including three generations (N = 250, 59% female), we examined the possible mediating role of parental psychopathology and emotion regulation in the association between a history of childhood abuse and perpetrating child abuse. Parents' own history of childhood abuse was associated with perpetrating abuse toward their children, and externalizing (but not internalizing) problems partially mediated this association statistically. Implicit and explicit emotion regulation were not associated with experienced or perpetrated abuse. Findings did not differ across fathers and mothers. Findings underline the importance of (early) treatment of externalizing problems in parents with a history of childhood abuse, to possibly prevent the transmission of child abuse.

Maternal Autonomy Support in a Randomized Controlled Trial of the Reminiscing and Emotion Training Intervention

Objective

The Reminiscing and Emotion Training (RET) intervention targets and improves maltreating mothers' elaboration and sensitivity in reminiscing (conversations about past emotional events), as well as children's emotion knowledge. However, in previous studies of RET, improvements in mothers' elaborative and sensitive reminiscing did not explain improvements in children's emotion knowledge. Thus, we evaluated whether RET is associated with improved maternal autonomy support during reminiscing and whether improved autonomy support is associated with enhanced child emotion knowledge after RET.

Methods

The sample included 248 mothers (165 maltreating and 83 nonmaltreating) and their 3- to 6-year-old children involved in a randomized controlled trial of RET. At baseline, we assessed maternal and child receptive language, dyadic reminiscing, and children's emotion knowledge. Then, maltreating mothers were randomized either to receive RET or participate in an active control condition including case management and written parenting materials. Nonmaltreating mothers did not receive intervention and participated as an additional control group. Families then completed an eight-week follow-up assessment.

Results

Maltreating mothers displayed significantly less baseline autonomy support during reminiscing than nonmaltreating mothers (partial eta squared = .028). Contrary to hypotheses, RET did not significantly improve autonomy support. However, baseline autonomy support was significantly and positively correlated with children's emotion knowledge at baseline (r = .20) and follow-up (r = .18).

Conclusion

Autonomy support during reminiscing may play a role in the development of emotion knowledge. Implications for developmental theory and clinical practice are discussed.

Reducing Family Violence Through Child Welfare Intervention: A Propensity Score-Matched Study of Fathers for Change

Intimate partner violence (IPV) is prevalent, costly, and detrimental to children's health and development. It often co-occurs with child abuse and neglect. Most children referred to child protective services (CPS) have witnessed IPV and are at increased risk for subsequent exposure, as well as repeat maltreatment. For CPS referred children, there is often a missed opportunity to interrupt family violence and prevent future occurrences. Fathers for Change (F4C) is a family level intervention designed to reduce IPV by improving emotion regulation and reflective functioning in fathers. To date, no study has examined whether F4C is associated with reduced recidivism in families referred to CPS. Using propensity score matching (PSM) to simulate an experimental design, the current study tests the hypothesis that families with fathers who completed F4C will have significantly lower rates of new CPS reports over a 12-month period compared to a PSM sample of families of fathers not referred to F4C. Data were extracted from a state CPS electronic case records system on all accepted child maltreatment reports received between January 1, 2015, and April 30, 2020. PSM was successful in balancing potential confounders (e.g., race, number of prior maltreatment reports, risk level, date of report), resulting in a comparison group approximate to one that could be achieved via a randomized control trial. Logistic regression analyses of 1:1 PSM pairs revealed that control fathers were 2.4 times more likely to have a repeat maltreatment report during the 12-month follow-up period than F4C fathers. These findings suggest that F4C may provide an effective approach for reducing risk of repeat maltreatment among CPS referred children with identified IPV exposure.

Dynamic regulatory processes among child welfare parents: Temporal associations between physiology and parenting behavior

This study examined how temporal associations between parents' physiological and behavioral responses may reflect underlying regulatory difficulties in at-risk parenting. Time-series data of cardiac indices (second-by-second estimates of inter-beat intervals - IBI, and respiratory sinus arrhythmia - RSA) and parenting behaviors were obtained from 204 child welfare-involved parents (88% mothers, Mage = 32.32 years) during child-led play with their 3- to 7-year-old children (45.1% female; Mage = 4.76 years). Known risk factors for maltreatment, including parents' negative social cognitions, mental health symptoms, and inhibitory control problems, were examined as moderators of intra-individual physiology-behavior associations. Results of ordinary differential equations suggested increases in parents' cardiac arousal at moments when they showed positive parenting behaviors. In turn, higher arousal was associated with momentary decreases in both positive and negative parenting behaviors. Individual differences in these dynamic processes were identified in association with parental risk factors. In contrast, no sample-wide RSA-behavior associations were evident, but a pattern of increased positive parenting at moments of parasympathetic withdrawal emerged among parents showing more total positive parenting behaviors. This study illustrated an innovative and ecologically-valid approach to examining regulatory patterns that may shape parenting in real-time and identified mechanisms that should be addressed in interventions.

Psychoanalytic Interventions with Abusive Parents: An Opportunity for Children's Mental Health

Research has extensively shown that most people who experience maltreatment in their childhood develop mental disorders, psychosocial adjustment problems, and, in many cases, become maltreating adults themselves. Preventing child maltreatment and treating abused children and abusive parents are, therefore, pressing public health issues. As established by the UK Children Act in 1989, child development is enhanced by remaining in the family whenever the child's safety is assured. Thus, developing prevention and intervention programs for the purpose of repairing, whenever possible, the child-parent relationship should be a social priority. This narrative review focuses on the psychoanalytic studies related to intrapsychic dynamics and therapeutic intervention for physically abusive parents. The role of the transgenerational transmission of abuse and parents' narcissistic fragility is crucial. Psychoanalytic interventions focus on helping the parent work through their past painful experiences and narcissistic vulnerability. Parent-child psychotherapy and mentalization-based treatment have been found to be prevalent, while there is scarce literature regarding intensive individual psychoanalytic treatment. Within the framework of attachment theory, brief interventions were developed; however, they did not prove effective for those parents who suffered experiences of maltreatment or severe neglect in childhood and for whom long-term parent-child psychotherapy resulted, which proved to be the most effective.

Emotion regulation as mediator between childhood adversity and psychopathology: A meta-analysis

Childhood adversity is a major risk factor for multiple forms of psychopathology, and recent efforts have focused on understanding the underlying psychological mechanisms. One outstanding candidate is emotion regulation, which has been associated with both childhood adversity, and psychopathology. Based on the available evidence, the present meta-analysis set out to investigate the mechanistic involvement of emotion regulation in the relation between childhood adversity and psychopathology. Systematic searches in three databases (PubMed; PsycINFO; Web of Science) identified 215 eligible studies. Using meta-analytic structural equation modeling, we fitted a partial mediation model to the available data across studies, in which childhood adversity was related to psychopathology both directly and through emotion regulation. Multiple emotion regulation dimensions were analyzed, including emotion regulation difficulties and the habitual use of rumination, distraction, reappraisal, and suppression. Measures of psychopathology included a wide range of internalizing and externalizing symptoms in both clinical and non-clinical samples. The results indicated that childhood adversity was positively associated with emotion regulation difficulties, as well as with the habitual use of rumination and suppression. In turn, these measures of emotion regulation were positively associated with psychopathology. Habitual reappraisal use showed negative relations with both childhood adversity and psychopathology. All these emotion regulation measures were supported as mediators in the relation between childhood adversity and psychopathology. In contrast, distraction was not related to childhood adversity or psychopathology, and its mediator role was not supported. These results suggest that altered emotion regulation is a consistent marker of childhood adversity and contributes to risk of psychopathology.