Recent Innovations in Psychology

Recent Innovations in Psychology

Maternal Reflective Functioning and Child Emotional Expression in Trauma Situations: The Mediating Role of the Mother-Child Relationship

Document Type : Original Article

Authors
Fatemeh Shahamat Dehsorkh 1
Marjan Hashemi Yazdi 2
1 Assistant Professor, Department of Psychology, Khayyam University, Mashhad, Iran.
2 MSc. of General Psychology, Khayyam University, Mashhad, Iran
10.22034/rip.2024.193937
Abstract
Children's responses to trauma depend on their psychological capacities. Given the importance of maternal reflective functioning in the formation of these psychological capacities, this research aims to investigate the mediating role of the mother-child relationship in the relationship between maternal reflective functioning and child emotional expression in trauma conditions. For this descriptive study, 74 mothers with children aged 4-8 years completed the Mother-Child Relationship Evaluation (MCRE) and the Parental Reflective Function Questionnaire (PRFQ) during the Covid-19 pandemic. To measure the children's emotional expression, the components of their drawings (depression, anxiety and excitability) were used. The results showed that despite the fit of the model, none of the indirect effects were significant (P>0.05). Direct effects showed that maternal prementalization was significantly related to the dysfunctional mother-child relationship and the child's emotional expression. In addition, interest and curiosity about the child's mental state were also related to the dysfunctional mother-child relationship (P<0.05). It seems that the mother's reflective functioning plays an important role in predicting the child's emotional expression in trauma situations. However, more research is needed to explain these relationships.
Keywords
trauma
mother-child relationship
maternal reflective functioning
children&‌‌‌rsquo
drawing
Subjects
Ahmad, M., Sechi, C., & Vismara, L. (2024). Advanced Maternal Age: A Scoping Review about the Psychological Impact on Mothers, Infants, and Their Relationship. Behavioral Sciences, 14(3), 147. https://doi.org/10.3390/bs14030147
Bareket-Bojmel, L., Shahar, G., & Margalit, M. (2021). COVID-19-related economic anxiety is as high as health anxiety: findings from the USA, the UK, and Israel. International journal of cognitive therapy, 14(3), 566-574. https://doi.org/10.1007/s41811-020-00078-3
Borelli, J. L., Lai, J., Smiley, P. A., Kerr, M. L., Buttitta, K., Hecht, H. K., & Rasmussen, H. F. (2021). Higher maternal reflective functioning is associated with toddlers’ adaptive emotion regulation. Infant mental health journal, 42(4), 473-487. https://doi.org/10.1002/imhj.21904
Camoirano, A. (2017). Mentalizing Makes Parenting Work: A Review about Parental Reflective Functioning and Clinical Interventions to Improve It [Review]. Frontiers in psychology, 8. https://doi.org/10.3389/fpsyg.2017.00014
Cénat, J. M., & Dalexis, R. D. (2020). The Complex Trauma Spectrum During the COVID-19 Pandemic: A Threat for Children and Adolescents' Physical and Mental Health. Psychiatry Research, 293, 113473-113473. https://doi.org/10.1016/j.psychres.2020.113473
Chokshi, B., Pletcher, B. A., & Strait, J. S. (2021). A trauma-informed approach to the pediatric COVID-19 response. Current problems in pediatric and adolescent health care, 51(2), 100970-100970. https://doi.org/10.1016/j.cppeds.2021.100970
Collin-Vézina, D., Brend, D., & Beeman, I. (2020). When it counts the most: Trauma-informed care and the COVID-19 global pandemic. Developmental Child Welfare, 2(3), 172-179. https://doi.org/10.1177/2516103220942530
Corman, L. (1967). El test del dibujo de la familia en la práctica médico-pedagógica. Kapelusz, Buenos Aires.URL:https://apunteca.usal.edu.ar/id/eprint/2519/
Dunn, J., O'Connor, T. G., & Levy, I. (2002). Out of the picture: A study of family drawings by children: From step, single-parent, and non-step families. Journal of clinical child and adolescent psychology, 31(4), 505-512. https://doi.org/10.1207/s15374424jccp3104_9
Ensink, K., Bégin, M., Normandin, L., & Fonagy, P. (2016). Maternal and child reflective functioning in the context of child sexual abuse: Pathways to depression and externalising difficulties. European journal of psychotraumatology, 7(1), 30611.https://doi.org/10.3402/ejpt.v7.30611
Ensink, K., Bégin, M., Normandin, L., & Fonagy, P. (2017). Parental reflective functioning as a moderator of child internalizing difficulties in the context of child sexual abuse. Psychiatry research, 257, 361-366. https://doi.org/10.1016/j.psychres.2017.07.051
Esbjørn, B. H., Pedersen, S. H., Daniel, S. I., Hald, H. H., Holm, J. M., & Steele, H. (2013). Anxiety levels in clinically referred children and their parents: Examining the unique influence of self‐reported attachment styles and interview‐based reflective functioning in mothers and fathers. British Journal of Clinical Psychology, 52(4), 394-407. https://doi.org/10.1111/bjc.12024
Fathi, M., AminYazdi, S. A., Kareshki, H., & Ahanchian, H. (2020). Investigating psychometric properties of Parental Reflective Functioning Questionnaire (PRFQ). Journal of Fundamentals of Mental Health, 22(5), 301-310. https://doi.org/10.22038/jfmh.2020.17346
Fonagy, P., Luyten, P., Moulton-Perkins, A., Lee, Y. W., Warren, F., Howard, S., ... & Lowyck, B. (2016). Development and validation of a self-report measure of mentalizing: The reflective functioning questionnaire. PloS one, 11(7), e0158678. https://doi.org/10.1371/journal.pone.0158678
Fonagy, P., Steele, H., & Steele, M. (1991). Maternal representations of attachment during pregnancy predict the organization of infant‐mother attachment at one year of age. Child development, 62(5), 891-905. https://doi.org/10.1111/j.1467-8624.1991.tb01578.x
Fornell, C., & Larcker, D. F. (1981). Structural equation models with unobservable variables and measurement error: Algebra and statistics. Journal of Marketing Research, 18 (1), 39–50. https://doi.org/10.1177/002224378101800313
Giannopoulou, I., Galinaki, S., Kollintza, E., Adamaki, M., Kympouropoulos, S., Alevyzakis, E., ... & Rizos, E. (2021). COVID‑19 and post‑traumatic stress disorder: The perfect ‘storm’for mental health. Experimental and Therapeutic Medicine, 22(4), 1-7.https://doi.org/10.3892/etm.2021.10596
Groth-Marnat, G. (2003). Handbook of psychological assessment. John Wiley & Sons. URL: https://psycnet.apa.org/record/2003-02911-000
Hair Jr, J. F., Hult, G. T. M., Ringle, C. M., Sarstedt, M., Danks, N. P., Ray, S., ... & Ray, S. (2021). An introduction to structural equation modeling. Partial least squares structural equation modeling (PLS-SEM) using R: a workbook, 1-29. URL: https://link.springer.com/chapter/10.1007/978-3-030-80519-7_1
Heron-Delaney, M., Kenardy, J. A., Brown, E. A., Jardine, C., Bogossian, F., Neuman, L., ... & Pritchard, M. (2016). Early maternal reflective functioning and infant emotional regulation in a preterm infant sample at 6 months corrected age. Journal of Pediatric Psychology, 41(8), 906-914. https://doi.org/10.1093/jpepsy/jsv169
Jurist, E. L. (2005). Mentalized affectivity. Psychoanalytic Psychology, 22(3), 426-444. https://doi.org/10.1037/0736-9735.22.3.426
Kakavandi, kh., & Shojaee, S. (2017). The Effectiveness of Life Skills Training on the Mother-Child Relationship in Mothers of Children with Hearing Problems. Journal of Family Research, 12(3), 483-500 (In Persian). URL: https://jfr.sbu.ac.ir/article_97426.html?lang=en
Khoshroo, S., & Seyed Mousavi, P. S. (2022). Parental Reflective Functioning as a Moderator for the Relationship Between Maternal Depression and Child Internalizing and Externalizing Problems. Child Psychiatry & Human Development, 53(6), 1319-1329. https://doi.org/10.1007/s10578-021-01214-6
Kim, J. S., Jin, M. J., Jung, W., Hahn, S. W., & Lee, S. H. (2017). Rumination as a mediator between childhood trauma and adulthood depression/anxiety in non-clinical participants. Frontiers in psychology, 8, 280620. https://doi.org/10.3389/fpsyg.2017.01597
Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., ... & Hu, S. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA network open, 3(3), e203976-e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
Lee, S. A., Mathis, A. A., Jobe, M. C., & Pappalardo, E. A. (2020). Clinically significant fear and anxiety of COVID-19: A psychometric examination of the Coronavirus Anxiety Scale. Psychiatry Research, 290, 113112. https://doi.org/10.1016/j.psychres.2020.113112
Lev-Wiesel, R., & Zeevi, N. (2007). The Relationship Between Mothers and Children With Down Syndrome as Reflected in Drawings. Art Therapy: Journal of the American Art Therapy Association, 24. https://doi.org/10.1080/07421656.2007.10129420
Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R., Brigden, A., ... & Crawley, E. (2020). Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. Journal of the American Academy of Child & Adolescent Psychiatry, 59(11), 1218-1239. https://doi.org/10.1016/j.jaac.2020.05.009
Luyten, P., Mayes, L. C., Nijssens, L., & Fonagy, P. (2017). The parental reflective functioning questionnaire: Development and preliminary validation. PloS one, 12(5), e0176218. https://doi.org/10.1371/journal.pone.0176218
Malchiodi, C. A. (2008). A group art and play therapy program for children from violent homes. In Creative interventions with traumatized children. (pp. 247-263). Guilford Press. URL: https://psycnet.apa.org/record/2008-02507-012
Mazzeschi, C., Buratta, L., Germani, A., Cavallina, C., Ghignoni, R., Margheriti, M., & Pazzagli, C. (2019). Parental Reflective Functioning in Mothers and Fathers of Children With ADHD: Issues Regarding Assessment and Implications for Intervention. Front Public Health, 7, 263. https://doi.org/10.3389/fpubh.2019.00263
Menashe-Grinberg, A., Shneor, S., Meiri, G., & Atzaba-Poria, N. (2022). Improving the parent–child relationship and child adjustment through parental reflective functioning group intervention. Attachment & Human Development, 24(2), 208-228. https://doi.org/10.1080/14616734.2021.1919159
Moreira, H., & Fonseca, A. (2023). Measuring parental reflective functioning: Further validation of the Parental Reflective Functioning Questionnaire in Portuguese mothers of infants and young children. Child Psychiatry & Human Development, 54(4), 1042-1054. https://doi.org/10.1007/s10578-021-01288-2
Nam, S. H., & Yang, J.-C. (2021). COVID-19 Pandemic and Mental Health of Vulnerable Two Groups: Developmental Trauma of the Child-Adolescents and Work Disaster of Health Care Workers. Chonnam medical journal, 57(1), 7-12. https://doi.org/10.4068/cmj.2021.57.1.7
Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, behavior, and immunity, 88, 901-907. https://doi.org/10.1016/j.bbi.2020.05.026
Robert, M. R. (1961). Manual of the mother-child relationship evaluation. NewYork: Manson Western Corporation, 42-55. URL: https://books.google.com/books/about/The_Mother_child_Relationship_Evaluation.
Robinson, C. M. (2018). Children and Trauma: Unexpected Resistance and Justice in Film and Drawings. Humanities, 7(1), 19. https://www.mdpi.com/2076-0787/7/1/19
Rosso, A. M., & Airaldi, C. (2016). Intergenerational Transmission of Reflective Functioning. Frontiers in psychology, 7, 1903. https://doi.org/10.3389/fpsyg.2016.01903
Rosso, A. M., Viterbori, P., & Scopesi, A. M. (2015). Are maternal reflective functioning and attachment security associated with preadolescent mentalization? Frontiers in psychology, 6, 1134-1134. https://doi.org/10.3389/fpsyg.2015.01134
Rostad, W., & Whitaker, D. (2016). The Association Between Reflective Functioning and Parent–Child Relationship Quality. Journal of Child and Family Studies, 25. https://doi.org/10.1007/s10826-016-0388-7
Rutherford, H. J. V., Goldberg, B., Luyten, P., Bridgett, D. J., & Mayes, L. C. (2013). Parental reflective functioning is associated with tolerance of infant distress but not general distress: evidence for a specific relationship using a simulated baby paradigm. Infant behavior & development, 36(4), 635-641. https://doi.org/10.1016/j.infbeh.2013.06.008
Saarni, C. (1999). The Development of Emotional Competence. Guilford Publications. URL: https://books.google.ro/books?id=nHRqbmVgQK4C
Sachs, B., & Hall, L. A. (1991). Maladaptive mother‐child relationships: A pilot study. Public health nursing, 8(4), 226-233. https://doi.org/10.1111/j.1525-1446.1991.tb00661.x
Shevlin, M., Nolan, E., Owczarek, M., McBride, O., Murphy, J., Gibson Miller, J., ... & Bentall, R. P. (2020). COVID‐19‐related anxiety predicts somatic symptoms in the UK population. British Journal of Health Psychology, 25(4), 875-882. https://doi.org/10.1111/bjhp.12430
Smaling, H. J. A., Huijbregts, S. C. J., Van der Heijden, K. B., Hay, D. F., Van Goozen, S. H. M., & Swaab, H. (2017). Prenatal reflective functioning and development of aggression in infancy: The roles of maternal intrusiveness and sensitivity. Journal of abnormal child psychology, 45, 237-248. https://doi.org/10.1007/s10802-016-0177-1
Stadelmann, S., Perren, S., Von Wyl, A., & Von Klitzing, K. (2007). Associations between family relationships and symptoms/strengths at kindergarten age: what is the role of children's parental representations?. Journal of Child Psychology and Psychiatry, 48(10), 996-1004. https://doi.org/10.1111/j.1469-7610.2007.01813.x
Stuhrmann, L. Y., Göbel, A., Bindt, C., & Mudra, S. (2022). Parental Reflective Functioning and Its Association With Parenting Behaviors in Infancy and Early Childhood: A Systematic Review [Systematic Review]. Frontiers in psychology, 13. https://doi.org/10.3389/fpsyg.2022.765312
Wendelboe, K. I., Nielsen, J. S., Stuart, A. C., & Væver, M. S. (2022). The parental reflective functioning questionnaire: Infant version in fathers of infants and association with paternal postpartum mental health. Infant Mental Health Journal, 43(6), 921-937. https://doi.org/10.1002/imhj.22023

  • Receive Date 11 March 2024
  • Revise Date 03 April 2024
  • Accept Date 07 April 2024
  • First Publish Date 07 April 2024