Iyengar, U; (2016) Understanding risk, resilience, and the neural correlates of unresolved trauma in mothers. Doctoral thesis , (UCL) University College London.

Abstract

For most mothers, interacting and engaging with their own infant is a rewarding experience which motivates maternal behavior while activating a neural network associated with maternal caregiving. Attachment theory emphasizes the quality of early relationships, how this impacts aspects of later functioning, and can also be viewed as a self-protective strategy that an individual uses to function effectively and manage relationships with others (Crittenden & Landini, 2011). For a mother with unresolved trauma or loss, hindered information processing may interfere with the ability to sensitively react to and respond to her infant, thus compromising her child’s development of secure attachment. Mothers with a history of drug abuse or addiction may also have a high risk of trauma, particularly unresolved trauma occurring in childhood. A mother’s own adverse childhood experience and trauma may predispose to addiction behaviors, and interact with drug exposure to impact maternal responses to infant cues on both a behavioral and neural level. This thesis aims to tie in the patterns of attachment across generations, unresolved trauma, and brain response in both normative and clinical populations, in several empirical studies. Study 1 explored the role of an attachment construct called “reorganizing” during the intergenerational transmission of unresolved trauma in mothers and infants. Mothers with unresolved trauma had insecure attachment themselves and were more likely to have infants with insecure attachment. However, all of the mothers with unresolved trauma who were reorganizing toward secure attachment had infants with secure attachment, demonstrating the potential to reverse the intergenerational transmission of insecure attachment. Study 3 focused on unresolved trauma in mothers predicting infant temperament moderated by risk and resilience factors, in both normative and substance-abusing mothers. In substance abusing mothers, cumulative unresolved trauma predicted less negative infant behavior when moderated by greater parental reflective functioning. Differentially, in a sample of normative mothers, the presence of unresolved trauma predicted less positive infant behavior when moderated by lower parental reflective functioning. Study 5 utilized fMRI to investigate patterns of brain activation in diverse groups of mothers with addiction and unresolved trauma. In response to seeing images of their own infant, substance abusing mothers demonstrated decreased activation in reward and mentalizing areas of the brain, compared to mothers without substance abuse. Patterns of neural activation in areas of mentalization were also different for mothers with and without substance abuse but all with Utr, suggesting a unique contribution of unresolved trauma in different mothers based on the presence of drug use. Taken as a whole, these studies add to the current attachment literature by providing empirical support and neuroimaging findings for the construct of unresolved trauma, as well as risk and protective factors associated with a clinical and normative sample of mothers.

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