Exploring Influences of Maternal ACEs and Concurrent Cumulative Risk on Child Behavior

• In Event: 3-061 - The Intergenerational Reach of Childhood Adversity: Exploring Transmission Mechanisms in Developmental and Ecological Contexts

Integrative Statement

Introduction: Though decades of research have established links between Adverse Childhood Experiences (ACEs) and mental and physical health outcomes, the intergenerational link between caregivers’ ACEs and their children’s outcomes has only recently emerged (Madigan et al., 2017). Meanwhile, the ACEs literature has not substantively accounted for the significant continuity in risk exposure through adolescence and into adulthood, nor has it sought to disentangle the effects of adversity in childhood and lifetime risk on outcomes for individuals and their children. This study aims to explore how maternal concurrent cumulative risk (CCR) factors influence the relationship between maternal ACEs and child behavior outcomes using data from a child welfare population.

Methods: Data were collected using a cross-sectional survey design as part of a statewide assessment of needs and services within a state child welfare system (CWS). Caregivers receiving in-home child welfare services were surveyed about their experiences and personal characteristics. Key measures for this study included the ACEs questionnaire, an 11-item self-report measure of childhood adversity (CDC, n.d.); a maternal CCR index constructed from 10 variables related to household composition, economic indicators, physical and mental health, and substance use (MacKenzie et al., 2011); as well as the withdrawing and aggressive behavior subscales of the Child Behavior Checklist (CBCL) for children ages 1.5-5 and the withdrawn/depressed and aggressive subscales of the CBCL for children ages 6-18 (Achenbach, 2009).
To test the relationship between ACEs, CCR, and child behaviors two OLS regression models were run predicting internalizing and externalizing CBCL scores for children ages 1.5-5 and 6-18. First, CBCL scores were regressed on maternal ACE scores, along with demographic covariates. In the second model, maternal CCR score was included as a predictor of children’s CBCL scores. Changes in the weight and significance of the ACE score coefficients when controlling for CCR would suggest that CCR is influencing the relationship between caregiver ACEs and child behavior previously attributed to ACE scores alone.

Results: Higher maternal ACE scores were associated with increased child externalizing behaviors at ages 1.5-5 and 6-18, and increased internalizing behaviors at ages 6-18. When maternal CCR was added to the model, the association between maternal ACEs and externalizing behaviors for children ages 1.5-5 was no longer significant. Further, maternal CCR demonstrated a significant association with increased externalizing and internalizing behaviors for this age group. In the models concerning children ages 6-18, both maternal ACEs and CCR were significantly related to internalizing behaviors, but only maternal ACEs were significantly associated with externalizing behaviors.

Conclusion: The results of this study suggest that children’s behaviors are influenced by caregiver’s experiences of childhood adversity as well as adulthood adversity. Though the presence of high ACE scores in caregivers is associated with negative behavior outcomes in children, it is important to understand how caregivers’ adulthood adversity, and thus their children’s concurrent adversity, contributes to these outcomes. Particularly in a child welfare population, it is important to take a holistic approach to screening for risk across caregivers’ lifespans, and deliver appropriate interventions to support behavioral well-being for children.

Authors

• Brett Greenfield, Rutgers
  Presenting Author

• Kate Stepleton, Rutgers
  Non-Presenting Author

• Jacquelynn Duron, Rutgers
  Non-Presenting Author

• Kerrie Ocasio, West Chester University
  Non-Presenting Author

• Emily Adlin Bosk, Rutgers
  Non-Presenting Author