Maternal adverse childhood experiences and health-related quality of life in preschool children: a cross-sectional study

Abstract

Background The intergenerational association between maternal adverse childhood experiences (ACEs) and their children’s health-related quality of life (HRQOL) is underexplored. This study aimed to examine such association in Chinese preschool children and to test the moderation role of children’s sex. Methods A cross-sectional study was conducted among 4243 mother–child dyads who attended randomly selected preschools. Mothers self-reported their experience of 12 forms of ACEs, including emotional abuse, physical abuse, emotional neglect, physical neglect, intimate partner violence, substance abuse in the household, incarcerated household member, mental illness in household, parental death, parental separation or divorce, bullying, and community violence. Children’s HRQOL was evaluated through mother report of the Pediatric Quality of Life Inventory version 4.0. Linear regression models were established to estimate the associations between maternal ACEs and their children’s HRQOL sub-scores and total scores. Stratified analysis and test for interaction were further conducted to evaluate whether the associations were moderated by children’s sex. Results Of the included mothers, 85.8% (n = 3641) had reported exposure to at least one ACE, and 22.3% (n = 948) were exposed to three or more ACEs. Compared to children of mothers without any ACE exposure, those of mothers with 1, 2, or ≥ 3 ACEs all had significantly lower scores of physical, social, and school functioning, as well as lower psychosocial health summary score and total scale score in both crude and adjusted models. However, only children of mothers with two or more ACEs had significantly poorer emotional functioning when compared to their counterparts whose mothers had no ACE exposure. A significant dose-response pattern was also observed between the number of maternal ACEs and children’s HRQOL sub-scores and total scores. Stratified analysis revealed sex-specific pattern between maternal ACEs and their children’s HRQOL. Nonetheless, children’s sex was not a significant moderator. Conclusions Our study showed that preschool children of mothers who had any experience of ACEs were at risk of poorer HRQOL. Our findings indicated that screening maternal ACEs in young children and promoting targeted interventions might be a feasible way to mitigate or stop the potential negative intergenerational health and wellbeing implications of ACEs.

Linkage of Mother's Childhood Adversity Experience and the Intergenerational Transmission of Parenting Violations: A Systematic Literature Review

“…Specifically, the research revealed that the likelihood of a child developing mental health conditions was significantly elevated, being three times higher (adjusted odds ratio [aOR] 3.01; 95% confidence interval [CI] 1.59-5.69), when their caregiver had experienced four or more Adverse Childhood Experiences (ACEs). Additionally, there was a twofold increase in the probability of the child experiencing these conditions if their caregiver also faced depression or anxiety (aOR 2.24; 95% CI 1.41-3.57) (Chen et al, 2023). The study's findings corroborate the hypothesis that adverse childhood experiences (ACEs) of mothers are linked to the transmission of parenting violations across generations, possibly mediated by several confounding factors.…”

The mediating role of trait mindfulness and dissociative experiences in the relationship between childhood emotional abuse and problematic internet use in Italian adolescents

“…Dissociation is frequently linked to stressful and traumatic situations, particularly when such events are experienced in childhood (Kate et al, 2021), as well as to internet‐related problematic behaviours (Canan et al, 2012). It appears that dissociative experiences and problematic use of the internet may rise as means to evade the negative feelings and emotions related to the emotional abuse suffered during childhood (Chen et al, 2023; Dalbudak et al, 2014). Individuals experiencing dissociation may find it easier to live a virtual life where anonymity and asynchronicity can be maintained long‐term rather than trying to experience real life (Canan et al, 2012).…”

“…Significant components that can increase the risk of developing problematic internet use (PIU) are adverse childhood experiences and the traumatic memories and emotional aspects associated (Chen et al, 2023). Emotional abuse is one of the adverse childhood experiences that mostly has a severe impact on a child's physical and psychological development due to its significant effects on emotional management, awareness and acceptance (Chen et al, 2023; Korolevskaia & Yampolskaya, 2023). Indeed, the relationship between psychological trauma and problematic behaviours has been studied, and research suggests that psychological trauma substantially increases susceptibility to PIU (Dalbudak et al, 2014).…”

“…Furthermore, the internet provides a platform for social interactions, allowing individuals to form connections with others without the barriers and challenges they might face in face‐to‐face interactions. This social connection, albeit virtual, can alleviate feelings of isolation and loneliness resulting from emotional abuse (Chen et al, 2023). In the proposed framework of our study, we extend Kardefelt‐Winther's compensatory internet use model by considering the roles of trait mindfulness and dissociative experiences in the aforementioned relationship.…”

Adverse childhood experiences, problematic internet use, and health-related quality of life in Chinese adolescents

“…HRQOL was assessed using the Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0) through self-reported paper questionnaires (Varni et al, 2001 ). The PedsQL 4.0 has shown good validity and reliability for Chinese children and adolescents (Hao et al, 2010 ; Fadhullah et al, 2022 ; Chen et al, 2023 ). It includes 23 items, which can be categorized into four dimensions, i.e.…”