NCCR-Synapsy

The Synaptic Bases of Mental Diseases

A mother’s lack of empathy impacts her child’s mental health

A Synapsy study shows that mothers with post-traumatic stress disorder due to interpersonal violence misread their children’s emotions due to a lack of emotional comprehension, a difficulty that, in turn, has been associated with their children’s level of aggressive behavior and depression.

When a child is exposed to interpersonal violence, such as rape, she may develop an acute stress disorder called Post-traumatic stress disorder (PTSD) and can transmit this trauma to her future children during a sensitive period of brain development for the acquisition of social-emotional skills. In an attempt to break this chain of transmission, researchers from the University Lausanne (UNIL), and Lausanne University Hospital (CHUV) examined the influence of these mothers on the emotional capacity of their own children. Sixty-one mother-child dyads participated in this study for a follow-up of almost 11 years. The results, published in the European Journal of Psychotraumatology, show that mothers with PTSD are less able to put themselves in their children’s shoes when it comes to understanding or predicting their emotions. This maternal difficulty is associated with behavioral problems such as aggression, and mood disorders such as depression, in their children. These findings indicate that it is important to intervene early with traumatized mothers to strengthen their connections to others and thus reduce the risk of causing psychopathology in their children.

Contact

Daniel Schechter

Senior Attending
SUPEA-DP, CHUV

Associate Professor
Faculty of Biology and Medicine, UNIL

Senior lecturer
Department of Psychiatry
Faculty of medicine, UNIGE

Daniel.Schechter@chuv.ch

DOI

10.1080/20008198.2021.2008152

A Synapsy study shows that mothers with post-traumatic stress disorder due to interpersonal violence misread their children’s emotions due to a lack of emotional comprehension, a difficulty that, in turn, has been associated with their children’s level of aggressive behavior and depression.

When a child is exposed to interpersonal violence, such as rape, she may develop an acute stress disorder called Post-traumatic stress disorder (PTSD) and can transmit this trauma to her future children during a sensitive period of brain development for the acquisition of social-emotional skills. In an attempt to break this chain of transmission, researchers from the University of Geneva (UNIGE) and Lausanne University Hospital (CHUV) examined the influence of these mothers on the emotional capacity of their own children. Sixty-one mother-child dyads participated in this study for a follow-up of almost 11 years. The results, published in the European Journal of Psychotraumatology, show that mothers with PTSD are less able to put themselves in their children’s shoes when it comes to understanding or predicting their emotions. This maternal difficulty is associated with behavioral problems such as aggression, and mood disorders such as depression, in their children. These findings indicate that it is important to intervene early with traumatized mothers to strengthen their connections to others and thus reduce the risk of causing psychopathology in their children.

“Domestic violence is very common in Switzerland: in 2019 more than 19,000 offenses were reported in the context of domestic violence, they only increased during the COVID-19 pandemic—and many more cases remain unreported,” says Daniel Schechter, Senior Attending at the Perinatal and Early Childhood Research of the Child and Adolescent Psychiatry Service (SUPEA) within the CHUV Department of Psychiatry, Associate Professor at UNIL, and researcher at the National Center of Research Synapsy. The trigger of the PTSD among the mothers includes violence between partners, as well as their own childhood histories of physical and sexual abuse and exposure to family violence; and the victims are mainly women. Many will develop psychiatric illnesses related to the stress of their experiences, including post-traumatic stress, which is characterized by emotional and physiologic dysregulation and vigilance to negative emotions. According to Daniel Schechter’s previous research, traumatized women often pass on these features to their offspring.

The purpose of this new study is to examine how mothers with PTSD affect their ability to predict their children’s emotional understanding and whether this affects the emotional understanding of their children, and by extension, their mental health.

A unique longitudinal dimension

Sixty-one mothers, thirty-six with PTSD developed as a result of interpersonal violence, and their sixty-one children participated in this study. Although the average age of the children was 7 years, the follow-up of these mother-child pairs has lasted for more than 11 years in order to understand, through a series of studies carried out during the 12 years of Synapsy’s existence, the full extent of the influence of the mothers’ trauma on the behavioral development of their children.

Misreading emotions

The mothers took an emotional comprehension test. “A picture of a dramatic situation was shown, for example a turtle lying on its back in a jar. At the same time, four faces representing emotions of anger, sadness, joy or passivity are presented to the mothers. They had to imagine which of the four emotions their child would feel when seeing the dramatic scene,” explains Dominik Moser, researcher at the SUPEA, Department of Psychiatry of the CHUV and at the University of Bern, and co-author of the study.

Mothers exposed to violence with PTSD have reduced performance on this test compared to mothers who have also experienced violence, but who have not developed PTSD. “Some mothers with PTSD think that children will laugh in response to a dead turtle in a jar,” he adds, before continuing, “These results show that PTSD mothers are unable to put themselves in their child’s shoes; they lack empathy. This difficulty can be dangerous, because their children will be disturbed in their learning of emotions”.

An impacted offspring

From then on, the researchers carried out the same test with the children to find out the impact of this maternal emotional deficiency on their own interpretation of emotions. The children, for their part, showed no difference between the two groups. However, by analyzing their mood and behavior, the research team was able to demonstrate a strong link between the inability to predict emotions in PTSD mothers and their children’s aggressive and/or depressive behaviors.

“This is important information for preventing mental health in children of traumatized mothers. Thanks to this mother-child cohort and our studies of the cohort members, we were able to show that an intervention with the mother when her child is still within a sensitive period for the development of emotion regulation at one to three years old, had a positive influence on the health of the children,” says Daniel Schechter. It is important to note that the present study concerns seven-year-olds since the behavioral symptoms may only be brought to clinical attention later once the children are in school. The early intervention method mentioned involves a new videofeeback-based therapy technique called Clinician-Assisted Videofeedback Exposure Sessions from which a 16-session manualized psychotherapy called CAVEAT has been developed. “Mothers are shown scenes of mother-child interaction while accompanied by a reflective psychotherapist and we help them develop their emotional comprehension skills early in their child’s development on this basis. The very encouraging results have been published several times and are in the process of being validated as a new treatment with the support of foundation funding,” says Daniel Schechter.

Caption: Emotional prediction test. Traumatized mothers are unable to predict their children's emotions when faced with a dramatic situation such as a dead turtle in its terrarium. This inability impacts the psychological development of their children who tend to be more aggressive and/or depressed.  © Francfort Communication & Partenaires

Contact

Daniel Schechter

Senior Attending
SUPEA-DP, CHUV

Associate Professor
Faculty of Biology and Medicine, UNIL

Senior lecturer
Department of Psychiatry
Faculty of medicine, UNIGE

Daniel.Schechter@chuv.ch

DOI

10.1080/20008198.2021.2008152

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