Experiences of Interpersonal Trauma Among Parents With Intellectual Disabilities: A Systematic Review

Abstract

Research has suggested highly elevated levels of interpersonal trauma (IPT) among parents with intellectual disabilities (ID), and that such experiences may contribute to the caregiving and child developmental problems often seen in this population. Conflicting results have however been reported, and there is no systematic review on this matter. This study therefore systematically reviewed the empirical evidence concerning (a) prevalence of IPT among parents with ID, and links with (b) caregiving-relevant and (c) child developmental outcomes, in accordance with the PRISMA 2020 guidelines. Searches were conducted in MEDLINE, CINAHL, PsycINFO, and PTSDpubs. Peer-reviewed empirical articles reporting exposure to any form of systematically assessed IPT (unspecified IPT, physical, sexual, and emotional abuse, neglect, prolonged childhood separations from caregivers, witnessing abuse in the family) among parents with ID were included, yielding a final selection of 20 studies. Findings consistently indicated markedly elevated levels of IPT among parents with ID, with a majority (>50%) having experienced some form of IPT. Estimates for both unspecified and specific forms were typically higher than corresponding estimates in other groups at elevated risk, and than meta-analytical general population estimates in comparable countries. Findings regarding caregiving-relevant outcomes were mixed but indicated links with adverse outcomes, particularly regarding parental mental health. Reports pertaining to child developmental outcomes were scant and inconsistent. We highlight important limitations in the extant literature and provide directions for future research and clinical practice.

Parental mentalising among mothers with intellectual disability or ADHD: Links with experiences of abuse, neglect and psychosocial risk

“…Experiences of childhood abuse/neglect were extremely common among the mothers, and cumulative abuse/neglect predicted elevated prementalising, in line with previous research linking childhood abuse to parental mentalising difficulties (e.g., Håkansson et al, 2018; Moser et al, 2019). Taken together, these findings corroborate reports on marked overrepresentation of childhood abuse among mothers with intellectual disability, and the negative impact of such experiences on their caregiving abilities (Hammarlund et al, 2022).…”

“…Mothers with intellectual disability have been found to run a heightened group‐level risk for caregiving problems (e.g., Aunos et al, 2008; Lindberg et al, 2017; Willems et al, 2007), and their children for negative developmental outcomes (e.g., Emerson & Brigham, 2014; McConnell et al, 2011; Orthmann Bless & Hellfritz, 2021). These mothers may also be vulnerable to mentalising difficulties, stemming from aspects of the intellectual disability (e.g., Sappok et al, 2022), from experiences of abuse/neglect (Håkansson et al, 2018; Hammarlund et al, 2022) and from psychosocial stressors (McConnell et al, 2011; Wade et al, 2018). Yet, there is no empirical knowledge on parental mentalising in this population.…”

“…Such effects often also extend to parenthood, with experiences of childhood abuse/neglect being associated with parental mentalising difficulties (e.g., Håkansson et al, 2018; Moser et al, 2019; San Cristobal et al, 2017). Crucially, experiences of childhood abuse are markedly overrepresented among mothers with intellectual disability (Hammarlund et al, 2022). Thus, these mothers may also have a heightened risk for parental mentalising difficulties due to abusive childhood experiences.…”

“…Third, mothers with intellectual disability are often exposed to high levels of psychosocial risk factors (e.g., poverty, social isolation, mental health problems; Hammarlund et al, 2022), and such exposure may also affect parental mentalising negatively. For instance, Wade et al (2018) reported, from a sample of normative mothers from the general population, that higher psychosocial risk was prospectively associated with lower parental mentalising, which in turn predicted lower child executive functioning and language abilities.…”

“…These mothers may also be vulnerable to mentalising difficulties, stemming from aspects of the intellectual disability (e.g., Sappok et al, 2022), from experiences of abuse/neglect (Håkansson et al, 2018;Hammarlund et al, 2022) and from psychosocial stressors (McConnell et al, 2011;Wade et al, 2018). Yet, there is no empirical knowledge on parental mentalising in this population.…”