Breaking the Cycle: Mediating Roles of Mental Health and Adverse Adult Experiences in the Link between ACEs and Later Parenting

Background:

Adverse childhood experiences (ACEs) are linked to maladaptive parenting, yet the mechanisms of effect are undetermined. Prior evidence suggests that mental health is a likely mediator, though the roles of specific internalizing and externalizing symptom profiles are uncertain. Moreover, it is unclear to what degree the effects of childhood adversity are mediated by ongoing exposure to adult adversity. The study addresses these gaps by examining the extent to which mental health symptoms and adverse adult experiences (AAEs) mediate the effects of ACEs on positive and negative parenting practices.

Methodology

Data were sourced from the Families and Children Thriving Study, a multi-wave investigation of 1,927 low-income Wisconsin families who enrolled in an evidence-based home visiting program. ACEs and AAEs of female primary caregivers were assessed at study wave 1 after program enrollment via the Childhood Experiences Survey (CES) and Adverse Adult Experiences Survey (AES), respectively. The CES and AES were to create 10-item count scores indicating participants’ levels of cumulative adversity in childhood and adulthood. Caregiver depression, anxiety, and anger were measured at wave 1 using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Dimensions of Anger Reactions-5, respectively. Self-reported positive and negative parenting practices were assessed at wave 3, when children were approximately six years old, using composite subscales from the Multidimensional Assessment of Parenting Scale.

Mediation models were explored for both positive and negative parenting outcomes via Hayes’ PROCESS Model 4. Separate analyses were performed to estimate the independent mediating effect of AAEs along with depression, anxiety, and anger symptoms while controlling for caregiver age, race/ethnicity, education, and number of children.

Results

ACEs were significantly associated with greater use of negative parenting practices but not with positive parenting. This association was fully mediated by maternal depression, anxiety, anger, and AAEs, as the direct effect of ACEs on negative parenting became non-significant in the presence of these mediators. Maternal depression (b = 0.0127, CI [0.0067, 0.0195]), anxiety (b = 0.0108, CI [0.0053, 0.0170]), and anger (b = 0.0083, CI [0.0041, 0.0132]) each significantly mediated this pathway. AAEs also emerged as a significant mediator (b = 0.0075, CI [0.0007, 0.0144]), particularly when modeled alongside maternal anger. ACEs were strongly linked to higher levels of all mediators, which in turn predicted increased negative parenting. For positive parenting, only maternal anger showed a small but significant negative effect (b = -0.0039, CI [-0.0079, -0.0001]).

Conclusion and Implications

The study highlights the cascading influence of early adversity on parenting via compromised maternal emotional health and cumulative adult adversity. Depression and anxiety symptoms helped to explain the link between ACEs and negative parenting, though anger symptoms and AAEs played an even more prominent mediating role. The results underscore the need for further research that aims to elucidate the life course and intergenerational effects of ACEs. The findings also have significant implications for prevention and early intervention programs, including home visiting and other two-generation approaches that may disrupt intergenerational cycles of trauma and reduce child welfare system involvement.