Linkage between teen mother's childhood adversity and externalizing behaviors in their children at age 11: Three aspects of parenting

The impact of maternal childhood maltreatment on child externalizing behaviour and the mediating factors underlying this association: a three-level meta-analysis and systematic review

Child maltreatment can negatively impact not only survivors but also survivors' children. However, research on the intergenerational effect of maternal childhood maltreatment on child externalizing behaviour has yielded contradictory results and has not yet been systematically synthesised. The current three-level meta-analysis and systematic review aimed to provide a quantitative estimate of the strength of the association between maternal childhood maltreatment and child externalizing behaviour and to summarise research on potential mediating factors of this association. PsycINFO, PubMed, and Embase were searched and 39 studies with 82 effects sizes were included in the meta-analysis. Results revealed a small significant association between maternal childhood maltreatment and child externalizing behaviour (r = 0.16; 95% CI 0.12-0.19; publication bias-adjusted effect size: r = 0.12, 95% CI 0.08-0.16). Maternal mental health, particularly depressive symptoms, maternal parenting and children's maltreatment exposure were the most frequently examined mediators of this association, with relatively robust mediating effects for children's maltreatment exposure and maternal depressive symptoms, but mixed evidence for the mediating role of maternal parenting. This meta-analysis provides evidence for a small but significant association between maternal childhood maltreatment and children's externalizing behaviour, emphasizing the need to develop effective preventive and intervention strategies to minimise the effects of childhood maltreatment on the next generation.

Do multigenerational homes moderate the intergenerational transmission of maternal adverse childhood experiences?

ABSTRACTBackground: Maternal adverse childhood experiences (ACEs) may lead to increased behavioural problems in children. However, the mediating roles of psychological distress and corporal punishment, two common mechanisms underlying the intergenerational transmission of maternal ACEs, in these relations have not been examined in Chinese samples. Multigenerational homes (MGH) are the dominate living arrangement in China; however, limited research focuses on the effects of MGHs on the intergenerational transmission of maternal ACEs.Objective: This study explored the parallel mediating effects of corporal punishment and psychological distress on the association between maternal ACEs and children's behaviour and whether MGHs can strengthen or weaken the relationship between maternal ACEs and corporal punishment or psychological distress.Participants and setting: Participants were 643 three-year-old children and their mothers (mean age of 32.85 years, SD = 3.79) from Wuhu, China.Methods: Mothers completed online questionnaires measuring ACEs, psychological distress, corporal punishment, their family structure, and children's behavioural problems. This study used a moderated mediation model.Results: The findings suggest that psychological distress and corporal punishment mediate the association between maternal ACEs and children's behavioural problems. The mediating role of corporal punishment was found depend on whether mothers and their children reside in MGHs. MGHs were not found to have a moderating role in the indirect relationship between maternal ACEs and children's behaviour problems via psychological distress.Conclusion: Our findings highlight the importance of addressing psychological distress and corporal punishment when designing interventions targeted Chinese mothers exposed to ACEs and their children, especially those living in MGHs.

Intergenerational cascade processes from parental childhood adversity to child emotional and behavioral problems

BACKGROUND

Parental adverse childhood experiences (ACEs) may transmit to the next generation and influence children's emotional and behavioral problems. Relatively little evidence exists on the underlying pathways of this intergenerational transmission at the family- and individual-level.

OBJECTIVE

This study examined the intergenerational cascade processes of parental ACEs on children's emotional and behavioral problems via family cohesion, children's ACEs, and children's self-control.

PARTICIPANTS AND SETTING

283 children (52 % male, Mage = 10.47 years) and their parents (61.1 % mothers, Mage = 38.62 years) were recruited for a 2-month longitudinal study with surveys administered at three time points.

METHOD

Mediation models examined the intergenerational effects of parental ACEs (T1/T3) and family cohesion (T1) as reported by parents, and children's ACEs (T1) and children's self-control (T2) as reported by children, on children's internalizing and externalizing problems (T3) as reported by parents.

RESULTS

Family cohesion, children's ACEs, and children's self-control sequentially mediated the link between parental ACEs and children's externalizing problems (indirect effect = 0.004, 95 % CI [0.001, 0.014]). Parental ACEs were directly linked with children's internalizing problems (β = 0.191, SE = 0.075, p = .011).

CONCLUSIONS

Findings demonstrated intergenerational cascades of distal and proximal risk processes from parental ACEs to children's behavioral problems. These findings have implications for future interventions on children's externalizing problems that aim at improving family cohesion and children's self-control for families exposed to childhood adversity.

Intergenerational Transmission of Parental Adverse Childhood Experiences and Children's Outcomes: A Scoping Review

Adverse childhood experiences (ACEs) are among the leading environmental causes of morbidity and mortality. Extending research on within-generation effects, more recent scholarship has explored between-generation consequences of ACEs. Despite growing interest in the intergenerational effects of parents' ACEs on children's outcomes, this line of scholarship has yet to be coalesced into a comprehensive review. The current study is a scoping review on the intergenerational transmission of parental ACEs and children's outcomes. Ten databases such as PubMed, APA PsycArticles, and Social Work Abstracts were searched. To be included, empirical studies must have been published in English and analyzed associations between a cumulative measure of at least four parental ACEs and children's outcomes. Sixty-eight studies qualified for the review and, among these, 60 were published in the most recent 5 years (2018-2022). Fifty-one studies had sample sizes smaller than 500, and 55 focused on the effect of maternal ACEs. Nearly all studies demonstrated that parental ACEs could affect children's outcomes directly or indirectly via mechanisms like maternal mental health problems or parenting-related factors. By scoping the extant literature, this review advances the knowledge base regarding the intergenerational impacts of parental childhood trauma and children's outcomes. It also reveals methodological limitations that should be addressed in future research to strengthen causal inferences along with practical implications for interventions that aim to interrupt the intergenerational transmission of trauma.

Maternal childhood adversity and adolescent marijuana use at age 17 years: The role of parental mental health and parenting behaviors

INTRODUCTION

Children's risk for marijuana use may be linked to their parents' history of childhood adversity, yet little is known about the mechanisms underlying this link. This study examined whether maternal parenting behavior and mental health serve as mechanisms linking maternal childhood adversity to their children's marijuana use at age 17 years, by gender.

METHODS

Data were from the Young Women and Child Development Study (59% male), a longitudinal panel study, which began in 1988 and followed mother-child dyads for 17 years (n = 240). Participants were recruited from health and social services agencies located in a metropolitan region of Washington State. Hypotheses were tested using Structural Equation Modeling in Mplus. Multiple-group analysis was conducted to evaluate potential gender differences.

RESULTS

Results showed that maternal childhood adversity was associated with their mental health outcomes (β = .32, p < .001), which in turn was predictive of mothers' harsh parenting (β = .27, p < .01). Maternal harsh parenting behavior was then associated with their children's marijuana use at age 17 years (β = .34, p < .001). Multiple group analyses revealed that the path from harsh parenting to adolescent marijuana use differed across genders being only significant for boys (β = .42, p < .001).

CONCLUSIONS

The intergenerational impact of childhood adversity highlights the need for interventions that target both parents and children. This would support teen mothers with a history of childhood adversity to acquire skills and knowledge to help mitigate its impact on their parenting behaviors and offset risks for their children.

Intergenerational Continuity of Childhood Adversity and Its Underlying Mechanisms Among Teen Mothers and Their Offspring

The present study investigates how parenting stress mediates the intergenerational continuity of childhood adversity in teenage mothers. Childhood adversity experiences of caregivers significantly affect their offspring's exposure to childhood adversity. However, little is known about the mechanisms linking childhood adversity across generations. The study measures how parental distress and parent-child dysfunctional interaction mediate the association between teen mothers' childhood adversity and their offspring's adversity, measuring when the offspring reached 11.5 years of age. The results revealed that parental distress, but not parent-child dysfunctional interaction, mediated the association between teen mothers' child abuse and their offspring's household dysfunction. This suggests that parental distress may be a crucial intervention target to prevent the intergenerational continuity of childhood adversity. The findings imply that efforts to prevent the intergenerational continuity of childhood adversity may be more successful if the public and professionals have a broader understanding of the associations between early adversity and parenting contexts. In conclusion, the study shed light on the potential mechanisms underlying the intergenerational continuity of childhood adversity and highlights the importance of targeting parenting stress, specifically parental distress, as an intervention strategy to prevent the perpetuation of childhood adversity across generations.

Maternal adverse childhood experiences and behavioral problems in preschool offspring: the mediation role of parenting styles

BACKGROUND

Maternal history of adverse childhood experiences (ACEs) has been found to be associated with children's health outcomes. However, the underlying mechanisms were unclear. This study aimed to examine the association between maternal ACEs and behavioral problems in their preschool offspring and to explore the potential mediating role of maternal parenting styles in the association.

METHODS

A cross-sectional study was conducted involving 4243 mother-child dyads in Chengdu, China. Mothers completed the Adverse Childhood Experiences-International Questionnaire (ACE-IQ) to assess their history of ACEs (i.e., physical abuse, emotional abuse, physical neglect, emotional neglect, witnessing domestic violence, household substance abuse, household mental illness, incarcerated household member, parental separation or divorce, parental death, bullying, and community violence), the short Egna Minnen Beträffande Uppfostran Parent Form (S-EMBU-P) to evaluate their parenting styles (i.e., emotional warmth, rejection, and overprotection), and the 48-item Conners' Parent Rating Scale (CPRS-48) to measure behavioral problems in their children. Logistic regression models were established to examine the association between cumulative number of maternal ACEs and children's behavioral problems. The mediating role of parenting styles in this association was explored by generalized structural equation models (GSEM).

RESULTS

Of the participating mothers, 85.8% (n = 3641) reported having experienced at least one type of ACE. Children of mothers with ≥2 ACEs showed a significantly increased risk of behavioral problems across all dimensions, including conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, anxiety, and hyperactivity index, in both crude and adjusted models (all p-values < 0.05). Dose-response patterns were also observed between the cumulative number of maternal ACEs and children's behavioral problems. In addition, maternal parenting styles of rejection emerged as a significant mediator, accounting for approximately 8.4-15.0% of the associations.

CONCLUSIONS

Our findings indicated an intergenerational association of maternal ACEs with behavioral problems in preschool offspring, which was mediated by maternal parenting styles of rejection. Early screening and targeted intervention strategies are critical to mitigate the downstream consequences of maternal ACEs on young children's outcomes. Providing support and resources to improve parenting skills may prove beneficial.

Maternal history of maltreatment and offspring's emotional and behavioral problems in adolescence: Do family factors contribute to the intergenerational risk transmission?

BACKGROUND

A history of childhood maltreatment often has a negative and long-lasting impact across different domains in life. A childhood maltreatment experience in parents may even affect the next generation. So far, the effects of family factors have been considered in the intergenerational transmission of adversity across the childhood years, but whether the effects remain until adolescence is less clear.

OBJECTIVE

Using data from a large population-based study in the Netherlands, including both mother and child reports, we examined whether maternal childhood maltreatment history is associated with increased mental health problems in offspring and the role of family functioning and harsh parenting as a potential pathway.

PARTICIPANTS

4912 adolescents (aged 13 years) and their mothers were recruited in the Generation R study.

METHODS

Mothers reported childhood maltreatment experiences using the Childhood Trauma Questionnaire (CTQ), and adolescents reported on their mental health using the Youth Self Report (YSR). Structural equation modeling (SEM) was used to test the association of maternal childhood maltreatment on mental health problems in offspring and family functioning and harsh parenting as mechanisms to explain this association.

RESULTS

Adolescents of mothers with a history of maltreatment had greater internalizing (β = 0.07, p < .01) and externalizing problems (β = 0.08, p < .01). Moreover, we found an indirect effect via family functioning over time and harsh parenting at ages 3 and 8 years which mediated this association.

CONCLUSION

We concluded an intergenerational effect of maternal childhood maltreatment on adolescents internalizing and externalizing problems. The findings might enable earlier intervention within the family context to mitigate the consequences of maternal childhood maltreatment.

Maternal History of Childhood Adversities and Later Negative Parenting: A Systematic Review

Adverse childhood experiences negatively impact future violence, victimization, perpetration, health, and lifelong development. The aim of the present study was to systematically review the scientific evidence of empirical studies on the association between maternal childhood adversity in a familial context, including maltreatment, household challenges, and later maternal negative parenting. A search was performed in the PubMed, PsycINFO, Web of Science, SciELO, and LILACS databases, using the combination of the following keywords: (neglect OR abuse OR maltreatment OR harsh parenting OR punishment OR discipline OR negative parenting practices) AND (adverse childhood experiences OR early adversity OR cycle of violence OR cycle of maltreatment OR history of maltreatment) AND (mother OR maternal). The results of 29 studies showed predominantly significant direct associations between maternal childhood adversities and negative parenting with their children (83%). Parental stress was also significantly associated with a maternal history of childhood adversities. Focusing on the type of maltreatment practices, there were similar intergenerational transmission types: homotypic and heterotypic. Few studies have examined the protective factors that could buffer the negative impact of a maternal childhood history of adversities on later negative parenting.

An Examination of Parents' Adverse Childhood Experiences (ACEs) History and Reported Spanking of Their Child: Informing Child Maltreatment Prevention Efforts

The current evidence indicates that spanking is harmful to children's health and development and should never be used by parents or other caregivers. However, the critical factors that inform effective spanking prevention strategies are still not well understood. The objective of the current study was to determine if a parent's own adverse childhood experiences (ACEs) history was associated with increased likelihood of reporting their child being spanked at age 10 or younger. Data were drawn from the Well-Being and Experiences Study (the WE Study), a community survey of parents and adolescents from 2017-2018 (N = 1000) from Canada. The results indicated that a parent's own history of physical abuse, emotional abuse, spanking, and household mental illness in childhood were associated with an increased likelihood that their child would have been spanked. These findings indicate that a parent's ACEs history may be related to how their own child is parented and identify families who may be more likely to rely on spanking. Preventing physical punishment is necessary for healthy child development, reducing the risk of further violence, and upholding children's rights to protection. Parent's ACEs history may be an important factor to consider when developing and implementing child maltreatment prevention efforts.

Mediators and moderators in the relationship between maternal childhood adversity and children's emotional and behavioural development: a systematic review and meta-analysis

Maternal experiences of childhood adversity can increase the risk of emotional and behavioural problems in their children. This systematic review and meta-analysis provide the first narrative and quantitative synthesis of the mediators and moderators involved in the link between maternal childhood adversity and children's emotional and behavioural development. We searched EMBASE, PsycINFO, Medline, Cochrane Library, grey literature and reference lists. Studies published up to February 2021 were included if they explored mediators or moderators between maternal childhood adversity and their children's emotional and behavioural development. Data were synthesised narratively and quantitatively by meta-analytic approaches. The search yielded 781 articles, with 74 full-text articles reviewed, and 41 studies meeting inclusion criteria. Maternal mental health was a significant individual-level mediator, while child traumatic experiences and insecure maternal-child attachment were consistent family-level mediators. However, the evidence for community-level mediators was limited. A meta-analysis of nine single-mediating analyses from five studies indicated three mediating pathways: maternal depression, negative parenting practices and maternal insecure attachment, with pooled indirect standardised effects of 0.10 [95% CI (0.03-0.17)), 0.01 (95% CI (-0.02 to 0.04)] and 0.07 [95% CI (0.01-0.12)], respectively. Research studies on moderators were few and identified some individual-level factors, such as child sex (e.g. the mediating role of parenting practices being only significant in girls), biological factors (e.g. maternal cortisol level) and genetic factors (e.g. child's serotonin-transporter genotype). In conclusion, maternal depression and maternal insecure attachment are two established mediating pathways that can explain the link between maternal childhood adversity and their children's emotional and behavioural development and offer opportunities for intervention.

Intergenerational Transmission of Maternal Adverse Childhood Experiences on Next Generation's Development: A Mini-Review

(Adverse childhood experiences (ACEs) have extremely harmful impacts on an individual’s physical, social and mental health throughout their life-span. Recently, it has been reported that maternal ACEs increase the risk of developmental delay in the offspring across generations. This mini review focuses on the direct relationship between maternal ACEs and child developmental delay, and potential mediators/moderators that associate their relationship. Six studies were identified using three search engines. The results indicated that four out of six studies reported at least one significant direct association between maternal ACEs and child development. Additionally, maternal biological, psychological, and social factors were identified as mediators or moderators. In summary, we identified that maternal ACEs increased the risk of developmental delay in children via biological and psychosocial pathways. Future research should examine potential buffering factors and identify when it is crucial to break the intergenerational transmission.

Intergenerational Trauma: Assessment in Biological Mothers and Preschool Children

Childhood trauma can lead to lifelong detrimental outcomes. Intergenerational trauma should be considered when supporting healthy parent-child relationships. Research is needed on intergenerational trauma in relation to children's negative life event exposure, which could compound intergenerational trauma. We examined the prevalence of and relations between mother and child traumas in a sample of 88 biological mothers and their preschool-aged children. We coded child negative life events to examine those related to intergenerational trauma. Results showed that mother traumas and child negative life events were positively associated; subtypes of mothers' traumas (abuse, neglect) and high trauma levels were associated with higher numbers of child negative life events, including those tied to parent trauma. It is necessary to consider how childhood trauma in adults and children is measured, and what analyses can reveal about the intergenerational context, especially considering compounding current, stressful world events.

Associations between out-of-home care and mental health disorders within and across generations in a Swedish birth cohort

Previous studies have shown that mental health disorders (MHD) among parents might be an important mechanism in the intergenerational transmission of out-of-home care (OHC). The current study aimed to further study this interplay by investigating the associations between OHC and MHD within and across generations. We used prospective data from the Stockholm Birth Cohort Multigenerational Study (SBC Multigen) on 9033 cohort members (Generation 1; G1) and their 15,305 sons and daughters (Generation 2; G2). By odds ratios of generalised structural equation modelling, we investigated the intergenerational transmission of OHC and MHD, respectively, as well as the association between OHC and MHD within each generation. Second, we examined the associations between OHC and MHD across the two generations. In order to explore possible sex differences, we performed the analyses stratified by the sex of G2. The results showed an intergenerational transmission of OHC, irrespective of sex. Regarding the intergenerational transmission of MHD, it was shown for both sexes although only statistically significant among G2 males. OHC was associated with MHD within both generations; in G2, this association was stronger among the males. While we found no direct association between OHC in G1 and MHD in G2, there was a significant association between MHD in G1 and OHC in G2. The latter was more evident among G2 females than G2 males. We conclude that OHC and MHD seem to be processes intertwined both within and across generations, with some variation according to sex. Although there did not seem to be any direct influences of OHC in one generation on MHD in the next generation, there was some indication of indirect paths going via parental MHD and child OHC.

•

Mental health disorders (MHD) (G1) was directly associated with out-of-home care (G2) among females.

•

There were no direct influences of OHC in one generation on MHP in the next generation.

•

There was some indication of indirect paths going via parental MHD and child OHC.

The Association Between Polyvictimization in Childhood and Intimate Partner Violence and Child Abuse in Adulthood

The main purpose of this study was to examine the association of family polyvictimization in childhood with the victimization or perpetration of spousal abuse and the perpetration of child abuse in adulthood. While associations between maltreatment in childhood and subsequent perpetration or victimization in adulthood are well documented, their association with polyvictimization in childhood (i.e., experiencing multiple types of victimization) has received less attention. This research aims to empirically investigate 1) whether early experiences of family polyvictimization are predictive of subsequent experience or spousal abuse or perpetration of child abuse and 2) whether there are gender differences in those associations. Through conducting Chi-square analysis and logistic regression analysis with South Korea's National Domestic Violence Survey 2019, the study found significant empirical evidence that polyvictimization is predictive of perpetration or experience of spousal abuse and perpetration of child abuse. Particularly, adults who experienced polyvictimization in childhood were more likely to perpetrate child abuse regardless of the type of abuse (p < .001). Polyvictimization in childhood was also significantly associated with perpetration and victimization of spousal abuse (p < .001). In regard to gender differences, this study found that males were more likely to be polyvictimized by family in childhood (15.11%) than females (10.23%), and polyvictimization was found to increase the likelihood of females being revictimized in adulthood. More attention should be paid to victimization by multiple types of violence within the family and its influence on intergenerational transmission of violence.

Maternal Adverse Childhood Experiences and Child Behavior Problems: A Systematic Review

CONTEXT

A growing body of research has examined the role of maternal adverse childhood experiences (ACEs) on child behavior problems.

OBJECTIVE

To summarize the literature examining the association between maternal ACEs and child behavior problems via a systematic review.

DATA SOURCES

Electronic searches were conducted in Medline, PsycINFO, and Embase (1998-June 2020). Reference lists were reviewed. In total, 3048 records were screened.

STUDY SELECTION

Studies were included if an association between maternal ACEs and child externalizing (eg, aggression) and/or internalizing (eg, anxiety) problems was reported. In total, 139 full-text articles were reviewed for inclusion.

DATA EXTRACTION

Data from 16 studies met full inclusion criteria. Studies were synthesized by child externalizing and internalizing outcomes.

RESULTS

Maternal ACEs were significantly associated with child externalizing problems across all studies (number of studies synthesized per outcome [k] = 11). Significant associations were also found for inattention, hyperactivity, and impulsivity (k = 4), and aggression (k = 2). For internalizing problems (k = 11), significant associations were identified across 8 studies and nonsignificant associations were reported for 3 studies. Maternal ACEs were consistently associated with child anxiety and depression (k = 5). However, inconsistent findings were reported for somatization (k = 2).

LIMITATIONS

Results are limited to mother-child dyads and questionnaire measures of behavior problems in primarily North American countries.

CONCLUSIONS

Mothers' ACEs demonstrated largely consistent associations with children's behavior problems. Future research is needed to determine if specific types of maternal ACEs (eg, household dysfunction) are more strongly associated with child behavior problems.

Addressing Parental Adverse Childhood Experiences in the Pediatric Setting

Parents’ own adverse childhood experiences (ACEs) impact their children’s physical and emotional health. Causal mechanisms are not fully understood but are likely multifactorial, affecting parent resiliency and attachment behaviors, with possible intergenerational transmission. Although universal screening for parental ACEs is controversial, they may be identified during pediatric care. Providers can address parental ACEs by consistently using trauma-informed, healing-centered approaches that acknowledge the impact of trauma and the presence of resilience, promote positive parenting skills, and provide compassionate support universally. When necessary, more targeted interventions may include referral to community social support services and parenting programming. Incorporating a two-generation approach in pediatrics may enhance and support child health and well-being more robustly.

Co-occurring risk and protective factors and regulatory behavior of infants living in low-income homes

Early self-regulation is a foundation for lifelong wellness and can be shaped by the interplay among several vital exposures. In this study, we examined the emergence of reliable profiles based upon exposure to risk and protective factors in infancy, determined if sociodemographic resources predict profile membership, and determined if these profiles predict early regulatory behaviors in a sample of infants reared in low-income homes. Data were collected from a sample of primarily Black or White mother-infant dyads living in low-income homes in the Midwest (n = 222) during the infants' first year of life (mean maternal age at enrollment: 26.29 years; range 18-43 years). Exposures included mother-infant interactions; father support; maternal depression, stress, and self-efficacy; home environment; food security; and breastfeeding duration. Sociodemographic resources included poverty status; economic hardship; maternal education, employment, and age; parental marital status; and infant race and sex. Infant regulatory behaviors were measured with the Infant Behavior Questionnaire-Revised Very Short Form effortful control subscale (mean age 11 months; range 8.5-14.3 months). Latent profile analysis was used to profile infants by risk and protective exposures. Regression was used to differentiate profiles by sociodemographic resources and to predict infant regulatory behavior from profiles. Three profiles emerged: low father support, good maternal mental health, and poor maternal mental health. A married mother, less economic hardship, and working mothers predicted infant exposure to good maternal mental health. Infant regulatory behavior was best when the infant was exposed to the good maternal mental health profile. Implications for future research are discussed.

Child maltreatment: An intergenerational cascades model of risk processes potentiating child psychopathology

BACKGROUND

Child maltreatment poses substantial risk for compromised mental health in children. Further, child abuse and neglect are potentiated within a cascade of intergenerational and current familial risk processes that require clarification to inform understanding of adverse outcomes and direct prevention and intervention efforts.

OBJECTIVE

Using a multi-informant design, the current study applied an intergenerational cascades approach to examine the interconnected pathways among several familial risk factors associated with child maltreatment and its consequences.

PARTICIPANTS

Participants were 378 children (aged 10-12) and their mothers from economically disadvantaged, ethnically diverse backgrounds. The sample included maltreated children recruited via CPS records and demographically comparable non-maltreated children.

METHODS

Structural equation modeling (SEM) was conducted to test sequential mediation pathways examining the independent and cascading effects of maternal history of childhood maltreatment, maternal adolescent childbearing, current maternal depression, and the child's lifetime history of maltreatment on the child's internalizing and externalizing symptoms.

RESULTS

Multigenerational developmental cascades were identified. Maternal history of maltreatment predicted chronic maltreatment for offspring, which in turn predicted greater internalizing (β = .167, p = .03) and externalizing symptoms (β = .236, p = .005) in late childhood. Similarly, children born to mothers who began childbearing in adolescence were more likely to experience chronic maltreatment during childhood and develop subsequent symptoms. Effects were found over and above a parallel cascade from maternal maltreatment to offspring psychopathology via a maternal depression pathway.

CONCLUSION

Findings reveal targets to prevent or ameliorate progressions of intergenerational risk pathways.

Child abuse in the West Bank of the occupied Palestinian territory (WB/oPt): social and political determinants

BACKGROUND

Child maltreatment is a global epidemic. It affects morbidity, mortality, social behavior, wellbeing, and quality of life of children. This study aims to assess prevalence of child abuse in the West Bank (WB) of the occupied Palestinian territory (oPt) and to determine some of its social and political associated factors.

METHODS

We analyzed secondary data obtained from a cross sectional study conducted on a sample representing Palestinian children on the West Bank and using the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) tool. The ISPCAN Child Abuse Screening Tool for parents (ICAST-P) questionnaire was completed by 1107 Palestinian mothers to estimate physical and emotional child abusive practices at home for children aged 0-12 years. Univariate, bivariate, and multivariate binary logistic regression analyses were performed using the SPSS® version 20 to assess prevalence and predictors of child abuse.

RESULTS

Overall, around 34% of the West Bank-children were abused by their mothers. Results of the logistic regression analysis indicated that male children, children of younger mothers, children whose fathers were with low levels of education, children whose mothers reported low levels of parental warmth, and children whose parents were exposed to political violence were at greater risk of being abused.

CONCLUSIONS

Child abuse is highly prevalent among children of the Palestinian society in the West Bank. Policy makers need to pay more attention to this epidemic. The association between child abuse and political violence found in this study makes a just solution for Palestinians essential for improving the welfare of children and families.

Family-Centered Primary Care for Teen Parents and Their Children

Although the teen birth rate in the United States continues to decline, births remain disproportionately high among disadvantaged teens and teens of color. The vulnerabilities and resilience of teen parents are described from a historical context, with recommendations for advancing primary care of these families. We endorse comprehensive primary care and clinical practices that capitalize on the strengths and resilience of these families while recognizing the social inequities that compromise their health and development. To strengthen the bonds among young mothers, fathers, and children, we recommend family-centered primary care services that are of a youth- and father-friendly, nonstigmatizing, strength-based, and trauma-informed nature.

The relationship between alpha asymmetry and ADHD depends on negative affect level and parenting practices

Atypical frontal alpha asymmetry is associated with the approach/withdrawal and affective processes implicated in many psychiatric disorders. Rightward alpha asymmetry, associated with high approach, is a putative endophenotype for attention deficit/hyperactivity disorder (ADHD). However, findings are inconsistent, likely because of a failure to consider emotional heterogeneity within the ADHD population. In addition, how this putative risk marker interacts with environmental factors known to increase symptom severity, such as parenting practices, has not been examined. The current study examined patterns of alpha asymmetry in a large sample of adolescents with and without ADHD, including the moderating role of negative affect and inconsistent discipline. Resting-state EEG was recorded from 169 well-characterized adolescents (nADHD = 79). Semi-structured clinical interviews and well-validated rating scales were used to create composites for negative affect and inconsistent discipline. The relationship between alpha asymmetry and ADHD diagnosis was moderated by negative affect. Right asymmetry was present only for those with ADHD and low levels of negative affect. In addition, greater right alpha asymmetry predicted severity of ADHD symptoms for those with the disorder, but only in the context of inconsistent parenting practices. Results confirm right alpha asymmetry is a possible endophenotype in ADHD but highlight the need to consider emotional heterogeneity and how biological risk interacts with child environment in order to fully characterize its relationship to disorder liability and severity.