Table 3.

Transmission frameworks, potential mechanisms and findings.

Citation and Year	Theoretical framework underpinning Method	Main Findings	Identified mechanism of transmission	Risk factor(s)/covariates	Protective factor(s)	Control group
Study 1. Dalgaard and Montgomery (2017)	Family functioning theory: Circumplex model; McMaster model; ABC-X family crisis model.	Family stressors were the strongest predictor of higher difficulty scores (n = 14 families) Clinically meaningful difference in mean SDQ difficulty scores between children in families with marital conflict, and those without 22% of variance in SDQ scores explained by role-reversal parenting and accumulation of family stressors Composite measure of adaptive family functioning associated with lower SDQ scores	Disrupted family functioning	Stressor pile-up Parent–child role reversal Marital conflict Having 2 trauma exposed parents	Family flexibility Family cohesion	Yes٭
Study 2. Dalgaard et al. (2016)	Attachment theory	Negative association between child attachment security (ATST) and total difficulty scores (SDQ) Sig. negative association between child attachment security and externalizing SDQ scores Sig. association between intra family communication style and child attachment style Sig. association between child attachment style and family presence of an unfiltered communication style Modulated disclosure may be associated with secure attachment	Disrupted attachment representations	Unfiltered speech Insecure attachment	Modulated disclosure	Yes٭
Study 3. East et al. (2018)	Attachment theory	Maternal torture sig. related to maternal withdrawal/detachment symptoms Sig. indirect effects of maternal torture on all child outcomes via mothers’ depressed mood Sig. indirect effect of maternal torture on child victimization via mothers’ volatility/panic symptoms	Mothers’ mental health symptoms	Maternal torture Torture sequelae	Mothers’ adaptive functioning	No
Study 4. Field et al. (2013)	Attachment theory	Sig. relationships reported between social support and PTSD, and mothers’ level of education and PTSD All PTSD subscale scores sig. correlated with role reversal and rejecting parenting Rejecting parenting sig. correlated with child anxiety Role reversal sig. correlated with child anxiety and depression Role reversing parenting mediated the relationship between (all sub-scales of) mothers’ PTSD and child anxiety, but did not fully explain the relationship	Attachment & parenting styles	Role reversal parenting Rejecting parenting	Maternal education Social support	Yes
Study 5. Han (2006)	Attachment theory Shattered assumptions theory Salutogenic theory	Perceived parental trauma sig. predicted attachment Perceived parental trauma was negatively associated with SOC Parent–child attachment positively predicted adolescents’ SOC Parent–child attachment played a fully mediational role between parental trauma and SOC	Disrupted attachment representations	Insecure attachment	Secure attachment	No
Study 6. Sangalang et al. (2017)	Family functioning theory	Mothers of US born children reported sig higher levels of TD and parent–child conflict US born children reported higher levels of anti-social behaviour Weaker family functioning was sig. associated with elevated levels of depressive symptoms, antisocial and delinquent behaviour Maternal (TD) was indirectly linked to child MH outcomes: For foreign born children (outside US), maternal TD was sig. associated with diminished family functioning and increased school problems Maternal TD was indirectly associated with child depressive symptoms and antisocial and delinquent behaviour, via diminished family functioning in foreign born children	Disrupted family functioning	Diminished family functioning	-	No
Study 7. Vaage et al. (2011)	Family systems theory	30% of families had one parent with a high psychological distress score (probable caseness) Sig. positive association between older childrens’ probable caseness and their fathers’ probable caseness Children (10–18 yrs) of fathers with a large family network (10+ members) in Norway reported lower problem mean scores Fathers’ social network (Norweigan friends) at T2 was sig positively associated with child outcomes at T3 Paternal PTSD at T1 was sig negatively associated with child MH @ T3	Disrupted family systems	Paternal PTSD	Social networks Early integration in host country	No
Study 8. Van Ee et al. (2012)	Attachment theory	Higher levels of mothers’ post traumatic stress symptoms were sig associated with higher levels of psychosocial problems in children Severity of PTSS was sig correlated with infants’ internalizing behaviours and total problems Mothers experiencing PTSS scored lower on all EA scales Higher levels of mothers’ post traumatic stress symptoms were sig associated with higher levels of insensitive, unstructured and hostile interactions Infants whose mothers reported higher levels of PTSS demonstrated lower levels of responsiveness and involvement	Disrupted attachment systems	Symptom severity Unstructured, hostile & in sensitive parenting Diminished maternal emotional availability	Caregiver self-regulation	No

Abbreviations: Significant (sig.), Sense of coherence (SOC), Attachment and traumatisation story task (ATST), Strengths and difficulties (SDQ), Post-traumatic stress disorder (PTSD), Mental health (MH), Post-traumatic stress symptoms (PTSS), Emotional availability (EA), Traumatic distress (TD).

٭Control only extends to the quantitative measure of adjustment – SDQ scores were compared to Danish norms.