Does maltreatment beget maltreatment? A systematic review of the intergenerational literature

Constructing the 'zero family': Breaking the intergenerational transmission of maltreatment from the perspective of care-experienced parents

BACKGROUND

Several studies have explored the mechanisms of intergenerational transmission of child maltreatment (ITCM), which also involves care-experienced parents; however, what is less explored is their direct experience, especially regarding resilience processes.

OBJECTIVE

Developing the theoretical framework of ITCM through an exploration of the perspectives of those who appear to have interrupted it.

PARTICIPANTS AND SETTING

A sample of 27 Italian parents - with experience in foster and/or residential care - who have broken the ITCM, completed an in-depth interview between May 2021 and February 2023.

METHODS

A Constructivist Grounded Theory (Charmaz, 2014) approach was adopted in carrying out the interviews, which focused on daily experiences of parenting (Morgan, 2011) and on factors perceived as supporting ITCM interruption. Data were analyzed using open, focused and theoretical coding; the analysis itself was discussed with a consultive board of care-experienced parents.

RESULTS

The study highlighted important aspects that, from parents' perspectives, play a role in breaking ITCM: for instance, how their parenting experience is a challenging process of constructing what they term 'zero family'. Furthermore, starting a family from scratch requires coming to terms with the past, re-imagining oneself as a parent, and managing the complexity of everyday life despite such tensions.

CONCLUSIONS

The results throw light on how the transition to parenthood itself is perceived as a significant developmental opportunity for the interruption of ITCM. However, many problems persist, foregrounding the relevance of discussing possible supports to strengthen parenting agency and skills. Such a discussion should therefore be increasingly informed by ecological approaches and parents' perspectives (also on everyday practices and life contexts), thus avoiding the risk of pathologizing responses.

The future of intergenerational transmission research: A prospective, three-generation approach

Dr. Dante Cicchetti's pioneering theory and research on developmental psychopathology have been fundamental to the proliferation of research on intergenerational transmission over the last 40 years. In part due to this foundation, much has been learned about continuities and discontinuities in child maltreatment, attachment, parenting, and psychopathology across generations. Looking towards the future, we propose that this field stands to benefit from a prospective, three-generation approach. Specifically, following established prospective, longitudinal cohorts of children over their transition to parenting the next generation will afford the opportunity to investigate the developmental origins of intergenerational transmission. This approach also can address key outstanding questions and methodological limitations in the extant literature related to the confounding of retrospective and prospective measures; examination of mediators and moderators; and investigation of the roles of biology, environment, and their interplay. After considering these advantages, we offer several considerations and recommendations for future research, many of which are broadly applicable to the study of two or more generations. We hope that this discussion will inspire the leveraging of existing prospective cohorts to carry forward Dr. Cicchetti's remarkable contributions, with the ultimate aim to inform the development of preventions and interventions that disrupt deleterious intergenerational cycles.

Levels of Involvement with Child Protection Services Associated with Early Adolescent Police Contact as a Victim and Person of Interest

The relationship between childhood maltreatment and subsequent offending/victimization is well established. However, the magnitude of this relationship for different levels of child protection services (CPS) involvement is poorly understood, due to measurement issues, lack of longitudinal data, and reliance on reports of substantiated maltreatment, which can underestimate the impact of maltreatment. This study examined associations between CPS involvement during childhood (ages 0 to <11 years) and police services contact (as a victim and/or a person of interest) for criminal incidents in early adolescence (11 to ~14 years), differentiated according to levels of CPS involvement (i.e., no risk of significant harm [non-ROSH], unsubstantiated ROSH, substantiated ROSH, and out-of-home care; each examined relative to no CPS contact). Data for 71,465 children were drawn from the New South Wales Child Development Study, an intergenerational, longitudinal investigation that uses administrative records from CPS and police alongside other health, justice, and education data. Multinomial regression analyses were conducted to determine associations between increasing levels of CPS involvement and police contact as a victim only, a person of interest only, and as both victim and person of interest while accounting for covariates (i.e., child's sex, Aboriginal, and/or Torres Strait Islander background, socioeconomic status, maternal age at child's birth, and parental offending history). Children exposed to any of the four levels of CPS involvement had higher odds of police contact, relative to children with no CPS involvement. Odds ratios were higher for contact with police as both a victim and a person of interest, compared to police contact as a victim or a person of interest only. These findings highlight that children with even unsubstantiated CPS reports (i.e., non-ROSH and unsubstantiated ROSH reports) are at heightened risk of police contact compared to children who are unknown to CPS, underlining the need to support all families in contact with CPS.

The Prevalence, Predictors, and Health Consequences of Disagreement in Reports of Child Maltreatment Exposure

The purpose of this study was to examine the prevalence, predictors, and consequences of disagreement between prospective caregiver and retrospective child reports of childhood physical and emotional maltreatment. The design was a secondary analysis of data from the Avon Longitudinal Study of Parents and Children, a three-decade long UK-based birth cohort. Prospective caregiver reports were in poor to fair agreement with retrospective child reports for physical and emotional maltreatment exposure, with caregivers tending to underreport exposure. Disagreement between reporters was associated with increased risk of depressive symptoms and substance use severity, but decreased risk for mental health diagnoses. Screening measures of childhood maltreatment exposure should take caution against using measures from different reporters interchangeably (i.e., from mother versus child). Disagreement in reports may indicate unmet need for mental health evaluation.

A prospective longitudinal study of multidomain resilience among youths with and without maltreatment histories

The majority of children with maltreatment histories do not go on to develop depression in their adolescent and adult years. These individuals are often identified as being "resilient", but this characterization may conceal difficulties that individuals with maltreatment histories might face in their interpersonal relationships, substance use, physical health, and/or socioeconomic outcomes in their later lives. This study examined how adolescents with maltreatment histories who exhibit low levels of depression function in other domains during their adult years. Longitudinal trajectories of depression (across ages 13-32) in individuals with (n = 3,809) and without (n = 8,249) maltreatment histories were modeled in the National Longitudinal Study of Adolescent to Adult Health. The same "Low," "increasing," and "declining" depression trajectories in both individuals with and without maltreatment histories were identified. Youths with maltreatment histories in the "low" depression trajectory reported lower romantic relationship satisfaction, more exposure to intimate partner and sexual violence, more alcohol abuse/dependency, and poorer general physical health compared to individuals without maltreatment histories in the same "low" depression trajectory in adulthood. Findings add further caution against labeling individuals as "resilient" based on a just single domain of functioning (low depression), as childhood maltreatment has harmful effects on a broad spectrum of functional domains.

Intergenerational effects of child maltreatment on adolescents' anxiety and depression in Ethiopia: the important mediating and moderating roles of current psychological distress

BACKGROUND

Child abuse is widespread around the world, and one continent with particularly high rates is Africa. Research in high- and middle-income countries shows the cascading effect of parental history of child abuse and neglect on adolescents' maltreatment and, in turn, on mental health problems. This cascade has been reported in young children but has rarely been studied in parent-adolescent dyads or in low-income countries (LICs). The goal of this study was to test intergenerational associations of child abuse and neglect and to examine how these experiences are in turn associated with youth anxiety and depression in an LIC.

METHODS

A total of 231 adolescents (age: 13-21 years) and 185 of their parents (n = 90 fathers and n = 95 mothers) were recruited from secondary schools in Addis Abeba, Ethiopia. Using a cross-sectional design, participants completed a set of questionnaires assessing child maltreatment (in adolescence and own past history in parents), parental psychological distress, youth depression and anxiety, and sociodemographic factors.

RESULTS

The frequencies of child maltreatment exposure were 68% for adolescents and 65% for their parents (when they were a child). Fifty-one percent and 42% of adolescents had borderline to clinical levels of anxiety and depression symptoms, respectively. Adolescents of parents with a history of child abuse and neglect also reported higher exposure to maltreatment themselves (p < 0.001). Current paternal, but not maternal, psychological distress mediated this intergenerational association of maltreatment experiences (95% CI [1.164, 9.467]). We further found parents' psychological distress to be a significant moderator of the indirect pathways of the intergenerational effect of child maltreatment on adolescents' anxiety and depression (95% CI [- 0.770, - 0.012]).

CONCLUSIONS

We found child maltreatment to be intergenerationally associated, and this effect subsequently affected adolescents' anxiety and depression through different pathways supporting the cascading effects across generations. Intervention plans may be effective through an array of possible indirect pathways and encourage the implementation of multiple access points to facilitate change in the lives of affected youth in Africa.

Intergenerational (Dis)continuity of Child Maltreatment: Variation by Parents' Childhood Victimization Experiences and Sex

This longitudinal population-based study examines the association between maltreatment victimization experiences and the likelihood of intergenerational (dis)continuity of maltreatment. Our data include all individuals born in 1983/1984 in Queensland (QLD), Australia who are registered as parents via birth records and who experienced system contacts for maltreatment victimization in childhood (n = 2906). Child safety data on system contacts as a child victim and person responsible for harm to a child were obtained from the Department of Children, Youth Justice and Multicultural Affairs. Out-of-home care experiences and maltreatment frequency, timing, and type were examined. Results indicated that childhood maltreatment experiences significantly differed between parents who were not subsequently responsible for harm to a child (cycle breakers) and parents who were subsequently responsible for harm to a child (cycle maintainers). Different patterns of association were observed across sex. These findings highlight the importance of recognizing the heterogeneity of victim maltreatment experiences and associated risk of maltreatment for their children, and can inform effective and targeted interventions by tailoring these by sex and developmental period.

Improving Parent-Child Relationships for Young Parents in the Shadow of Complex Trauma: A Single-Case Experimental Design Series

This study provides a preliminary evaluation of a dyadic intervention for young parents with a history of complex trauma, Holding Hands Young Parents (HHYP). Four mothers (17-22 years) and toddlers (12-33 months) completed the intervention, designed to improve parent-child relationships, parental self-regulation, self-efficacy and mental health, and child behaviour/emotional problems. An A-B single case experimental design series with follow-up and randomised baseline, used observational and self-report measures throughout. Linear mixed models demonstrated improvement in reciprocity and parental sensitivity over the treatment phase, with no evidence of shifts in scores at beginning or end of treatment. There was no evidence for changes in child engagement, negative states, intrusiveness or withdrawal. Reliable Change Index indicated improvement in parent-reported self-regulation, self-efficacy, stress and child emotional/behavioural problems from baseline to follow-up for all four mothers; depression showed reliable change for three. This study demonstrates relational change between young parents and their toddlers and provides preliminary data on the HHYP protocol.

Maternal Childhood Maltreatment and Adolescent Internalizing Problems: The Mediating Role of Maternal Depressive Symptoms and Offspring Childhood Maltreatment

Research has demonstrated the predictive effect of maternal childhood maltreatment on adolescent internalizing problems. However, few studies have explored the mediating mechanisms of how mothers' experiences of childhood maltreatment are transmitted to their offspring's internalizing problems over time. The present multi-informant study investigated the potential mediating effects of maternal depressive symptoms and offspring's childhood maltreatment experiences on the relation between maternal childhood maltreatment and adolescent internalizing problems. A total of 823 Chinese youth (43.4% girls; Mage = 10.26 years, SD = 0.94) and their mothers participated in a two-wave longitudinal study with one-year intervals. Mothers reported their experiences of childhood maltreatment and depressive symptoms, while youth reported their childhood maltreatment experiences and internalizing problems. Findings of path analysis indicated that maternal emotional abuse at T1 could significantly predict adolescent internalizing problems at T2, after controlling for a baseline of adolescent internalizing problems. Maternal emotional abuse, emotional neglect, and physical neglect at T1 can influence adolescent internalizing problems at T2 through maternal depressive symptoms at T1 to adolescent internalizing problems at T1. Maternal emotional abuse at T1 displayed statistically significant indirect effects on adolescent internalizing problems at T2 successively through the pathway from adolescent emotional abuse at T1 to adolescent internalizing problems at T1. The findings supported the cycle of maltreatment hypothesis. The present study highlights the intergenerational link between maternal childhood maltreatment and adolescent internalizing problems, as well as reveals the mediating mechanisms in this relation.

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.

Breaking the Cycle of Family Violence: A Critique of Family Violence Interventions

As the intergenerational transmission of family violence is associated with numerous negative outcomes, interventions are needed to interrupt this cycle. Our aim is to review the family violence intervention literature and to assess whether and how interventions interrupt the intergenerational transmission of family violence. Papers about interventions were identified through database searches (PubMed, JSTOR, CINAHL, PsycINFO), supplemented by review of references and relevant review papers. Eligibility criteria included: empirical studies detailing interventions to interrupt or prevent child abuse/maltreatment and/or intimate partner violence, published between January 2000 and August 2020, and written in English. Of the 14 papers included in this narrative review, only 3 explicitly stated that they aimed to break the cycle of family violence; 12 papers came from high-income countries, and 10 focused on individuals, with half focusing on mothers. We identify effective intervention approaches, including long-term one-on-one coaching and home visits to improve parenting. Results demonstrate a dose-response relationship, suggesting the lasting value of increased intervention frequency and duration. We highlight gaps in the literature, including the need for interventions in low-income countries, and those geared toward fathers and neighborhoods/communities. We also examine the many methodological challenges of this work, such as possible biases related to the use of retrospective data, lack of objective outcome measures, and absence of long-term follow-up. Our recommendations for future research include incorporating trauma-informed frameworks, developing standardized definitions and measures to facilitate the comparison of intervention results, and designing more interventions specifically for fathers/husbands and for the prevention of intimate partner violence.

The Association Between Adverse Childhood Experiences and Different Types of Offending Behavior: An Examination Across Two Generations of British Males

Research has established a relationship between trauma exposure, often conceptualized as Adverse Childhood Experiences (ACEs), and offending, with some evidence suggesting that both trauma and offending can be transmitted from one generation to the next. Further, while some evidence suggests that experiencing a high number of ACEs is associated with different types of offenses, it is not known whether these associations are similar across generations. The current study aims to address this gap in knowledge by examining the effects of ACEs on different offense types across two generations, utilizing data from a longitudinal study of British male participants and their male children. Results suggest that high ACE scores are associated with several offense types within generations, but the effect of parental ACEs on the subsequent generation's offending was weak. Alongside a discussion of these findings, study limitations and future research directions are also presented.

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.

Intergenerational Transmission of Child Abuse Among Married Women in South Korea: A Multigroup Analysis of Empathetic Communication (TSL: Thanks, Sorry, and Love)

Intergenerational transmission of child abuse (hereinafter referred to as ITCA) has been continuously reported. Supportive relations with others have also been discussed as a protective factor to prevent this cycle. However, research has mainly investigated supportive adult and peer relationships formed in childhood, with little discussion of the impact of supportive partner relationships formed after becoming an adult. This study examined whether empathetic communication (hereinafter referred to as TSL: "Thanks, Sorry, and Love") attenuates the transmission of married women's child abuse experiences to subsequent generations mediated by intimate partner violence (hereinafter referred to as IPV). TSL is a communication strategy that promotes positive communication between intimate partners. We expected TSL to promote positive communication between couples through a process of self-transformation. Data from 1,122 married women were obtained from a nation-wide survey conducted in South Korea. All the survey respondents lived with partners and their own children simultaneously. For this study, structural equation model multigroup analysis was conducted to determine whether the pathways would be attenuated by TSL levels, showing that a high level of TSL communication attenuated the ITCA mediated by IPV. However, this process was maintained in the low-level TSL group. TSL is thus a protective factor against the ITCA. The findings suggest that healing processes can occur not only through childhood relationships but also through those formed after adulthood. Ultimately, to help victims recover, it is necessary to expand communication programs such as TSL that help victims learn how to express their feelings through healthy relationships with their partners.

Child-to-Parent Violence Specialist and Generalist Perpetrators: Risk Profile and Gender Differences

Like other forms of domestic violence, child-to-parent violence (CPV) is a social and health-related problem. The identification of risk factors has preventive and therapeutic implications. This paper analyzes the risk profiles and gender differences of 206 CPV cases between 12 and 28 years of age (58% males) from clinical and judicial contexts in Spain, assessed using the Child to Parent Violence Risk (CPVR) Assessment tool. Two profiles were compared according to the extent of their violence: those using only CPV (specialist, 64.1%) and those also using other types of violence (generalist, 35.9%), as coded by professionals working with the cases. Generalist perpetrators had a significantly higher prevalence in terms of the bidirectionality of the violence (being victims at home), bullying victimization, empathy problems, anger management issues, attitudes justifying violence, antisocial behavior, failure of previous interventions, violence between parents, cohabitation problems other than CPV, problematic education style, and inversion of the hierarchy. Females were less likely to be generalists, and, in the case of female specialists, violence from parents and issues in the family context may have been among the main explanations for their violence. The results suggest differences between groups, which is consistent with previous research, but also the need for more accurate typological classification methods.

Attachment, Mentalizing and Trauma: Then (1992) and Now (2022)

This article reviews the current status of research on the relationship between attachment and trauma in developmental psychopathology. Beginning with a review of the major issues and the state-of-the-art in relation to current thinking in the field of attachment about the impact of trauma and the inter-generational transmission of trauma, the review then considers recent neurobiological work on mentalizing and trauma and suggests areas of new development and implications for clinical practice.

The effects of maternal prenatal depression on child mental health: The moderating role of maternal childhood trauma

BACKGROUND

There is a large body of evidence suggesting that maternal prenatal depression significantly predicts mental health problems in children. However, little is known about the role of maternal childhood trauma within this effect.

METHODS

The current study utilized a sample of 187 mother-child dyads (51.3 % boys) from the Shanghai Sleep Birth Cohort (SSBC), a six-year prospective longitudinal study. The effects of maternal depression at late pregnancy (Center for Epidemiological Survey-Depression Scale) on the child mental health at six years old (Strengths and Difficulties Questionnaire) were analyzed, with different types of maternal childhood trauma (Childhood Trauma Questionnaire) being examined as moderators.

RESULTS

The results showed that maternal prenatal depression positively predicted child mental health problems (β = 0.13, p < .05) and there was a significant moderating effect of maternal childhood emotional abuse (β = -0.05, p < .05); that is, in mothers with high childhood emotional abuse, child mental health problems remained high regardless of maternal prenatal depression (β = -0.02, p = .78), while in mothers with low childhood emotional abuse, maternal prenatal depression significantly predicted child behavioral and emotional problems (β = 0.20, p < .05).

LIMITATIONS

Relatively high socio-economic status samples, retrospective reports of maternal childhood trauma and the single reporter were the limitations of this study.

CONCLUSIONS

The findings provided new insights into the impact of maternal prenatal depression on child mental health, highlighting the importance of intervention efforts targeting mothers with prenatal depression and childhood trauma history.

Homotypical and Heterotypical Intergenerational Continuity of Child Maltreatment: Evidence from a Cohort of Families Involved with Child Protection Services

Child maltreatment (CM) in one generation can predict CM in the next generation, a concept known as intergenerational continuity. Yet, the form taken by the intergenerational continuity of CM remains unclear and fathers are mostly absent from this literature. This longitudinal study aimed to document patterns of intergenerational continuity of substantiated CM, on the maternal and paternal sides, by examining the presence of: homotypical CM, which is the same type of CM in both generations; and heterotypical CM, which is different CM types in both generations. The study included all children substantiated for CM with the Centre Jeunesse de Montréal between 1 January 2003, and 31 December 2020, with at least one parent who was also reported to that agency during their childhood (n = 5861 children). The cohort was extracted using clinical administrative data, and logistic regression models were tested with the children's CM types as the dependent variables. Homotypical continuity was found for: (1) physical abuse on the paternal side; (2) sexual abuse on the maternal side; and (3) exposure to domestic violence on the maternal side. Heterotypical continuity was also prevalent, but to a lesser extent. Interventions helping maltreated parents overcome their traumatic past are essential to foster intergenerational resilience.

Intergenerational Pathways Linking Mothers' Adverse Childhood Experiences and Children's Social-Emotional Problems

Despite the persistent hypothesis that adverse childhood experiences (ACE) have intergenerational implications, empirical research documenting the effects and the mechanisms of transmission remains underdeveloped. This study examined the intergenerational effects of mothers' adverse childhood experiences on their offspring's social-emotional development and whether the association was mediated by mothers' mental health, adult adversity, and perceptions of paternal involvement. The study sample included 831 mothers (19-49 years old, 47.5% White) with children aged 12-48 months who participated in a longitudinal investigation of low-income families in Wisconsin. ACEs were assessed by home visitors, and two waves of survey data were collected by researchers to assess demographics, mediators, and social-emotional outcomes. A path analysis showed that the association between maternal ACEs and children's social-emotional problems was fully mediated, with postpartum mental health acting as a primary mechanism. Implications for intervention and future research directions are discussed.

Child maltreatment and victimization

It is estimated that up to 25% of all children growing up worldwide experience child maltreatment, making it a global emergency with substantial individual and public health consequences. This chapter addresses one of the most societally pervasive consequences of child maltreatment which is known as the "cycle of victimization." This concept depicts the increased risk of maltreated individuals to victimize others later in life, both within and outside the family environment. To understand the architecture of this victimization cycle, the chapter further sheds light on neurocognitive mechanisms aiding different forms of victimization and the buffering role of social support that could help break the cycle of victimization. Advancing our understanding of these complex and interrelated mechanisms will ultimately facilitate the design and implementation of more targeted early treatments and (preventive) interventions and support a move toward a safer society.

A Prospective Cohort Study on the Intergenerational Transmission of Childhood Adversity and Subsequent Risk of Psychotic Experiences in Adolescence

BACKGROUND AND HYPOTHESIS

Previous studies have shown a robust relationship between childhood adversity and subsequent psychotic symptoms. However, the role of familial risk factors underlying this relationship remains largely unclear. Here, we tested whether offspring childhood adversity and postnatal maternal psychopathology mediated the relationship between maternal childhood adversity and offspring psychotic experiences.

STUDY DESIGN

N = 3068 mother-offspring dyads were included. Maternal history of childhood adversity was retrospectively assessed using the Childhood Trauma Questionnaire during pregnancy. Maternal psychopathology was assessed during and after pregnancy. Twenty-four offspring childhood adversities were assessed by maternal interview when the child was 10 years old. Offspring psychotic experiences were examined using self-report at 14 years. Structural equation mediation models were conducted to explore whether maternal postnatal psychopathology and offspring childhood adversities sequentially mediated the relationship between maternal childhood adversity and offspring psychotic experiences. Analyses were adjusted for sociodemographic confounders.

STUDY RESULTS

Maternal history of childhood adversity was associated with offspring childhood adversities (β = 0.12, 95% CI: 0.09 to 0.16). Offspring childhood adversity mediated the association of maternal childhood adversity with offspring hallucinations (βindirect effect = 0.008, 95% CI: 0.002 to 0.014, proportion mediated = 16.3%) and delusions (βindirect effect = 0.006, 95% CI: 0.000 to 0.012, proportion mediated = 13.1%).

CONCLUSIONS

Intergenerational transmission of childhood adversity can be considered of relevance in the etiology of psychosis vulnerability and can potentially serve as a modifiable risk factor.

Traumatic head injury due to child maltreatment: epidemiology, cost analysis, and impact of prevention

BACKGROUND

Traumatic head injury due to child maltreatment (THI-CM), also known as abusive head trauma (AHT), is a significant public health problem due to the wide array of consequences affecting multiple domains of a child's health and development. Several studies have evaluated its cost on healthcare systems, families, and societies. Many jurisdictions have implemented caregiver education programs to prevent THI-CM.

OBJECTIVES

This paper aims to provide a brief overview of the epidemiology and cost analysis of THI-CM and discuss its prevention and the intergenerational transmission of child maltreatment.

METHODS

Although not systematic, a literature search of original articles published from 2000 to 2022 in English and French was undertaken using the following databases: PubMed, EMBASE (Ovid), and PsycINFO (OVID). The search combined terms related to traumatic head injury and child maltreatment, with terms related to its cost and prevention. Studies of children aged 0-5 years old were included. The authors completed a screen of the titles and abstracts to determine relevance with respect to this article.

RESULTS

Globally, although THI-CM accounts for a small proportion of cases of child maltreatment, there is a high incidence of death and neurological sequelae compared to other causes of head trauma.The incidence of THI-CM is likely underestimated due to the lack of standardized definitions, differences in reporting, and challenges in identifying less severe cases. Cost analysis studies reveal the significant short- and long-term costs associated with THI-CM. Caregiver education programs have been studied and implemented in many centers and have shown varying but promising results.

CONCLUSION

A multi-pronged approach to prevention efforts should be considered to support families and help to prevent THI-CM and maltreatment throughout childhood.

Factors Contributing to Violent Discipline in the Classroom: Findings From a Representative Sample of Primary School Teachers in Tanzania

The need for intervention strategies aiming to reduce teachers' use of violent discipline methods has been expressed repeatedly, especially for countries where this practice is socially and legally accepted. Nevertheless, initial targets for interventions are not clearly identified, as factors contributing to teachers' use of violence are still understudied. In the present study, we examined the interplay between teachers' own experiences of violence, their attitudes, current stress, and their use of violent discipline in a representative sample of 173 Tanzanian primary school teachers (53.7% female, M_age = 38.1 years, SD_age = 10) using structural equation modeling. Our model showed good model fit (χ² [48, n = 173] = 78.058 (p = .004), CFI = .962, TLI = .948, RMSEA = .060 [90% CI [.034, .084], PCLOSE = .233], SRMR = .048). Results indicated direct associations between positive attitudes toward violent discipline (β = .41), stress (β = .23), and teachers' own experiences of violence (β = .21) with teachers' use of violence. Teachers' own experiences of violence were significantly associated with positive attitudes (β = .39), and these significantly mediated the association between teachers' own experiences of violence and their use of violent discipline (β =.23). Our findings underscore the relevance of past experiences, societal norms, and current working conditions in understanding teachers' violence against students. Interventions aiming to reduce teachers' use of violent discipline may focus on stress management, societal norms, personal beliefs on violent discipline, and how teachers' own previous experiences of violence may influence teacher's disciplining behavior.

Centering Our Voices: Experiences of Violence Among Homeless African American Women

Women experiencing homelessness who are also survivors of violence require uniquely tailored programs to accommodate complex needs. To understand how violence shaped the lives of formerly homeless African American women, an instrumental case study design and community-based participatory research approach was utilized in this qualitative study. Focus group interviews with graduates (N = 40) from a long-term transitional housing program were conducted. Using thematic analysis, identified themes included: cycles of violence, violence in the community, relationships with children, and coping with violence. These themes illustrated survivors' growth through supportive programming and highlighted services dedicated to empowering women who have experienced violence.

Factors Contributing to Violence Against Children: Insights From a Multi-informant Study Among Family-Triads From Three East-African Refugee Camps

Parental violence poses a considerable, yet mitigable risk for the mental health and well-being of refugee children living in resource-poor refugee camps. However, little is known about potential risk factors for parental violence in these settings. Using an ecological systems perspective and a multi-informant approach, we investigated ontogenic (parental childhood experiences of violence), microsystem (parents' and children's psychopathology) and exosystem (families' monthly household income) risk factors for child-directed parental violence in a sample of 226 Burundian families living in refugee camps in Tanzania. Data were collected through individual structured clinical interviews with mothers, fathers, and children. In the child-report path model [χ² (6) = 7.752, p = .257, comparative fit index (CFI) = 0.99, root mean square error of approximation (RMSEA) = 0.036 (p = .562)], children's posttraumatic stress disorder (PTSD) symptoms, externalizing symptoms and paternal PTSD symptoms were positively associated with violence by both parents. Maternal psychosocial impairment was positively associated with child-reported paternal violence. In the parent-report path model [χ² (6) = 7.789, p = .254, CFI = 0.97, RMSEA = 0.036 (p = .535)], children's externalizing problems as well as a lower monthly household income were positively related to maternal violence. Each parent's childhood victimization was positively linked to their use of violence against children. Maternal psychosocial impairment and paternal alcohol abuse were positively associated with paternal violence. Child and paternal psychopathology, maternal psychosocial impairment, parents' childhood victimization, and families' socioeconomic status may be important targets for prevention and intervention approaches aiming to reduce parental violence against refugee children living in camps.

Emotion regulation as mediator between childhood adversity and psychopathology: A meta-analysis

Childhood adversity is a major risk factor for multiple forms of psychopathology, and recent efforts have focused on understanding the underlying psychological mechanisms. One outstanding candidate is emotion regulation, which has been associated with both childhood adversity, and psychopathology. Based on the available evidence, the present meta-analysis set out to investigate the mechanistic involvement of emotion regulation in the relation between childhood adversity and psychopathology. Systematic searches in three databases (PubMed; PsycINFO; Web of Science) identified 215 eligible studies. Using meta-analytic structural equation modeling, we fitted a partial mediation model to the available data across studies, in which childhood adversity was related to psychopathology both directly and through emotion regulation. Multiple emotion regulation dimensions were analyzed, including emotion regulation difficulties and the habitual use of rumination, distraction, reappraisal, and suppression. Measures of psychopathology included a wide range of internalizing and externalizing symptoms in both clinical and non-clinical samples. The results indicated that childhood adversity was positively associated with emotion regulation difficulties, as well as with the habitual use of rumination and suppression. In turn, these measures of emotion regulation were positively associated with psychopathology. Habitual reappraisal use showed negative relations with both childhood adversity and psychopathology. All these emotion regulation measures were supported as mediators in the relation between childhood adversity and psychopathology. In contrast, distraction was not related to childhood adversity or psychopathology, and its mediator role was not supported. These results suggest that altered emotion regulation is a consistent marker of childhood adversity and contributes to risk of psychopathology.

Childhood adversity and impaired reward processing: A meta-analysis

BACKGROUND

Childhood adversity (CA) is associated with increased risk of psychopathology, and reward processing (RP) may be one of the underlying mechanisms. However, evidence on impaired RP in childhood adversity is theoretically and methodologically heterogeneous.

OBJECTIVE

To provide a quantitative overview of studies on the relation between childhood adversity and RP assessed at the behavioral and subjective levels, and identify differences between studies that influence the effect size.

PARTICIPANTS AND SETTING

Twenty-seven studies (overall N = 6801) were included.

METHODS

Peer-reviewed publications describing empirical studies on the relation between CA and behavioral and self-report measures of RP in humans were identified through systematic searches in six bibliographic databases. Effect sizes (r) were pooled using random-effects models. The potential moderator role of RP dimension, type of RP assessment, type of childhood adversity assessment, and age were examined.

RESULTS

Results indicated a small, but consistent association between CA and impaired RP (r = 0.12; 95% CI: 0.07, 0.16), with medium heterogeneity (I² = 62.43). The effect size was significantly larger (i.e., medium-sized) in studies that focused on reward learning rather than reward valuation and reward responsiveness; used cognitive tasks rather than self-report assessments of RP; and relied on official records rather than subjective reports of CA. There was evidence of publication bias, but overall effect size remained significant after imputation.

CONCLUSIONS

These results suggest that multidimensional RP impairments (e.g., deficits in reward learning, biased reward valuation) are a consistent marker of CA, and may represent mechanisms underlying the increased risk of psychopathology.

Victimization history in female forensic psychiatric patients with intellectual disabilities: Results from a Dutch multicenter comparative study

BACKGROUND

Victimization is highly prevalent in individuals with mild intellectual disability (MID) or borderline intellectual functioning (BIF) and is an important risk factor for mental health problems and violent behavior. Not much is known, however, about victimization history in women with MID-BIF admitted to forensic mental health care.

AIMS

The aim of this multicenter study is to gain insight into victimization histories and mental health problems of female forensic psychiatric patients with MID-BIF.

METHODS

File data were analyzed of 126 women with MID-BIF who have been admitted to one of five Dutch forensic psychiatric hospitals between 1990 and 2014 and compared to data of 76 female patients with average or above intellectual functioning and to a matched sample of 31 male patients with MID-BIF.

RESULTS

All forensic patients had high rates of victimization, but women with MID-BIF showed an even higher prevalence of victimization during both childhood and adulthood and more complex psychopathology compared to female patients without MID-BIF. Compared to male forensic patients with MID-BIF, women with MID-BIF were more often victim of sexual abuse during childhood. During adulthood, the victimization rate in these women was more than three times higher than in men.

CONCLUSIONS

Victimization is a salient factor in female forensic patients with MID-BIF and more gender-responsive trauma-focused treatment is needed.

Early Abusive Relationships-Influence of Different Maltreatment Types on Postpartum Psychopathology and Mother-Infant Bonding in a Clinical Sample

Postpartum psychopathology is a well-documented risk factor for impaired mother-infant bonding and thus child development. Increasingly, the focus of research in this area lies on maternal adverse childhood experiences that mothers bring into the relationship with their own baby, especially regarding the possible intergenerational transmission of traumatic experiences. Several studies showed that there is no direct link between child maltreatment and mother-infant bonding as one part of mother-child relationship, but that this link is mediated by postpartum psychopathology. To date, few studies examined differential effects between sexual, physical, and emotional abuse, and physical and emotional neglect, especially in a clinical sample. The aim of this study is to investigate whether the relationship between child maltreatment, psychopathology, and mother-infant bonding can be found for different forms of child maltreatment in patients of a mother-baby unit. Our sample consisted of 330 mothers of a mother-baby-unit in a psychosomatic clinic, who filled out self-report measures at time of admission. Mothers reported on maternal child maltreatment history with the Childhood Trauma Questionnaire, on current psychopathology with the Brief Symptom Inventory, and on mother-infant bonding with the Postpartum Bonding Questionnaire. Mediation analyses were performed with psychopathology as mediator, child maltreatment history as independent, and mother-infant bonding as dependent variable. There was no total effect of child maltreatment on mother-infant bonding. However, there were significant indirect effects of child maltreatment in general (ab = 0.09) and of the various forms of child maltreatment on mother-infant bonding via psychopathology (0.16 ≤ ab ≤ 0.34). The strongest effect was found for emotional abuse. After controlling for psychopathology, the direct effect of physical abuse on mother-infant bonding presented as a negative significant effect. This indicates that the more severe the physical abuse experienced, the better the self-reported bonding. A similar, but non-significant trend was found for sexual abuse. Our findings highlight the importance of assessing neglect forms of child maltreatment as well as abuse in women during the perinatal period. It further supports initial findings that different forms of child maltreatment can have differential effects on mother-infant bonding as one aspect of the mother-child relationship. Further research should include observational data to compare with self-report measures.

The role of parent-to-child maltreatment in the pathway of self-reported depressive symptoms in Pakistani adolescents

Background

Parent-to-child maltreatment has been demonstrated to drastically affect a child’s mental well-being and plays a significant role in developing depressive symptoms. However, little is established about the effect of frequency of parent-to-child maltreatment on the development of depressive symptoms among Pakistani adolescents.

Methods

A longitudinal prospective study was conducted, from 2015 to 2017, with 800 adolescents aged 11–17 years old recruited from 32 systematically selected urban and peri-urban areas of Karachi. First, these adolescents were screened for parent-to-child maltreatment in 2015 in a cross-sectional survey. Children with diagnosed psychiatric conditions were excluded from the study. In the second phase, these individuals were followed for 2 years to investigate the symptoms of depressive disorder using a validated tool, “CES-D (Center for Epidemiological Studies) Depression scale.” The Cox proportional algorithm was used to examine the relationship between the frequency of parent-to-child maltreatment and depressive symptoms.

Results

Approximately 11% of frequently, 9% of occasionally parent-to-child, and 7%of negligibly maltreated adolescents reported depressive symptoms over 2 years. The other significant predictors of depressive symptoms were no formal education of the child (RR: 3.15, 95% CI: 1.35–7.34), presence of stressful home environment (RR: 2.19, 95% CI: 1.22–3.94), and having both uneducated parents (RR: 1.70, 95% CI: 0.90–3.21). The frequently maltreated females were found to have 4 times the higher risk compared to rarely maltreated males. In addition, frequently maltreated males were twice likely to develop depressive symptoms.

Conclusion

The results suggested that frequent parent-to-child maltreatment occurring during childhood leads to the development of depressive symptoms later in the adolescence period. Thus, there is a dire need for interventions to raise awareness among the society on the issue of parent-to-child mistreatment to minimize later mental health consequences.

Childhood Disability-Related Abuse: A Retrospective Proof-of-Concept Study

Although the phenomenon of disability-related abuse has been well-documented in adults with disabilities, the occurrence of disability-related abuse in childhood has not been studied. Therefore, the purpose of this study was to establish proof of concept for childhood disability-related abuse. American adults (n = 485) retrospectively report on physical, sexual, and disability-related abuse that they experienced before the age of 18. The sample consisted of 382 participants with no disability, 55 participants with an adult-onset disability, and 48 participants with a childhood-onset disability. Disability-related abuse was conceptualized as involving either (a) the denial of assistive technology or (b) the denial of care, permission, or assistance with an activity of self-care. Childhood denial of assistive technology was rare in all groups (1.3%-2.1%), but denial of care, assistance, or permission was significantly higher in the childhood-onset disability group (20.8%) than either the adult-onset (7.3%) or no-disability (6.5%) groups. The three groups did not significantly differ in the rates of reported childhood physical or sexual abuse. This study provides preliminary proof-of-concept evidence for childhood disability-related abuse, particularly denial of care.

"Who maltreats? Distinct pathways of intergenerational (dis)continuity of child maltreatment"

BACKGROUND

Maltreatment victimization history is an established risk factor for child maltreatment across generations. However, many parents with a victimization history do not maltreat, and many parents with no victimization history do have victimized children.

OBJECTIVES

To understand differences in demographic and maltreatment risk factors across the following intergenerational patterns of maltreatment: cycle maintainers, cycle breakers, cycle initiators, and a comparison group (no maltreatment).

PARTICIPANTS AND SETTING

Data were drawn from a large population-based cohort in Queensland, Australia and included 32,574 biological parents and their children. Maltreatment experiences as a victim or person responsible for harm towards a child were obtained from the Queensland Child Protection System.

METHODS

Multinomial regression was completed with the full sample to compare the three maltreatment groups with the comparison group. Logistic regressions were conducted on all pairwise combinations of maltreatment groups. Models accounted for several demographic and maltreatment factors.

RESULTS

Compared with breakers, maintainers were more likely to be Indigenous (OR = 1.86), never married (OR = 0.34), younger at first birth (OR = 0.87), have ≥3 children (OR = 1.99), be younger at first-and older at last-maltreatment victimization (ORs = 0.97 and 1.07, respectively), and experience a higher frequency of victimization (OR = 1.05). Amongst maltreaters, males were significantly more likely to be initiators while females were more likely to be maintainers (OR = .62). There were few other differences between initiators and maintainers.

CONCLUSIONS

Meaningful differences among the three maltreatment groups were revealed suggesting that research should focus on the intergenerational discontinuity of maltreatment.

Developmental pathways from maternal history of childhood maltreatment and maternal depression to toddler attachment and early childhood behavioral outcomes

The current study examined the development of toddler attachment and early childhood behavior among children of mothers with a history of childhood maltreatment and current major depressive disorder. Maternal depression, maternal sensitivity, and toddler attachment were assessed as mediators of the association between maternal history of childhood maltreatment and child internalizing and externalizing behavior. Participants were from a low-income, largely racial minority urban sample and included 123 mothers with (n = 69) and without (n = 54) major depressive disorder at baseline and their children assessed at 12, 26, and 36 months old. Findings suggest maternal depression and maternal sensitivity mediated the association between maternal history of childhood maltreatment and disorganized attachment. Maternal depression, but not disorganized attachment, mediated the association between maternal history of childhood maltreatment and child symptomatology. Results suggest that supporting mothers through depression and processing their adverse childhood experiences are critical in fostering positive child development.

Race and sex differences in adverse childhood experiences among Asian/Pacific Islander college students

Adverse childhood experiences (ACEs) may be detrimental to health, yet are understudied in Asians/Pacific Islanders (API). We described the prevalence of individual ACEs among API college students compared to White college students. Participants: College students (n = 8,472) from 17 Minnesota postsecondary institutions completed the College Student Health Survey in spring 2015. Methods: Students self-reported on 11 ACEs. We assessed differences in prevalence of individual ACEs between APIs and Whites. Results: APIs were more likely to report having been physically abused (adj. OR = 2.04), verbally abused (adj. OR = 1.25), and raped (adj. OR = 1.75) relative to Whites. Stratification by sex showed API males were more likely to have been sexually abused relative to White males, with additional ACEs differing significantly by sex and race. Conclusions: Individual ACE prevalence differed between APIs and Whites and is often sex-specific. Additional research is needed to estimate ACE prevalence in other racial/ethnic groups and their health impacts.

Intergenerational transmission of child maltreatment in South Australia, 1986-2017: a retrospective cohort study

BACKGROUND

The extent of intergenerational transmission of child maltreatment is unclear due to methodological limitations in previous studies. In this study, we aimed to examine factors associated with intergenerational transmission of child maltreatment and quantify its extent in a population sample over a 30-year period in South Australia.

METHODS

In this retrospective cohort study, we used linked administrative data from the South Australian Birth Registry to identify dyads of mothers and their children both born in South Australia between July 1, 1986, and June 30, 2017. Three child protection system (CPS) outcomes (any CPS involvement, substantiated maltreatment, and time spent in out-of-home care) were computed from data obtained from the South Australian Department for Child Protection. Multivariable Cox regression models were used to estimate hazard ratios (HRs) for child CPS outcomes according to their mother's CPS exposure.

FINDINGS

38 556 unique mother-child dyads were included. 458 (2·0%) of 23 437 children whose mothers had no CPS involvement in childhood had a substantiated report of maltreatment and 127 (0·5%) spent time in out-of-home care. By comparison, 970 (22·1%) of 4382 children whose mothers experienced substantiated maltreatment in childhood had substantiated maltreatment and 469 (10·7%) spent time in out-of-home care. After adjusting for potential confounders, children of mothers with any CPS involvement in childhood had an increased risk of CPS contact compared with children whose mothers had no CPS involvement; this risk was greatest for children of mothers who had both substantiated maltreatment and spent time in out-of-home care (HR 6·25 [95% CI 5·59-6·98] for any CPS involvement, 13·69 [10·08-16·92] for substantiated maltreatment, and 25·78 [18·23-36·45] for any time in out-of-home care). Risks of child CPS outcomes were substantially increased for children of mothers who had a first CPS notification under the age of 1 year or who had any CPS notification at age 13-17 years.

INTERPRETATION

Children are at high risk of maltreatment if their mother experienced maltreatment as a child. Assisting survivors of childhood maltreatment, particularly female survivors, provides a crucial intervention opportunity to help prevent further child abuse and neglect.

FUNDING

Australian National Health and Medical Research Council; Channel 7 Children's Research Foundation.

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.

Explaining the accumulation of victimization in vulnerable children: Interpersonal violence among children traumatized by war and disaster in a children's home in Sri Lanka

Research in postconflict settings indicated that children's exposure to war and natural disaster is a significant predictor of experiencing violence within their families. However, it is unclear if this effect is driven by characteristics of traumatized children or their parents. To disentangle these different factors we conducted a survey in a children's home in Sri Lanka. A total of 146 institutionalized children (aged 8 to 17) were interviewed using standardized questionnaires administered by local senior counselors in order to assess children's exposure to mass trauma, family violence, and violence in the institution as well as their mental health. Linear regression analyses revealed that, controlling for potential confounds, previous exposure to civil war was a significant predictor of violence by guardians in the children's home. In addition, previous exposure to family violence was a significant predictor of violence by peers in the institutions. A mediation analysis showed that children's internalizing and externalizing behavior problems partly mediated the relationship between violence prior to the admission to the children's home and violence in the children's home. The findings of our study provide evidence for the assumption that the transmission of mass trauma into interpersonal violence can occur independently from parents through children's psychopathology.

Recognition of children's emotional facial expressions among mothers reporting a history of childhood maltreatment

Several studies have shown that child maltreatment is associated with both positive and negative effects on the recognition of facial emotions. Research has provided little evidence of a relation between maltreatment during childhood and young adults' ability to recognize facial displays of emotion in children, an essential skill for a sensitive parental response. In this study, we examined the consequences of different forms of maltreatment experienced in childhood on emotion recognition during parenthood. Participants included sixty-three mothers of children aged 2 to 5 years. Retrospective self-reports of childhood maltreatment were assessed using the short form of the Childhood Trauma Questionnaire (CTQ). Emotion recognition was measured using a morphed facial emotion identification task of all six basic emotions (anger, disgust, fear, happiness, sadness, and surprise). A Path Analysis via Structural Equation Model revealed that a history of physical abuse is related to a decreased ability to recognize both fear and sadness in children, whereas emotional abuse and sexual abuse are related to a decreased ability to recognize anger in children. In addition, emotional neglect is associated with an increased ability to recognize anger, whereas physical neglect is associated with less accuracy in recognizing happiness in children's facial emotional expressions. These findings have important clinical implications and expand current understanding of the consequences of childhood maltreatment on parents' ability to detect children's needs.

Maternal symptoms of depression and sensitivity mediate the relation between maternal history of early adversity and her child temperament: The inheritance of circumstance

We examined maternal depression and maternal sensitivity as mediators of the association between maternal childhood adversity and her child's temperament in 239 mother-child dyads from a longitudinal, birth cohort study. We used an integrated measure of maternal childhood adversity that included the Childhood Trauma Questionnaire and the Parental Bonding Index. Maternal depression was assessed with the Edinburgh Postnatal Depression Scale at 6 months postpartum. Maternal sensitivity was assessed with the Ainsworth maternal sensitivity scales at 6 months. A measure of "negative emotionality/behavioral dysregulation" was derived from the Early Childhood Behaviour Questionnaire administered at 36 months. Bootstrapping-based mediation analyses revealed that maternal depression mediated the effect of maternal childhood adversity on offspring negative emotionality/behavioral dysregulation (95% confidence interval [0.026, 0.144]). We also found a serial, indirect effect of maternal childhood adversity on child negative emotionality/behavioral mediated first by maternal depression and then by maternal sensitivity (95% confidence interval [0.031, 0.156]). Results suggest the intergenerational transmission of the effects of maternal childhood adversity to the offspring occurs through a two-step, serial pathway, involving maternal depression and maternal sensitivity.

Expanding our Understanding of Intergenerational Exposure to Adversity

The present study examined the intergenerational continuity of adverse childhood experiences (ACEs) for parents and their adolescent offspring. Data were from a longitudinal study of the effects of maltreatment on adolescent development. Only biological parents (n=185) and one adolescent per parent (n=164) were included in the analytic sample. Self-reported retrospective data on childhood adversities was obtained at the 3^rd wave for parents and the 4^th wave for adolescents (M _age=18.16). For siblings in the study, one was randomly chosen to be included. Latent class analysis was used to examine 1-4 class solutions for parents and adolescents separately and crosstabs were used to show the concordance between assignment to similar classes for the parent and child. Results indicated 2 class solutions for both the parent and child: a high ACEs class characterized by witnessing intimate partner violence and all maltreatment types and a low ACES class characterized by no adversities. Concordance was highest for both parent and child being assigned to the low ACEs class (52% of the dyads). There were 9% of the dyads who were concordant for being assigned to the high ACEs class, indicating less continuity of adversity than expected. Overall the findings show some intergenerational continuity of adversity, but further work should be done to characterize the different patterns of concordance/discordance between parent and child ACEs.

Parental Exposure to Childhood Maltreatment and Offspring's Mental Health: Investigating Pathways Through Parental Adversity and Offspring Exposure to Maltreatment

Parental exposure to child maltreatment (CM) is an important predictor of their offspring's CM experiences and mental health. However, less attention has been paid to examine possible mechanisms of transmission, which is critical to inform prevention and intervention efforts. The current study tested (1) whether the association between parental CM exposure and offspring CM exposure was mediated by (a) parental exposure to violence in adulthood or (b) other emotional stressors/adversities in adulthood and (2) the indirect effects from parental CM exposure to offspring mental health outcomes through parental adversity and offspring CM exposure. Data came from a longitudinal study of maltreatment on adolescent development, and analyses focused on adolescents living with a biological parent (N = 185, 51% female). Biological parents (95% mothers) reported on their history of CM and exposure to other adversities across their lifetime. Adolescents self-reported lifetime CM experiences and current depression, anxiety, posttraumatic stress disorder, and externalizing behaviors in late adolescence (M_age = 18.49). Results showed a significant indirect effect of parent CM exposure on offspring's CM exposure and mental health through parental emotional stressors/adversities, but not physical violence. These findings highlight different types of stressors that may impact the risk for intergenerational transmission of CM and subsequent offspring mental health.

Intergenerational transmission: Theoretical and methodological issues and an introduction to four Dutch cohorts

Behaviors, traits and characteristics are transmitted from parents to offspring because of complex genetic and non-genetic processes. We review genetic and non-genetic mechanisms of intergenerational transmission of psychopathology and parenting and focus on recent methodological advances in disentangling genetic and non-genetic factors. In light of this review, we propose that future studies on intergenerational transmission should aim to disentangle genetic and non-genetic transmission, take a long-term longitudinal perspective, and focus on paternal and maternal intergenerational transmission. We present four large longitudinal cohort studies within the Consortium on Individual Development, which together address many of these methodological challenges. These four cohort studies aim to examine the extent to which genetic and non-genetic transmission from the parental generation shapes parenting behavior and psychopathology in the next generation, as well as the extent to which self-regulation and social competence mediate this transmission. Conjointly, these four cohorts provide a comprehensive approach to the study of intergenerational transmission.

Childhood Maltreatment and Violent Outcomes: A Systematic Review and Meta-Analysis of Prospective Studies

The risk of violence following childhood maltreatment is uncertain. This meta-analytic review identified prospective studies that have examined this association. We systematically searched three electronic databases (PsycINFO, EMBASE, and MEDLINE) and completed a targeted search on Google Scholar. These were supplemented with scanning reference lists and correspondence with authors. We considered non-English-language and unpublished studies. Studies were included if childhood maltreatment was measured before age 18 years and occurred before violent outcomes. We identified 18 eligible studies with data on 39,271 participants. We conducted meta-analysis to calculate odds ratios (ORs) using random-effects models. Heterogeneity was explored through subgroup analyses and meta-regression. The overall OR of violent outcomes in childhood maltreatment was 1.8 (95% confidence interval [1.4, 2.3]) with substantial heterogeneity (I2 = 92%). Meta-regression suggested that risk of violence following childhood maltreatment was more elevated in samples with higher percentage of females, in higher quality investigations, in studies with case-linkage methods compared to that followed-up participants over time using a prospective cohort design, when general population or matched controls were used rather than selected population controls, and when violent outcomes were ascertained in older individuals. In conclusion, the risk of later violence perpetration was modestly increased in individuals with a history of childhood maltreatment. Preventative strategies and interventions for childhood maltreatment may have an important role in violence reduction. Methodological issues and recommendations for future research are discussed.

A Systematic Review of Reviews of the Outcome of Noninstitutional Child Maltreatment

The aim of the systematic review described in this article was to synthesize available high-quality evidence on the outcomes of noninstitutional child maltreatment across the life span. A systematic review of previous systematic reviews and meta-analyses was conducted. Ten databases were searched. One hundred eleven papers which met stringent inclusion and exclusion criteria were selected for review. Papers were included if they reported systematic reviews and meta-analyses of longitudinal or cross-sectional controlled studies, or single-group cohort primary studies of the outcomes of child maltreatment in the domains of physical and mental health and psychosocial adjustment of individuals who were children lived mainly with their families. Using AMSTAR criteria, selected systematic reviews and meta-analyses were found to be of moderate or high quality. Searches, study selection, data extraction, and study quality assessments were independently conducted by two researchers, with a high degree of interrater reliability. The 111 systematic reviews and meta-analyses reviewed in this article covered 2,534 independent primary studies involving 30,375,962 participants, of whom more than 518,022 had been maltreated. The magnitude and quality of this evidence base allow considerable confidence to be placed in obtained results. Significant associations were found between a history of child maltreatment and adjustment in the domains of physical health, mental health, and psychosocial adjustment in a very wide range of areas. The many adverse outcomes associated with child maltreatment documented in this review highlight the importance of implementing evidence-based child protection policies and practices to prevent maltreatment and treat child abuse survivors.

Intergenerational effects of childhood maltreatment: A systematic review of the parenting practices of adult survivors of childhood abuse, neglect, and violence

A history of maltreatment in childhood may influence adults' parenting practices, potentially affecting their children. This systematic review examines 97 studies investigating associations of parental childhood victimization with a range of parenting behaviors that may contribute to the intergenerational effects of abuse: abusive parenting, problematic parenting, positive parenting, and positive parental affect. Key findings include: (1) parents who report experiencing physical abuse or witnessing violence in the home during childhood are at increased risk for reporting that they engage in abusive or neglectful parenting; (2) a cumulative effect of maltreatment experiences, such that adults who report experiencing multiple types or repeated instances of victimization are at greatest risk for perpetrating child abuse; (3) associations between reported childhood maltreatment experiences and parents' problematic role reversal with, rejection of, and withdrawal from their children; (4) indirect effects between reported childhood maltreatment and abusive parenting via adult intimate partner violence; and (5) indirect effects between reported childhood maltreatment and lower levels of positive parenting behaviors and affect via mothers' mental health. Thus, childhood experiences of maltreatment may alter parents' ability to avoid negative and utilize positive parenting practices. Limitations of this body of literature include few prospective studies, an overreliance on adults' self-report of their childhood victimization and current parenting, and little examination of potentially differential associations for mothers and fathers.

Viewing the Cycle of Violence Through a Gendered Pathways Lens: Perceived Parental Tolerance of Violence, Peer Influence, and Child Aggressive Behavior

The purpose of the present study was to determine whether a child's perception of adult tolerance of violence interfaced with peer associations and violent offending. It was hypothesized that a child's perception of his or her parents' tolerance for violence would predict the peer influence effect for aggressive behavior in boys but not girls. Control variables included the parent's stated tolerance of violence, the child's personal attitude toward violence, recent parental divorce or separation, and child maltreatment within the past 12 months. Using the first three waves of the National Youth Survey (NYS), the relationships between perceived parental tolerance of violence and the peer influence and selection effects were examined. A negative binomial path analysis of the male subsample (n = 736) revealed that perceived parental tolerance of violence predicted the peer influence effect (peer violence leading to participant violent offending) but not the peer selection effect (participant violent offending leading to peer violence) in boys. In girls (n = 679), neither pathway was significant. The current findings indicate that in boys, perceived parental attitudes toward violence help account for the cycle of violence, perhaps by encouraging the child's association with violent peers. Programs designed to change these perceptions and the parental/community attitudes these perceptions may reflect could be an effective means of intervention for violent youth.

Objective and subjective experiences of child maltreatment and their relationships with psychopathology

Does psychopathology develop as a function of the objective or subjective experience of childhood maltreatment? To address this question, we studied a unique cohort of 1,196 children with both objective, court-documented evidence of maltreatment and subjective reports of their childhood maltreatment histories made once they reached adulthood, along with extensive psychiatric assessment. We found that, even for severe cases of childhood maltreatment identified through court records, risk of psychopathology linked to objective measures was minimal in the absence of subjective reports. In contrast, risk of psychopathology linked to subjective reports of childhood maltreatment was high, whether or not the reports were consistent with objective measures. These findings have important implications for how we study the mechanisms through which child maltreatment affects mental health and how we prevent or treat maltreatment-related psychopathology. Interventions for psychopathology associated with childhood maltreatment can benefit from deeper understanding of the subjective experience.

Associations of exposure to intimate partner violence and parent-to-child aggression with child competence and psychopathology symptoms in two generations

BACKGROUND

Associations of exposure to intimate partner violence (IPV) and parent-to-child aggression (PCA) with child adjustment have not been examined adequately for community samples.

OBJECTIVE

To examine main, cumulative, and interactive associations of IPV and PCA (separately for physical and psychological aggression) with four aspects of child adjustment (i.e., externalizing and internalizing behavior; social and scholastic competence). Associations were examined between (a) G1 parent behavior and the adjustment of G2 boys (N = 203) at ages 13-14 years and (b) G2 parent behavior and the adjustment of G3 children (N = 294) at ages 4-5 and 11-12 years.

PARTICIPANTS AND SETTING

Families in a prospective, multigenerational dataset.

METHODS

Measures included reports by caregivers, children, and teachers. Cross-sectional regression models (controlling for parent socioeconomic status and G3 child gender) examined: (a) main effects of IPV or PCA, (b) the simultaneous (i.e., cumulative) effects of both IPV and PCA, and (c) interactive effects of IPV and PCA (sample size permitting) on each of the child adjustment outcomes.

RESULTS

When considered simultaneously, PCA (but not IPV) was associated with each aspect of child adjustment. The interaction between PCA and IPV indicated lower G2 adolescent scholastic competence and greater G3 preschool externalizing behavior for children exposed to lower levels of IPV and higher levels of PCA.

CONCLUSION

Psychological and physical PCA were associated with child adjustment problems even when accounting for IPV. Findings support the use of evidence-based programs to prevent PCA and PCA-associated child adjustment problems.