Effects of Maternal Trauma on Cambodian American Young Adults’ Mental Health: Serial Mediation Analyses through Mother’s PTSD and Parenting Behaviors

Background and Purpose: Young Cambodian Americans are the descendants of Cambodian genocide survivors resettling in the U.S. as refugees (Chan, 2015). Their parents carried severe, unresolved trauma, contributing to elevated rates of PTSD. The effects of the trauma mothers experienced during the genocide impacted their parenting behaviors and extended adverse effects to their children’s mental health. Intergenerational trauma (ITT) studies show parental trauma is linked to adverse mental health outcomes among genocide survivors’ offspring (Giladi & Bell, 2012; Payne et al., 2021; Yehuda et al., 2008; Zasiekina et al., 2026).This study aims to examine the relationship between maternal trauma exposure during the Cambodia genocide young adults’ mental health and determine if mothers’ PTSD symptoms and parenting behaviors significantly mediate this relationship.

Methods: The data for this study were collected from second-generation Cambodian American (CA) young adults born in the U.S. or migrated to the U.S. by the age of five whose mother is a survivor of the Khmer Rouge regime. Maternal trauma exposure was measured by a 20-item checklist of traumatic events adapted from the Harvard Trauma Questionnaire. Maternal PTSD symptoms were measured by a 20-item checklist adapted from the PTSD Checklist for DSM-5 (PCL-5). Parenting behaviors measure consists of three subscales: rejection (7 items), emotional warmth (6 items), and overprotection/control (9 items). Three serial multiple mediation models were used to examine whether the relationship between maternal trauma exposure and offspring mental health operates through two key mechanisms: Maternal PTSD symptoms and Parenting behaviors (rejection, overprotection, and emotional warmth).

Results: Maternal trauma exposure did not directly predict offspring mental health in any model. Maternal PTSD symptoms consistently emerged as the significant mediator between maternal trauma and offspring mental health. In model 1, Maternal trauma exposure was positively associated with higher maternal PTSD symptoms (b= 1.219, t= -6.533, 95% CI [.849, 1.588]). The PTSD symptom predicted parental rejection (b=1.348, t= 4.55, 95% CI [.761, 1.934]), and thereby predicted the young adults’ mental health, controlling for age, gender, and education. Similarly, in model 2, the path between maternal trauma exposure and young adults’ mental health was significantly mediated by maternal PTSD symptoms and parental overprotection (b=.0.97, t=2.743, 95% [CI 0.269, 1.670]). In model 3, parental emotional warmth was not a significant mediator in the association between maternal trauma exposure and young adults’ mental health.

Conclusions and Implications: The findings indicated that maternal PTSD serves as the primary mechanism linking the mothers’ trauma arising from the Cambodian genocide to the mental well-being of their adult children. Mothers’ parenting behaviors, rejection, and overprotection were influenced by their PTSD symptoms, suggesting culturally responsive, trauma‑informed approaches addressing parental PTSD and strengthening parent–child relationships are needed among the Cambodian Americans. Community-based programs and clinical interventions should incorporate strategies that reduce PTSD symptoms among parents and promote adaptive parenting practices, while concurrently cultivating resilience in young adults. Findings argue for routine assessment of ACEs, and the integration of trauma‑informed and anti-racist approaches when working with genocide survivors and their offspring.