Mediators and moderators in the relationship between maternal childhood adversity and children's emotional and behavioural development: a systematic review and meta-analysis

Abstract

Maternal experiences of childhood adversity can increase the risk of emotional and behavioural problems in their children. This systematic review and meta-analysis provide the first narrative and quantitative synthesis of the mediators and moderators involved in the link between maternal childhood adversity and children's emotional and behavioural development. We searched EMBASE, PsycINFO, Medline, Cochrane Library, grey literature and reference lists. Studies published up to February 2021 were included if they explored mediators or moderators between maternal childhood adversity and their children's emotional and behavioural development. Data were synthesised narratively and quantitatively by meta-analytic approaches. The search yielded 781 articles, with 74 full-text articles reviewed, and 41 studies meeting inclusion criteria. Maternal mental health was a significant individual-level mediator, while child traumatic experiences and insecure maternal–child attachment were consistent family-level mediators. However, the evidence for community-level mediators was limited. A meta-analysis of nine single-mediating analyses from five studies indicated three mediating pathways: maternal depression, negative parenting practices and maternal insecure attachment, with pooled indirect standardised effects of 0.10 [95% CI (0.03–0.17)), 0.01 (95% CI (−0.02 to 0.04)] and 0.07 [95% CI (0.01–0.12)], respectively. Research studies on moderators were few and identified some individual-level factors, such as child sex (e.g. the mediating role of parenting practices being only significant in girls), biological factors (e.g. maternal cortisol level) and genetic factors (e.g. child's serotonin-transporter genotype). In conclusion, maternal depression and maternal insecure attachment are two established mediating pathways that can explain the link between maternal childhood adversity and their children's emotional and behavioural development and offer opportunities for intervention.

The Mediating Role of Attachment Styles in the Relationship of Parent-child Relationship and Parenting Styles With Children’s Behavioral Problems After Divorce

“…These conditions can be further categorized into two distinct groups known as internalizing and externalizing problems [2]. The result of the study confirmed that childhood adversities can expose successive generations of families to the consequences of poorer health and vulnerability to behavioral and mental health problems [3].…”

Factors affecting the association between maternal adverse childhood experiences and preschool children’s behavioural problems: a systematic review of mediators and moderators

“…Certain variables (e.g., maternal mind-mindedness, maternal sensitivity, maternal attachment styles) demonstrated significant effects when examined via more complex models. A similar review was recently conducted that examined the research question in the context of all children below the age of 18 years, 47 capturing less than half of the studies that this review included and also warranting caution when generalizing findings as development in preschool differs substantially from other developmental periods (i.e., teenage). Both reviews do however identify a pertinent role of maternal depressive symptoms/depression as a mediator of the association between maternal ACEs and children's behavioural problems.…”

Programming the next generation of prenatal programming of stress research: A review and suggestions for the future of the field

“…Broad adoption of these newer findings is delayed in our field though. For example, in what appears to be the first systematic review and meta-analysis of mediators of the link between maternal childhood adversity and children's socioemotional and behavioral development (Ma et al, 2022), there is discussion of some evidence for antenatal or lifetime maternal depression and maternal perinatal health (e.g., gestational diabetes, abortion history and smoking during pregnancy) as mediators, but most associations reviewed in that paper well null, and prenatal programing was not mentioned/considered as a mediating process by the authors. Beyond the focus on children's mental health outcomes, however, scholars are paying increasing attention.…”