In 2024, Mårten Hammarlund defended his thesis on parenting in people with intellectual disabilities. Mårten Hammarlund has studied parenting and child development in families where one parent – usually the mother – has a mild intellectual disability. More specifically, he examines which factors in these parents' background and current situation increase the risk of difficulties in parenting and child development. Central to the thesis is the concept of parental mentalization.

Personal experiences affect parental mentalizations skills

Parents who struggle with parental mentalization find it difficult to empathize with their child in various ways. An example might be when a two-year-old does not want to come home from the playground, but instead throws themself on the ground and screams. A mother who has difficulty mentalizing the child may then perceive that ‘the child is making trouble just to embarrass her’ and become angry and scold the child. In other words, the mother equates the child's intentions with her own experience of shame and distress.

Previous research on parents without IF suggests that parents' mentalization skills can be negatively affected by interpersonal trauma during childhood and by psychosocial stress. Mårten Hammarlund wanted to see if this also applies to mothers with IF.

To find out, he interviewed mums with mild IF and mums with ADHD, in order to make a comparison. The interviews mapped the mothers' vulnerability growing up and the presence of psychosocial risk factors in their current lives. A standardized test was used to assess the capacity for parental mentalization, in which mothers were asked to respond to a number of statements about their children's behavior.

The mothers who showed the greatest difficulty in mentalizing their children were those who had experienced the most interpersonal trauma and psychosocial stress

Experiences of interpersonal trauma, such as abuse and neglect, during childhood were found to be very common among the mothers with ID. The results also showed that, at a group level, these mothers were at increased risk of mentalizing difficulties in the form of a non-mentalizing approach to their children's behaviors. However, a significant minority of IF mothers did not exhibit such difficulties, and these mothers had generally experienced comparatively less interpersonal trauma and lived in better psychosocial conditions.

– The mothers who showed the greatest difficulties in mentalizing their children were those who had been most exposed to interpersonal trauma and psychosocial stress. This is in line with our other studies, in which extensive interpersonal trauma and psychosocial distress have been linked to, for example, lower responsiveness to children's signals, specific difficulties in interpreting children's emotional expressions, and to insecure and disorganized attachment in children.

Variations in parenting exist among all parents

Mothers with ID and their children are a vulnerable group in many ways. They often live with poverty, mental illness and poor social support, and a large proportion of children are placed outside the home while growing up. Understanding the causes of parenting difficulties in this group is important to better support families in need. It is also important in order to counteract discrimination.

Previous research has shown that mothers with mild IF are often met with skepticism and prejudice from professionals. This skepticism is usually based, Mårten Hammarlund believes, on the notion that the disability makes these parents fundamentally different from other parents. That parents with IF will inevitably have great difficulties in parenting, and that these difficulties always have their roots in the disability itself.

– Our research contributes to a more complex picture. While disability is likely to be a vulnerability factor for some parenting difficulties, there is considerable variation in parenting-related abilities among parents with IF, just as among parents in general. And, as with parents in general, the mothers with IF who have the most difficulties also tend to have been more exposed to interpersonal trauma and psychosocial hardship.

– These findings are important for a better understanding of parents with ID who are struggling with parenting. They also point to the importance of assessing parenting abilities of parents with IF on an individual basis, rather than assuming that the disability itself causes extensive parenting difficulties.

Trauma-informed approach and customized support important

According to Mårten Hammarlund, there are several things you can do to help these particular parents. Of course, it's important to provide support on pure parenting skills, such as how to interact in a sensitive and safe way with children, but not only, he stresses.

– If parenting difficulties in this group are linked to other risk factors in the parenting context, support also needs to address these. Here I am thinking primarily of long-term efforts to combat poverty, unemployment and social exclusion, and support in getting adequate help for mental illness. Unfortunately, such support is currently difficult to obtain for many mothers with IF.

Many mothers with IF have been victims of abuse or neglect, which can affect both their trust in others and their receptiveness to support programmes.

– This does not necessarily mean that all vulnerable mothers need trauma treatment. But it is important that support organizations ensure that they have knowledge of trauma-informed care, in order to be able to create safe and welcoming environments for these mothers.

What do you hope the conclusions of the thesis will lead to?

– I hope that the thesis can contribute to reducing the ‘alienation’ of parents with IF. That the environment, apropos mentalization, would, to a greater extent consider possible difficulties in these parents also in the light of their life history and experiences, rather than only in the light of a clinical diagnosis.

Mårten Hammarlund also hopes that the thesis will help to change, for example, the screening activities of units working with the target group.

– I hope that more knowledge will be gained about trauma-informed care and that we will succeed in identifying severely traumatized parents with IF and help them to get the support they need.

What is the next step?

– I am a trained clinical psychologist and child psychotherapist, so I will be working mainly with teaching and treatment at the Erica Foundation in Stockholm. It's an organization that focuses a lot on vulnerable children and families, and where there's a lot of knowledge about trauma, parenting and child development, so I'm really looking forward to that!

Mårten is also keen to continue his research after his doctorate.

– Research is very stimulating and exciting, so I will try to continue this work within the framework of the Erica Foundation's research activities, but also through projects together with colleagues at SU and other universities around the country.

 

Read the dissertation Neglected ghosts of contested nurseries: The role of interpersonal trauma and psychosocial adversity for caregiving among parents with intellectual disability