Maternal Adverse Childhood Experiences and Offspring Behavior Problems: A Meta-analysis

• In Event: Poster Session 04
  In Poster Session: PS 04 Topic - Developmental Psychopathology

Abstract

Background: A growing body of research now suggests that the negative impact of adverse childhood experiences (ACEs; i.e., maltreatment and/or household dysfunction before the age of 18 years) on physical and mental health may span generations, with risk passed from maternal ACEs to offspring externalizing and internalizing symptoms (e.g., Adkins et al., 2020; Doi Esteves et al., 2017; Hatch et al., 2020; McDonnell & Valentino, 2016; Schickedanz et al., 2018). Nonetheless, substantial variability exists in this literature, with some studies identifying moderate intergenerational associations (e.g., Blair et al., 2019; Khan & Renk, 2019) and others finding weak or null associations (e.g., Letourneau et al., 2019; Narayan et al., 2017). In order to clarify discrepancies in the existing literature, the aim of the current study was to conduct a meta-analysis to synthesize findings on the association between maternal ACEs and child behavior problems (i.e., internalizing and externalizing problems).

Method: Electronic searches were conducted in MEDLINE, PsycINFO, and EMBASE (up to June 2020). Reference lists were also searched for relevant studies. Studies were included if an association between maternal ACEs and child behavior problems (i.e., total problems, externalizing problems, and/or internalizing problems) was reported. Included studies were extracted using a standard coding form and 20% were double-coded for reliability (values ranged from 0.77 to 1.00). Random effects meta-analyses were used to derive correlations and moderators were explored with Q- and I2-statistics.

Results: In total, 3,048 non-duplicate abstracts were screened. Of these, 139 full text articles were reviewed, and k = 22 studies (N = 10,530 dyads) met inclusion criteria. Maternal ACEs were significantly associated with children’s total behavior problems (k = 18; r = 0.12; 95% CI = .08, .16), externalizing problems (k = 10; r = .18; 95% CI = .11, .26), and internalizing problems (k = 12; r = .14; 95% CI = .08, .19). Significant heterogeneity was identified in all of the meta-analyses. Study quality was identified as a significant moderator of externalizing problems, whereby effect sizes were weaker in studies of greater methodological quality. No other sample or study-level moderators emerged as significant.

Conclusions: Overall, maternal ACEs demonstrated a small, but significant intergenerational association with child behavior problems. Findings suggest that screening for parental ACEs in the presence of child internalizing or externalizing symptoms may be justified in some circumstances. However, care providers should utilize holistic approaches to screening that consider the multiple antecedents of child behavioral symptoms and ensure they are embodying the principles of trauma-informed care. As all studies were conducted in North America, future research is needed to determine whether these associations hold in other Westernized and non-Westernized countries.

Authors

• Jessica Cooke, University of Calgary (U of C)
  Presenting Author

• Nicole Racine, University of Ottawa
  Non-Presenting Author

• Paolo Pador, University of Calgary
  Non-Presenting Author

• Sheri Madigan, University of Calgary (U of C)
  Non-Presenting Author