A Systematic Review of Intergenerational Transmission of Risk from Maternal ACEs to Child Behavioral Outcomes

Authors' Affiliations

Hope O'Neill, Department of Psychology, College of Arts and Sciences, East Tennessee State University Rachel Schott, Department of Psychology, College of Arts and Sciences, East Tennessee State University Julia Dodd, Ph.D., Department of Psychology, College of Arts and Sciences, East Tennessee State University Richard Wallace, MA, MDiv, MAOM, MSLS, MPH, EdD., Quillen College of Medicine Library, East Tennessee State University

Location

Culp Center Rm. 303

Start Date

4-25-2023 2:20 PM

End Date

4-25-2023 2:40 PM

Faculty Sponsor’s Department

Psychology

Name of Project's Faculty Sponsor

Julia Dodd

Classification of First Author

Graduate Student-Doctoral

Competition Type

Competitive

Type

Oral Presentation

Project's Category

Psychology

Abstract or Artist's Statement

Public and scholarly interest in the intergenerational effects of maternal adverse childhood experiences (ACEs) on children’s internalizing or externalizing behaviors continues to grow. ACEs are defined as traumatic events that occur prior to the age of eighteen, such as emotional, physical, or sexual abuse, neglect, and household dysfunction. The existing research has helped explicate the potential intergenerational consequences of these events on a child’s behavior, which provides useful information on who is the most at-risk. A systematic review was conducted to determine these effects. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases CIANHL, PubMed, PsycINFO, PsycARTICLES, Sociological Abstracts, and Web of Science were used to search for articles measuring maternal ACEs and child internalizing or externalizing behaviors. Other inclusion criteria were that the journal articles presented results from empirical studies, and the articles were published between 1995 and January 2022. The initial search yielded 1601 possible articles. Two independent reviewers reviewed all abstracts to determine whether the study met inclusion criteria; 22 articles were retained for data extraction. Across studies, children were assessed across a range of ages from 6 weeks to 16-17 years old. Participants were primarily recruited from medical clinics, followed by schools, although there was diversity of recruitment site, with some studies recruiting from Head Start programs, domestic violence shelters, WIC clinics, CPS reports, and an online platform. The majority of studies included used retrospective reporting of the original 10-item ACEs questionnaire to assess maternal ACEs, and the Child Behaviors Checklist was commonly used to assess child internalizing and externalizing behaviors. The outcomes most commonly predicted by maternal ACEs included child externalizing behaviors, depression, behavioral and social-emotional problems, anxiety, and negative temperament characteristics. Other outcomes less commonly assessed, but found to be associated with maternal ACEs, were lower academic performance, developmental delays, attention problems, trauma symptoms, and likelihood of psychiatrics diagnosis overall. Inconsistent results were found for internalizing behaviors, as some studies found these to be significantly associated with maternal ACEs, while this relationship was not significant in other studies. Mediators and moderators explored in the studies were also extracted and will be presented as well. Results of this systematic review highlight what is currently known in this field, and identify opportunities for future research. For example, examining internalizing behaviors as a unitary construct may be less helpful than examining specific internalizing behaviors individually, given the conflicting findings in this area.

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Apr 25th, 2:20 PM Apr 25th, 2:40 PM

A Systematic Review of Intergenerational Transmission of Risk from Maternal ACEs to Child Behavioral Outcomes

Culp Center Rm. 303

Public and scholarly interest in the intergenerational effects of maternal adverse childhood experiences (ACEs) on children’s internalizing or externalizing behaviors continues to grow. ACEs are defined as traumatic events that occur prior to the age of eighteen, such as emotional, physical, or sexual abuse, neglect, and household dysfunction. The existing research has helped explicate the potential intergenerational consequences of these events on a child’s behavior, which provides useful information on who is the most at-risk. A systematic review was conducted to determine these effects. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases CIANHL, PubMed, PsycINFO, PsycARTICLES, Sociological Abstracts, and Web of Science were used to search for articles measuring maternal ACEs and child internalizing or externalizing behaviors. Other inclusion criteria were that the journal articles presented results from empirical studies, and the articles were published between 1995 and January 2022. The initial search yielded 1601 possible articles. Two independent reviewers reviewed all abstracts to determine whether the study met inclusion criteria; 22 articles were retained for data extraction. Across studies, children were assessed across a range of ages from 6 weeks to 16-17 years old. Participants were primarily recruited from medical clinics, followed by schools, although there was diversity of recruitment site, with some studies recruiting from Head Start programs, domestic violence shelters, WIC clinics, CPS reports, and an online platform. The majority of studies included used retrospective reporting of the original 10-item ACEs questionnaire to assess maternal ACEs, and the Child Behaviors Checklist was commonly used to assess child internalizing and externalizing behaviors. The outcomes most commonly predicted by maternal ACEs included child externalizing behaviors, depression, behavioral and social-emotional problems, anxiety, and negative temperament characteristics. Other outcomes less commonly assessed, but found to be associated with maternal ACEs, were lower academic performance, developmental delays, attention problems, trauma symptoms, and likelihood of psychiatrics diagnosis overall. Inconsistent results were found for internalizing behaviors, as some studies found these to be significantly associated with maternal ACEs, while this relationship was not significant in other studies. Mediators and moderators explored in the studies were also extracted and will be presented as well. Results of this systematic review highlight what is currently known in this field, and identify opportunities for future research. For example, examining internalizing behaviors as a unitary construct may be less helpful than examining specific internalizing behaviors individually, given the conflicting findings in this area.