Maternal adverse childhood experiences, attachment style, and mental health: Pathways of transmission to child behavior problems
Maternal adverse childhood experiences, attachment style, and mental health: Pathways of transmission to child behavior problems
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DOI：
10.1016/j.chiabu.2019.04.011
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发表时间：
2019-07-01
影响因子：
4.8
通讯作者：
Madigan, Sheri
中科院分区：
文献类型：
--
作者：
Cooke, Jessica E.;Racine, Nicole;Madigan, Sheri
背景：调查发现，母亲的不良童年经历（ACE）给孩子的结果带来了代际风险。然而，这种传播的机制只能部分地用产妇的心理健康来解释。成人依恋不安全感已被证明介导ACE和心理健康结果之间的关联，但本研究对儿童行为问题的扩展尚未进行研究。目的：通过母亲的依恋不安全感和心理健康，研究从母亲ACE到5岁儿童行为问题风险的级联。参与者和设置：本研究的研究对象是2011年1月至2014年10月收集的1994对前瞻性纵向队列中的母婴配对。方法：母亲回顾性报告儿童36个月时的ACE。当孩子长到60个月大时，母亲完成了对他们的依恋风格、抑郁和焦虑症状以及孩子行为问题的测量。路径分析表明，母亲ACE通过母亲依恋回避、依恋焦虑和抑郁症状与儿童的内化问题间接相关，但不直接相关（β = 0.05，95%CI [-0.001，0.10]）。母亲ACE通过母亲依恋回避、依恋焦虑和抑郁间接预测儿童的外化问题。还观察到母亲ACE对儿童外化问题的直接影响（β = 0.06，95%CI [0.01，0.11]）。结论：母亲ACE通过直接和间接中介途径影响儿童不良行为结局的风险。针对有ACE病史的母亲，将母亲的不安全依恋风格和抑郁症状作为干预目标，可能有助于减轻风险的代际传递。
Background: Investigations have found mothers' adverse childhood experiences (ACEs) confer an intergenerational risk to their children's outcomes. However, mechanisms underlying this transmission have only been partially explained by maternal mental health. Adult attachment insecurity has been shown to mediate the association of ACEs and mental health outcomes, yet an extension of this research to children's behavioral problems has not been examined.Objective: To examine the cascade from maternal ACEs to risk for child behavioral problems at five years of age, via mothers' attachment insecurity and mental health.Participants and setting: Participants in the current study were 1994 mother-child dyads from a prospective longitudinal cohort collected from January 2011 to October 2014.Methods: Mothers retrospectively reported their ACEs when children were 36 months of age. When children were 60 months of age, mothers completed measures of their attachment style, depression and anxiety symptoms, and their children's behavior problems.Results: Path analysis demonstrated maternal ACEs were associated with children's internalizing problems indirectly via maternal attachment avoidance, attachment anxiety, and depression symptoms, but not directly (beta = .05, 95% CI [-.001, .10]). Maternal ACEs indirectly predicted children's externalizing problems via maternal attachment avoidance, attachment anxiety, and depression. A direct effect was also observed from maternal ACEs to child externalizing problems (beta = .06, 95% CI [.01, .11]).Conclusions: Maternal ACEs influenced children's risk for poor behavioral outcomes via direct and indirect intermediary pathways. Addressing maternal insecure attachment style and depression symptoms as intervention targets for mothers with histories of ACEs may help to mitigate the intergenerational transmission of risk.