Pathways explaining the intergenerational effects of ACEs: The mediating roles of mothers' mental health and the quality of their relationships with their children

Background The effects on children of their parents' accumulated adverse childhood experiences (ACEs), or the mechanisms through which the intergenerational transmission of trauma operates, is still poorly understood. Objective The present study explored whether mothers' experiences of childhood adversity predicted the presence of social, emotional, or behavioural difficulties in their children, and if the association of maternal ACEs with these child outcomes was mediated by maternal mental health and the quality of the parent-child relationship. Participants and Setting: Three hundred and fourteen mothers attending an Irish community-based therapeutic family service. Methods Surveys assessed mothers' exposure to ACEs, their mental health, their perception of the quality of the relationship they have with their children, and their children's social, emotional, and behavioural difficulties. Results Serial mediation analysis supported the view that mothers' own experiences of adversities experienced in childhood predict the presence of social, emotional, or behavioural difficulties in their children both directly and indirectly via their negative impact upon maternal mental health and the quality of parent-child interactions. These relationships were noted while controlling for child gender and age, and a range of socio economic status (SES) factors. Conclusions Understanding how ACEs negatively impact upon mothers' mental health and the quality of their relationship with their children, which in turn negatively impacts upon a range of child development domains, can inform early intervention strategies designed to improve life course outcomes for mothers and their children and contribute towards breaking the transmission of intergenerational risk.