Intergenerational Transmission Of Risk Research Articles

Maternal emotion dysregulation, parenting stress, and child physiological anxiety during dark-enhanced startle.

Maternal emotion dysregulation (ED) plays a crucial role in the development of psychopathology in children. The current study aimed to investigate parenting stress as a mediator of the relationship between maternal emotion dysregulation and child startle potentiation, with child sex as a moderator. Mothers were interviewed to obtain self-report of maternal ED and parenting stress and child's dark-enhanced startle (DES) response was measured using electromyographic recordings of the eye-blink muscle during the delivery of acoustic probes. We found that maternal ED was positively correlated with both her parenting stress and her child's DES. A bootstrap analysis yielded a full mediation of the association between ED and child DES via parenting stress. Child sex was not a significant moderator of these relationships. These results suggest that maternal ED has important consequences for the intergenerational transmission of risk and also highlight the interaction of behavioral and biological mechanisms of risk.

Parental depression and parent and child stress physiology: Moderation by parental hostility.

This study examined the moderating role of parental hostility on the associations between parental depression and the cortisol awakening response (CAR) and morning cortisol levels of both parents and children. 148 parents and 148 preschool-aged children provided salivary cortisol samples at waking, 30 and 45 min post-waking on two consecutive days. Parental depression was assessed using a clinical interview, and parental hostility was assessed using an observational parent-child interaction task. Results indicated that the combination of parental lifetime depression and high parental hostility was associated with lower morning cortisol levels in both parents and children. This interactive effect was present in children regardless of their exposure to parental depression. In addition, the combination of higher levels of parents' current depressive symptoms and parental hostility was associated with lower parent CAR. Lastly, parents' and children's lower morning cortisol levels were associated with parent-reported child externalizing symptoms. Findings demonstrate that parents and children have similar stress system functioning related to parental depression and the parenting context, as well as children's behavioral problems, which may play a role in the intergenerational transmission of risk for psychopathology.

Neglect, Sexual Abuse, and Witnessing Intimate Partner Violence During Childhood Predicts Later Life Violent Attitudes Against Children Among Kenyan Women: Evidence of Intergenerational Risk Transmission From Cross-Sectional Data.

Violence against children, including corporal punishment, remains a global concern. Understanding sources of support for corporal punishment within cultures, and the potential for intergenerational transmission of child maltreatment, is essential for policy-development and community engagement to protect children. In this study, we use data from a cross-section of women in Meru County, Kenya (n = 1,974) to profile attitudes toward violence against children using the Velicer Attitudes Towards Violence-Child subscale. We find reported histories of sexual abuse, emotional and physical neglect, and witnessing interpersonal violence during childhood predict more violent attitudes toward children in adulthood. The pathway between these forms of child maltreatment and violent attitudes is significantly mediated by family function, perceived stress, and attitudes toward violence against women. Interventions to prevent sexual abuse, intimate partner violence, and promote attachments between parents and children may benefit future generations in this population. Furthermore, secondary prevention of the effects of these childhood adversities may require development of social support, improving family function and challenging violent attitudes against women.

Maternal Child Sexual Abuse Is Associated With Lower Maternal Warmth Toward Daughters but Not Sons

ABSTRACTMothers with a history of child sexual abuse report less warmth toward their children, but whether this association differs by child gender is unknown. We examined the association of maternal child sexual abuse and warmth across child gender, accounting for depression, post-traumatic stress disorder, and child physical abuse. We verbally administered self-report measures to a cross-sectional sample of 154 mothers with a child between 8 and 12 years old. Eighty-five mothers based warmth responses on a son, and 69 on a daughter. We conducted a hierarchical multiple regression, including child gender, maternal child sexual abuse, child physical abuse, depression, post-traumatic stress disorder, and 4 two-way interaction terms with child gender. Maternal depression predicted decreased warmth, regardless of child gender, and maternal child sexual abuse predicted decreased warmth, but only toward daughters. Given previous research suggesting that maternal warmth predicts child well-being, the current finding may represent an important avenue of intergenerational transmission of risk in girls.

Prenatal Major Depressive Disorder, Placenta Glucocorticoid and Serotonergic Signaling, and Infant Cortisol Response.

Extending prior studies of prenatal adversity and depressive symptoms, we tested associations between maternal prenatal major depressive disorder (MDD) and infant cortisol regulation. Based on prior findings by our group, we also tested placenta glucocorticoid (HSD11B2 methylation) and serotonin (SLC6A4 gene expression) signaling as moderators of links between prenatal MDD and infant cortisol. Participants were 153 mother-infant pairs from a low-income, diverse sample (M [SD] age = 26 [6] years). Repeated structured diagnostic interviews were used to identify mothers with (a) prenatal MDD, (b) preconception-only MDD, and (c) controls. Placenta samples were assayed for HSD11B2 methylation and SLC6A4 gene expression. Infant salivary cortisol response to a neurobehavioral examination was assessed at 1 month. Daughters of prenatal MDD mothers had 51% higher baseline (ratio = 1.51; 95% confidence interval [CI] = 1.01-2.27; p = .045) and 64% higher stress responsive cortisol (ratio = 1.64; 95% CI = 1.05-2.56; p = .03) than daughters of controls and 75% higher stress-responsive cortisol (ratio = 1.75; 95% CI = 1.04-2.94; p = .04) than daughters of preconception-only MDD mothers. HSD11B2 methylation moderated links between prenatal MDD and baseline cortisol (p = .02), with 1% methylation decreases associated with 9% increased baseline cortisol in infants of prenatal MDD mothers (ratio = 1.09; 95% CI = 1.01-1.16). SLC6A4 expression moderated links between prenatal MDD and cortisol response among boys alone (p = .007), with 10-fold increases in expression associated with threefold increases in stress-responsive cortisol (ratio = 2.87; 95% CI = 1.39-5.93) in sons of control mothers. Results highlight specificity of associations between prenatal versus preconception MDD and cortisol regulation and the importance and complexity of placenta glucocorticoid and serotonergic pathways underlying the intergenerational transmission of risk from maternal adversity.

Maternal abuse history and reduced fetal heart rate variability: Abuse-related sleep disturbance is a mediator.

The consequences of childhood maltreatment are profound and long lasting. Not only does the victim of abuse suffer as a child, but there is mounting evidence that a history of maltreatment places the next generation at risk for significant psychopathology. Research identifies postnatal factors as affecting this intergenerational transmission of trauma. However, emerging evidence suggests that part of this risk may be transmitted before birth, passed on via abuse-related alterations in the in utero environment that are as yet largely unidentified. To date, no study has directly assessed the influence of pregnant women's abuse history on fetal neurobehavioral development, nor considered trauma-associated poor sleep quality as a mediator reflecting established physiological dysregulation. Using data from 262 pregnant adolescents (ages 14-19), a population at elevated risk for childhood maltreatment, the current study examined maternal emotional abuse history and sleep quality in relation to third-trimester fetal resting heart rate variability, an index of parasympathetic nervous system functioning. The results indicate that maternal emotional abuse history is indirectly associated with lower fetal heart rate variability via abuse-related sleep disturbances. These data demonstrate an association between maternal abuse histories and fetal development, showing that at least part of the intergenerational transmission of risk occurs during pregnancy.

Development of self-inflicted injury: Comorbidities and continuities with borderline and antisocial personality traits.

Self-inflicted injury (SII) is a continuum of intentionally self-destructive behaviors, including nonsuicidal self-injuries, suicide attempts, and death by suicide. These behaviors are among the most pressing yet perplexing clinical problems, affecting males and females of every race, ethnicity, culture, socioeconomic status, and nearly every age. The complexity of these behaviors has spurred an immense literature documenting risk and vulnerability factors ranging from individual to societal levels of analysis. However, there have been relatively few attempts to articulate a life span developmental model that integrates ontogenenic processes across these diverse systems. The objective of this review is to outline such a model with a focus on how observed patterns of comorbidity and continuity can inform developmental theories, early prevention efforts, and intervention across traditional diagnostic boundaries. Specifically, when SII is viewed through the developmental psychopathology lens, it becomes apparent that early temperamental risk factors are associated with risk for SII and a range of highly comorbid conditions, such as borderline and antisocial personality disorders. Prevention efforts focused on early-emerging biological and temperamental contributors to psychopathology have great potential to reduce risk for many presumably distinct clinical problems. Such work requires identification of early biological vulnerabilities, behaviorally conditioned social mechanisms, as well as societal inequities that contribute to self-injury and underlie intergenerational transmission of risk.

Associations Between Incarcerated Fathers’ Cumulative Childhood Risk and Contact With Their Children

Incarcerated fathers often experience early life risk factors that cumulate over time and are compounded by the negative repercussions of imprisonment. These dynamics may contribute to the intergenerational transmission of risk and help explain the persistent link between paternal incarceration and poor child outcomes. Contact between incarcerated fathers and their children can benefit them both, but there is limited research on the factors that affect father–child contact. Using data from the 2004 Survey of Inmates in State Correctional Facilities and a sample of fathers with at least one minor child ( N = 5,809), the authors found that incarcerated fathers who experienced more childhood risk factors had less frequent contact with their children. A variety of inmate characteristics were also significant predictors of father–child contact. Parenting interventions could address incarcerated fathers’ childhood risk experiences, which likely undermine the development and maintenance of family relationships, to help them develop prosocial skills.

Adverse childhood experiences, poverty, and parenting stress.

Adverse childhood experiences (ACEs) are associated with physical and mental health problems in adulthood, as well as unresolved or discordant states of mind regarding attachments that have implications for problematic parenting. Currently, there are no studies on the association between ACEs and adults' subjective experiences of stress in the parenting role, where socioeconomic status (SES)−related poverty effects have been controlled for--the central question behind the current study. We examined exposure to ACEs among 118 mothers (n = 33 low SES/impoverished and n = 85 middle/high SES) and parenting distress. Participants completed an ACE questionnaire that assessed exposure to 10 adverse experiences from childhood (e.g., abuse, neglect, household dysfunction), and the Parenting Stress Index−Short Form. Parenting distress and ACEs were significantly higher in the low SES group; yet, even after controlling for SES, higher ACE scores added significant explained variance in parental distress in a linear regression model. DISCUSSION focuses on the need to administer ACE screening in prenatal and pediatric settings to identify and to offer trauma- and attachment-informed treatment, so to reduce the intergenerational transmission of risk associated with problematic parenting. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Language: en

Intergenerational transmission of maltreatment: A multilevel examination.

Despite the commonly held belief that there is a high degree of intergenerational continuity in maltreatment, studies to date suggest a mixed pattern of findings. One reason for the variance in findings may be related to the measurement approach used, which includes a range of self-report and official indicators of maltreatment and both cross-sectional and longitudinal designs. This study attempted to shed light on the phenomenon of intergenerational continuity of maltreatment by examining multiple indicators of perpetration of maltreatment in young adults and multiple risk factors across different levels within an individual's social ecology. The sample included 166 women who had been placed in out-of-home care as adolescents (>85% had a substantiated maltreatment incident) and followed into young adulthood, and included three waves of adolescent data and six waves of young adult data collected across 10 years. The participants were originally recruited during adolescence as part of a randomized controlled trial examining the efficacy of the Treatment Foster Care Oregon intervention. Analyses revealed weak to modest associations among the three indicators of perpetration of maltreatment in young adulthood, that is, official child welfare records, self-reported child welfare system involvement, and self-reported maltreatment (r = .03-.51). Further, different patterns of prediction emerged as a function of the measurement approach. Adolescent delinquency was a significant predictor of subsequent self-reported child welfare contact, and young adult partner risk was a significant predictor of perpetration of maltreatment as indexed by both official child welfare records and self-reported child welfare contact. In addition, women who were originally assigned to the intervention condition reported perpetrating less maltreatment during young adulthood. Implications for measurement and interventions related to reducing the risk for intergenerational transmission of risk are discussed.

Neural markers of familial risk for depression: An investigation of cortical thickness abnormalities in healthy adolescent daughters of mothers with recurrent depression.

Having a mother with major depressive disorder (MDD) is one of the strongest predictors of depression in late adolescence and early adulthood. Despite this fact, we know little about the neural mechanisms involved in the intergenerational transmission of risk for depression. Twenty-eight never-disordered daughters of recurrent depressed mothers (high-risk) and 36 never-disordered daughters of never-depressed mothers (low-risk) were scanned using MRI. Scan data were processed to provide measurements of cortical gray matter thickness. A general linear model was conducted at each surface point to assess the main effect of familial risk on cortical structure as well as to explore the interaction of familial risk and age. High-risk girls exhibited significantly thinner cortical gray matter in the right fusiform gyrus relative to low-risk girls. Exploratory analyses indicated interactions of risk group and age in the bilateral anterior insula and right anterior cingulate cortex (ACC); whereas low-risk girls exhibited an inverse association between age and thickness, girls at high risk for depression showed the reverse pattern. Additional exploratory analyses, using scores on the Children's Sadness Management Scale, indicated that thinner gray matter in the ACC of high-risk girls was associated with greater difficulty in managing sadness. These findings indicate that anomalous reductions in the cortical thickness of the fusiform gyrus may be a marker of risk for MDD. The interaction of age and group for gray matter thickness of the insula and ACC suggests a particularly important role for these regions in risk for depression and warrants additional research in longitudinal studies.

Concordance of mother–daughter diurnal cortisol production: Understanding the intergenerational transmission of risk for depression

A growing body of research is demonstrating concordance between mother and child diurnal cortisol production. In the context of maternal history of depression, intergenerational concordance of cortisol production could contribute to hypercortisolemia in children of depressed mothers, which has been shown to increase risk for MDD. The current study is the first to examine concordance in diurnal cortisol production between mothers with a history of depression and their never-depressed, but high-risk, children. We collected salivary cortisol across 2 days from mothers with (remitted; RMD) and without (CTL) a history of recurrent episodes of depression and their never-depressed daughters. As expected, RMD mothers and their daughters both exhibited higher cortisol production than did their CTL counterparts. Moreover, both across and within groups, mothers’ and daughters’ cortisol production were directly coupled. These findings suggest that there is an intergenerational concordance in cortisol dysregulation that may contribute to hypercortisolemia in girls at familial risk for depression.

Interventions for postnatal depression assessing the mother-infant relationship and child developmental outcomes: a systematic review.

Postnatal depression (PND) has negative effects on maternal well-being as well as implications for the mother–infant relationship, subsequent infant development, and family functioning. There is growing evidence demonstrating that PND impacts on a mother’s ability to interact with sensitivity and responsiveness as a caregiver, which may have implications for the infant’s development of self-regulatory skills, making the infant more vulnerable to later psychopathology. Given the possible intergenerational transmission of risk to the infant, the mother–infant relationship is a focus for treatment and research. However, few studies have assessed the effect of treatment on the mother–infant relationship and child developmental outcomes. The main aim of this paper was to conduct a systematic review and investigate effect sizes of interventions for PND, which assess the quality of the mother–infant dyad relationship and/or child outcomes in addition to maternal mood. Nineteen studies were selected for review, and their methodological quality was evaluated, where possible, effect sizes across maternal mood, quality of dyadic relationship, and child developmental outcomes were calculated. Finally, clinical implications in the treatment of PND are highlighted and recommendations made for further research.

The roles of resilience and childhood trauma history: Main and moderating effects on postpartum maternal mental health and functioning

ObjectiveRecently postpartum women participated to investigate main and moderating influences of resilience and childhood history of maltreatment on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), parental sense of mastery, and family functioning. MethodAt 4-months postpartum, 214 mothers (145 with a history of childhood abuse or neglect) completed interviews assessing mental health symptoms, positive functioning, resilience and trauma history. Multiple and moderated linear regression with the Connor-Davidson Resilience Scale (CD-RISC) and Childhood Trauma Questionnaires (CTQ) were conducted to assess for main and moderating effects. ResultsResilience, childhood trauma severity, and their interaction predicted postpartum PTSD and MDD. In mothers without childhood maltreatment, PTSD was absent irrespective of CD-RISC scores. However, for those with the highest quartile of CTQ severity, 8% of those with highest resilience in contrast with 58% of those with lowest CD-RISC scores met PTSD diagnostic criteria. Similar, in those with highest resilience, no mothers met criteria for postpartum MDD, irrespective of childhood trauma, while for those with lowest quartile of resilience, 25% with lowest CTQ severity and 68% of those with highest CTQ severity were depressed. The CD-RISC, but not the CTQ, was predictive of postpartum sense of competence. The CD-RISC and the CTQ were predictive of postpartum family functioning, though no moderating influence of resilience on childhood trauma was found. ConclusionsResilience is associated with reduced psychopathology and improved wellbeing in all mothers. It further serves as a buffer against psychiatric symptoms following childhood trauma. Such findings may assist in identification of those at greatest risk of adverse functioning postpartum, utilization of resilience-enhancing intervention may benefit perinatal wellness, and reduce intergenerational transmission of risk.

Childhood adversity, adult homelessness and the intergenerational transmission of risk: a population‐representative study of individuals in households with children

AbstractThis study tested for associations between childhood adversity, adult homelessness and contexts of developmental risk in households with children. Data were drawn from the 2010 Washington State Behavioral Risk Factor Surveillance System, representative of the population of Washington State residents. Considering adults in households with children, those who experienced higher levels of childhood adversity were more likely to have experienced homelessness in adulthood. Meanwhile, a 10‐factor index of cumulative developmental risk was independently associated with childhood adversity and with adult homelessness. Adult homelessness appears to represent a circumstance through which past childhood adversities are brought forward and associated with contexts of developmental risk for subsequent generations of children.

Enhancing positive parent–child interactions and family functioning in a poverty sample: a randomized control trial

This study tested the attachment-based intervention program Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) in a randomized controlled trial with poor families of toddlers screened for professional’s concerns about the child’s caregiving environment. The VIPP-SD is an evidence-based intervention, but has not yet been tested in the context of poverty. The sample included 43 families with 1- to 4-year-old children: mean age at the pretest was 29 months and 51% were boys. At the pretest and posttest, mother–child interactions were observed at home, and mothers reported on family functioning. The VIPP-SD proved to be effective in enhancing positive parent–child interactions and positive family relations in a severely deprived context. Results are discussed in terms of implications for support services provided to such poor families in order to reduce intergenerational risk transmission.

Family Relations in the Genomic Era: Communicating about Intergenerational Transmission of Risk for Disability

Interest in the familial aspects of disability has heightened in recent years. Three forms of disability—hearing loss, Fragile X syndrome, and autism spectrum disorders—are used here to illustrate the complex and rapidly evolving understanding of the meaning and nature of heritability and carrier status for disability. The authors raise six questions to address if the promise of genomic research leads to real benefits for families: (a) Is the public interested in carrier testing? (b) Who is responsible for carrier testing? (c) Is the public prepared to use genomic information? (d) Should genomic testing or information about testing be tailored to specific audiences or target populations? (e) What strategies can be used to enable informed decision‐making? (f) How will carrier testing affect family relationships and communication patterns? These and other factors will require a comprehensive analysis of the individual and societal implications for family relations in the genomic era.

Intergenerational transmission of postpartum hemorrhage risk: analysis of 2 Scottish birth cohorts

The purpose of this study was to determine risk factors for postpartum hemorrhage (PPH) that includes intergenerational transmission of risk of postpartum hemorrhage. We linked birth records of women and their daughters and granddaughters in 2 Scottish birth cohorts: the Walker cohort (collected from 1952-1966) and the Scottish Morbidity Records cohort (collected from 1975-present). We determined clinical risk factors for PPH. We then quantified the risk of PPH in women whose mothers/grandmothers had postpartum hemorrhage before and after adjustment for these risk factors. The risk of PPH in women whose mothers/grandmothers had PPH was no greater than in those whose mothers/grandmothers did not have PPH. Our study had sufficient power (80%) to detect an odds ratio of 1.3, should such an increase in odds that is associated with familial history exist. In contrast, the adjusted odds ratios that were conferred by nulliparity, having a large baby, cesarean delivery, and genital tract trauma were 1.47, 1.84, 8.20, and 9.61, respectively. Women whose mothers/grandmothers had PPH do not appear to be at increased risk themselves. We confirmed an increased risk of PPH that was associated with nulliparity, delivering a large baby, cesarean delivery, and genital tract trauma. We were unable to demonstrate an effect of intergenerational transmission of PPH, although our study was underpowered to detect an odds ratio <1.3. Thus, we confirm that any risk conferred by familial history, should it exist, is less than that conferred by factors in the index pregnancy itself.

Adverse Childhood Experiences (ACEs) Questionnaire and Adult Attachment Interview (AAI): Implications for parent child relationships

Although Adverse Childhood Experiences (ACEs) are linked to increased health problems and risk behaviors in adulthood, there are no studies on the association between ACEs and adults’ states of mind regarding their early childhood attachments, loss, and trauma experiences. To validate the ACEs questions, we analyzed the association between ACEs and emotional support indicators and Adult Attachment Interview (AAI) classifications in terms of unresolved mourning regarding past loss or trauma and discordant states of mind in cannot classify (U/CC) interviews. Seventy-five urban women (41 clinical and 34 community) completed a questionnaire on ACEs, which included 10 categories of abuse, neglect, and household dysfunction, in addition to emotional support. Internal psychological processes or states of mind concerning attachment were assessed using the AAI. ACE responses were internally consistent (Cronbach's α=.88). In the clinical sample, 84% reported≥4 ACEs compared to 27% among the community sample. AAIs judged U/CC occurred in 76% of the clinical sample compared to 9% in the community sample. When ACEs were≥4, 65% of AAIs were classified U/CC. Absence of emotional support in the ACEs questionnaire was associated with 72% of AAIs being classified U/CC. As the number of ACEs and the lack of emotional support increases so too does the probability of AAIs being classified as U/CC. Findings provide rationale for including ACEs questions in pediatric screening protocols to identify and offer treatment reducing the intergenerational transmission of risk associated with problematic parenting.

Early Exposure to Parental Depression and Parenting: Associations with Young Offspring’s Stress Physiology and Oppositional Behavior

Hypothalamic-pituitary-adrenal (HPA) axis reactivity to stress is posited to play a role in the intergenerational transmission of risk for psychopathology and other negative outcomes in the offspring of depressed parents. We tested the hypothesis that the joint, interactive effects of exposure to parental depression during early childhood and parental hostility impact the development of young children's stress physiology and early emerging behavior problems. A sample of 165 preschool-age children (81 boys, 84 girls), of whom 103 had a parent with a history of depression, was exposed to a stress-inducing laboratory task, and five salivary cortisol samples were obtained. Parents completed clinical interviews and an observational parent-child interaction task. We found that the offspring exposed to maternal depression during early childhood and whose parents displayed hostile parenting behaviors during an observational task evidenced high and increasing cortisol levels in response to a laboratory stressor. In addition, the total amount of exposure to maternal depression over the child's life exerted a dose-response effect on the positive relation between parental hostility and child observed oppositional behavior. This study underscores the importance of the early rearing environment on young children's stress physiology and early emerging behavior problems.