The Effect of Mothers' Adverse Childhood Experiences on Children's Internalizing and Externalizing Behaviors

Background: While there has been extensive investigation of the ways in which Adverse Childhood Experiences (ACEs) influence physical and psychological developmental trajectories that persist throughout the life course, less attention has been paid to intergenerational effects, specifically whether caregivers’ history of childhood trauma is linked to clinical symptoms in their children. Understanding how and to what extent the effects of early adversity are transmitted from parent to child is critical to interrupting cycles of violence and vulnerability in families. The purpose of this study is to identify whether (1) there is an association between cumulative maternal adversity in childhood and the next generation’s psychosocial functioning, and if so, (2) to delineate whether this association is linked to internalizing or externalizing symptoms and moderated by child age in a clinical sample of families involved with the child welfare system.

Methods: Data for this study were drawn from a telephone survey of 259 mothers whose families were receiving in-home child welfare services in a populous, Northeastern state in 2017. Mothers reported their exposure to ACEs, using the Adverse Childhood Experience module of the Behavioral Risk Factor Surveillance System, and their children’s behavior, using internalizing and externalizing subscales of the Child Behavior Checklist (CBCL). Respondents were also asked about their needs and those of their children, as well as services they used during the course of their child welfare involvement. To assess the relationship between parental ACEs and children’s emotional and behavioral functioning, children’s standardized internalizing and externalizing CBCL scores were regressed onto mothers’ ACE scores, controlling for demographic factors. Models interacting caregiver ACE score and child age were also run to examine whether the relationship between mother’s ACEs and child behavior is dependent on child age.

Results: A significant, positive relationship was observed between caregiver ACEs and both children’s internalizing and externalizing behaviors. A mother’s exposure to an additional ACE was associated with higher scores on both the aggressive and withdrawn CBCL subscales of 0.10 (p < .000) and 0.09 (p < .000) standard deviations, respectively. The interacted models did not lend support to the hypothesis that the relationship between caregiver ACEs and child behavior might be dependent on the child’s developmental stage.

Conclusions and Implications: This research suggests that adversity affects individuals across the life-course and has the potential to influence the behavior of future generations. While the mechanism underlying the association between maternal ACEs and child outcomes remains to be fully understood, these findings indicate that more research on intergenerational effects of ACES is needed. Broadly, identification of adverse childhood histories in women planning families, expecting children, or caring for children presents critical opportunities for intervening to assess personal challenges and allay perpetuation of these risks to children. For families engaged with the child welfare system, recognition of the cumulative risks of parents’ personal histories along with the child maltreatment experiences of their children may be important for promoting stronger parenting interactions and family well-being, but also promoting parents’ personal well-being.