Skip to main content
NCBI home page
European Journal of Psychotraumatology logoLink to European Journal of Psychotraumatology
. 2023 Mar 15;14(1):2185414. doi: 10.1080/20008066.2023.2185414

Intergenerational associations of adverse and positive maternal childhood experiences with young children’s psychosocial well-being

Asociaciones intergeneracionales de experiencias maternas adversas y positivas de la infancia con el bienestar psicosocial de los niños pequeños

母亲不良和积极的童年经历与幼儿社会心理健康的代际关联

Yantong Zhu a, Gengli Zhang b, Tokie Anme c,CONTACT
PMCID: PMC10026815  PMID: 36919776

ABSTRACT

Background: Maternal adverse childhood experiences (ACEs) are believed to have negative consequences on offspring health. However, positive childhood experiences (PCEs) may be concurrent with ACEs, and little is known about how ACEs and PCEs transmit intergenerationally in the context of each other.

Objective: To explore the independent effect of maternal ACEs and PCEs on offspring psychosocial well-being and how ACEs and PCEs are intergenerationally transmitted in their context.

Method: Data were 2587 mother–child dyads in Anhui provinces of China. Mothers retrospectively reported their ACEs and PCEs, as well as provided demographic characteristics and their children’s psychosocial well-being. Logistic regression models were performed to explore the associations of maternal ACEs and PCEs with offspring psychosocial well-being.

Results: Separate unadjusted logistic regression models showed that children with mothers reported high ACEs scores were more likely to have psychosocial challenges (total difficulties and prosocial problems), while children whose mothers reported high PCEs scores were less likely to have psychosocial challenges. When we added maternal ACEs and PCEs to a same model, we found that PCEs slightly neutralised the negative effects of ACEs on offspring’s total difficulties and prosocial problems. When stratified by sample, mothers with high PCE scores and higher maternal ACEs were related with a higher risk of offspring total difficulties; mothers with low levels of ACEs and high PCEs tend to report a lower risk of offspring total difficulties.

Conclusions: Results suggest that PCEs are positively and intergenerationally transmitted. Results suggest that PCEs are positively and intergenerationally transmitted. More programme should be provided to increase maternal PCEs. When preventing the intergenerational transmission of ACEs, specific interventions should be provided to mothers with different levels of PCEs.

KEYWORDS: Maternal ACEs, maternal PCEs, offspring psychosocial well-being, Chinese preschoolers, resilience

HIGHLIGHTS

  • Positive childhood experiences positively transmit intergenerationally.

  • Stronger relationship between maternal ACEs and risk of offspring total difficulties was observed among mothers with above-average positive childhood experiences scores.

  • A stronger relationship between maternal PCEs and fewer offspring total difficulties was observed among mothers with low adverse maternal childhood experiences scores.

1. Background

Adverse childhood experiences (ACEs) include abuse, neglect, and dysfunctional households, can be harmful to individuals’ health (Felitti et al., 1998). A new and emerging line of studies examined the intergenerational transmission of ACEs and found that mothers’ ACEs not only affect their parenting abilities but also their children's behavioural problems (Greene et al., 2020; McDonald et al., 2019). There are two main categories of behaviour problems: those that are externalising (defined by aggressiveness and acting-out behaviours) and those that are internalising (characterised by anxiety, withdrawal, and depression) (Achenbach & Rescorla, 2000). Previous research has emphasised the influence of maternal ACEs on their offspring behavioural problems, and there may be biological and psychosocial mechanisms which can explain the relationship between maternal ACEs and offspring behavioural problems (Cooke et al., 2019). Previous studies have suggested that almost 70% of Chinese preschool mothers experienced at least one ACEs (Wang et al., 2022). Therefore, we should pay more attention to the intergenerational transmission of the ACEs of Chinese preschool mothers on their offspring’s psychosocial well-being.

Positive childhood experiences (PCEs) include internal and external perceived safety, security, support, and positive and predictable quality of life from birth to the age of 18 (Narayan et al., 2018). Studies have shown that parental PCEs may also transmit across generations as well and should be included when screening for parents’ and children’s ACEs (Narayan et al., 2021). PCEs are viewed as factors promoting positive adult functioning (Narayan et al., 2018), which may buffer the effect of maternal ACEs on offspring negative outcomes. Therefore, current study aimed to explore the independent relationships between maternal ACEs, PCEs, and offspring psychosocial well-being, and the associations of maternal ACEs and PCEs with offspring psychosocial well-being in the context of each other.

1.1. Maternal ACEs and offspring psychosocial well-Being

Mothers with higher level of ACEs tend to be at risk in mental health problems and problematic parenting, which may affect psychosocial well-being in offspring. Letourneau et al. (2019) found that maternal ACEs may lead to anxiety and depression, thus causing their children to internalise and externalise problems. In addition, studies suggest that mothers with higher exposure to ACEs may have parenting difficulties, which increase the risk of offspring problem behaviours (Greene et al., 2020). Previous studies have suggested that maternal ACEs are associated with problematic parenting and emotional dysregulation (Bailey et al., 2012; Julian et al., 2018; Lomanowska et al., 2017). These difficulties might make it more difficult to establish stable, supportive households, which might then have an impact on a child's development and the wellbeing of the family (Collins et al., 2000). Other studies have found biological mechanisms between maternal ACEs and offspring psychosocial well-being (Monk et al., 2019). Currently, there are differences in the strength and statistical significance of relationships between parental ACEs and behaviour problems in children, and one possible explanation for these disparities is the variation in sample sociodemographic characteristics (Racine et al., 2018). In comparison to western countries, Asian cultures are seen to be more supportive of strict parenting practices and punishments (Wang and Liu, 2014). In China, it is usual for parents to seldom express their love for their children and instead to display their authority by disciplining or intimidating them when children don't perform according to their expectation (Evans, 2012). Additionally, several studies noted that in traditional Chinese society, the social expectations for girls are higher, which might increase the self-blame experienced by Chinese female and eventually result in mental health issues for Chinese mothers who have experienced ACEs (Jiang et al., 2022). Therefore, it is important to identify whether maternal ACEs affects psychosocial well-being in the offspring.

1.2. Maternal PCEs and offspring psychosocial well-being

Research on PCEs and the extent to which they may act as important protective factors for the intergenerational transmission of ACEs have been largely overlooked by the extant literature. From the perspective of developmental psychopathology, early experiences are transactional and cumulative, and their interaction with subsequent developmental stages may differentially predict the pathways of risk versus resilience (Cicchetti, 2016; Masten et al., 2021; Sameroff, 2000). Previous studies have suggested that PCEs may confer the potential for more resilient functioning and are associated with low mental health risks (Bellis et al., 2018; Bethell et al., 2019). Despite facing adversity, parents with rich PCEs may be better able to use these resources to protect their children against from negative outcomes (Narayan et al., 2021). However, a recent study conducted in a Chinese sample found that participants with higher PCEs were more likely to have mental problems than participants with lower PCEs (Xu et al., 2022). To date, few studies have revealed the intergenerational effect of PCEs and ACEs in their context. Therefore, this study aims to extend previous research by revealing the intergenerational effects of PCEs and ACEs in their context among Chinese preschool mothers and their children.

1.3. Current study

In this study, we aimed to extend literatures by examining the independent effect of maternal ACEs and PCEs on offspring psychosocial well-being, as well as how maternal ACEs and PCEs are associated with offspring psychosocial well-being in the context of one another. Based on previous studies, we hypothesised that: (1) maternal PCEs are independently negatively associated with offspring psychosocial well-being; (2) PCEs will counteract ACEs’ detrimental impacts on offspring psychosocial well-being; (3) the relationship between maternal ACEs and psychosocial well-being will be decreased among those with higher than average PCEs scores; and (4) PCEs will have less effect on offspring psychosocial well-being on those with four or more maternal ACEs compared to mothers with three or fewer ACEs.

2. Methods

2.1. Study design and participants

Data were obtained from the first wave of the Anhui Family Cohort study, which aims to break the intergenerational cycle of ACEs. Parent–child dyads from 11 kindergartens in Anhui provinces of China in 2022. Kindergartens in China provide educational and care services for children aged 3–6 before children enter elementary school. The gross domestic product (GDP) of Anhui province in 2020 was CNY 3,868.1 billion, representing moderate level in China (National Bureau of Statistics of China, 2021). The detail of study design and participants also can be found in our previous study (Zhu et al., 2022). Of the total sample, the average age of mothers were 34.38 years (SD = 4.89). Their offspring were 2,587 three- to six-year-old preschoolers (51.8% male) with a mean age (M) of 64.24 months (SD = 10.33). Over 90% of families have an annual income that is greater than 50,000 Yuan and higher than the poor family income standard (Ji et al., 2020).

The objectives of the study were informed to teachers and school principals, and parents were invited to attend the parent-teacher conference to introduce the aim of this study. A total of 2587 parents received the invitation, and all agreed to participate in this study. After receiving the consent forms, online questionnaires were sent to the parents. Parents were requested to answer all the study questions in the questionnaire as well as to provide their demographic information. 2587 online questionnaire were received, all the parents provided the valid data that was used in the subsequent data analysis. This study was approved by the ethics committee of our affiliated university.

2.2. Measurement

2.2.1. Maternal ACEs

Maternal ACEs were measured using the Chinese version of the Adverse Childhood Experiences International Questionnaire (ACE-IQ) (WHO, 2019; Wang et al., 2022). Mothers were asked to report adverse childhood experiences before the age of 18 years. The ACE-IQ includes seven categories: emotional abuse (two items, i.e. ‘Did a parent, guardian, or other household members yell, scream or swear at you, insult or humiliate you?’), emotional neglect (two items, i.e. ‘Did your parents/guardians understand your problems and worries?’), physical abuse (two items, i.e. ‘Did your parents/guardians understand your problems and worries?’), physical neglect (three items, i.e. ‘Did your parents/guardians understand your problems and worries?’), peer bullying (three items, i.e. ‘Did your parents/guardians understand your problems and worries?’), community violence (two items, i.e. ‘Did you see or hear someone being threatened in real life?’), and household dysfunction (six items, i.e. ‘Did you live with a household member who was ever sent to jail or prison?’). The first five categories were measured using a 5-point scale ranging from 1 (never true) to 5 (very often true). If they responded as ‘rarely true,’ ‘sometimes true,’ ‘often true,’ or ‘very often true’ to any of the category's items, they were considered to have been exposed to it; otherwise, they were coded ‘0.’ Household dysfunction was measured using a 2-point scale and participants answered ‘yes’ or ‘no’. If they answered ‘yes’ to any of the six questions, they were considered to have been exposed to household dysfunction and labelled ‘1,’ whereas those who did not were coded ‘0.’ The cumulative ACE-IQ score ranged from 0 to 7 in this study. The ACE-IQ Chinese version showed a satisfied Cronbach’s alpha in our study (0.77).

2.2.2. Maternal PCEs

The Benevolent Childhood Experiences (BCEs) Scale was used to measure maternal PCEs (Narayan et al., 2018), which has been proved good validity and reliability (Zhan et al., 2021). Mothers reported PCEs according to their positive experiences before the age of 18. The PCEs contained 10 yes/no items related to predictable and positive quality of life, social support, perceived internal and relational safety (Narayan et al., 2018). The total score of BCEs scale ranged from 0 to 10, with a high score indicating a high level of PCEs. Cronbach’s α of the Chinese version of BCEs scale was 0.70.

2.2.3. Offspring psychosocial well-Being

Strengths and Difficulties Questionnaire (SDQ) Chinese version was used to measure offspring’s psychological well-being (Du et al., 2008; Goodman, 1997; Shan et al., 2019). Mothers reported their offspring behaviours according to the past six months. The scale includes five subscales: conduct problems (five items), hyperactivity (five items), emotional problems (five items), peer problems (five items), and prosocial behaviour (five items). Mothers responded on a 3-point scale ranging from 0 (not true) to 2 (certainly true). The prosocial behaviour subscale reflects the child’s strength, while the other four subscales comprise children’s total difficulties. The score for prosocial behaviour ranged from 0 to 10 and was cut off into at-risk (0-5) and normal group (≥6). The scores for total difficulties ranged from 0 to 40 in the at-risk (≥14) and normal (0-13) groups (Shan et al., 2019). The cut-off values have been validated in Chinese children aged 3–16 years (Du et al., 2008). Cronbach’s α for prosocial behaviour and total difficulties were 0.75 and 0.76, respectively.

2.2.3. Covariates

Child age (months), child sex (1 = male, 2 = female), mother’s age (years), and family socioeconomic status (SES) were included as covariates (Zhu et al., 2022). Five indicators were used for SES: father and mother’s occupation, education level, and family income. The details can be found in Table 1.

Table 1.

Demographic information for participants and descriptive information for all variables.

Variables Category n (%) or Mean ± SD
Child’s age (month)   64.24 ± 10.33
Child’s gender Boy 1340 (51.8)
  Girl 1247 (48.2)
Maternal age (year)   34.38 ± 4.89
Father’s occupation Unemployed, nontechnical worker, and farmer 154 (6.0)
  Semi-technical worker and small business owner 666 (25.7)
  Technical worker and semi-professional 577 (22.3)
  Professional, officer, and owner of mid-sized business 736 (28.4)
  High-level professional and administrators 454 (17.5)
Mother’s occupation Unemployed, nontechnical worker, and farmer 716 (27.7)
  Semi-technical worker and small business owner 341 (13.2)
  Technical worker and semi-professional 556 (21.5)
  Professional, officer, and owner of mid-sized business 823 (31.8)
  High-level professional and administrators 151 (5.8)
Father’s education level Primary school or below 21 (0.8)
  Middle school or below 414 (16.0)
  High school or vocational secondary school 416 (16.1)
  Vocational college degree 579 (22.4)
  Bachelor's degree 1005 (38.8)
  Master's degree or above 152 (5.9)
Mother’s education level Primary school or below 33 (1.3)
  Middle school or below 461 (17.8)
  High school or vocational secondary school 370 (14.3)
  Vocational college degree 674 (26.1)
  Bachelor's degree 948 (36.6)
  Master's degree or above 101 (3.9)
Family’s annual income <50000 RMB 255 (9.9)
  50001–10,0000 RMB 749 (29.0)
  100,001–150,000 RMB 672 (26.0)
  150,001–300,000 RMB 677 (26.2)
  >300,000 RMB 234 (9.0)
ACEs   3.44 ± 1.85
PCEs   9.10 ± 1.45
Total difficulties Normal 2077 (80.3)
  At risk 510 (19.7)
Prosocial problems Normal 2036 (78.7)
  At risk 551 (21.3)
Open in a new tab

ACEs: adverse childhood experiences; PCEs: positive childhood experiences.

2.2.4. Data analysis

First, we used descriptive analysis to describe the demographic characteristics of the participants. We then used a series of logistic regressions for the binary outcome variable. Two separate unadjusted logistic regression models were used to test the independent associations between maternal ACEs and PCEs and offspring total difficulties and prosocial problems (Hypothesis 1). We then adjusted for children’s age, sex, months’ age, five SES indicators, the PCEs score, and the ACEs score in each model (Hypothesis 2). To test the relationship between maternal ACEs and total difficulties and prosocial problems in the context of PCEs (Hypothesis 3), we stratified the participants by PCEs score into two groups by a mean split (≤9.0 vs. > 9.0), which were often used in Western and Chinese samples in grouping PCEs (Crandall et al., 2019; Hou et al., 2022). A logistic regression model was used to examine maternal ACEs, total difficulties, and prosocial problems in the two PCEs groups. Children’s age, sex, months’ age, and five SES indicators were controlled in the model. To test the relationship between maternal PCEs and total difficulties and prosocial problems in the context of ACEs (hypothesis 4), we stratified the participants by score on ACEs into high and low ACEs groups (≥4.0 vs. 0–3) (Meehan et al., 2022). Furthermore, logistic regression was performed for PCEs and offspring outcomes in the two ACEs groups and was controlled for children’s age, sex, months’ age, and five SES indicators. SPSS (version 28.0; SPSS Inc., Chicago, IL, USA) was used for data analysis.

3. Results

A total of 2,587 mothers reported ACEs and PCEs with a mean score of 3.44 (SD = 1.85) and 9.10 (SD = 1.45), respectively. In total, 19.7% (n = 510) of the offspring were reported to be at risk for total difficulties and 21.3% (n = 551) were reported to be at a risk of prosocial problems. More than half (57.4%) of the mothers reported having all 10 PCEs. The percentage of participants endorsing emotional abuse, emotional neglect, physical abuse, physical neglect, community violence, peer bullying, and household dysfunction were 46.5%, 22.7%, 58.6%, 44.1%, 69.4%, 65.8%, and 36.7%, respectively. The prevalence rates of each type of PCEs (caregivers with whom felt safe, good friends, comfortable beliefs, like schools, caring teachers, good neighbours, supportive adults, opportunities to have a good time, love yourself, a predictable home routine) were 95.3%, 98.1%, 88.8%, 94.7%, 89.9%, 92.3%, 73.1%, 90.6%, 93.7%, and 93.6%, respectively. Table 1 shows the results of the descriptive statistics. Table 2 shows the correlations of main variables.

Table 2.

Correlations for Main Research Variables.

Measure 1 2 3 4
1 ACEs –      
2 PCEs −.31** –    
3 Total difficulties .22** −.17** –  
4 Prosocial problems −.15** .13** −.43** –
Open in a new tab

** p < .01.

3.1. Maternal childhood experiences and offspring outcomes

The logistic regression results are presented in Table 3. In the unadjusted model, children whose mothers reported high ACEs scores were more likely to have total difficulties (OR = 1.23; 95%CI = 1.16, 1.29) and prosocial problems (OR = 1.09; 95%CI = 1.03, 1.14). In the adjusted model, when controlling for children’s age, gender, maternal age, family socioeconomic status, and PCEs, the results for ACEs and offspring outcomes remained significant, and the estimates showed a slight decrease for ACEs and total difficulties (OR = 1.18; 95%CI = 1.13, 1.27) and prosocial problems (OR = 1.07; 95%CI = 1.02, 1.14). Children whose mothers reported high PCEs scores were less likely to have risk for total difficulties (OR = 0.82; 95%CI = 0.77, 0.87) and prosocial problems (OR = 0.90; 95%CI = 0.85, 0.95). When controlling for children’s age, gender, maternal age, family socioeconomic status, and ACEs, the results for PCEs and offspring outcomes remained significant, and the estimates showed a slight decrease for PCEs and total difficulties (OR = 0.88; 95%CI = 0.83, 0.94) and prosocial problems (OR = 0.93; 95%CI = 0.87, 0.99).

Table 3.

Independent associations between maternal ACEs and PCEs and offspring outcomes.

  ACEs PCEs
Outcome variables Unadjusted Adjusteda Unadjusted Adjustedb
Total difficulties 1.23 (1.16, 1.29) *** 1.18 (1.13, 1.27) *** 0.82 (0.77, 0.87) *** 0.88 (0.83, 0.94) ***
Prosocial problems 1.09 (1.03, 1.15) ** 1.07 (1.02, 1.14) * 0.90 (0.85, 0.95) *** 0.93 (0.87, 0.99) *
Open in a new tab

Note: ** p < .01, *** p < .001. The reference group for total difficulties and prosocial problems comprised the normal group.

a

Adjusted models for children’s age, sex, maternal age, family socioeconomic status (five factors), and PCEs. bAdjusted models for children’s age, sex, maternal age, family socioeconomic status (five factors), and ACEs.

ACEs: adverse childhood experiences; PCEs: positive childhood experiences.

3.2. Associations of maternal ACEs and PCEs with offspring outcomes in the context of one another

After adjusting for covariates, when stratifying the sample by PCEs scores, mothers with high average PCE scores (e.g. > 9 PCEs) and higher maternal ACEs were associated with a higher risk of total difficulties problems in offspring (>9 PCEs: OR = 1.24, 95%CI = 1.14, 1.34; ≤ 9 PCEs: OR = 1.20, 95%CI = 1.10, 1.31). Furthermore, when stratifying the sample by ACEs scores, mothers with low levels of ACEs (e.g. < 4 ACEs) and high PCEs were associated with a lower risk of offspring total difficulties problems (<4 ACEs: OR = 0.79, 95%CI = 0.69, 0.90; ≥ 4 ACEs: OR = 0.89, 95%CI = 0.83, 0.96). The results were shown in Table 4 and Table 5.

Table 4.

Association between maternal ACEs and offspring outcomes in the context of PCEs.

  Stratification by PCEs score  
  ≤9 PCEs >9 PCEs
  n = 1103 n = 1484
Outcome variables ACEs ACEs
Total difficulties 1.20 (1.10, 1.31) *** 1.24 (1.14, 1.34) ***
Prosocial problems 1.07 (0.98, 1.16) 1.11 (1.03, 1.19) **
Open in a new tab

Note: ** p < .01, *** p < .001. All models control for children’s age, sex, maternal age, and family socioeconomic status (five factors). The reference group for total difficulties and prosocial problems comprised the normal group.

ACEs: adverse childhood experiences; PCEs: positive childhood experiences.

Table 5.

Association between maternal PCEs and offspring outcomes in the context of ACEs.

  Stratification by ACEs score  
  <4 ACEs ≥4 ACEs
  n = 1264 n = 1323
Outcome variables PCEs PCEs
Total difficulties 0.79 (0.69, 0.90) *** 0.89 (0.83, 0.96) **
Prosocial problems 0.85 (0.75, 0.97) * 0.95 (0.89, 1.02)
Open in a new tab

Note: * p < .05, ** p < .01, *** p < .001. All models control for children’s age, sex, maternal age, and family socioeconomic status (five factors). The reference group for total difficulties and prosocial problems comprised the normal group.

ACEs: adverse childhood experiences; PCEs: positive childhood experiences.

4. Discussion

This study is the first to examine the associations of maternal PCEs with offspring psychosocial well-being among Chinese preschool samples and the impact of mothers’ ACEs and PCEs on offspring psychosocial well-being in the context of one another. Similar to previous studies, this study found negative associations between PCEs and offspring’s total difficulties and prosocial problems. The associations of maternal ACEs and PCEs with offspring outcomes in the context of one another show different results.

Similar with previous studies, children whose mother with high level of ACEs were more likely to have psychosocial difficulties (Greene et al., 2020; McDonald et al., 2019). According to attachment theory (Bowlby, 2008), mothers who experienced adversities in childhood may develop mental representations of unreliability and untrustworthiness with parents, subsequently leading to the formation of insecure and disordered attachments, which in turn lead to the adoption of negative parenting strategies in adulthood and cause offspring psychosocial difficulties (Cooke et al., 2019). Exposure to early adversity may affect brain development and have long last effect on mental illness (Navalta et al., 2018). Previous studies have shown that several areas connected to the default mode network have decreased cortical thickness (i.e. posterior cingulate cortex) and surface area (i.e. rostral anterior cingulate cortex) among young adults who experienced childhood trauma (Price et al., 2021), which may associate with low emotional regulation and tend have to mental illness (Etkin et al., 2010). There is also some consistent evidence that exposure to ACEs is positively related to NR3C1 epigenetic modification and mental illness (Lang et al., 2020). Children's mental health suffers as a result of being raised by a mentally ill parent (Leijdesdorff et al., 2017). Furthermore, a recent study revealed that parental ACEs can affect DNA methylation in her new-born offspring intergenerationally and therefore cause their children’ later behavioural problems (Merrill et al., 2021; Scorza et al., 2020). HPA-axis function is also an explanation of intergeneration transmission of maternal ACEs. Frequency and exposure to ACEs are positive correlated with changes in the function of the maternal HPA-axis and higher levels of its end product, cortisol, and result in offspring behavioural problems (Thomas-Argyriou et al., 2021). The results also revealed that children whose mothers had higher PCEs were less likely to have psychosocial difficulties. Parents with higher PCEs may be more likely to generate feelings of kindness, compassion, and security in their children (Narayan et al., 2019), which may enhance parent–child relationships and decrease the risk of behavioural problems (Zhu et al., 2021). More PCEs in childhood may lead to better long-term mental health outcomes and fewer chronic health problems as children age (Shaw et al., 2003), which may reduce the risk of psychological problems in children (Boursnell, 2011). In addition, a previous study suggested that positive childhood experiences can be transmitted through generations by influencing constructive parental methods (Chen et al., 2008), positive attitudes (Morris et al., 2021), and behaviours (Kosterman et al., 2011).

Furthermore, when we added maternal PCEs and ACEs to the same model, we found that PCEs slightly neutralised the negative effects of ACEs on offspring’s psychosocial well-being (total difficulties and prosocial problems). According to the compensatory model of resilience, separate from a risk factor, positive or protective variables have a direct, independent impact on a result. Furthermore, these positive factors counteract the negative effects of risk factors and have the opposite result (Zimmerman, 2013). In particular, if women report high ACEs and low positive childhood experiences, assessing PCEs during pregnancy, adulthood, and parenthood may promote chances to provide resources and take preventive action before children are born (Davis & Narayan, 2020).

However, the relationship between maternal ACEs and offspring total difficulties was stronger among those with above-average PCEs scores than among those with average or lower PCEs. Similar to previous studies, ACEs had stronger associations with negative outcomes in those with more PCEs (Crandall et al., 2019; Xu et al., 2022). This may be because individuals who have had more PCEs may feel more shame when ACEs occur (Crandall et al., 2019). Studies have suggested that shame can cause distortions in the child–parent relationship, which can have long-term negative consequences (Kirby et al., 2019). Mothers with high-level shame tend to have less compassion and high-level psychological control for their children (Kirby et al., 2019), thus leading their offspring behavioural problems (Olsen et al., 2002; Zhang et al., 2019).

With four or more ACEs, the benefit of maternal PCEs was still present, but the effect decreased. According to the Challenge Model, moderate levels of adversity immunise against additional adverse exposures, leaving people sensitive to negative outcomes (Zimmerman, 2013). However, if the adversity is too high, the system becomes overwhelmed, and coping becomes difficult (Crandall et al., 2019). Previous studies have also suggested that PCEs can reduce the influence of ACEs on mental health to some extent, but they cannot completely eliminate the detrimental effects of high ACEs exposure (Qu et al., 2022). Therefore, the effect of PCEs may decrease when mothers have high levels of ACEs.

Overall, our study extends the previous study by revealing the negative associations of maternal PCEs and offspring psychological well-being and the associations of maternal ACEs and PCEs with offspring outcomes in the context of one another. This is particular when mothers with high levels of PCEs were associated with a higher risk of total difficulties problems in their offspring. Nonetheless, the results of this study must be interpreted in the context of some limitations. First, this study did not include sexual abuse in maternal ACEs. Although previous studies have suggested that sexual abuse is related to offspring health (Roberts et al., 2004), because of the shame and sensitivity involved in sexual victimisation in China, we did not include childhood sexual abuse. Second, ACEs and PCEs were retrospectively reported by the mothers. Recall bias may exist because of the amount of time that has elapsed between the events and remembrance. Third, the offspring outcomes were reported by their parents. A single source of data may not accurately reflect children’s psychological well-being. In future studies, we recommend integrating these methods in future investigations for more thorough assessments (e.g. teacher-report children’s psychological well-being).

5. Conclusions

Maternal ACEs are negatively associated with offspring psychological well-being, whereas PCEs have a positive effect on intergenerational transmission. In the context of one another, PCEs have a stronger effect on offspring total difficulties when mothers have lower ACE, and ACEs have a stronger effect on offspring total difficulties when mothers have higher PCEs. More programme should be provided to increase maternal PCEs. When preventing the intergenerational transmission of ACEs, specific interventions should be provided to mothers with different levels of PCEs.

Acknowledgments

We express our deepest gratitude to all the participants.

Funding Statement

This work was supported by JSPS KAKENHI [grant number JP21H00790] and JST SPRING.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

Yantong Zhu: Formal analysis, conceptualisation, methodology, writing–original draft.

Gengli Zhang: Editing and reviewing.

Tokie Anme: Data curation, visualisation, supervision, project administration, funding acquisition.

Ethics approval

This study was approved by the Ethics Committee of the Anhui Normal University (AHNU-ET2021034). The children’s parents were informed about the study’s objectives and processes, and that they had the right to withdraw from the study at any time.

Consent to participate

All participants provided written informed consent prior to participation.

Consent for publication

The authors consent to the publication of the work in the journal.

References

  1. Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA preschool forms and profiles (Vol. 30). University of Vermont, Research Center for Children, Youth, & Families. [Google Scholar]
  2. Bailey, H. N., DeOliveira, C. A., Wolfe, V. V., Evans, E. M., & Hartwick, C. (2012). The impact of childhood maltreatment history on parenting: A comparison of maltreatment types and assessment methods. Child Abuse & Neglect, 36(3), 236–246. 10.1016/j.chiabu.2011.11.005 [DOI] [PubMed] [Google Scholar]
  3. Bellis, M. A., Hughes, K., Ford, K., Hardcastle, K. A., Sharp, C. A., Wood, S., Homolova, L., & Davies, A. (2018). Adverse childhood experiences and sources of childhood resilience: A retrospective study of their combined relationships with child health and educational attendance. BMC Public Health, 18(1), 1–12. 10.1186/s12889-018-5699-8 [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bethell, C., Jones, J., Gombojav, N., Linkenbach, J., & Sege, R. (2019). Positive childhood experiences and adult mental and relational health in a statewide sample. JAMA Pediatrics, 173(11), e193007–e193007. 10.1001/jamapediatrics.2019.3007 [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Boursnell, M. (2011). Parents with mental illness: The cycle of intergenerational mental illness. Children Australia, 36(1), 26–35. 10.1375/jcas.36.1.26 [DOI] [Google Scholar]
  6. Bowlby, J. (2008). Attachment. Basic books. [Google Scholar]
  7. Chen, Z.-y., Liu, R. X., & Kaplan, H. B. (2008). Mediating mechanisms for the intergenerational transmission of constructive parenting. Journal of Family Issues, 29(12), 1574–1599. 10.1177/0192513X08318968 [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cicchetti, D. (2016). Socioemotional, personality, and biological development: Illustrations from a multilevel developmental psychopathology perspective on child maltreatment. Annual Review of Psychology, 67(1), 187–211. https://www.annualreviews.org/doi/abs/10.1146annurev-psych-122414-033259. 10.1146/annurev-psych-122414-033259 [DOI] [PubMed] [Google Scholar]
  9. Collins, W. A., Maccoby, E. E., Steinberg, L., Hetherington, E. M., & Bornstein, M. H. (2000). Contemporary research on parenting: The case for nature and nurture. American Psychologist, 55(2), 218–232. 10.1037/0003-066X.55.2.218 [DOI] [PubMed] [Google Scholar]
  10. Cooke, J. E., Racine, N., Plamondon, A., Tough, S., & Madigan, S. (2019). Maternal adverse childhood experiences, attachment style, and mental health: Pathways of transmission to child behavior problems. Child Abuse & Neglect, 93, 27–37. 10.1016/j.chiabu.2019.04.011 [DOI] [PubMed] [Google Scholar]
  11. Crandall, A., Miller, J. R., Cheung, A., Novilla, L. K., Glade, R., Novilla, M. L. B., Magnusson, B. M., Leavitt, B. L., Barnes, M. D., & Hanson, C. L. (2019). ACEs and counter-ACEs: How positive and negative childhood experiences influence adult health. Child Abuse & Neglect, 96, Article 104089. 10.1016/j.chiabu.2019.104089 [DOI] [PubMed] [Google Scholar]
  12. Davis, E. P., & Narayan, A. J. (2020). Pregnancy as a period of risk, adaptation, and resilience for mothers and infants. Development and Psychopathology, 32(5), 1625–1639. 10.1017/S0954579420001121 [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Du, Y., Kou, J., & Coghill, D. (2008). The NICE ADHD health technology assessment: A review and critique. Child and Adolescent Psychiatry and Mental Health, 2(1), 1–15. 10.1186/1753-2000-2-1 [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Etkin, A., Prater, K. E., Hoeft, F., Menon, V., & Schatzberg, A. F. (2010). Failure of anterior cingulate activation and connectivity with the amygdala during implicit regulation of emotional processing in generalized anxiety disorder. American Journal of Psychiatry, 167(5), 545–554. 10.1176/appi.ajp.2009.09070931 [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Evans, H. (2012). The intimate individual: Perspectives from the mother-daughter relationship in urban China. In A. B. Kipnis (Eds), Chinese modernity and the individual psyche (pp. 119–147). Culture, Mind, and Society. New York: Palgrave Macmillan. 10.1057/9781137268969_6 [DOI]
  16. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245–258. 10.1016/S0749-3797(98)00017-8 [DOI] [PubMed] [Google Scholar]
  17. Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38(5), 581–586. 10.1111/j.1469-7610.1997.tb01545.x [DOI] [PubMed] [Google Scholar]
  18. Greene, C. A., Haisley, L., Wallace, C., & Ford, J. D. (2020). Intergenerational effects of childhood maltreatment: A systematic review of the parenting practices of adult survivors of childhood abuse, neglect, and violence. Clinical Psychology Review, 80, Article 101891. 10.1016/j.cpr.2020.101891 [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Hou, H., Zhang, C., Tang, J., Wang, J., Xu, J., Zhou, Q., Yan, W., Gao, X., & Wang, W. (2022). Childhood experiences and psychological distress: Can benevolent childhood experiences counteract the negative effects of adverse childhood experiences? Frontiers in Psychology, 13, 800871–800871. 10.3389/fpsyg.2022.800871 [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Ji, Y., Yun, Q., Jiang, X., & Chang, C. (2020). Correlates, facilitators and barriers of physical activity among primary care patients with prediabetes in Singapore – a mixed methods approach. BMC Public Health, 20(1), 1–9. 10.1186/s12889-019-7969-5 [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Jiang, W., Ji, M., Chi, X., & Sun, X. (2022). Relationship between adverse childhood experiences and mental health in Chinese adolescents: Differences among girls and boys. Children, 9(5), 689. 10.3390/children9050689 [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Julian, M. M., Rosenblum, K. L., Doom, J. R., Leung, C. Y., Lumeng, J. C., Cruz, M. G., Vazquez, D. M., & Miller, A. L. (2018). Oxytocin and parenting behavior among impoverished mothers with low vs. high early life stress. Archives of Women's Mental Health, 21(3), 375–382. 10.1007/s00737-017-0798-6 [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Kirby, J. N., Sampson, H., Day, J., Hayes, A., & Gilbert, P. (2019). Human evolution and culture in relationship to shame in the parenting role: Implications for psychology and psychotherapy. Psychology and Psychotherapy: Theory, Research and Practice, 92(2), 238–260. 10.1111/papt.12223 [DOI] [PubMed] [Google Scholar]
  24. Kosterman, R., Mason, W. A., Haggerty, K. P., Hawkins, J. D., Spoth, R., & Redmond, C. (2011). Positive childhood experiences and positive adult functioning: Prosocial continuity and the role of adolescent substance use. Journal of Adolescent Health, 49(2), 180–186. 10.1016/j.jadohealth.2010.11.244 [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Lang, J., McKie, J., Smith, H., McLaughlin, A., Gillberg, C., Shiels, P. G., & Minnis, H. (2020). Adverse childhood experiences, epigenetics and telomere length variation in childhood and beyond: A systematic review of the literature. European Child & Adolescent Psychiatry, 29(10), 1329–1338. 10.1007/s00787-019-01329-1 [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Leijdesdorff, S., van Doesum, K., Popma, A., Klaassen, R., & van Amelsvoort, T. (2017). Prevalence of psychopathology in children of parents with mental illness and/or addiction. Current Opinion in Psychiatry, 30(4), 312–317. 10.1097/YCO.0000000000000341 [DOI] [PubMed] [Google Scholar]
  27. Letourneau, N., Dewey, D., Kaplan, B. J., Ntanda, H., Novick, J., Thomas, J. C., Deane, A. J., Leung, B., Pon, K., & Giesbrecht, G. (2019). Intergenerational transmission of adverse childhood experiences via maternal depression and anxiety and moderation by child sex. Journal of Developmental Origins of Health and Disease, 10(1), 88–99. 10.1017/S2040174418000648 [DOI] [PubMed] [Google Scholar]
  28. Lomanowska, A. M., Boivin, M., Hertzman, C., & Fleming, A. S. (2017). Parenting begets parenting: A neurobiological perspective on early adversity and the transmission of parenting styles across generations. Neuroscience, 342, 120–139. 10.1016/j.neuroscience.2015.09.029 [DOI] [PubMed] [Google Scholar]
  29. Masten, A. S., Lucke, C. M., Nelson, K. M., & Stallworthy, I. C. (2021). Resilience in development and psychopathology: Multisystem perspectives. Annual Review of Clinical Psychology, 17(1), 521–549. 10.1146/annurev-clinpsy-081219-120307 [DOI] [PubMed] [Google Scholar]
  30. McDonald, S., Madigan, S., Racine, N., Benzies, K., Tomfohr, L., & Tough, S. (2019). Maternal adverse childhood experiences, mental health, and child behaviour at age 3: The all our families community cohort study. Preventive Medicine, 118, 286–294. 10.1016/j.ypmed.2018.11.013 [DOI] [PubMed] [Google Scholar]
  31. Meehan, A. J., Baldwin, J. R., Lewis, S. J., MacLeod, J. G., & Danese, A. (2022). Poor individual risk classification from adverse childhood experiences screening. American Journal of Preventive Medicine, 62(3), 427–432. 10.1016/j.amepre.2021.08.008 [DOI] [PubMed] [Google Scholar]
  32. Merrill, S. M., Moore, S. R., Gladish, N., Giesbrecht, G. F., Dewey, D., Konwar, C., MacIssac, J. L., Kobor, M. S., & Letourneau, N. L. (2021). Paternal adverse childhood experiences: Associations with infant DNA methylation. Developmental Psychobiology, 63(6), e22174. 10.1002/dev.22174 [DOI] [PubMed] [Google Scholar]
  33. Monk, C., Lugo-Candelas, C., & Trumpff, C. (2019). Prenatal developmental origins of future psychopathology: Mechanisms and pathways. Annual Review of Clinical Psychology, 15(1), 317–344. 10.1146/annurev-clinpsy-050718-095539 [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Morris, A. S., Hays-Grudo, J., Zapata, M. I., Treat, A., & Kerr, K. L. (2021). Adverse and protective childhood experiences and parenting attitudes: The role of cumulative protection in understanding resilience. Adversity and Resilience Science, 2(3), 181–192. 10.1007/s42844-021-00036-8 [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Narayan, A. J., Ippen, C. G., Harris, W. W., & Lieberman, A. F. (2019). Protective factors that buffer against the intergenerational transmission of trauma from mothers to young children: A replication study of angels in the nursery. Development and Psychopathology, 31(1), 173–187. 10.1017/S0954579418001530 [DOI] [PubMed] [Google Scholar]
  36. Narayan, A. J., Lieberman, A. F., & Masten, A. S. (2021). Intergenerational transmission and prevention of adverse childhood experiences (ACEs). Clinical Psychology Review, 85, Article 101997. 10.1016/j.cpr.2021.101997 [DOI] [PubMed] [Google Scholar]
  37. Narayan, A. J., Rivera, L. M., Bernstein, R. E., Harris, W. W., & Lieberman, A. F. (2018). Positive childhood experiences predict less psychopathology and stress in pregnant women with childhood adversity: A pilot study of the benevolent childhood experiences (BCEs) scale. Child Abuse & Neglect, 78, 19–30. 10.1016/j.chiabu.2017.09.022 [DOI] [PubMed] [Google Scholar]
  38. National Bureau of Statistics of China . (2021). China statistical yearbook. https://data.stats.gov.cn/
  39. Navalta, C. P., McGee, L., & Underwood, J. (2018). Adverse childhood experiences, brain development, and mental health: A call for neurocounseling. Journal of Mental Health Counseling, 40(3), 266–278. 10.17744/mehc.40.3.07 [DOI] [Google Scholar]
  40. Olsen, S. F., Yang, C., Hart, C. H., Robinson, C. C., Wu, P., Nelson, D. A., Nelson, L. J., Jin, S., & Wo, J. (2002). Maternal psychological control and preschool children's behavioral outcomes in China, Russia, and the United States. In Barber B. K. (Ed.), Intrusive parenting: How psychological control affects children and adolescents (pp. 235–262). American Psychological Association. 10.1037/10422-008 [DOI] [Google Scholar]
  41. Price, M., Albaugh, M., Hahn, S., Juliano, A. C., Fani, N., Brier, Z. M., Legrand, A. C., van Stolk-Cooke, K., Chaarani, B., Potter, A., Peck, K., Allgaier, N., Banaschewski, T., Bokde, A. L. W., Quinlan, E. B., Desrivières, S., Flor, H., Grigis, A., Gowland, P., Heinz, A., … Garavan, H. (2021). Examination of the association between exposure to childhood maltreatment and brain structure in young adults: A machine learning analysis. Neuropsychopharmacology, 46(11), 1888–1894. 10.1038/s41386-021-00987-7 [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Qu, G., Ma, S., Liu, H., Han, T., Zhang, H., Ding, X., Sun, L., Qin, Q., Chen, M., &Sun, Y. (2022). Positive childhood experiences can moderate the impact of adverse childhood experiences on adolescent depression and anxiety: Results from a cross-sectional survey. Child Abuse & Neglect, 125, Article 105511. 10.1016/j.chiabu.2022.105511 [DOI] [PubMed] [Google Scholar]
  43. Racine, N., Plamondon, A., Madigan, S., McDonald, S., & Tough, S. (2018). Maternal adverse childhood experiences and infant development. Pediatrics, 141(4), e20172495. 10.1542/peds.2017-2495 [DOI] [PubMed] [Google Scholar]
  44. Roberts, R., O’Connor, T., Dunn, J., Golding, J., & Team, A. S. (2004). The effects of child sexual abuse in later family life; mental health, parenting and adjustment of offspring. Child Abuse & Neglect, 28(5), 525–545. 10.1016/j.chiabu.2003.07.006 [DOI] [PubMed] [Google Scholar]
  45. Sameroff, A. J. (2000). Developmental systems and psychopathology. Development and Psychopathology, 12(3), 297–312. 10.1017/S0954579400003035 [DOI] [PubMed] [Google Scholar]
  46. Scorza, P., Duarte, C. S., Lee, S., Wu, H., Posner, J. E., Baccarelli, A., & Monk, C. (2020). Epigenetic intergenerational transmission: Mothers’ adverse childhood experiences and DNA methylation. Journal of the American Academy of Child & Adolescent Psychiatry, 59(7), 900. 10.1016/j.jaac.2020.03.008 [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Shan, W., Zhang, Y., Zhao, J., Zhang, Y., Cheung, E. F., Chan, R. C., & Jiang, F. (2019). Association between maltreatment, positive parent–child interaction, and psychosocial well-being in young children. The Journal of Pediatrics, 213, 180–186.e1. e181. 10.1016/j.jpeds.2019.06.050 [DOI] [PubMed] [Google Scholar]
  48. Shaw, B. A., Krause, N., Chatters, L. M., Connell, C. M., & Ingersoll-Dayton, B. (2003). Social structural influences on emotional support from parents early in life and adult health status. Behavioral Medicine, 29(2), 68–79. 10.1080/08964280309596059 [DOI] [PubMed] [Google Scholar]
  49. Thomas-Argyriou, J. C., Letourneau, N., Dewey, D., Campbell, T. S., & Giesbrecht, G. F.., & APrON Study Team (2021). The role of HPA-axis function during pregnancy in the intergenerational transmission of maternal adverse childhood experiences to child behavior problems. Development and Psychopathology, 33(1), 284–300. 10.1017/S0954579419001767 [DOI] [PubMed] [Google Scholar]
  50. Wang, M., & Liu, L. (2014). Parental harsh discipline in mainland China: Prevalence, frequency, and coexistence. Child Abuse & Neglect, 38(6), 1128–1137. 10.1016/j.chiabu.2014.02.016 [DOI] [PubMed] [Google Scholar]
  51. Wang, X., Yin, G., Guo, F., Hu, H., Jiang, Z., Li, S., Shao, Z., & Wan, Y. (2022). Associations of maternal adverse childhood experiences with behavioral problems in preschool children. Journal of Interpersonal Violence, 37(21-22), NP20311–NP20330. 10.1177/08862605211050093 [DOI] [PubMed] [Google Scholar]
  52. World Health Organization . (2019). Adverse childhood experiences international questionnaire (ACE-IQ) [EB/OL]. http://www.who.int/violence_injury_prevention/violence/activities/adverse_childhood_experiences/en/.
  53. Xu, Z., Zhang, D., Ding, H., Zheng, X., Lee, R. C.-M., Yang, Z., Mo, P. K.-H., Lee, E. K.-P., & Wong, S. Y.-S. (2022). Association of positive and adverse childhood experiences with risky behaviours and mental health indicators among Chinese university students in Hong Kong: An exploratory study. European Journal of Psychotraumatology, 13(1), Article 2065429. 10.1080/20008198.2022.2065429 [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Zhan, N., Xie, D., Zou, J., Wang, J., & Geng, F. (2021). The validity and reliability of benevolent childhood experiences scale in Chinese community adults. European Journal of Psychotraumatology, 12(1), Article 1945747. 10.1080/20008198.2021.1945747 [DOI] [PMC free article] [PubMed] [Google Scholar]
  55. Zhang, W., Wang, M., & Ying, L. (2019). Parental mindfulness and preschool children’s emotion regulation: The role of mindful parenting and secure parent-child attachment. Mindfulness, 10(12), 2481–2491. 10.1007/s12671-019-01120-y [DOI] [Google Scholar]
  56. Zhu, Y.-T., Li, X., Jiao, D.-D., Tanaka, E., Tomisaki, E., Watanabe, T., Sawada, Y., Zhu, Z., Ajmal, A., & Matsumoto, M. (2021). Development of social skills in kindergarten: A latent class growth modeling approach. Children, 8(10), 870. 10.3390/children8100870 [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Zhu, Y., Zhang, G., & Anme, T. (2022). Patterns of adverse childhood experiences among Chinese preschool parents and the intergenerational transmission of risk to offspring behavioural problems: Moderating by coparenting quality. European Journal of Psychotraumatology, 13(2), doi: 10.1080/20008066.2022.2137913 [DOI] [PMC free article] [PubMed] [Google Scholar]
  58. Zimmerman, M. A. (2013). Resiliency theory: A strengths-based approach to research and practice for adolescent health. Health Education & Behavior, 40(4), 381–383 10.1177/1090198113493782. [DOI] [PMC free article] [PubMed]

Articles from European Journal of Psychotraumatology are provided here courtesy of Taylor & Francis

RESOURCES