Department of Psychology, University of Denver, United States of America; Department of Psychiatry and Child Trauma Research Program, University of California, San Francisco, United States of America.
Department of Psychiatry and Child Trauma Research Program, University of California, San Francisco, United States of America.
Clin Psychol Rev. 2021 Apr;85:101997. doi: 10.1016/j.cpr.2021.101997. Epub 2021 Feb 28.
In recent years, research and practice on adverse childhood experiences (ACEs) have shifted from delineating effects of ACEs on adulthood health problems to preventing ACEs in children. Nonetheless, little attention has focused on how parents' own childhood experiences, adverse or positive, may influence the transmission of ACEs across generations. Children's risk for ACEs and potential for resilience may be linked to the early child-rearing experiences of their parents carried forward into parenting practices. Additionally, parents with multiple ACEs may have PTSD symptoms, an under-recognized mediator of risk in the intergenerational transmission of ACEs. Guided by developmental psychopathology and attachment theory with an emphasis on risk and resilience, we argue that a more comprehensive understanding of parents' childhood experiences is needed to inform prevention of ACEs in their children. Part I of this review applies risk and resilience concepts to pathways of intergenerational ACEs, highlighting parental PTSD symptoms as a key mediator, and promotive or protective processes that buffer children against intergenerational risk. Part II examines empirical findings indicating that parents' positive childhood experiences counteract intergenerational ACEs. Part III recommends clinically-sensitive screening of ACEs and positive childhood experiences in parents and children. Part IV addresses tertiary prevention strategies that mitigate intergenerational ACEs and promote positive parent-child relationships.
近年来，关于不良童年经历（ACEs）的研究和实践已经从描述 ACEs 对成年后健康问题的影响，转变为预防儿童时期的 ACEs。尽管如此，人们很少关注父母自身的童年经历（无论是负面的还是正面的）如何影响 ACEs 在代际间的传递。儿童遭受 ACEs 的风险和潜在的适应能力可能与其父母的早期育儿经历有关，并延续到育儿实践中。此外，有多种 ACEs 的父母可能患有创伤后应激障碍（PTSD）症状，这是 ACEs 在代际传递中风险的一个未被充分认识的中介因素。本研究以发展心理病理学和依恋理论为指导，重点关注风险和适应能力，认为需要更全面地了解父母的童年经历，以便为预防其子女遭受 ACEs 提供信息。本综述的第一部分将风险和适应能力的概念应用于 ACEs 的代际传递途径，强调父母 PTSD 症状作为关键的中介因素，以及促进或保护儿童免受代际风险影响的过程。第二部分考察了表明父母积极的童年经历可以抵消代际 ACEs 的实证发现。第三部分建议对父母和儿童进行 ACEs 和积极童年经历的临床敏感筛查。第四部分讨论了减轻代际 ACEs 和促进积极亲子关系的三级预防策略。
