Maternal Adverse Childhood Experiences Predict CPS-Referred Children's Externalizing and Internalizing Symptoms at Age 10

• In Event: Poster Session 12
  In Poster Session: PS 12 Topic - Family Context & Processes

Abstract

Adverse childhood experiences (ACEs) place individuals at risk for poor health outcomes across the lifespan (e.g., Monnat & Chandler, 2015). Moreover, maternal ACEs have been shown to negatively affect health outcomes for offspring (e.g., Lê-Scherban et al., 2018). Several mechanisms, such as stress transmission and changes to the parenting environment, are theorized to explain the link between maternal ACEs and child outcomes (e.g., Champagne, 2008; Chung et al., 2009). Of note, maternal sensitivity has been shown to buffer children from adverse outcomes, especially among children living in high-risk environments (Farrell et al., 2017). However, there is a dearth of research exploring the intergenerational links among maternal ACEs, maternal sensitivity, and child outcomes (e.g., emotional and behavioral problems) during middle childhood. Thus, the current study examined whether maternal ACEs significantly predicted internalizing and externalizing symptoms at age 10 among CPS-referred children, even when controlling for maternal sensitivity in middle childhood.

Participants included 84 mother-child dyads who were referred from Child Protective Services due to allegations of maltreatment when children were infants (see Table 1). Families were randomized to receive an attachment-based experimental intervention or control intervention in infancy. When children were in middle childhood, they completed follow-up research visits when they were 8 and 10. Maternal sensitivity was assessed using an observational task when children were 8 (M= 8.37 years, SD= 4.04 months). Sensitivity scores ranged from 1 to 5 (M = 2.87, SD = 0.89, ICC = .91), with higher scores indicating higher levels of sensitivity. When children were 10 (M= 10.58 years, SD= 5.44 months), mothers completed the Adverse Childhood Experiences Questionnaire (ACEs; Felitti et al., 1998; M = 2.84, SD = 2.69) and the Child Behavior Checklist (CBCL; Achenbach & Rescorla, 2001; Mint = 3.33, SDint = 4.03; Mext = 7.30, SDext = 8.24). Intervention group was not significantly associated with maternal ACEs, sensitivity, or CBCL scores.

Hierarchical linear regression analyses were performed to assess whether maternal ACEs predicted children’s internalizing and externalizing symptoms at age 10, even when controlling for maternal sensitivity at age 8. Regression analyses also controlled for child sex. Maternal ACEs significantly and positively predicted CPS-referred children’s externalizing and internalizing symptoms at age 10 (Table 2). Additionally, in both models, maternal sensitivity at age 8 significantly and negatively predicted externalizing and internalizing symptoms.

To the best of our knowledge, the present study is the first to provide evidence that among CPS-referred families, maternal ACEs place offspring at risk for emotional and behavioral problems during middle childhood. These findings highlight the importance of screening for maternal ACEs and developing and disseminating evidence-based interventions for vulnerable families.

Authors

• Amanda M. Flagg, State University of New York at Albany (SUNY Albany)
  Presenting Author

• Lindsay Zajac, Children’s Hospital of Philadelphia
  Non-Presenting Author

• Caroline K. Pemberton Roben, University of Delaware
  Non-Presenting Author

• Mary Dozier, University of Delaware
  Non-Presenting Author