Intergenerational Transmission Of Risk Research Articles

Using network analysis to illuminate the intergenerational transmission of adversity

ABSTRACT Objective: The effects of maternal exposure to adverse childhood experiences (ACEs) may be transmitted to subsequent generations through various biopsychosocial mechanisms. However, studies tend to focus on exploring one or two focal pathways with less attention paid to links between different pathways. Using a network approach, this paper explores a range of core prenatal risk factors that may link maternal ACEs to infant preterm birth (PTB) and low birthweight (LBW). Methods: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 8379) to estimate two mixed graphical network models: Model 1 was constructed using adverse infant outcomes, biopsychosocial and environmental risk factors, forms of ACEs, and sociodemographic factors. In Model 2, ACEs were combined to represent a threshold ACEs score (≥4). Network indices (i.e., shortest path and bridge expected influence [1-step & 2-step]) were estimated to determine the shortest pathway from ACEs to infant outcomes, and to identify the risk factors that are vital in activating other risk factors and adverse outcomes. Results: Network analyses estimated a mutually reinforcing web of childhood and prenatal risk factors, with each risk connected to at least two other risks. Bridge influence indices suggested that childhood physical and sexual abuse and multiple ACEs were highly interconnected to others risks. Overall, risky health behaviours during pregnancy (i.e., smoking & illicit drug use) were identified as ‘active’ risk factors capable of affecting (directly and indirectly) other risk factors and contributing to the persistent activation of the global risk network. These risks may be considered priority candidate targets for interventions to disrupt intergenerational risk transmission. Our study demonstrates the promise of network analysis as an approach for illuminating the intergenerational transmission of adversity in its full complexity. HIGHLIGHTS We took a network approach to assessing links between ACEs and birth outcomes. ACEs, other prenatal risk factors, and birth outcomes had complex inter-connections Health behaviours in pregnancy were indicated as optimal intervention targets.

Perspective: Obesity—an unexplained epidemic

ABSTRACTSince 1980, obesity prevalence among US adults has soared from 14% to 42%. The commonly accepted explanation is pervasive overeating: ever-increasing energy intake as the population gains weight, year after year. However, evidence does not support this hypothesis. National data on energy intake and energy availability show increases between 1961 and 2000, during modern industrialization of food; but a plateau or declines thereafter—even as obesity continued rising—and while physical activity modestly increased. Thus, Americans appear to be eating relatively less since 2000, for ever-increasing body sizes, as time has progressed. Although both energy intake and energy availability are measured with error, such errors would have to be new since 2000 and systematically increasing over time for these 2 separate, independent measures. Given the tremendous societal consequences of obesity, and failure to date of energy balance–focused interventions to stem the tide, it is critical for the scientific community to consider and test alternative hypotheses. Growing evidence suggests complex, interrelated biological interactions between food processing (including acellular nutrients, depleted prebiotics, additives), gut microbial composition and function, host metabolic expenditure, and intergenerational transmission of risk (including epigenetics, noncoding RNAs, microbial species). In this paradigm, whereas increasing energy intake may have contributed to rising obesity in earlier years, today pervasive adiposity and its physiologic adaptations have created a biological milieu which interacts with industrialized foods to promote escalating obesity, even with stable energy intake—a self-sustaining, difficult-to-reverse cycle. These scientific hypotheses must be rigorously evaluated, because even partial confirmation would dramatically shift and expand current prevention and treatment strategies. Urgent new investment in research is required. Simultaneously, uncertain evidence on the obesity epidemic's primary drivers does not mean there is no evidence on actions that can help, and existing science must be more rapidly translated and refined into clinical, public health, and policy interventions.

Shapes of subcortical structures in adolescents with and without familial history of substance use disorder.

It has been suggested that intergenerational transmission of risk for substance use disorder (SUD) manifests in the brain anatomy of substance naïve adolescents. While volume and shapes of subcortical structures (SSS) have been shown to be heritable, these structures, especially the pallidum, putamen, nucleus accumbens, and hippocampus, have also been associated with substance use disorders. However, it is not clear if those anatomical differences precede substance use or are the result of that use. Therefore, we examined if volume and SSS of adolescents with a family history (FH+) of SUD differed from adolescents without such a history (FH−). Because risk for SUD is associated with anxiety and impulsivity, we also examined correlations between these psychological characteristics and volume/SSS. Using structural MRI and FSL software, we segmented subcortical structures and obtained indices of SSS and volumes of 64 FH+ and 58 FH− adolescents. We examined group differences in volume and SSS, and the correlations between volume/SSS and trait anxiety and impulsivity. FH+ adolescents had a significant inward deformation in the shape of the right anterior hippocampus compared to FH− adolescents, while the volume of this structure did not differ between groups. Neither shape nor volume of the other subcortical structures differed between groups. In the FH+ adolescents, the left hippocampus shape was positively correlated with both trait anxiety and impulsivity, while in FH− adolescents a negative correlation pattern of SSS was seen in the hippocampus. SSS appears to capture local anatomical features that traditional volumetric analysis does not. The inward shape deformation in the right anterior hippocampus in FH+ adolescents may be related to the known increased risk for behavioral dysregulation leading to SUD in FH+ offspring. Hippocampus shape also exhibits opposite patterns of correlation with anxiety and impulsivity scores across the FH+ and FH− adolescents. These novel findings may reveal neural correlates, not captured by traditional volumetric analysis, of familial transmission of increased vulnerability to SUD.

The impact of maternal adverse childhood experiences and prenatal depressive symptoms on foetal attachment: Preliminary evidence from expectant mothers across eight middle-income countries

BackgroundMothers from middle-income countries (MIC) are estimated to have higher rates of adverse childhood experiences (ACEs) and depression during pregnancy compared to mothers from high income countries. Prenatal depression can adversely impact on a mother's feelings towards her foetus and thus may be partially responsible for intergenerational transmission of risk associated with maternal ACEs. However, the extent to which prenatal depressive symptoms mediate the association between maternal ACEs and foetal attachment is unknown. MethodsData on foetal attachment, ACEs, and prenatal depression came from mothers in their third trimester of pregnancy (n = 1,185) located across eight MICs, participating in the prospective birth cohort Evidence for Better Lives Study – Foundational Research (EBLS-FR). Data were from the baseline measurement. ResultsFull-sample path mediation analyses, adjusting for relevant covariates, suggested a full mediating effect of prenatal depression. However, at the individual-country level, both positive and negative effects of ACEs on foetal attachment were observed after the inclusion of depressive symptoms as a mediator, suggesting cultural and geographical factors may influence a mother's empathic development after ACE exposure. LimitationsAs no follow-up measurements of depressive symptoms or postnatal attachment were included in the analyses, the findings cannot be extrapolated to the postnatal period and beyond. Further, causality cannot be inferred as the study was observational. ConclusionsThe findings reinforce the importance of screening for prenatal depression during antenatal care in MICs. Addressing prenatal depression within maternal health care may support foetal attachment and contribute to reducing the intergenerational transmission of disadvantage.

Paternal distress and child behavior problems in low-SES families: Quality of father–child interactions as mediators.

This study examines, in low-income families, whether fathers' distress is associated with behavioral problems in preschool children and if the quality of father-child interactions mediates this association. Participants were 81 children between the ages of 3 and 5 years and their parents who were receiving social welfare. Quality of father-child interactions was assessed during a free-play situation and a toy cleanup task, fathers' parenting stress and psychological distress were self-reported, and children's behavior problems were assessed by both parents. Results showed that the quality of father-child interactions during free play, but not during cleanup, partially mediated the link between father distress and child internalizing and externalizing behavior problems. Our findings point to the role of the father-child relationship in the intergenerational transmission of risk in the preschool period. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Emotion socialization in mothers who experienced maltreatment: Mentalizing the past may help the present.

Adults who experienced childhood maltreatment (CM) are at increased risk for parenting problems. Mentalization capacity may disrupt intergenerational patterns of problematic parenting among mothers with a CM history. In this study, we examine: (a) parents' use of negative emotion socialization practices as one path of intergenerational transmission of risk in mothers with CM and (b) whether mothers' ability to mentalize about the emotion socialization behaviors of attachment figures diminishes intergenerational similarity in negative emotion socialization practices. Mentalization was operationalized as the frequency of cognitive processing words in mothers' narrative responses to questions about how and why attachment figures responded to their negative emotions during childhood. Participants included 154 mothers with and without a self-reported CM history in a case-control design, matched on child age, gender, maternal education, and race/ethnicity. Mothers with CM recollected more unsupportive responses to their negative emotions during childhood, which in turn predicted using more punishing, ignoring, and magnifying responses toward their own child's negative emotions (i.e., a significant indirect effect). However, greater cognitive processing language when describing the emotional climate of childhood diminished this pathway (i.e., a significant moderated effect). Among mothers who recollected unsupportive responses to emotions from their parents, those whose narratives included more cognitive processing words did not act in similar ways toward their own child whereas those who used fewer cognitive processing words did. These preliminary findings support the growing body of research suggesting that the quality of mentalization can be a protective factor among adults who experienced childhood maltreatment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Robust genetic nurture effects on education: A systematic review and meta-analysis based on 38,654 families across 8 cohorts

Similarities between parents and offspring arise from nature and nurture. Beyond this simple dichotomy, recent genomic studies have uncovered "genetic nurture" effects, whereby parental genotypes influence offspring outcomes via environmental pathways rather than genetic transmission. Such genetic nurture effects also need to be accounted for to accurately estimate "direct" genetic effects (i.e., genetic effects on a trait originating in the offspring). Empirical studies have indicated that genetic nurture effects are particularly relevant to the intergenerational transmission of risk for child educational outcomes, which are, in turn, associated with major psychological and health milestones throughout the life course. These findings have yet to be systematically appraised across contexts. We conducted a systematic review and meta-analysis to quantify genetic nurture effects on educational outcomes. A total of 12 studies comprising 38,654 distinct parent(s)-offspring pairs or trios from 8 cohorts reported 22 estimates of genetic nurture effects. Genetic nurture effects on offspring's educational outcomes (βgenetic nurture = 0.08, 95% CI [0.07, 0.09]) were smaller than direct genetic effects (βdirect genetic = 0.17, 95% CI [0.13, 0.20]). Findings were largely consistent across studies. Genetic nurture effects originating from mothers and fathers were of similar magnitude, highlighting the need for a greater inclusion of fathers in educational research. Genetic nurture effects were largely explained by observed parental education and socioeconomic status, pointing to their role in environmental pathways shaping child educational outcomes. Findings provide consistent evidence that environmentally mediated parental genetic influences contribute to the intergenerational transmission of educational outcomes, in addition to effects due to genetic transmission.

Attachment insecurity moderates the link between maternal childhood neglect and postpartum bonding to the infant.

Mothers who experienced childhood neglect are at increased risk of parenting difficulties in adulthood, but adult attachment relationships may be protective. Eighty-eight postpartum women seeking outpatient psychiatric care completed self-report measures on adverse childhood experiences, adult attachment, mental health symptoms, and bonding. Beyond the effects of maternal mental health on bonding, childhood neglect predicted bonding difficulties only in mothers with more insecure attachments, suggesting adult attachment as a potential point of intervention to reduce the intergenerational transmission of risk.

Maternal Emotion Regulation Difficulties and the Intergenerational Transmission of Risk

Maternal Emotion Regulation Difficulties and the Intergenerational Transmission of Risk

Affective and Autonomic Reactivity During Parent-Child Interactions in Depressed and Non-Depressed Mothers and Their Adolescent Offspring.

Depression presents risks that are profound and intergenerational, yet research on the association of depression with the physiological processes that might be associated with impaired mental and physical health has only recently been contextualized within the family environment. Participants in this multi-method case-control study were 180 mother-adolescent dyads (50% mothers with a history of depression treatment and current depressive symptoms). In order to examine the association between maternal depression and affective and autonomic reactivity amongst these mothers and their adolescent offspring we collected self-reported measures of positive and negative affect, as well as measures of cardiovascular and electrodermal autonomic activity, during mother-adolescent interaction tasks. Findings indicated that depressed mothers and their adolescent offspring exhibited greater self-reported negative affect reactivity during a problem-solving interaction and blunted (i.e., low) sympathetic activity as measured via skin conductance level across both interaction tasks. These effects remained significant after controlling for a range of potential covariates, including medication use, sex, age, adolescents own mental health symptoms, and behavior of the other interactant, along with correcting for multiple comparisons. Findings indicate that depressed mothers and their adolescent offspring both exhibit patterns of affect and physiology during interactions that are different from those of non-depressed mothers and their offspring, including increased negative affect reactivity during negative interactions and blunted sympathetic activity across both positive and negative interactions. These findings have potential implications for understanding the role of family processes in the intergenerational transmission of risk for depressive disorders.

Prenatal maternal transdiagnostic, RDoC-informed predictors of newborn neurobehavior: Differences by sex.

We examined whether Research Domain Criteria (RDoC)-informed measures of prenatal stress predicted newborn neurobehavior and whether these effects differed by newborn sex. Multilevel, prenatal markers of prenatal stress were obtained from 162 pregnant women. Markers of the Negative Valence System included physiological functioning (respiratory sinus arrhythmia [RSA] and electrodermal [EDA] reactivity to a speech task, hair cortisol), self-reported stress (state anxiety, pregnancy-specific anxiety, daily stress, childhood trauma, economic hardship, and family resources), and interviewer-rated stress (episodic stress, chronic stress). Markers of the Arousal/Regulatory System included physiological functioning (baseline RSA, RSA, and EDA responses to infant cries) and self-reported affect intensity, urgency, emotion regulation strategies, and dispositional mindfulness. Newborns' arousal and attention were assessed via the Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale. Path analyses showed that high maternal episodic and daily stress, low economic hardship, few emotion regulation strategies, and high baseline RSA predicted female newborns' low attention; maternal mindfulness predicted female newborns' high arousal. As for male newborns, high episodic stress predicted low arousal, and high pregnancy-specific anxiety predicted high attention. Findings suggest that RDoC-informed markers of prenatal stress could aid detection of variance in newborn neurobehavioral outcomes within hours after birth. Implications for intergenerational transmission of risk for psychopathology are discussed.

Transmission of parental childhood trauma to child behavior problems: Parental Hostile/Helpless state of mind as a moderator

BackgroundLittle attention has been given to intergenerational transmission of risk, mainly whether caregivers’ history of childhood maltreatment is linked to behavioral symptoms in their children and which protective/risk factors are involved in this transmission process. ObjectiveThis study examined if parental Hostile/Helpless (H/H) state of mind with respect to attachment moderated the association between parental childhood trauma and behavior problems in maltreated children. Participants and settingThe sample included 61 parents and their children victims or at very high risk of maltreatment, aged between 1 and 6 years old. MethodParents retrospectively reported their childhood trauma and completed a measure of their children’s behavior problems. Independent observers assessed H/H attachment representations. ResultsAmong parents with H/H states of mind, more severe traumatic childhood experiences were associated with more externalizing and internalizing behavior problems in their children. Among non-H/H parents, associations between parental childhood trauma and child behavior problems were not significant. ConclusionsIn the context of trauma, this study suggests that the absence of a H/H state of mind in parents (i.e., the presence of an organized attachment state of mind) is a protective factor for child adjustment. H/H mental representations of self and attachment experiences as targets of intervention for parents with histories of maltreatment may help reduce the transmission of risk in maltreating families.

Shapes of Subcortical Structures in Adolescents With and Without Familial History of Substance Use Disorder

Background: To explore if intergenerational transmission of risk for substance use disorder (SUD) manifests in brain anatomy of substance naive adolescents. Differences in anatomical shapes of subcortical structures (SSS) have been detected in neuroimaging studies, even in the absence of volume differences and SSS have been shown to be heritable. Therefore, we examined if the SSS of adolescents with a family history (FH+) of SUD differed from the SSS of adolescents without a family history of SUD (FH-). Because risk for SUD is associated with anxiety and impulsivity, we also examined correlations between these psychological characteristics and SSS. Methods: Using structural MRI, we obtained indices of SSS from 64 FH+ and 58 FH- adolescents and examined group differences and correlations between shape indices, trait anxiety and impulsivity. Findings: FH+ adolescents had a significant inward deformation in the shape of the right anterior hippocampus compared to FH- adolescents, while the volume of the right anterior hippocampus did not differ. Compared to FH- adolescents, the shape deformation of the brainstem, amygdala, hippocampus, putamen, pallidum and nucleus accumbens of FH+ adolescents exhibited an inverted correlational pattern with trait anxiety and impulsivity. Interpretation: SSS appears to capture anatomical features that traditional volumetric analysis does not. The inward shape deformation in the right anterior hippocampus in the FH+ adolescents may be related to the known increased risk for behavioral dysregulation leading to SUD in FH+ offspring. This novel approach may reveal neural correlates of familial transmission of increased vulnerability to problematic substance use. Funding Statement: This study was supported in part by NIDA (5R01 DA038154, PI: Christina W. Hoven) Declaration of Interests: No authors report any financial relationships with commercial interests. Ethics Approval Statement: The New York State Psychiatric Institute’s Institutional Review Board approved this study, and informed consent/assent was obtained from every participant.

Hippocampal subregion volume in high-risk offspring is associated with increases in depressive symptoms across the transition to adolescence

BackgroundThe hippocampus has been implicated in the pathophysiology of depression. This study examined whether youth hippocampal subregion volumes were differentially associated with maternal depression history and youth's depressive symptoms across the transition to adolescence. Methods74 preadolescent offspring (Mage=10.74+/-0.84 years) of mothers with (n = 33) and without a lifetime depression history (n = 41) completed a structural brain scan. Youth depressive symptoms were assessed with clinical interviews and mother- and youth-reports prior to the neuroimaging assessment at age 9 (Mage=9.08+/-0.29 years), at the neuroimaging assessment, and in early adolescence (Mage=12.56+/-0.40 years). ResultsMaternal depression was associated with preadolescent offspring's reduced bilateral hippocampal head volumes and increased left hippocampal body volume. Reduced bilateral head volumes were associated with offspring's increased concurrent depressive symptoms. Furthermore, reduced right hippocampal head volume mediated associations between maternal depression and increases in offspring depressive symptoms from age 9 to age 12. LimitationsThis study included a modest-sized sample that was oversampled for early temperamental characteristics, one neuroimaging assessment, and no correction for multiple comparisons. ConclusionsFindings implicate reductions in hippocampal head volume in the intergenerational transmission of risk from parents to offspring.

Introduction to the special section on the intergenerational transmission of risk for substance use.

Six original research papers were submitted to this Special Section to address questions regarding the intergenerational transmission of risk for cannabis and other substance use. Study teams recruited youth in Iowa, Washington, Oregon, New York, and Arizona in the 1980s-1990s, assessed them into adulthood, and recruited their partners and offspring for another study. All of the studies assessed substance use in 2 or more generations. Other strengths in this section include the strong representation of fathers, the demographic diversity of the samples as a whole, and the demonstrations of varied statistical and replication approaches. The findings highlight features of parental histories of cannabis use during adolescence that are associated with their children's risk for cannabis use and factors that explain or weaken intergenerational similarities. Two groups of prevention scholars also offered commentaries on the implications of these studies for prevention and training, and collaboration. It is hoped that the Special Section will stimulate new hypotheses, replications, and communication among etiological and prevention researchers. Furthermore, the papers highlight that the familial transmission of substance use risk should be taken into account more fully in the design of prevention programs to maximize impacts for youth as well as their future offspring. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Intergenerational congruence in adolescent onset of alcohol, tobacco, and marijuana use.

We examined alcohol, tobacco, and marijuana (ATM) use onset across early to late adolescence in a sample of fathers and their offspring. We tested a theory of developmental congruence in polysubstance use, or the extent to which fathers' ATM use onset in early adolescence increased risk for earlier ATM onset by their offspring. Average rates of adolescent ATM use onset were also compared across generations, which may reflect intergenerational discontinuity and secular trends. Children (n = 223, 44% boys) and their fathers (n = 113; originally recruited as boys at neighborhood risk for delinquency) contributed repeated prospective self-reports of their ATM use across adolescence (as late as age 18 years). Mothers' ATM use (retrospective) through age 18 years was available for 205 children. Data were analyzed using discrete-time survival mixture analysis. Compared with their fathers, boys and girls showed later onset for tobacco use, and girls showed later onset alcohol use. Developmental congruence was partially supported: Children showed earlier ATM use onset if their fathers were assigned to the early adolescent polysubstance use onset class, compared to the late-adolescent predominantly alcohol and tobacco onset class; mothers' ATM use in adolescence attenuated this effect. Consistent with national secular trends, rates of adolescent onset tobacco and alcohol use declined across generations, whereas marijuana use onset did not. However, there was intergenerational transmission of risk for early polysubstance use onset. Prevention that delays early substance use may have early life span effects as well as transgenerational implications. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Baseline Characteristics of a Dyadic Cohort of Mothers With Chronic Pain and Their Children.

A growing body of research has demonstrated a robust link between parental chronic pain and child pain and psychological function. Although the association between parent and child pain is strong, there are limited data to understand environmental and behavioral processes that account for the association and how this develops over time. This longitudinal cohort study was designed to understand the potential mechanisms that confer risk or resilience for chronic pain among child offspring of mothers with chronic pain. The current paper presents baseline data on the cohort to describe the pain and psychosocial characteristics of mothers with chronic pain and their 8- to 12-year-old children. A total of 400 mothers with chronic pain and their children were enrolled into the longitudinal study and completed measures of pain, physical, and psychosocial functioning. Mothers reported a range of pain and pain-related disability and were grouped into 4 pain grades (PGs) representing different pain and disability levels. Mothers in these groups differed on rates of widespread pain and opioid use. Maternal PGs also differed by physical function, fatigue, sleep disturbance, and psychological function. Most children in this sample reported pain and psychosocial symptoms in the nonclinical range, and child variables did not differ by maternal PG. Maternal disability and function were concurrently associated with child psychosocial function. While maternal PGs map broadly onto several dimensions of maternal functioning, they were not significantly related to child pain or function. Results may help identify potential protective factors in the intergenerational transmission of risk for chronic pain.

Parenting practices and intergenerational cycle of victimization in Peru.

Existing research has suggested children of caregivers with histories of exposure to trauma are at heightened risk for victimization, but few studies have explored potential mechanisms that explain this intergenerational transmission of risk. With data from peri-urban households in Lima, Peru (N = 402), this study analyzes parenting behaviors in the relation between caregivers' trauma history and child victimization for children aged 4-17. Results indicated caregivers' trauma history and negative parenting behaviors related to child victimization, and negative parenting behaviors mediated this relation. Positive parenting behaviors did not have significant direct effects and were not mediators of risk transmission. Parenting behaviors did not moderate the relation between caregiver and child victimization, suggesting parenting behaviors may not buffer or exacerbate intergenerational transmission. Post-hoc analyses revealed family type (e.g., single, cohabitating/married) exerted significant direct and moderating effects on child risk, interacting with positive parenting. Families with married/cohabitating caregivers reported overall lower levels of child victimization; however, the relation between positive parenting and victimization was slightly stronger for children in single-parent families. Results highlight potential pathways of the intergenerational cycle of victimization and suggest high-risk families in Peru may benefit from parenting supports, especially pertaining to remediation of negative parenting behaviors.

The Effects of Maternal Depression on Infant White Matter Organization and Social-Emotional Development: A Longitudinal Study

The mechanisms underlying the intergenerational transmission of risk for depression are unclear. We examined whether maternal depressive symptoms during and after pregnancy were associated with offspring infant white matter organization and with symptoms in toddlerhood.

Studying the Intergenerational Transmission of Risk for Depression: Current Status and Future Directions

Studying offspring of depressed mothers is a promising strategy for elucidating factors that contribute to depression onset, given that these offspring are 3 to 6 times more likely to develop depression than are their low-risk peers. In this article, we briefly describe representative findings from studies of younger and older offspring of depressed mothers and identify factors that have garnered the most consistent empirical support across development. We discuss what these studies can and cannot tell us about mechanisms that might underlie the intergenerational transmission of risk for depression regardless of the age of offspring being studied. Finally, in light of limitations of this literature, we offer recommendations for future research.