Children Under Fire: The Role of Maternal Caregiving, Reflection Functioning, and Posttraumatic Stress Disorder

Objective: The study seeks to examine the psychological maladjustment of children who are exposed to continuous terror attacks. It is hypothesized that maternal posttraumatic stress disorder (PTSD) may hinder mothers' sensitive and responsive caregiving, reflective functioning, and viewing of her child (as “difficult”), which can subsequently negatively impact their children’s psychological adjustment. Method: A cohort of 235 mother–child dyads participated in the study. The children's (aged 7–11; 43% boys) psychological maladjustment was assessed by the PAQ. The mothers completed the DSM–5 checklist for PTSD, Caregiving System Functioning scale, Rumination-Reflection Questionnaire, and Difficult Child scale. Results: High levels of maternal PTSD, high scores of avoidant caregiving, and low reflective functioning of the mother predicted the child's psychological maladjustment. Maternal levels of PTSD moderated the associations between maternal avoidant caregiving and reflection, and child’s maladjustment, whereas perceiving the child as difficult moderated the association between maternal reflection and child maladjustment. Conclusion: The findings suggest that, to enhance the psychological adjustment of children confronted with stressful life situations, their mothers must be able to process their traumatizing experiences, or else they may struggle to provide their children with emotional regulation and support.