Skip to main content
NCBI home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2022 Sep 25.
Published in final edited form as: Fam Process. 2021 Apr 21;61(1):422–435. doi: 10.1111/famp.12652

The Intergenerational Impact of Adverse Childhood Experiences on Hispanic Families: The Mediational Roles of Parental Depression and Parent–Adolescent Communication

LUCAS G OCHOA *, ALEJANDRA FERNANDEZ †, TAE KYOUNG LEE *, YANNINE ESTRADA †, GUILLERMO PRADO †
PMCID: PMC9509697  NIHMSID: NIHMS1833712  PMID: 33880753

Abstract

Parental exposure to adverse childhood experiences (ACEs) has been documented as a strong risk factor for subsequent externalizing behaviors in their youth. Although studies have investigated ACEs and their intergenerational association with youth externalizing behaviors, this association has not been investigated in Hispanic families. Additionally, substantial gaps in the literature exist explaining the mechanisms by which this association occurs. The purpose of this study was to examine whether parent–adolescent communication and parental depressive symptomatology explain the relationship between parent’s ACE score and adolescent externalizing behaviors. This secondary data analysis utilized baseline data from an ongoing randomized controlled trial evaluating the relative effectiveness of an online parenting intervention for Hispanic adolescents. The sample consisted of 456 parents and their adolescents between the ages of 12–16. Using path modeling, parental depressive symptomatology and parent–adolescent communication were simultaneously examined as mechanisms that may explain the intergenerational relationship between parental exposure to ACEs and externalizing behaviors in Hispanic youth. Parental depressive symptomatology and parent–adolescent communication both significantly mediated the association between parental exposure to ACEs and adolescent externalizing behaviors. Understanding the mechanisms explaining the intergenerational association between parental exposure to ACEs and adolescent externalizing behaviors may aid future research examining problematic behaviors in Hispanic youth.

Keywords: Adverse Childhood Experiences, Depression, Parent–Adolescent Communication, Hispanic

Externalizing behaviors during early adolescence remains a significant public health concern, specifically among Hispanics adolescents who are among the fastest growing minority populations in the United States (U.S.; Colby, & Ortman, 2017). Compared with non-Hispanic whites, Hispanic youth have disproportionately higher rates of externalizing behaviors (Forster, Grigsby, Soto, Schwartz, & Unger, 2015; Kann et al., 2018). Externalizing behaviors refer to a range of behavior problems that are manifested in children’s outward behavior (e.g., cigarette smoking, alcohol use, conduct problems, aggression, and rule-breaking; Liu, 2004). The expression of these problematic behaviors during early adolescent development may signal risk for the development of social maladaptation including aggression, criminality (Bongers, Koot, Van Der Ende, & Verhulst, 2004), and substance use in later adulthood (Englund, Egeland, Oliva, & Collins, 2008; Loney, Taylor, Butler, & Iacono, 2007). Given the growing proportion of Hispanic youth in the U.S., identifying and understanding the factors associated with externalizing behaviors among this population is of critical public health importance.

Parental Exposure to Adverse Childhood Experiences and Adolescent Externalizing Behaviors

Parental exposure to adverse childhood experiences may be important to examine when studying the determinants of youth externalizing behaviors, given their intergenerational impact on individuals and their families (Bosquet Enlow, Englund, & Egeland, 2018; Lê-Scherban, Wang, Boyle-Steed, & Pachter, 2018; Matthews, 2014). Adverse childhood experiences (ACEs) refer to physical, sexual, or psychological abuse, neglect, or living in a dysfunctional household before age 18 (Felitti et al., 1998). Individuals exposed to ACEs are at significantly higher odds of developing both acute and chronic behavioral disorders, including depression, substance abuse, risky sexual behavior (Campbell, Walker, & Egede, 2016), and suicidality (Dube et al., 2001). Moreover, additional evidence suggests that the adverse effects of ACEs can be diffused across generations, that is, intergenerationally, affecting the children of those initially victimized (Lev-Wiesel, 2007; Sangalang & Vang, 2017). Existing research is limited in their examination of ACEs among Hispanic adults. Most studies consist of exclusively non-Hispanic White samples or contain a very small number of Hispanics (Campbell et al., 2016; Dube et al., 2001; Felitti et al., 1998). A more recent study, however, that followed a sample of U.S. Hispanic adults between the ages of 18 and 74, found that the majority of participants (77%) reported at least one ACE before the age of 18, and 29% reported four or more ACEs during the same time period (Llabre et al., 2017). These results indicate that the prevalence of ACEs may be higher among Hispanics compared to previous studies that sampled few Hispanics/Latinos.

This intergenerational outcomes associated with early childhood adversity is of significant concern given that high rates of externalizing behaviors have been reported in the children of parents exposed to ACEs, with symptoms often appearing as early as infancy and continuing into adolescence (Ehrensaft & Cohen, 2012; Schickedanz, Halfon, Sastry, & Chung, 2018). For Hispanic populations ACEs may be particularly detrimental such that they may undermine cultural values of positive family functioning (e.g., an emphasis on the importance of family cohesion, communication, and interdependence; Sabogal, Marín, Otero-Sabogal, Marín, & Perez-Stable, 1987). ACEs may ultimately weaken these protective cultural values and lead to increased adolescent externalizing behaviors (Marsiglia, Parsai, & Kulis, 2009).

Additionally, although previous studies have examined the intergenerational outcomes associated with ACEs (Narayan et al., 2017; Schofield et al., 2018), the psychosocial mechanisms explaining the intergenerational association of ACEs with externalizing behaviors in Hispanic youth remain largely unexamined in the Hispanic community.

Exposure to ACEs and the Effect on Parent–Adolescent Communication and Parental Depression

There is an extensive empirical literature on the relationship between the cumulative burden of ACEs and mental health outcomes in later adulthood (Campbell et al., 2016; Chapman et al., 2004; Mersky, Topitzes, & Reynolds, 2013). Explicitly, the aforementioned studies found that as the exposure to ACE increases, the greater risk of experiencing symptoms of depression subsequently increases. Moreover, experiencing sexual abuse during childhood was associated with 80% increased odds of depression (Campbell et al., 2016). For example, Chapman et al. (2004) found that the lifetime prevalence of depressive disorders among individuals who were exposed to ACEs was 23%. Notably, women who reported experiencing childhood emotional abuse were 2.7 times more likely to report lifetime or recent depressive disorders, while men were 2.5 more likely to report lifetime or recent depressive disorders than individuals who did not experience such adversity (Chapman et al., 2004).

Additionally, extensive research has shown that parenting practices (e.g., parental involvement, parental monitoring) and parent–child relationship (e.g., constructive communication) may be strongly affected by parental exposure to ACEs (Bailey, DeOliveira, Wolfe, Evans, & Hartwick, 2012; Roberts, O’Connor, Dunn, & Golding, 2004). Individuals exposed to ACEs are more likely to engage in risky sexual behaviors that contribute to unintended pregnancy and become parents themselves at a young age (Anda et al., 2002; Hughes et al., 2017). Likewise, individuals exposed to such adversity during childhood are more likely to choose a violent partner (Hillis et al., 2004). These behaviors may disturb parent–child relationships and parent–child communication, resulting in harsh or permissive parenting practices (Amato & Fowler, 2002). Parents may be unable to effectively communicate appropriate or expected behaviors to their children, resulting in a subsequent increase in problematic behaviors.

Effects of Parent–Adolescent Communication and Parent Depression on Youth Externalizing Behaviors

The relationship between parent–child communication and problem behaviors, specifically externalizing behaviors, has been extensively studied in Hispanic families. For example, Davidson and Cardemil (2009) examined family relationships and parental monitoring in a sample of Hispanic parents and their youth and found higher levels of externalizing behaviors in the children of families who reported low levels of parent–child communication.

Additionally, when compared to children of parents without a psychiatric history, children of parents with symptoms of depression have a range of adverse outcomes, including higher levels of externalizing behaviors (Foster, Garber, & Durlak, 2008). These disturbances could be paramount for Hispanic populations, as families represent a vital source of strength and support, making Hispanic youth especially vulnerable to the sequela of parental exposure to adversity (Allem, Soto, Baezconde-Garbanati, & Unger, 2015).

ACEs have the capability of leading to not only harmful intrapersonal effects, such as parental depression, but also negative interpersonal parenting practices, such as ineffective family communication (Belsky, Conger, & Capaldi, 2009). In turn, the negative intrapersonal and interpersonal effects of ACEs may affect not only the person who experienced adverse childhood experiences but also their child, such that children of those who reported ACEs may subsequently engage in externalizing behaviors (Amos, Furber, & Segal, 2011).

Current Study and Hypotheses

The purpose of this study was to examine the direct and indirect associations between ACEs in Hispanic parents and symptoms of externalizing behaviors among youth mediated through parent–adolescent communication and parental depressive symptomatology. Using path modeling, parental depressive symptomatology and parent–adolescent communication were simultaneously examined as mechanisms of action that may explain the association between parental exposure to ACEs and youth externalizing behaviors. We hypothesized that higher parental ACE scores will be associated with higher levels of depressive symptomatology and lower levels of parent–adolescent communication and these factors would be associated with youth externalizing behavior. Given the adverse outcomes associated with childhood adversity, understanding the intergenerational impact of ACEs on adolescent behavior problems can provide insight into the consequences of childhood adversity among Hispanic families.

METHODS

This secondary data analysis utilized baseline data from an ongoing randomized controlled trial evaluating the relative effectiveness of an online parenting intervention in preventing drug use, sexual risk behaviors, and sexually transmitted infections in a universal sample of Hispanic adolescents. Participants were recruited from pediatric primary care clinics, including an academic health clinic, private clinics, community health clinics, a community hospital, and a pediatric mobile clinic, in the South Florida area.

Participants and Procedures

The study sample consisted of 456 Hispanic parents and their adolescents. The mean adolescent age was 13.90 years (SD = 1.37) and parents were, on average, 43.24 years old (SD = 6.64). A majority of parents who participated in the study were female (92.9%), while 52.9% of the youth in the sample were males. Most parents (87.5%) were born in a Spanish-speaking country in the Americas. A majority of adolescent participants were born in the United States (55.8%). Most families were of low income, such that 50.2% reported a household income of less than $30,000 per year. Additional participant information and descriptive statistics can be found in Table 1.

Table 1.

Participant Characteristics (N = 456)

Parents
 Adolescents
Characteristic M (SD) / n (%) Min–Max M (SD) / n (%) Min–Max
Age 43.24 (6.64) 27.00–66.00 13.90 (1.37) 12.00–16.00
Female 421 (92.9%) 241 (52.9%)
US Born 56 (12.5%) 253 (55.8%)
Number of Years in the US
 Less than 3 years (%) 101 (22.1%) 112 (24.6%)
 3–10 years (%) 65 (14.3%) 59 (12.9%)
 More than 10 years (%) 287 (62.9%) 271 (59.4%)
 No Response 3 (0.7%) 14 (3.1%)
Annual Income
 Under $30,000 229 (50.2%)
 $30,000 to $50,000 69 (15.1%)
 Greater than $50,000 63 (13.8%)
 No response 95 (20.9%)
Marital Status
 Married 266 (58.3%)
 Living with Someone 28 (6.1%)
 Separated 51 (11.2%)
 Divorced 61 (13.4%)
 Widowed 2 (0.4%)
 Never Married & Not Living with Someone 37 (8.1)
 No response 11 (2.4%)
Adverse Childhood Experiences 2.00 (2.84) 0.00–17.00
Externalizing Behaviors (Parent Reported) 5.12 (8.14) 0.00–43.00
Parent–Adolescent Communication 76.34 (10.12) 38.00–100.00
Depressive Symptomatology 36.20 (7.06) 20.00–62.00
Open in a new tab

Note. M = mean; Max. = maximum score; Min. = minimum score; SD = standard deviation; Minimum and maximum scores refer to observed range of scores.

Study data were collected and managed using REDCap electronic data capture software hosted at the University of Miami, Department of Public Health Sciences (Harris et al., 2009). All data analyzed as part of this study came from the baseline assessment. This study was approved by the University of Miami’s Institutional Review Board.

Measures

Adverse childhood experiences

Parental exposure to adverse childhood experiences was measured using the Adverse Childhood Experience Questionnaire (17 items; Felitti et al., 1998). To differentiate between adverse events, nine different categories of adversity were used. Childhood abuse was defined using four categories, including experiencing psychological abuse (2 questions), neglect (4 questions), physical abuse (2 questions), and sexual abuse (2 questions). Exposure to household dysfunction was measured using five distinct categories, which included exposure to parental separation or divorce (1 question), household substance abuse (1 question), household mental illness (1 question), mother treated violently (3 questions), and incarcerated household member (1 question). Respondents were defined as exposed to a category if they responded “yes” to one or more of the questions within a category. The total number of ACEs experienced by respondents was summed to calculate parental ACE score (0 to 17) with higher scores indicating more childhood adversity. This score was used to assess the cumulative effect of multiple ACEs on the individual.

Adolescent externalizing behaviors

The 22-item Conduct Problem subscale of the (parent-reported) Revised Behavior Problem Checklist (RBPC) was utilized (Quay & Peterson, 1987) to assess externalizing behaviors. The RBPC is composed of six subscales that measure conduct problems, socialized aggression, attention problems/immaturity, anxiety/withdrawal, psychotic behavior, and motor tension/excess in young children and adolescents. Parents rated their adolescent behavior on a scale from “0 (No problem) to 2 (Severe Problem),” with higher scores indicating higher levels of youth externalizing behaviors. A sample item included “(My child is) Irritable, hot-tempered, easily angered.” The Cronbach’s α for the present study was 0.96.

Parent–adolescent communication

To assess family communication, the 20-item Parent–Adolescent Communication Scale was utilized (Barnes & Olson, 1985). Each item was rated on a 5-point Likert scale from 1 (Strongly disagree) to 5 (Strongly agree). Item examples include “When I ask questions, I get honest answers from my child;” “My child insults me when she/he is angry with me;” “I openly show affection to my child.” Possible scores ranged from 20 to 100 with higher scores indicating better parent–adolescent communication. The Cronbach’s α for the parent–adolescent communication scale in the present study was 0.82.

Parent depressive symptomatology

The 20-item Center for Epidemiologic Studies Depression Scale (CES-D) was utilized (Radloff, 1977) to measure depressive symptomatology among parents. The CES-D has demonstrated test–retest reliability and has been successfully used with Hispanic and Spanish-speaking adults (Black et al., 1999). Respondents were asked to report how often they felt symptoms of depression in the past week. Response choices ranged from 1 (rarely or none of the time [less than 1 day]) to 4 (All of the time [5–7 days]). The Cronbach’s α of parent depressive symptomology within this study was 0.83.

Data Analytic Strategy

The analytical plan included several steps. First, descriptive statistics (i.e., means, standard deviations) and correlations among study variables were examined. Second, the direct association between parental exposure to ACEs and externalizing behaviors was examined by using a bivariate regression model. Third, using MacKinnon’s product-of-coefficients approach, including tests of asymmetric confidence intervals (MacKinnon, 2008) we examined whether parent–adolescent communication and parental depressive symptomatology mediated the association between parental exposure to ACEs and adolescent externalizing behaviors. We used 10,000 bootstrap 95% confidence intervals (CIs) to determine the significance of the standardized direct, indirect, and total estimates. Results for the hypothesized model are shown in Figure 1.

Figure 1.

Figure 1.

Open in a new tab

Results of the Hypothesized Model

Note. The model was just identified; therefore, we do not report global fit indices. Adolescent externalizing behaviors: R2 = .16, p < .001; Parent Depressive Symptomatology: R2 = .03, p = .051; Parent–adolescent Communication: R2 = .05, p < .05.

Standardized coefficients (β) were reported as effect sizes (Kline & Santor, 1999). As such, effect sizes were interpreted based on small (=.10), medium (=.24), and large effects (=.37). To evaluate acceptable model fit we used the comparative fit index (CFI; >.95) and Tucker-Lewis index (TLI; >.95; Hu & Bentler, 1999). We addressed missing data by using full information maximum likelihood (FIML) estimation (Enders, 2011). Analyses were conducted in Mplus Version 8.0 (Muthén and Muthen, 2017) using the full sample (n = 456).

RESULTS

Sample descriptive statistics and bivariate correlations are shown in Tables 1 and 2, respectively. All correlations were in the hypothesized directions.

Table 2.

Pearson Bivariate Correlations (N = 456)

1. ACE
n = 453		 2. PAC
n = 444		 3. DEP
n = 428		 4. EXT
n = 444
1. ACE — −0.23* 0.18* 0.17*
2. PAC — −0.17* −0.33*
3. DEP — 0.17*
4. EXT —
Open in a new tab

Note. ACE = Parental exposure to Adverse Childhood Experiences; DEP = Parental Depressive Symptomatology; EXT = Externalizing Behaviors (Parent Report); PAC = Parent–Adolescent Communication (Parent Report).

*

p < .01.

Direct Association of Adverse Childhood Experiences (ACE) on Adolescent Externalizing Behaviors

Study results indicated a positive association between parental exposure to ACEs and adolescent externalizing behaviors (β = 0.20; 95% confidence interval [CI] = 0.11, 0.29; p < .001; R2 = .04) even after adjusting for parental depressive symptomology and parent–adolescent communication.

Mediational Associations of Parental Depressive Symptomatology and Parent–Adolescent Communication

After adjusting for the direct association of parent ACEs on adolescent externalizing problems, we found several significant associations in the hypothesized mediation model (see Table 3). Results indicated a positive association between parental exposure to ACEs and parental depressive symptomatology (β = 0.18; 95% CI = 0.07, 0.27; p < .01), which, in turn, was related to adolescent externalizing behaviors (β = 0.12; 95% CI = 0.02, 0.22; p < .05). The mediational associations between parental exposure to ACEs and externalizing behaviors through parental depressive symptomatology was significant (β = 0.02; 95% CI = 0.006, 0.05; p < .05). Moreover, parental exposure to ACEs was negatively associated with parent–adolescent communication (β = −0.23; 95% CI = −0.33, −0.12; p < .001), which was related to adolescent externalizing behaviors (β =−0.32; 95% CI = −0.40, −0.22; p < .001). The mediational associations between parental exposure to ACEs and externalizing behaviors through parent–adolescent communication was also significant (β = 0.07; 95% CI = 0.04, 0.12; p < .01).

Table 3.

Full model Results

Unstandardized
 Standardized
b SE CI p-Value β SE CI p-Value
Primary caregiver childhood adversity → Parent Depressive Symptomatology 0.449 0.117 0.187, 0.713 .000 0.181 0.054 0.072, 0.283 .001
Primary caregiver childhood adversity → Parent–adolescent Communication −0.803 0.164 −1.183, −0.427 .000 −0.226 0.054 −0.330, −0.085 .000
Primary caregiver childhood adversity → Adolescent Externalizing Behaviors 0.040 0.018 −0.001, 0.082 .022 0.103 0.052 −0.002, 0.200 .047
Parent Depressive Symptomatology → Adolescent Externalizing Behaviors 0.019 0.007 0.004, 0.034 .007 0.124 0.050 0.024, 0.220 .013
Parent–adolescent Communication → Adolescent Externalizing Behaviors −0.034 0.005 −0.044, −0.024 .000 −0.315 0.047 −0.402, −0.218 .000
Parent–adolescent Communication ↔ Parent Depressive Symptomatology −9.360 3.776 −17.537, −2.641 .013 −0.137 0.052 −0.243, −0.037 .008
Indirect effects
 Primary caregiver childhood adversity → Parent Depressive Symptomatology → Externalizing Behaviors 0.009 0.004 0.002, 0.020 .037 0.022 0.011 0.006, 0.050 .038
 Primary caregiver childhood adversity → Parent–adolescent Communication → Externalizing Behaviors 0.028 0.008 0.014, 0.046 .000 0.071 0.021 0.035, 0.118 .001
Open in a new tab

Note. b = unstandardized betas; β = standardized betas. Bootstrap 95% confidence intervals (CI).

Post Hoc Analyses

A post hoc analysis was performed to examine the direct and indirect associations between ACEs subscales (exposure to child abuse and exposure to household dysfunction) and adolescent externalizing behaviors through parent depressive symptomatology and parent–adolescent communication. When not considering mediation variables, post hoc analysis indicated there was positive association between parental exposure to household dysfunction and adolescent externalizing behaviors (β = 0.13; 95% CI = 0.01, 0.24; p < .05) but no association between parental exposure to child abuse and adolescent externalizing behaviors (β = 0.09; 95% CI = 0.02, 0.22; p = .11). Alternatively, when examining mediational associations between exposure to child abuse and exposure to household dysfunction through parent depressive symptomatology and parent–adolescent communication (see Figure 2), there was only an indirect association between exposure to child abuse and adolescent externalizing behaviors through parent–adolescent communication (β = 0.06; 95% CI = 0.03, 0.11; p < .01) and no indirect association between exposure to household dysfunction and adolescent externalizing behaviors.

Figure 2.

Figure 2.

Open in a new tab

Model Results

Note. Only significant effects are shown. Dashed lines represent nonsignificant findings.

DISCUSSION

The purpose of this study was to examine the direct and indirect association between parent exposure to adverse childhood experiences (ACEs) and adolescent externalizing behaviors through parent–adolescent communication and parental depressive symptomatology. Due to the adverse public health and social consequences of externalizing behaviors during early adolescent development and possible negative sequela into adulthood, understanding the psychosocial mechanisms that influence the intergenerational transmission of ACEs may provide insight into how parental exposure to ACEs may, directly and indirectly, affect youth development, especially within the context of Hispanic families living in the United States (U.S.). Understanding these psychosocial mechanisms is of fundamental importance among the Hispanic/Latino community, considering they are one of the fastest growing minority population in the U.S. and there is evidence that they have a disproportionately higher ACE score than previously reported (Llabre et al., 2017).

Our findings supported our hypotheses, such that parental exposure to ACEs was directly and significantly associated with increased levels of adolescent externalizing behaviors. Hispanic parents exposed to ACEs, such as childhood neglect and living in a dysfunctional household, may become detached or unable to form secure attachments with others (Schore, 2002). As noted previously, Hispanic parents who have experienced ACEs may also have a weakened belief in family cohesion. Thus, Hispanic parents’ transmission of protective cultural values, such as strong family cohesion, to their child may be interchanged with their exposure to early childhood adversity (Belsky et al., 2009; Serbin & Karp, 2003). Alternatively, previous research indicating that Hispanic mothers with higher levels of family functioning (e.g., strong sense of identification with, and protection of familial honor, respect, and cooperation among family members) were less likely to have been involved in abusive behaviors toward their child (e.g., hit her child) when compared to mothers reporting lower levels of family functioning (Coohey, 2001). In turn, adolescents may react favorably to positive family functioning behaviors, such as family cohesion and familism, by engaging in less aggressive behaviors, conduct problems, and rule breaking themselves (Marsiglia et al., 2009). Future studies should examine the longitudinal association between parental exposure to ACEs, reported levels of family functioning, and adolescent externalizing behaviors.

Findings also supported our hypothesis that parental depressive symptomatology and parent–adolescent communication mediated the association between parental exposure to ACEs and adolescent externalizing behaviors. Parental exposure to ACEs may lead to depressive symptomology as parents may develop unhealthy coping mechanisms (Campbell et al., 2016; Stevens, Colwell, Smith, Robinson, & McMillan, 2005) or are unable to learn effective parenting skills. For example, the effect of experiencing depressive symptomology, and perhaps an accumulation of comorbid disabling health outcomes (Campbell et al., 2016), may limit parental willingness or capacity to monitor adolescent behaviors (Dawlett, Auslander, & Rosenthal, 2010). As a result of limited parental monitoring, adolescents may feel free to engage in delinquency, vandalism, and associate with deviant peers (Davidson & Cardemil, 2009; Hoeve et al., 2009).

Parents reacting to their exposure to ACEs may become detached from their adolescent due to their inability to maintain healthy relationships (Oral et al., 2016), limiting the communication between parent and adolescent (Ingoglia, Lo Coco, Liga, & Grazia Lo Cricchio, 2011). In addition, parents who have been exposed to ACEs can often lack appropriate communication skills as research shows that increased exposure to ACEs negatively impacts developmental domains, including communication (Folger et al., 2018). Parents lacking effective communication skills may be unable to explain to their adolescent what is considered acceptable and unacceptable behaviors, possibly leading to adolescent externalizing behaviors (Davidson & Cardemil, 2009). Further, a lack of parent–adolescent communication may result in the inability of an adolescent to effectively communicate with their parent and receive appropriate feedback if they are experiencing interpersonal conflict (e.g., bullying; Offrey & Rinaldi, 2017), leading them to solve such conflicts through externalizing behaviors (Reijntjes et al., 2011).

Although the purpose of this study was to examine the dose–response association between cumulative ACE exposure and adolescent externalizing behaviors, results from the post hoc analyses suggest varying direct and indirect associations between ACE subdimensions and externalizing behaviors; exposure to household dysfunction is directly associated while exposure to child abuse is indirectly associated to adolescent externalizing behaviors. Previous research shows that when examined separately, household dysfunction and childhood abuse have different associations with health outcomes (e.g., smoking, obesity, fair or poor general health; Dube, Cook, Edwards, 2017). Parents’ exposure to household dysfunction may influence adolescent externalizing behaviors directly if parents exemplify or build a similar household environment where dysfunction is normative, and it may be easier for an adolescent to engage in antisocial behaviors. Alternatively, parents’ exposure to childhood abuse may damage relational skills and make it harder for parents to communicate effectively with adolescents.

Limitations and Suggestions for Future Research

There were several limitations present in the current study. First, due to the cross-sectional nature of this study design, causal relationships cannot be determined between the variables examined. Additionally, mediation effects cannot be confirmed given the lack of temporal data. Further, there is a possibility that there could be a bidirectional association between the mediators and adolescent outcomes, such that adolescent externalizing behaviors may affect parental depressive symptomatology and parent–adolescent communication. Future studies should focus their efforts on longitudinal models to identify whether these associations are evident across time and the directionality of these results. Second, the current study is limited by its reliance on parent self-report of all variables. Specifically, this study relied on parent reports of perceptions of family communication and perceptions of adolescent externalizing behaviors. Research suggests, however, parents may be better reporters of adolescent externalizing behaviors when compared to adolescent reports (De Los Reyes, & Kazdin, 2005). Finally, given the unique nature of the South Florida area, generalizations to Hispanic subgroups found in other geographical locations should be made with caution.

CONCLUSION

Despite the limitations, the present study provides insight into the association of parental exposure to adverse childhood experiences simultaneously with both risk (i.e., parental depression) and protective (i.e., parent–adolescent communication) factors, and in turn, the associations of these psychosocial factors with Hispanic adolescent externalizing behaviors. The insight gained regarding parental depression and parent–adolescent communication as mediators in the relationship between parental exposure to ACEs and adolescent behavior problems offers an opportunity to potentially interrupt the intergenerational transmission of trauma and preventing adolescent externalizing behaviors through interventions that target improvements in parent–adolescent communication. Existing evidence-based family intervention has been shown to not only improve parent–adolescent communication but also improve adolescent behavioral outcomes, such as externalizing behaviors, substance use, and risky sexual behaviors (Coatsworth, Pantin, & Szapocznik, 2002; Pantin et al., 2009; Van Ryzin, Stormshak, & Dishion, 2012). For example, Familias Unidas may help parents who reported ACEs, who possibly came from a dysfunctional family environment without effective parent–adolescent communication behaviors, by improving parent–adolescent communication. The intervention did so by including family sessions where a facilitator guides a discussion between parents and adolescent on a variety of topics, including externalizing behaviors. Parents and adolescents use different communication strategies to address adolescent stressors experienced in the family, peer, and school environment, in turn reducing how adolescent externalize their behaviors. However, parents may need additional support outside of interventions due to reported ACEs and depressive symptoms and intervention scientists may do a great service by providing referrals to clinical therapy. Clinical therapist, in turn, may want to discuss adverse childhood experiences as a possible source of trauma that may be contributing to parents’ depression and may need to be addressed to decrease depressive symptoms, improve parent–adolescent communication, and decrease adolescent externalizing behaviors. Epidemiological studies indicating the high prevalence of physical, sexual or psychological abuse, neglect, or living in a dysfunctional household in Hispanic populations (Llabre et al., 2017) highlight the importance of understanding the downstream impact of adverse childhood experiences on Hispanic families living in the U.S.

Acknowledgments

The authors thank the study participants for their participation in this study. This research was supported by Award Number R01DA040756–01A1 from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.

Footnotes

All authors have no potential conflicts of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the Institutional Review Board at the University of Miami, Miller School of Medicine. The research also complies with the Declaration of Helsinki.

REFERENCES

  1. Allem JP, Soto DW, Baezconde-Garbanati L, & Unger JB (2015). Adverse childhood experiences and substance use among Hispanic emerging adults in Southern California. Addictive Behaviors, 50, 199–204. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Amato PR, & Fowler F (2002). Parenting practices, child adjustment, and family diversity. Journal of marriage and family, 64(3), 703–716. [Google Scholar]
  3. Amos J, Furber G, & Segal L (2011). Understanding maltreating mothers: A synthesis of relational trauma, attachment disorganization, structural dissociation of the personality, and experiential avoidance. Journal of Trauma & Dissociation, 12, 495–509. [DOI] [PubMed] [Google Scholar]
  4. Anda RF, Chapman DP, Felitti VJ, Edwards V, Williamson DF, Croft JB & et al. (2002). Adverse childhood experiences and risk of paternity in teen pregnancy. Obstetrics & Gynecology, 100, 37–45. [DOI] [PubMed] [Google Scholar]
  5. Bailey HN, DeOliveira CA, Wolfe VV, Evans EM, & Hartwick C (2012). The impact of childhood maltreatment history on parenting: A comparison of maltreatment types and assessment methods. Child Abuse & Neglect, 36, 236–246. [DOI] [PubMed] [Google Scholar]
  6. Barnes HL, & Olson DH (1985). Parent-adolescent communication and the circumplex model. Child Development, 438–447. [Google Scholar]
  7. Belsky J, Conger R, & Capaldi DM (2009). The intergenerational transmission of parenting: Introduction to the special section. Developmental Psychology, 45, 1201. [DOI] [PubMed] [Google Scholar]
  8. Black SA, Espino DV, Mahurin R, Lichtenstein MJ, Hazuda HP, Fabrizio D et al. (1999). The influence of noncognitive factors on the Mini-Mental State Examination in older Mexican-Americans: Findings from the Hispanic EPESE. Journal of Clinical Epidemiology, 52, 1095–1102. [DOI] [PubMed] [Google Scholar]
  9. Bongers IL, Koot HM, Van Der Ende J, & Verhulst FC (2004). Developmental trajectories of externalizing behaviors in childhood and adolescence. Child Development, 75, 1523–1537. [DOI] [PubMed] [Google Scholar]
  10. Bosquet Enlow M, Englund MM, & Egeland B (2018). Maternal childhood maltreatment history and child mental health: Mechanisms in intergenerational effects. Journal of Clinical Child & Adolescent Psychology, 47(suppl 1), S47–S62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Campbell JA, Walker RJ, & Egede LE (2016). Associations between adverse childhood experiences, high-risk behaviors, and morbidity in adulthood. American Journal of Preventive Medicine, 50, 344–352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Chapman DP, Whitfield CL, Felitti VJ, Dube SR, Edwards VJ, & Anda RF (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82, 217–225. [DOI] [PubMed] [Google Scholar]
  13. Coatsworth JD, Pantin H, & Szapocznik J (2002). Familias Unidas: A family-centered ecodevelopmental intervention to reduce risk for problem behavior among Hispanic adolescents. Clinical Child and Family Psychology Review, 5, 113–132. [DOI] [PubMed] [Google Scholar]
  14. Colby SL, & Ortman JM (2017). Projections of the size and composition of the US population: 2014 to 2060: Population estimates and projections.
  15. Coohey C (2001). The relationship between familism and child maltreatment in Latino and Anglo families. Child Maltreatment, 6, 130–142. [DOI] [PubMed] [Google Scholar]
  16. Davidson TM, & Cardemil EV (2009). Parent-child communication and parental involvement in Latino adolescents. The Journal of Early Adolescence, 29, 99–121. [Google Scholar]
  17. Dawlett MF, Auslander BA, & Rosenthal SL (2010). The relationship of maternal depression to parental monitoring of adolescents: Reports from mother-adolescent dyads. Clinical Pediatrics, 49, 287–289. [DOI] [PubMed] [Google Scholar]
  18. De Los Reyes A, & Kazdin AE (2005). Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study. Psychological Bulletin, 131, 483. [DOI] [PubMed] [Google Scholar]
  19. Dube SR, Anda RF, Felitti VJ, Chapman DP, Williamson DF, & Giles WH (2001). Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: Findings from the Adverse Childhood Experiences Study. JAMA, 286, 3089–3096. [DOI] [PubMed] [Google Scholar]
  20. Dube SR, Cook ML, & Edwards VJ (2010). Health-related outcomes of adverse childhood experiences in Texas, 2002. Preventing Chronic Disease, 7(3). [PMC free article] [PubMed] [Google Scholar]
  21. Ehrensaft MK, & Cohen P (2012). Contribution of family violence to the intergenerational transmission of externalizing behavior. Prevention Science, 13, 370–383. [DOI] [PubMed] [Google Scholar]
  22. Enders CK (2011). Analyzing longitudinal data with missing values. Rehabilitation Psychology, 56, 267. [DOI] [PubMed] [Google Scholar]
  23. Englund MM, Egeland B, Oliva EM, & Collins WA (2008). Childhood and adolescent predictors of heavy drinking and alcohol use disorders in early adulthood: A longitudinal developmental analysis. Addiction, 103, 23–35. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14, 245–258. [DOI] [PubMed] [Google Scholar]
  25. Folger AT, Eismann EA, Stephenson NB, Shapiro RA, Macaluso M, Brownrigg ME et al. (2018). Parental adverse childhood experiences and offspring development at 2 years of age. Pediatrics, 141, e20172826. [DOI] [PubMed] [Google Scholar]
  26. Forster M, Grigsby T, Soto DW, Schwartz SJ, & Unger JB (2015). The role of bicultural stress and perceived context of reception in the expression of aggression and rule breaking behaviors among recent-immigrant Hispanic youth. Journal of Interpersonal Violence, 30, 1807–1827. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Foster CJE, Garber J, & Durlak JA (2008). Current and past maternal depression, maternal interaction behaviors, and children’s externalizing and internalizing symptoms. Journal of Abnormal Child Psychology, 36, 527–537. [DOI] [PubMed] [Google Scholar]
  28. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, & Conde JG (2009). Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42, 377–381. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, & Marks JS (2004). The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics, 113, 320–327. [DOI] [PubMed] [Google Scholar]
  30. Hoeve M, Dubas JS, Eichelsheim VI, Van der Laan PH, Smeenk W, & Gerris JR (2009). The relationship between parenting and delinquency: A meta-analysis. Journal of Abnormal Child Psychology, 37, 749–775. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Hu LT, & Bentler PM (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55. [Google Scholar]
  32. Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C et al. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet Public Health, 2, e356–e366. [DOI] [PubMed] [Google Scholar]
  33. Ingoglia S, Lo Coco A, Liga F, & Grazia Lo Cricchio M (2011). Emotional separation and detachment as two distinct dimensions of parent—Adolescent relationships. International Journal of Behavioral Development, 35, 271–281. [Google Scholar]
  34. Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Queen B et al. (2018). Youth risk behavior surveillance—United States, 2017. MMWR Surveillance Summaries, 67, 1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Kline RB, & Santor DA (1999). Principles & practice of structural equation modelling. Canadian Psychology, 40, 381. [Google Scholar]
  36. Lê-Scherban F, Wang X, Boyle-Steed KH, & Pachter LM (2018). Intergenerational associations of parent adverse childhood experiences and child health outcomes. Pediatrics, 141, e20174274. [DOI] [PubMed] [Google Scholar]
  37. Lev-Wiesel R (2007). Intergenerational transmission of trauma across three generations: A preliminary study. Qualitative Social Work, 6, 75–94. [Google Scholar]
  38. Liu J (2004). Childhood externalizing behavior: Theory and implications. Journal of Child and Adolescent Psychiatric Nursing, 17, 93–103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Llabre MM, Schneiderman N, Gallo LC, Arguelles W, Daviglus ML, Gonzalez F et al. (2017). Childhood trauma and adult risk factors and disease in Hispanics/Latinos in the US: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. Psychosomatic Medicine, 79, 172. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Loney BR, Taylor J, Butler MA, & Iacono WG (2007). Adolescent psychopathy features: 6-Year temporal stability and the prediction of externalizing symptoms during the transition to adulthood. Aggressive Behavior: Official Journal of the International Society for Research on Aggression, 33, 242–252. [DOI] [PubMed] [Google Scholar]
  41. MacKinnon D (2008). Multivariate applications series. Introduction to Statistical Mediation Analysis. New York, NY: Routledge. [Google Scholar]
  42. Marsiglia FF, Parsai M, & Kulis S (2009). Effects of familism and family cohesion on problem behaviors among adolescents in Mexican immigrant families in the southwest United States. Journal of Ethnic & Cultural Diversity in Social Work, 18, 203–220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Matthews KA (2014). Hispanic teen mothers exposed to childhood trauma: Reflections on mirroring to assist therapists in providing effective therapeutic treatments to help prevent trans-generational trauma. Doctoral dissertation, Saybrook University. [Google Scholar]
  44. Mersky JP, Topitzes J, & Reynolds AJ (2013). Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: A cohort study of an urban, minority sample in the US. Child Abuse & Neglect, 37, 917–925. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Muthén LK, & Muthen B (2017). Mplus user’s guide: Statistical analysis with latent variables, user’s guide. Los Angeles, CA: Muthén & Muthén. [Google Scholar]
  46. Narayan AJ, Kalstabakken AW, Labella MH, Nerenberg LS, Monn AR, & Masten AS (2017). Intergenerational continuity of adverse childhood experiences in homeless families: Unpacking exposure to maltreatment versus family dysfunction. American Journal of Orthopsychiatry, 87, 3. [DOI] [PubMed] [Google Scholar]
  47. Offrey LD, & Rinaldi CM (2017). Parent–child communication and adolescents’ problem-solving strategies in hypothetical bullying situations. International Journal of Adolescence and Youth, 22, 251–267. [Google Scholar]
  48. Oral R, Ramirez M, Coohey C, Nakada S, Walz A, Kuntz A et al. (2016). Adverse childhood experiences and trauma informed care: the future of health care. Pediatric Research, 79, 227. [DOI] [PubMed] [Google Scholar]
  49. Pantin H, Prado G, Lopez B, Huang S, Tapia MI, Schwartz SJ et al. (2009). A randomized controlled trial of Familias Unidas for Hispanic adolescents with behavior problems. Psychosomatic Medicine, 71, 987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Quay HC, & Peterson DR (1987). Manual for the revised behavior problem checklist. Department of Psychology, University of Miami. [Google Scholar]
  51. Radloff LS (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. [Google Scholar]
  52. Reijntjes A, Kamphuis JH, Prinzie P, Boelen PA, Van der Schoot M, & Telch MJ (2011). Prospective linkages between peer victimization and externalizing problems in children: A meta-analysis. Aggressive Behavior, 37, 215–222. [DOI] [PubMed] [Google Scholar]
  53. Roberts R, O’Connor T, Dunn J, Golding J, & ALSPAC Study Team. (2004). The effects of child sexual abuse in later family life; mental health, parenting and adjustment of offspring. Child Abuse & Neglect, 28, 525–545. [DOI] [PubMed] [Google Scholar]
  54. Sabogal F, Marín G, Otero-Sabogal R, Marín BV, & Perez-Stable EJ (1987). Hispanic familism and acculturation: What changes and what doesn’t? Hispanic Journal of Behavioral Sciences, 9, 397–412. [Google Scholar]
  55. Sangalang CC, & Vang C (2017). Intergenerational trauma in refugee families: A systematic review. Journal of Immigrant and Minority Health, 19, 745–754. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Schickedanz A, Halfon N, Sastry N, & Chung PJ (2018). Parents’ adverse childhood experiences and their children’s behavioral health problems. Pediatrics, 142, e20180023. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Schofield TJ, Donnellan MB, Merrick MT, Ports KA, Klevens J, & Leeb R (2018). Intergenerational continuity in adverse childhood experiences and rural community environments. American Journal of Public Health, 108, 1148–1152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  58. Schore AN (2002). Dysregulation of the right brain: a fundamental mechanism of traumatic attachment and the psychopathogenesis of posttraumatic stress disorder. Australian and New Zealand Journal of Psychiatry, 36, 9–30. [DOI] [PubMed] [Google Scholar]
  59. Serbin L, & Karp J (2003). Intergenerational studies of parenting and the transfer of risk from parent to child. Current Directions in Psychological Science, 12, 138–142. [Google Scholar]
  60. Stevens SL, Colwell B, Smith DW, Robinson J, & McMillan C (2005). An exploration of self-reported negative affect by adolescents as a reason for smoking: Implications for tobacco prevention and intervention programs. Preventive Medicine, 41, 589–596. [DOI] [PubMed] [Google Scholar]
  61. Van Ryzin MJ, Stormshak EA, & Dishion TJ (2012). Engaging parents in the family check-up in middle school: Longitudinal effects on family conflict and problem behavior through the high school transition. Journal of Adolescent Health, 50, 627–633. [DOI] [PMC free article] [PubMed] [Google Scholar]

RESOURCES