Department of Psychiatry and Behavioral Sciences, University of California, San Francisco.
Department of Psychology, Arizona State University.
Am Psychol. 2021 Feb-Mar;76(2):337-349. doi: 10.1037/amp0000762.
Decades of research indicate that individuals exposed to childhood adversity are at risk for poor physical and mental health across their life span. More recently, intergenerational transmission of trauma and prenatal programming frameworks suggest an even longer reach for adverse childhood experiences (ACEs), with consequences that extend to subsequent generations. Beyond the individual-level consequences typically observed by empirical studies of ACEs, mothers' experiences of early adversity may also compromise the maternal-child dyadic relationship. We propose a conceptual model whereby mothers' ACEs impact maternal-infant dyadic functioning and later biobehavioral health outcomes through heightened perinatal psychosocial risk. We provide support for the proposed paths and mechanistic processes in our model with data drawn from Las Madres Nuevas, a longitudinal study of low-income Mexican-origin families who participated in a series of home and laboratory visits from the prenatal period through early childhood. Higher ACEs exposure among Las Madres Nuevas participants was associated with numerous perinatal psychosocial risk factors, which predicted poorer mother-infant dyadic functioning. Compromised dyadic functioning during infancy was associated with later maternal mental health and child behavior problems. We conclude with discussion of prevention and treatment strategies that can buffer against proposed risk pathways, including perinatal assessment of maternal ACEs and psychosocial risk, perinatal treatment of maternal distress, and mother-infant therapy in the postpartum period. It is our hope that the proposed conceptual model will serve as a guide for future research to examine the lasting consequences of childhood adversities within and across generations among high-risk populations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
几十年来的研究表明,儿童时期经历逆境的个体在其整个生命周期中都面临身心健康不良的风险。最近,创伤的代际传递和产前编程框架表明,逆境的影响甚至更为深远,其后果会延伸到后代。除了实证研究中通常观察到的个体层面后果外,母亲早期经历逆境也可能损害母婴二元关系。我们提出了一个概念模型,认为母亲的 ACE 会通过增加围产期心理社会风险,影响母婴二元关系的功能,进而影响后期的生物行为健康结果。我们用来自 Las Madres Nuevas 的数据为我们的模型中提出的路径和机制过程提供了支持,这是一项对低收入墨西哥裔美国家庭进行的纵向研究,这些家庭从产前阶段到幼儿期参与了一系列家庭和实验室访问。Las Madres Nuevas 参与者的 ACE 暴露程度越高,与许多围产期心理社会风险因素相关,这些因素预测了母婴二元关系的功能较差。婴儿期二元关系功能受损与后期母亲的心理健康和儿童行为问题有关。我们最后讨论了预防和治疗策略,可以缓冲所提出的风险途径,包括对母亲 ACE 和心理社会风险的围产期评估、对母亲痛苦的围产期治疗以及产后母婴治疗。我们希望所提出的概念模型将作为未来研究的指南,以研究高危人群中儿童逆境在代际内和代际之间的持久后果。(PsycInfo 数据库记录(c)2021 APA,保留所有权利)。