Luo Shengyu, Chen Dezhong, Li Chunrong, Lin Li, Chen Weiqing, Ren Yan, Zhang Yuchi, Xing Fenglin, Guo Vivian Yawei
Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Child Adolesc Psychiatry Ment Health. 2023 Aug 10;17(1):95. doi: 10.1186/s13034-023-00646-3.
Maternal history of adverse childhood experiences (ACEs) has been found to be associated with children's health outcomes. However, the underlying mechanisms were unclear. This study aimed to examine the association between maternal ACEs and behavioral problems in their preschool offspring and to explore the potential mediating role of maternal parenting styles in the association.
A cross-sectional study was conducted involving 4243 mother-child dyads in Chengdu, China. Mothers completed the Adverse Childhood Experiences-International Questionnaire (ACE-IQ) to assess their history of ACEs (i.e., physical abuse, emotional abuse, physical neglect, emotional neglect, witnessing domestic violence, household substance abuse, household mental illness, incarcerated household member, parental separation or divorce, parental death, bullying, and community violence), the short Egna Minnen Beträffande Uppfostran Parent Form (S-EMBU-P) to evaluate their parenting styles (i.e., emotional warmth, rejection, and overprotection), and the 48-item Conners' Parent Rating Scale (CPRS-48) to measure behavioral problems in their children. Logistic regression models were established to examine the association between cumulative number of maternal ACEs and children's behavioral problems. The mediating role of parenting styles in this association was explored by generalized structural equation models (GSEM).
Of the participating mothers, 85.8% (n = 3641) reported having experienced at least one type of ACE. Children of mothers with ≥2 ACEs showed a significantly increased risk of behavioral problems across all dimensions, including conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, anxiety, and hyperactivity index, in both crude and adjusted models (all p-values < 0.05). Dose-response patterns were also observed between the cumulative number of maternal ACEs and children's behavioral problems. In addition, maternal parenting styles of rejection emerged as a significant mediator, accounting for approximately 8.4-15.0% of the associations.
Our findings indicated an intergenerational association of maternal ACEs with behavioral problems in preschool offspring, which was mediated by maternal parenting styles of rejection. Early screening and targeted intervention strategies are critical to mitigate the downstream consequences of maternal ACEs on young children's outcomes. Providing support and resources to improve parenting skills may prove beneficial.
研究发现母亲童年不良经历（ACEs）史与儿童健康结局相关。然而，其潜在机制尚不清楚。本研究旨在探讨母亲ACEs与其学龄前子女行为问题之间的关联，并探究母亲养育方式在该关联中的潜在中介作用。
在中国成都对4243对母婴进行了一项横断面研究。母亲们完成了《童年不良经历国际问卷》（ACE-IQ）以评估她们的ACEs史（即身体虐待、情感虐待、身体忽视、情感忽视、目睹家庭暴力、家庭药物滥用、家庭精神疾病、家庭成员入狱、父母分居或离婚、父母死亡、欺凌和社区暴力），完成了简版《父母养育方式问卷》（S-EMBU-P）以评估她们的养育方式（即情感温暖、拒绝和过度保护），并完成了48项版的《康纳斯父母评定量表》（CPRS-48）以测量其子女的行为问题。建立逻辑回归模型以检验母亲ACEs累积数量与儿童行为问题之间的关联。通过广义结构方程模型（GSEM）探究养育方式在该关联中的中介作用。
在参与研究的母亲中，85.8%（n = 3641）报告至少经历过一种类型的ACE。在未调整和调整后的模型中，母亲有≥2种ACEs的儿童在所有维度上出现行为问题的风险均显著增加，包括品行问题、学习问题、身心问题、冲动多动、焦虑和多动指数（所有p值<0.05）。在母亲ACEs累积数量与儿童行为问题之间也观察到剂量反应模式。此外，母亲的拒绝养育方式是一个显著的中介因素，约占该关联的8.4%-15.0%。
我们的研究结果表明母亲ACEs与学龄前子女行为问题之间存在代际关联，这种关联由母亲的拒绝养育方式介导。早期筛查和针对性干预策略对于减轻母亲ACEs对幼儿结局的下游影响至关重要。提供支持和资源以提高养育技能可能会有所帮助。
