Maternal Childhood Trauma and the Longitudinal Trajectory of Attention Problems from Preschool to Preadolescence in an Urban Cohort

Background: Attention problems often emerge early in life and may persist into adolescence, potentially disrupting learning and behavior if left unaddressed. Emerging evidence suggests that maternal childhood trauma (MCT) can have long-term intergenerational effects on children’s neurodevelopmental outcomes. However, attention problems have received less focus. This study investigated the association of MCT with the developmental course of attention problems in children from preschool years to preadolescence, adjusting for important confounders, including maternal psychological distress as a time-varying covariate and children’s postnatal exposure to violence as a time-invariant covariate.

Methods: Data were from a prospective longitudinal cohort of 307 urban, low-income mother–child dyads (54% girls) recruited at birth for a study on prenatal cocaine exposure. Attention problems were assessed at ages 4, 6, 9, 10, 11, and 12 using caregiver-reported Child Behavior Checklist. At the 4-year postpartum assessment, maternal experience of childhood trauma was retrospectively assessed using the Childhood Trauma Questionnaire. Maternal psychological distress was assessed via the Brief Symptom Inventory at all time points. Children’s lifetime exposure to violence was child-reported at age 12 using the Assessment of Liability and Exposure to Substance Use and Antisocial Behavior. Latent Growth Curve Modeling (LGCM) was conducted in Mplus v.8.8 using full information maximum likelihood estimation to test associations between MCT and children’s attention problem trajectory, adjusting for time-varying (maternal psychological distress) and time-invariant covariates (child-reported postnatal violence exposure, prenatal cocaine exposure, child sex, race, caregiver age, and education).

Results: The unconditional LGCM fit the data, χ²(11)=21.001, p=.033; CFI=.986; TLI=.981; RMSEA=.054 (90%CI=.015-.088), SRMR=.056. At age 4, children’s average attention problem score was 2.78 (p<.001), with a significant increase over the following eight years (mean slope=0.25, p<.001). The conditional LGCM fit the data, χ²(190)=318.29, p<.001, CFI=.924, TLI=.925, RMSEA=.047 (90%CI=.038-.056), SRMR=.073. Higher MCT was associated with higher overall levels of children’s attention problems (intercept b=0.197, p=.011), but not with the rate of increase over time (slope β=−0.040, p=.603). While there was no sex difference in overall levels of attention problems (β = 0.071, p=.314), girls exhibited a steeper increase than boys (β=0.197, p=.005). Children with higher violence exposure levels demonstrated a faster escalation in attention problems (β = 0.134, p=.041). Maternal psychological distress was associated with attention problems at each time point (ps<.001). Other covariates were not significant.

Conclusions and Implications: In the general population, attention problems are typically most pronounced during preschool years and tend to decline as children mature. The increasing trajectory observed from ages 4 to 12 in this urban cohort is noteworthy. Preschool-age screening for attention problems may be valuable in identifying children at risk, especially girls. Even after accounting for psychological distress across all time points, children of mothers reporting higher MCT exhibited elevated attention problems during preschool years, which persisted throughout childhood. Notably, children’s postnatal violence exposure, given its association with a less optimal trajectory of attention problems, emerged as a critical target for mitigating maladaptive development. Expanded investigations into modifiable contextual mechanisms may help inform developmentally timed interventions aimed at interrupting the intergenerational effects of trauma.