Maternal exposure to childhood maltreatment and mental and behavioral disorders in children

Abstract

Exposure to maltreatment in childhood is associated with lifelong risk of mental and behavioral disorders. Whether the effects extend to the next generation remains unclear. We examined whether maternal exposure to childhood abuse and neglect in her own childhood were associated with mental and behavioral disorders and psychiatric symptoms in her children, and whether maternal lifetime mental and behavioral disorders or lower education level mediated or added to the effects. Mothers (n = 2252) of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction cohort study completed the Childhood Trauma Questionnaire and reported on their education and their 7.0-12.1-year-old children's psychiatric symptoms using the Strengths and Difficulties Questionnaire. We identified lifetime mental and behavioral disorder diagnoses for the mothers and diagnoses for their children from birth (2006-2010) until 8.4-12.8 years (12/31/2018) from Care Register for Health Care. We found that maternal exposure to childhood abuse, but not neglect, was associated with higher hazards of mental and behavioral disorders (hazard ratio 1.20, 95% confidence interval 1.06-1.37) in children. These associations were partially mediated by maternal mental and behavioral disorders and education (proportion of effect size mediated: 23.8% and 15.1%, respectively), which together with maternal exposure to childhood abuse added to the hazard of mental and behavioral disorders in children. Similar associations were found for maternal exposure to childhood abuse and neglect with psychiatric symptoms in children. To conclude, maternal exposure to childhood maltreatment is associated with mental and behavioral disorders and psychiatric symptoms in children. Our findings call for interventions to prevent intergenerational transmission.

Keywords: Childhood maltreatment; Cohort study; Intergenerational; Psychopathology.

Fig. 1

Maternal lifetime mental and behavioral disorders and education level partially mediate the association between maternal exposure to childhood abuse and mental and behavioral disorders in children (panel a). They also partially mediate the associations of maternal exposure to childhood abuse (panel b) and childhood neglect (panel c) with child total difficulties, captured with the Strengths and Difficulties Questionnaire. Mediation analyses were conducted with structured equation models and in separate models for the mediators. The models are adjusted for maternal age and child’s sex and birth year (panel a) and maternal age and child’s sex and age at psychiatric symptom assessment (panel b, c). Numbers represent unstandardized regression coefficients, 95% confidence intervals, and p values. Maternal abuse and neglect exposure continuous sum scores and child total difficulties scores are expressed in standard deviation units

Fig. 2

The incidence rates and cumulative incidences of mental and behavioral disorders in children whose mothers have none, one, two, or three of the maternal adversities, namely maternal exposure to moderate-to-severe childhood abuse, maternal lifetime mental and behavioral disorders, and/or lower education level. The figure shows the additive effects of maternal exposure to these adversities on mental and behavioral disorders in children. The curves show incidence rates and the numbers represent cumulative incidences of mental and behavioral disorders in children, hazard ratios (HR), and 95% confidence intervals (CI); p values refer to linear trends from Cox models adjusted for maternal age and child’s sex and birth year

Fig. 3

Total difficulties psychiatric symptom scores, captured by the Strength and Difficulties Questionnaire, in children whose mothers have none, one, two, or three of the maternal adversities. These adversities included maternal exposure to moderate-to-severe childhood abuse, maternal lifetime mental and behavioral disorders, and/or lower education level (panel a) and maternal exposure to moderate-to-severe childhood neglect, maternal lifetime mental and behavioral disorders, and/or lower education level (panel b). The figure shows estimated marginal means and 95% confidence intervals of child total difficulties according to number of maternal adversities, adjusted for maternal age and child’s sex and age. Child total difficulties scores are expressed in standard deviation units; p values refer to linear trends from linear regression models