Mediating roles of family functioning and adverse childhood experiences between traumatized mothers and their adolescent children

OBJECTIVE: Trauma experiences of North Korean defector (NKD) mothers during escape and resettlement may extend beyond the individual and shape the mental health of the next generation. This study examined the association between post-traumatic stress disorder (PTSD) symptoms in NKD mothers and the mental health of their adolescent children, focusing on the mediating roles of family functioning and adverse childhood experiences (ACE). METHODS: Survey data from 113 NKD mother-adolescent child dyads (children aged 12-24) were collected from 2023 to 2024. Mothers reported on their traumatic experiences, PTSD symptoms, and family functioning, whereas adolescent children reported on family functioning, ACE, depression, and anxiety. Serial mediation was tested using PROCESS Macro Model 6 with 5000 bootstrap resamples. RESULTS: NKD mothers reported an average of 9.9 traumatic events, and 34.5% met criteria for probable PTSD. Mothers with probable PTSD reported lower family functioning. Similarly, their adolescent children reported lower family functioning and greater exposure to ACE. Analysis identified no significant direct association between maternal PTSD symptoms and children's mental health. However, significant indirect associations were identified, with family functioning and ACE serving as sequential mediators linking maternal PTSD to adolescent depression and anxiety. Family functioning preceded ACE in this pathway. CONCLUSION: Within this NKD sample, maternal trauma was associated with adolescent mental health not directly but through disrupted family functioning and adversity rooted in histories of separation and instability. These findings suggest that breaking the intergenerational cycle requires a multidimensional approach-one that pairs maternal PTSD treatment with parenting-focused support and addresses the structural sources of childhood adversity unique to the NKD resettlement experience.