Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-15T19:23:31.018Z Has data issue: false hasContentIssue false

Intergenerational transmission of adverse childhood experiences via maternal depression and anxiety and moderation by child sex

Published online by Cambridge University Press:  03 September 2018

N. Letourneau
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada
D. Dewey
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada
B. J. Kaplan
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada
H. Ntanda
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada
J. Novick
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada
J. C. Thomas
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada
A. J. Deane
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada
B. Leung
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada
K. Pon
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada
G. F. Giesbrecht
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada
the APrON Study Team
Affiliation:
Department of Pediatrics, University of Calgary, Child Development Center, Calgary, AB, Canada

Abstract

Adverse childhood experiences (ACEs) of parents are associated with a variety of negative health outcomes in offspring. Little is known about the mechanisms by which ACEs are transmitted to the next generation. Given that maternal depression and anxiety are related to ACEs and negatively affect children’s behaviour, these exposures may be pathways between maternal ACEs and child psychopathology. Child sex may modify these associations. Our objectives were to determine: (1) the association between ACEs and children’s behaviour, (2) whether maternal symptoms of prenatal and postnatal depression and anxiety mediate the relationship between maternal ACEs and children’s behaviour, and (3) whether these relationships are moderated by child sex. Pearson correlations and latent path analyses were undertaken using data from 907 children and their mothers enrolled the Alberta Pregnancy Outcomes and Nutrition study. Overall, maternal ACEs were associated with symptoms of anxiety and depression during the perinatal period, and externalizing problems in children. Furthermore, we observed indirect associations between maternal ACEs and children’s internalizing and externalizing problems via maternal anxiety and depression. Sex differences were observed, with boys demonstrating greater vulnerability to the indirect effects of maternal ACEs via both anxiety and depression. Findings suggest that maternal mental health may be a mechanism by which maternal early life adversity is transmitted to children, especially boys. Further research is needed to determine if targeted interventions with women who have both high ACEs and mental health problems can prevent or ameliorate the effects of ACEs on children’s behavioural psychopathology.

Type
Original Article
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Felitti, VJ, Anda, RF, Nordenberg, D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med. 1998; 14, 245258.Google Scholar
2. McLaughlin, KA. Future directions in childhood adversity and youth psychopathology. J Clin Child Adolesc Psychol. 2016; 45, 361382.Google Scholar
3. Danese, A, Moffitt, TE, Harrington, H, et al. Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers. Arch Pediatr Adolesc Med. 2009; 163, 11351143.Google Scholar
4. McDonald, S, Tough, S. Alberta Adverse Childhood Experiences Survey 2013 Report, 2014. Alberta Centre for Child, Family and Community Services, Calgary, AB.Google Scholar
5. Anda, RF, Felitti, VJ, Bremner, JD, et al. The enduring effects of abuse and related adverse experiences in childhood. Eur Arch Psychiatry Clin Neurosci. 2006; 256, 174186.Google Scholar
6. Schilling, EA, Aseltine, RH, Gore, S. Adverse childhood experiences and mental health in young adults: a longitudinal survey. BMC Public Health. 2007; 7, 30.Google Scholar
7. Leeners, B, Rath, W, Block, E, Görres, G, Tschudin, S. Risk factors for unfavorable pregnancy outcome in women with adverse childhood experiences. J Perinat Med. 2014; 42, 171178.Google Scholar
8. McDonnell, CG, Valentino, K. Intergenerational effects of childhood trauma: evaluating pathways among maternal ACEs, perinatal depressive symptoms, and infant outcomes. Child Maltreat. 2016; 21, 317326.Google Scholar
9. Wosu, AC, Gelaye, B, Williams, MA. History of childhood sexual abuse and risk of prenatal and postpartum depression or depressive symptoms: an epidemiologic review. Arch Womens Ment Health. 2015; 18, 659671.Google Scholar
10. Biaggi, A, Conroy, S, Pawlby, S, Pariante, CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord. 2016; 191, 6277.Google Scholar
11. Madigan, S, Wade, M, Plamondon, A, Maguire, JL, Jenkins, JM. Maternal adverse childhood experience and infant health: biomedical and psychosocial risks as intermediary mechanisms. J Pediatr. 2017; 1, 19.Google Scholar
12. Thomas, JC, Letourneau, N, Bryce, CI, Campbell, TS, Giesbrecht, GF. Biological embedding of perinatal social relationships in infant stress reactivity. Dev Psychobiol. 2017; 59, 425435.Google Scholar
13. Letourneau, N, Dennis, C, Linder, J, Cosic, N. The effect of perinatal depression treatment for mothers on parenting and child development: a systematic review. Depress Anxiety. 2017; 34, 928–966.Google Scholar
14. Fredland, N, McFarlane, J, Symes, L, Maddoux, J. Exploring the association of maternal adverse childhood experiences with maternal health and child behavior following intimate partner violence. J Womens Health. 2017; 27, 65–71.Google Scholar
15. Atladottir, HO, Gyllenberg, D, Langridge, A, et al. The increasing prevalence of reported diagnoses of childhood psychiatric disorders: a descriptive multinational comparison. Eur Child Adolesc Psychiatry. 2014; 24, 173–183.Google Scholar
16. Halfon, N, Houtrow, A, Larson, K, Newacheck, PW. The changing landscape of disability in childhood. Future Child. 2012; 22, 1342.Google Scholar
17. Renner, LM, Slack, KS. Intimate partner violence and child maltreatment: understanding intra-and intergenerational connections. Child Abuse Negl. 2006; 30, 599617.Google Scholar
18. McFarlane, J, Symes, L, Binder, BK, Maddoux, J, Paulson, R. Maternal-child dyads of functioning: the intergenerational impact of violence against women on children. Matern Child Health J. 2014; 18, 22362243.Google Scholar
19. Stith, SM, Rosen, KH, Middleton, KA, et al. The intergenerational transmission of spouse abuse: A meta‐analysis. J Marriage Fam. 2000; 62, 640654.Google Scholar
20. Kingston, D, Tough, S, Whitfield, H. Prenatal and postpartum maternal psychological distress and infant development: a systematic review. Child Psychiatry Hum Dev. 2012; 43, 683714.Google Scholar
21. Kingston, D, Tough, S. Prenatal and postnatal maternal mental health and school-age child development: a systematic review. Matern Child Health J. 2014; 18, 17281741.Google Scholar
22. Falah-Hassani, K, Shiri, R, Dennis, C-L. The prevalence of antenatal and postnatal co-morbid anxiety and depression: a meta-analysis. Psychol Med. 2017; 47, 20412053.Google Scholar
23. Fricchione, G. Generalized anxiety disorder. N Engl J Med. 2004; 351, 675682.Google Scholar
24. Campbell, SB, Cohn, JF, Murray, L, Cooper, PJ. The timing and chronicity of postpartum depression: implications for infant development. In Postpartum Depression and Child Development (eds. Murray L, Cooper P), 1997, pp. 165–197. Guilford Press: New York, NY.Google Scholar
25. Lee, AM, Lam, SK, SMSM, Lau, et al. Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol. 2007; 110, 11021112.Google Scholar
26. Muñoz, RF, Le, H-N, Ippen, CG, et al. Prevention of postpartum depression in low-income women: development of the Mamás y Bebés/Mothers and Babies Course. Cogn Behav Pract. 2007; 14, 7083.Google Scholar
27. Falah-Hassani, K, Shiri, R, Dennis, C-L. The prevalence of antenatal and postnatal co-morbid anxiety and depression: a meta-analysis. Psychol Med. 2017; 47, 20412053.Google Scholar
28. Field, T. Postpartum anxiety prevalence, predictors and effects on child development: a review. J Psychiatry Psychiatr Disord. 2017; 1, 86102.Google Scholar
29. O’connor, TG, Heron, J, Golding, J, Beveridge, M, Glover, V. Maternal antenatal anxiety and children’s behavioural/emotional problems at 4 years. Br J Psychiatry. 2002; 180, 502508.Google Scholar
30. Van den Bergh B, al. e. Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: links and possible mechanisms. A review. Neurosci Biobehav Rev. 2005; 29, 237–258.Google Scholar
31. Field, T, Diego, M, Hernandez-Reif, M. Prenatal depression effects on the fetus and newborn: a review. Infant Behav Dev. 2006; 29, 445455.Google Scholar
32. Field, T. Prenatal depression effects on early development: a review. Infant Behav Dev. 2011; 34, 114.Google Scholar
33. Giallo, R, Woolhouse, H, Gartland, D, Hiscock, H, Brown, S. The emotional–behavioural functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: a prospective Australian pregnancy cohort study. Eur Child Adolesc Psychiatry. 2015; 24, 12331244.Google Scholar
34. Grace, SL, Evindar, A, Stewart, D. The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature. Arch Womens Ment Health. 2003; 6, 263274.Google Scholar
35. Giesbrecht, G, Letourneau, N, Campbell, T. Sexually dimorphic and interactive effects of prenatal maternal cortisol and psychological distress on infant cortisol reactivity. Dev Psychopathol. 2017; 29, 805818.Google Scholar
36. Waters, CS, Hay, DF, Simmonds, JR, van Goozen, SH. Antenatal depression and children’s developmental outcomes: potential mechanisms and treatment options. Eur Child Adolesc Psychiatry. 2014; 23, 957971.Google Scholar
37. Thomas, JC, Magel, C, Tomfohr-Madsen, L, et al. Adverse childhood experiences and HPA axis function in pregnant women. Horm Behav. 2018; 102, 1022.Google Scholar
38. Moehler, E, Brunner, R, Wiebel, A, Reck, C, Resch, F. Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother–child bonding. Arch Womens Ment Health. 2006; 9, 273278.Google Scholar
39. Field, T. Postpartum depression effects on early interactions, parenting, and safety practices: a review. Infant Behav Dev. 2010; 33, 16.Google Scholar
40. Schrock, M, Woodruff-Borden, J. Parent-child interactions in anxious families. Child Fam Behav Ther. 2010; 32, 291310.Google Scholar
41. Letourneau, N, Tramonte, L, Willms, JD. Maternal depression, family functioning and children’s longitudinal development. J Pediatr Nurs. 2012; 28, 223234.Google Scholar
42. Letourneau, N, Dennis, C, Benzies, K, et al. Postpartum depression is a family affair: addressing the impact on mothers, fathers, and children. Issues Ment Health Nurs. 2012; 33, 445457.Google Scholar
43. Field, T. Postpartum depression effects on early interactions, parenting and safety practices: a review. Infant Behav Dev. 2011; 33, 16.Google Scholar
44. Pemberton, CK, Neiderhiser, JM, Leve, LD, et al. Influence of parental depressive symptoms on adopted toddler behaviors: an emerging developmental cascade of genetic and environmental effects. Dev Psychopathol. 2010; 22, 803818.Google Scholar
45. Chaplin, T, Aldao, A. Gender differences in emotion expression in children: a meta-analytic review. Psychol Bull. 2013; 139, 735765.Google Scholar
46. Wadhwa, PD, Buss, C, Entringer, S, Swanson, JM. Developmental Origins of Health and Disease: brief history of the approach and current focus on epigenetic mechanisms. Seminars in Reproductive Medicine, 2009; 27, 358.Google Scholar
47. Arnett, AB, Pennington, BF, Willcutt, EG, DeFries, JC, Olson, RK. Sex differences in ADHD symptom severity. J Child Psychol Psychiatry 2014; 56, 632–639.Google Scholar
48. Glover, V, Hill, J. Sex differences in the programming effects of prenatal stress on psychopathology and stress responses: an evolutionary perspective. Physiol Behav. 2012; 106, 736740.Google Scholar
49. Trapolini, T, McMahon, CA, Ungerer, JA. The effect of maternal depression and marital adjustment on young children’s internalizing and externalizing behaviour problems. Child Care Health Dev. 2007; 33, 794803.Google Scholar
50. Chaplin, TM, Aldao, A. Gender differences in emotion expression in children: a meta-analytic review. Psychol Bull. 2013; 139, 735765.Google Scholar
51. Leman, PJ, Tenenbaum, HR. Practising gender: children’s relationships and the development of gendered behaviour and beliefs. Br J Dev Psychol. 2011; 29, 153157.Google Scholar
52. Carter, AS, Garrity-Rokous, FE, Chazan-Cohen, R, Little, C, Briggs-Gowan, MJ. Maternal depression and comorbidity: predicting early parenting, attachment security, and toddler social-emotional problems and competencies. J Am Acad Child Adolesc Psychiatry. 2001; 40, 1826.Google Scholar
53. Goodman, S, Rouse, M, Copnnell, A, et al. Maternal depression and child psychopathology: a meta-analytic review. Clin Child Fam Psychol Rev. 2011; 14, 127.Google Scholar
54. Goodman, SH, Gotlib, IH. Children of Depressed Parents: Mechanisms of Risk and Implications for Treatment. 2002. American Psychological Association: Washington, DC.Google Scholar
55. Fleming, A, Klein, E, Corter, C. The effects of a social support group on depression, maternal attitudes and behavior in new mothers. J Child Psychol Psychiatry. 1992; 33, 685698.Google Scholar
56. Coburn, SS, Gonzales, N, Luecken, L, Crnic, K. Multiple domains of stress predict postpartum depressive symptoms in low-income Mexican American women: the moderating effect of social support. Arch Womens Ment Health. 2016; 19, 10091018.Google Scholar
57. Meritesacker, B, Bade, U, Haverkock, A, Pauli-Pott, U. Predicting maternal reactivity/sensitivity: the role of infant emotionality, maternal depressiveness/anxiety, and social support. [References] Infant Ment Health J. 2004; 25, 4761.Google Scholar
58. Herwig, J, Wirtz, M, Bengal, J. Depression, partnership, social support, and parenting: interaction of maternal factors with behavioral problems of the child. J Affect Disord. 2004; 80, 199208.Google Scholar
59. Cutrona, C, Troutman, B. Social support, infant temperament, and parenting self-efficacy: a mediational model of postpartum depression. Child Dev. 1986; 57, 15071518.Google Scholar
60. Norbeck, JS, Anderson, NJ. Life stress, social support, and anxiety in mid‐and late‐pregnancy among low income women. Res Nurs Health. 1989; 12, 281287.Google Scholar
61. Falah-Hassani, K, Shiri, R, Dennis, C-L. Prevalence and risk factors for comorbid postpartum depressive symptomatology and anxiety. J Affect Disord. 2016; 198, 142147.Google Scholar
62. Kaplan, BJ, Giesbrecht, GF, Leung, BM, et al. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods. Matern Child Nutr. 2014; 10, 4460.Google Scholar
63. Murphy, A, Steele, M, Dube, S, et al. Adverse Childhood Experiences (ACES) questionnaire: and Adult Attachment Interview (AAI): implications for parent child relationships. Child Abuse Negl. 2014; 38, 224233.Google Scholar
64. Anda, RF, Felitti, VJ, Bremner, JD, et al. The enduring effects of abuse and related adverse experiences in childhood. Eur Arch Psychiatry Clin Neurosci. 2006; 256, 174186.Google Scholar
65. Cox, JL, Holden, J, Sagovsky, R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987; 150, 782786.Google Scholar
66. Brouwers, EP, van Baar, AL, Pop, VJ. Does the Edinburgh Postnatal Depression Scale measure anxiety? J Psychosom Res. 2001; 51, 659663.Google Scholar
67. Huizink, AC, Mulder, EJ, de Medina, PGR, Visser, GH, Buitelaar, JK. Is pregnancy anxiety a distinctive syndrome? Early Hum Dev. 2004; 79, 8191.Google Scholar
68. Derogatis, L. Symptom Checklist-90-R: Administration, Scoring, and Procedure Manual. 1994. NCS Pearson Inc.: Minneapolis, MN.Google Scholar
69. Dinning, WD, Evans, RG. Discriminant and convergent validity of the SCL-90 in psychiatric inpatients. J Pers Assess. 1977; 41, 304310.Google Scholar
70. Vallejo, MA, Jordán, CM, Díaz, MI, Comeche, MI, Ortega, J. Psychological assessment via the internet: a reliability and validity study of online (vs paper-and-pencil) versions of the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R). J Med Internet Res. 2007; 9, 122.Google Scholar
71. Achenbach, TM, Rescorla, LA. Manual for the ASEBA Preschool Forms and Profiles. 2010. University of Vermont: Burlington, VT.Google Scholar
72. Kristensen, S, Henriksen, TB, Bilenberg, N. The Child Behavior Checklist for Ages 1.5–5 (CBCL/1½–5): assessment and analysis of parent-and caregiver-reported problems in a population-based sample of Danish preschool children. Nord J Psychiatry. 2010; 64, 203209.Google Scholar
73. Michalos, AC. Essays on the Quality of Life (vol. 19), 2003. Springer Science & Business Media: New York City, NY.Google Scholar
74. Mplus Version 7.3 [computer program], 1988–2015. Los Angeles, CA: Muthén & Muthén.Google Scholar
75. Rabe-Hesketh, S, Skrondal, A. Generalized Latent Variable Modeling: Multilevel, Longitudinal, and Structural Equation Models. 2004. Chapman and Hall/CRC: London, UK.Google Scholar
76. Hayes, AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. 2013. Guilford Press: New York.Google Scholar
77. Bentler, PM. Comparative fit indexes in structural models. Psychol Bull. 1990; 107, 238.Google Scholar
78. Lt, Hu, Bentler, PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling. 1999; 6, 155.Google Scholar
79. Bearden, WO, Sharma, S, Teel, JE. Sample size effects on chi square and other statistics used in evaluating causal models. J Mark Res. 1982; 19, 425430.Google Scholar
80. Roza, SJ, Hofstra, MB, van der Ende, J, Verhulst, FC. Stable prediction of mood and anxiety disorders based on behavioral and emotional problems in childhood: a 14-year follow-up during childhood, adolescence, and young adulthood. Am J Psychiatry. 2003; 160, 21162121.Google Scholar
81. Essex, MJ, Klein, MH, Cho, E, Kraemer, HC. Exposure to maternal depression and marital conflict: gender differences in children’s later mental health symptoms. J Am Acad Child Adolesc Psychiatry. 2003; 42, 728737.Google Scholar
82. Schore, AN. All our sons: the developmental neurobiology and neuroendocrinology of boys at risk. Infant Ment Health J. 2017; 38, 1552.Google Scholar
83. Holzman, C, Eyster, J, Tiedje, LB, et al. A life course perspective on depressive symptoms in mid-pregnancy. Matern Child Health J. 2006; 10, 127183.Google Scholar
84. Cloitre, M, Stovall‐McClough, C, Zorbas, P, Charuvastra, A. Attachment organization, emotion regulation, and expectations of support in a clinical sample of women with childhood abuse histories. J Trauma Stress. 2008; 21, 282289.Google Scholar
85. Al Odhayani, A, Watson, WJ, Watson, L. Behavioural consequences of child abuse. Can Fam Physician. 2013; 59, 831836.Google Scholar
86. Giesbrecht, G, Poole, J, Letourneau, N, Campbell, T, Kaplan, B. The buffering effect of social support on HPA axis function during pregnancy. Psychosom Med, 2013; 75, 856–862.Google Scholar
87. Alexander, GM, Wilcox, T. Sex differences in early infancy. Child Dev Perspect. 2012; 6, 400406.Google Scholar
88. Avan, B, Richter, LM, Ramchandani, PG, Norris, SA, Stein, A. Maternal postnatal depression and children’s growth and behaviour during the early years of life: exploring the interaction between physical and mental health. Arch Dis Child. 2010; 95, 690695.Google Scholar
89. Choe, DE, Olson, SL, Sameroff, AJ. Effects of early maternal distress and parenting on the development of children’s self-regulation and externalizing behavior. Dev Psychopathol. 2013; 25, 437453.Google Scholar
90. Arnett, AB, Pennington, BF, Willcutt, EG, DeFries, JC, Olson, RK. Sex differences in ADHD symptom severity. J Child Psychol Psychiatry. 2015; 56, 632639.Google Scholar
91. Dube, SR, Williamson, DF, Thompson, T, Felitti, VJ, Anda, RF. Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse Negl. 2004; 28, 729737.Google Scholar
92. Hardt, J, Rutter, M. Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry. 2004; 45, 260273.Google Scholar
Supplementary material: File

Letourneau et al. supplementary material

Table S1

Download Letourneau et al. supplementary material(File)
File 17.7 KB