Maternal Adverse Childhood Experiences and Developmental Milestones: Cumulative Effects and Transmission via Psychopathology

• In Event: 2-092 - Intergenerational Risk and Resilience: Continuity, Discontinuity, and Mechanisms of Transmission

Integrative Statement

A substantial body of research has documented the association between maternal adverse childhood experiences (ACEs), perinatal maternal psychopathology, and child socioemotional development (Browne et al., 2015; Goodman & Gotlib, 1999; Goodman et al., 2011). The mechanisms linking these factors are complex, characterized by intergenerational transmission, bidirectionality, and indirect effects (Stein et al., 2014). A significantly smaller body of research has considered the pathways linking ACEs, maternal psychopathology and developmental milestones (Folger et al., 2018; Liu et al., 2017; Tuovinen et al., 2018). To date, none of these studies have thoroughly examined questions pertaining to timing and direction of effects across pregnancy and the postnatal period. Given the transactional nature of development (Sameroff, 2010), it is possible that there are bidirectional effects between maternal psychopathology and developmental milestones that remain unexplored, as is the case with child socioemotional development (Hails & Shaw, 2010; Plamondon et al, 2017). Moreover, the possibility of intergenerational transmission of risk associated with maternal ACEs on developmental milestones via maternal psychopathology remains uncertain. As such, the present study sought to examine the multiple associations amongst maternal ACEs, pre- and postnatal maternal psychopathology, and child developmental milestones across the first four years of life.

Participating mother-child dyads come from the Conditions Affecting Neuro-Development and Learning Environments (CANDLE) Study (N=1349). Mothers were recruited in Memphis and Shelby County, Tennessee during pregnancy and assessed during home and clinic visits repeatedly until children were four years of age. Mothers reported on their own ACEs (count of ACEs from the Traumatic Life Events Questionnaire; Kubany et al., 2000) and psychopathology (Global Distress Index from the Brief Symptom Inventory; Derogatis & Melisaratos, 1983) during the third trimester. Subsequently, mothers reported on their own psychopathology and child developmental milestones (Scales of Independent Behavior-Revised; Bruininks et al., 1996) when children were 12, 24, 36 and 48 months old. A cross-lagged panel analysis was conducted examining four hypotheses: (H1) pre- and postnatal maternal psychopathology would predict child developmental milestones, (H2) developmental milestones would predict postnatal maternal psychopathology, (H3) maternal ACEs would predict developmental milestones via maternal psychopathology, and (H4) there would be cumulative effects of maternal ACEs on maternal psychopathology and developmental milestones over time.

The hypothesized model was a good fit to observed data. Support was found for all hypotheses except H2. First, higher levels of pre- and postnatal maternal psychopathology predicted developmental milestones that were delayed (H1). Second, there were four distinct indirect effects linking maternal ACEs, maternal psychopathology, and developmental milestones (H3). Third, maternal ACEs offered a cumulative (i.e., repeated) prediction of maternal psychopathology and developmental milestones across the first four years, even when controlling for previous levels of these variables (H4). Lastly, there was no evidence of developmental milestones predicting subsequent levels of maternal psychopathology (H2). Findings suggest that maternal ACEs impact child developmental milestones through multiple mechanisms, and these processes unfold in a dynamic fashion across the initial years of life. Implications for understanding the intergenerational transmission of adversity, intervention, and policy will be discussed.

Authors

• Dillon T. Browne, Department of Psychology, University of Waterloo
  Presenting Author

• Kaja Lewinn, Department of Psychiatry, University of California, San Francisco
  Non-Presenting Author

• Fran Tylavsky, The University of Tennessee Health Sciences Center
  Non-Presenting Author

• Nicole R. Bush, University of California, San Francisco (UCSF), Departments of Psychiatry and Pediatrics
  Non-Presenting Author