Mothers’ adverse childhood experiences and their preschool children’s behavioural problems: Mediation by mothers’ adult attachment pattern and moderation by children’s sex-assigned-at-birth

Stefan Kurbatfinski^1,2*Aliyah Dosani^1,3,4Andrew F. Hayes⁵Deborah Dewey^2,6,7Nicole Letourneau^2,7,8

• ¹Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
• ²Owerko Centre, Alberta Children's Hospital Research Institute (ACHRI), Calgary, Alberta, Canada
• ³Faculty of Health, Community, and Education, School of Nursing and Midwifery, Mount Royal University, Calgary, Alberta, Canada
• ⁴O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
• ⁵Haskayne School of Business, University of Calgary, Calgary, Alberta, Canada
• ⁶Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
• ⁷Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
• ⁸Departments of Pediatrics, Psychiatry, and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

Background: Mothers’ insecure adult attachment pattern (i.e., dismissive, preoccupied) has been proposed to positively mediate the associations between mothers’ adverse childhood experiences (ACEs) and their preschool children’s sex-specific behavioural problems. However, findings remain mixed with few focusing on a total score ranging from secure to insecure. Therefore, the aim of this study was to novelly employ the Revised-Experiences in Close Relationships (ECR-R) questionnaire to explore if (1) mothers’ adult attachment pattern measured continuously from secure to insecure mediates the relationship between maternal ACEs and children’s internalizing and externalizing behaviours and (2) child sex-assigned-at-birth moderated the effects. Methods: Data (n=636) derived from the prospective APrON Study (participants recruited during early pregnancy). Maternal ACEs were measured at child age 1, while children’s behavioural problems and mothers’ adult attachment pattern at child age 5. Findings: Positive, indirect effects on children’s internalizing (*bootstrap 95% CI [0.10, 0.58]) and externalizing (*[0.11, 0.62]) problems were supported. Post-hoc, a positive, indirect effect through preoccupied adult attachment pattern on their children’s internalizing problems was supported (*[0.04, 0.47]), but the effect did not differ from that of dismissive adult attachment pattern (*[-0.45, 0.15]). No moderation was observed (p>0.05). Significance: This study is the first to employ the ECR-R to measure mothers’ adult attachment pattern continuously from secure to insecure. Findings suggest that (1) adult attachment pattern measured continuously mediates the association between mothers’ ACEs and their preschool children’s behavioural problems and (2) preoccupied adult attachment pattern behaviours may play a stronger role than those of dismissive.