The Association Between Parental Adverse Childhood Experiences and Children’s Socioemotional Difficulties: A Meta-Analysis

• In Event: Enhancing Our Understanding of Risk Factors of Socioemotional Problems Through Cutting-Edge Methodological and Biopsychosocial Approaches

Abstract

Introduction: A growing body of research now suggests that the negative impact of adverse childhood experiences (ACEs) on physical and mental health may span generations. That is, parental childhood adversity is a distal risk factor for intergenerational outcomes (Racine et al., 2018), which may not account for substantial variance in children’s behavioral problems. Currently, the magnitude of the association between parental ACEs and child behavior problems is undetermined due to existing variability across studies. Specifically, while some studies have identified moderate intergenerational associations (Blair et al., 2019; Khan & Renk, 2019), others have found weak or null associations (e.g., Letourneau et al., 2019). In order to clarify discrepancies in the existing literature and inform evidence-based recommendations regarding ACEs screening practices, 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).

Hypotheses: Based on previous work (e.g., Cooke et al., 2020) , we anticipated small but significant associations between maternal ACEs and child behavioral and emotional difficulties.

Study Population: A total of 22 studies were included.

Methods: Searches were conducted in MEDLINE, Embase, and PsycINFO up to November 2021 by a health sciences librarian. Inclusion criteria were as follows: (1) reported a measure of parental ACEs; (2) measure of ACEs assessed domains of maltreatment and household dysfunction; (3) reported a measure of child behavior problems assessed prior to 18 years of age; and (4) reported sufficient data to calculate an effect size. Potential moderators included: parent gender (% mothers), child age when behavior problems were assessed (in months), child sex (% males), sample income level (high proportion [≥ 80%] of low income vs. low-to-moderate proportion [<0-79%]), racial/ethnic minority (% minority), method of assessing parent ACEs (e.g., questionnaire, structured interview), method of assessing child behavior problems (e.g., questionnaire, structured interview), child behavior problems informant (e.g., parent, child, teacher), mean ACEs score of the sample, total study quality score, study design (cross-sectional vs. longitudinal), publication status (published vs. unpublished), and country and region where the study took place. Data analysis was conducted using Comprehensive Meta-Analysis (CMA, Version 3.0) (Borenstein et al., 2013).

Results: The electronic search yielded 3,049 studies after duplicates were removed and 140 studies underwent full-text review. In total, 22 studies (10,520 dyads) met full inclusion criteria for the meta-analyses. Maternal ACEs were significantly associated with children’s total behavior problems (k = 18; r = .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). Mean ACEs score was identified as a significant moderator of the association between parent ACEs and child externalizing difficulties. Specifically, stronger effect sizes were found in studies with higher mean ACE scores: for every unit increase in ACEs score, the effect size increased by .10 (95% CI = .01, .19). No other significant moderators were identified.

Authors

• Nicole Racine, University of Ottawa
  Presenting Author

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

• Rachel Eirich, University of Calgary (U of C)

• Audrey-Ann Deneault, University of Calgary (U of C)

• Sheri Madigan, University of Calgary (U of C)