Parental childhood maltreatment and the later-life relationship with parents

Daily stress reactivity and risk appraisal mediates childhood parental abuse predicting adulthood psychopathology severity: An 18-year longitudinal mediation analysis

Identifying mechanisms of childhood abuse-adulthood psychopathology relations could facilitate preventive efforts, but most prior studies used cross-sectional or two-wave designs and did not test the effects of childhood maternal and paternal abuse separately. Our 18-year three-wave study thus determined if Wave 2 daily stress reactivity and risk appraisal severity mediated Wave 1 retrospectively-reported childhood maternal and paternal abuse on Wave 3 generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD), alcohol (AUD), and substance use disorder (SUD) self-rated symptom severity. Longitudinal structural equation modeling was employed, adjusting for Wave 1 psychopathology severity. Higher childhood maternal and paternal abuse consistently predicted greater future daily stress reactivity and risk appraisal, and these mediators subsequently predicted increased GAD, MDD, and PD, but not AUD and SUD severity. Daily stress reactivity and risk appraisal consistently mediated the pathways between childhood maternal and paternal abuse predicting heightened adulthood GAD, MDD, and PD (Cohen's d = 0.333-0.888) but not AUD and SUD severity. Mediation effect sizes were stronger for childhood maternal (24.5-83.0%) than paternal (19.5-56.0%) abuse as the predictor. The latent interaction between Wave 1 childhood maternal and paternal abuse did not moderate the effect of Wave 1 maternal or paternal abuse on any Wave 3 adulthood psychopathology severity through Wave 2 daily stress reactivity and risk appraisal. Our research emphasizes the urgent requirement for continuous evaluation and intervention initiatives in trauma-informed care, both in inpatient and outpatient treatment settings.

Familial Abuse During Childhood and Later-Life Health: Exploring the Role of Victim-Perpetrator Relationships

OBJECTIVES

Childhood abuse has been extensively studied in relation to later-life health, yet relatively little attention has been given to understanding the nuanced dynamics across victim-perpetrator relationships. This study addresses this gap by identifying typologies of familial perpetrators of childhood abuse in a national sample and examining their associations with various health outcomes, including physical and mental health as well as substance abuse.

METHODS

We used 2 waves of data from the Midlife in the US Study (n = 6,295, mean age = 46.9 at baseline). The analysis was completed in 3 stages. Using Latent Class Analysis (LCA), we identified subpopulations of victims with distinct familial perpetrator histories. With assigned LCA memberships and propensity score weighting, we investigated the extent to which specific victim-perpetrator relationships are associated with health outcomes measured at baseline and a 10-year follow-up adjusting for other early-life risks. We evaluated whether the observed associations differ across the waves.

RESULTS

Parental and sibling abuse commonly co-occur, surpassing the occurrence of single perpetrators. Although minimal health disparities are evident between sibling-only abuse and no/little abuse groups at baseline, parent-only abuse is associated with compromised health outcomes. Severe abuse from both siblings and parents is linked to the most adverse health outcomes. At the follow-up survey, the associations between familiar abuse and health outcomes weakened, particularly for substance abuse.

DISCUSSION

This study, delving into family relationships, family violence, and health disparities, provides new evidence to augment our comprehension of the enduring link between childhood abuse and health within the family context.

Positive reappraisal coping mediates the relationship between parental abuse and lack of affection on adulthood generalized anxiety severity

Exposure to parental abuse and lack of parental affection during childhood are risk factors for adulthood psychopathology. Tendency to engage in positive reappraisal may be a plausible mechanism underlying this relationship. The current study examined if positive reappraisal coping mediated the relationship between maternal/paternal abuse/affection and adulthood generalized anxiety disorder (GAD) symptoms. Participant data (N = 3294) from the Midlife Development in the United States study was collected in three waves, spaced nine years apart. Longitudinal structural equation mediation modeling examined whether positive reappraisal coping at Time 2 mediated the relationship between maternal/paternal abuse/affection at Time 1 and GAD symptoms at Time 3, controlling for GAD symptoms at Time 1. Positive reappraisal coping mediated maternal/paternal childhood abuse - GAD symptom severity and maternal/paternal childhood affection - GAD severity relations. Maternal and paternal abuse was associated with lower positive reappraisal tendencies, predicting increased GAD symptom severity. Conversely, higher maternal/paternal affection was associated with increased positive reappraisal, predicting lower GAD severity. Incremental prediction revealed that childhood abuse to GAD severity via positive reappraisal path was significant for maternal but not paternal abuse, whereas affection from both parents remained significant. Positive reappraisal coping may be a possible mechanism linking childhood experiences to adulthood GAD severity.

Resilience to stress across the lifespan: Childhood maltreatment, heart rate variability, and bereavement

Following a stressful life event, there is considerable variation in how individuals respond and adapt. Multiple models of risk and resilience show that adverse childhood experiences may be associated with an individual's response to stress later in life. While there is considerable support that early adversity can sensitize the stress response system and lead to adverse outcomes later in life, there is mounting evidence that in adolescence and young adulthood, certain biological predispositions to stress may be associated with resilience in the context of subsequent stressors. In this study, we evaluated how individual differences in vagally mediated heart rate variability moderated the relationship between childhood maltreatment and grief among a sample of individuals experiencing a stressful life event (i.e., spousal bereavement) over time. Data were collected at approximately 3, 4.5, and 6.5 months after the death of a spouse (n = 130). Heart rate variability moderated the relationship between childhood maltreatment and grief symptoms over time (b = -0.03, p < .001), such that among individuals with more severe experiences of childhood maltreatment, those with higher heart rate variability had a faster recovery from grief than those with low heart rate variability. This research highlights an overall pattern of resilience among older adult's following spousal bereavement, as well as the relationships between childhood maltreatment, heart rate variability, and differential responses to grief following the loss of a spouse. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Support for Older Parents in Need in Europe: The Role of the Social Network and of Individual and Relational Characteristics

Background and Objectives

Adult children form the backbone of informal care for older parents. To date, limited attention has been paid to the complex mechanism of providing support to older parents. The present study investigated mezzo- and micro-level correlates of provision of support to older parents. The focus was on the child-parent relationship in childhood and in the present.

Research Design and Methods

Data were derived from the Survey of Health, Ageing and Retirement in Europe (SHARE). The analytic sample comprised respondents who participated in SHARE Waves 6-8 and reported having an unhealthy mother (N = 1,554) or father (N = 478). We used hierarchical logistic regression to address 3 models including individual resources, child-parent characteristics, and social resources. We conducted separate analyses for mothers and fathers.

Results

Providing support to a parent depended primarily on personal resources followed by the quality of the relationship with the parent. A larger social network of the care provider was also related to increased likelihood of providing support. Support to a mother was associated with positive evaluations of the relationship with her in the present and in childhood. At the same time, negative evaluations of the relationship with the father in childhood were negatively related to providing support to him.

Discussion and Implications

The findings point to a multidimensional mechanism, in which adult children's resources are a prominent factor in shaping caregiving behaviors toward their parents. Clinical efforts should focus on adult children's social resources and the quality of the child-parent relationship.

Association between poor parent-daughter relationships and the risk of hyperglycemia in pregnancy: a hospital-based prospective cohort study in Japan

BACKGROUND

Adverse child experiences (ACEs), childhood maltreatment and household dysfunction, are risk factors of hyperglycemia in pregnancy (HIP), including diabetes before pregnancy, gestational diabetes (GDM), and overt diabetes in pregnancy, through increased risk of unhealthy behaviors, obesity, and stress response system dysfunction. While ACEs are often difficult to be assessed in hospital settings, parent-daughter relationship, that is, pregnant women's relationship with their parents can be considered as a measurable maker for ACEs that may be associated with HIP. The purpose of this study is to examine the association between poor parent-daughter relationship and HIP.

METHODS

Hospital-based prospective cohort study was conducted in Japan (N = 6,264). Women visiting participating 58 facilities for delivery between April 2019 and March 2020 were included. Parent-daughter relationship was assessed by a questionnaire asking whether participants were satisfied with their relationship with their parents. HIP was diagnosed based on the criteria used in Japan. A multiple logistic regression model was applied to adjust for covariates.

RESULTS

Pregnant women who were not very satisfied and not satisfied at all with the relationship with their parents, and HIP were 343 (5.5%), 74 (1.2%), and 274 (4.4%), respectively. Pregnant women who were not very satisfied with their parent-daughter relationship showed a significant positive association with HIP in the crude model (odds ratio (OR): 1.71, 95% confidence interval (CI): 1.11-2.63). When stratified by psychiatric disease history, we found a significant positive association among those without psychiatric disease history (OR: 1.77, 95% CI: 1.11-2.84), but not among those with psychiatric disease history (OR: 0.61, 95% CI: 0.16-2.28).

CONCLUSIONS

Poor parent-daughter relationship was associated with the risk of HIP among pregnant women without psychiatric disease history, suggesting that this simple question could be used to estimate the risk of HIP when it was challenging to inquire directly about ACEs. Further research is needed to elucidate the mechanism of the association.

Mediating effect of fear and externality of happiness in the association between psychological maltreatment and psychological well-being

This study aims to explore whether psychological maltreatment predicts young adults' psychological well-being through fear of happiness and externality of happiness. The current study included 490 young adults from a public university in an urban city in Turkey. Participants were 36% male, and they ranged in age from 18 to 39 years (M= 21.77, SD = 2.40). Findings from the study revealed that psychological maltreatment had a significant predictive effect on psychological well-being, fear of happiness, and externality of happiness. Further, fear of happiness and externality of happiness mediated the impact of psychological maltreatment on psychological well-being. These findings indicate that fear and externality of happiness are important sources that can help to explain the association between childhood psychological maltreatment and psychological well-being among young adults. Therefore, there is a need to design a more comprehensive prevention and intervention approach for improving people's psychological well-being in the context of psychological maltreatment.

Trait self-acceptance mediates parental childhood abuse predicting depression and anxiety symptoms in adulthood

BACKGROUND

Biopsychosocial models posit that experiencing parental childhood abuse increases vulnerability to psychopathology in adulthood. There are a lack of studies investigating mediators of the parental childhood abuse-adulthood psychopathology relation. The current study investigated if trait self-acceptance mediated the parental childhood abuse-adulthood major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) severity relations.

METHODS

Participants (n = 3294) partook in the 18-year Midlife Development in the United States (MIDUS) study at three time-points. We conducted structural equation modeling analyses to test how maternal and paternal childhood abuse at Time 1 would independently positively predict MDD, GAD, and PD severity at Time 3, and if self-acceptance at Time 2 mediated those relations while controlling for adulthood MDD, GAD, and PD severity at Time 1.

RESULTS

Self-acceptance notably mediated the parental childhood abuse-adulthood MDD, GAD, and PD relations. Overall, higher paternal and maternal childhood abuse was associated with lower self-acceptance. Reduced self-acceptance predicted heightened adulthood MDD, GAD, and PD.

CONCLUSION

Findings highlight the importance of understanding the parental childhood abuse-adulthood psychopathology relation and the possible mechanisms of its long-term impact.

Filial Caregiving and Chinese Adults' Depressive Symptoms: Do Early-Life Parent-Child Relationships Matter?

This study investigated the association between caregiving time and depressive symptoms among Chinese adult children aged 45 and above, and whether early-life relationships with parents moderated the association. We used data from the 2011, 2013, and 2018 waves of China Health and Retirement Longitudinal Study (CHARLS) and the 2014 CHARLS Life History Survey, which included 4781 respondents with living mothers and 2710 respondents with living fathers. Results from multilevel models showed that caregiving time for mothers or fathers was not significantly associated with adults' depressive symptoms in general. However, more caregiving time for mothers was significantly associated with more depressive symptoms among respondents experiencing more frequent maternal childhood physical abuse. Altogether, childhood maltreatment may affect levels of caregiving stress decades later. Filial caregivers with a history of childhood physical abuse may require support.

Childhood abuse and adult relationships with perpetrating parents: impacts on depressive symptoms of caregivers of aging parents

Objectives: Combining the stress process model of caregiving and life course perspective, this study examined the long-term associations among childhood abuse, relationships between perpetrating parents and adult children, and adult children's well-being in the context of caregiving for a perpetrating parent.Method: Using a sample of family caregivers from the Wisconsin Longitudinal Study, this study investigated (a) whether contact frequency and emotional closeness with an abusive parent mediated the longitudinal effects of parental childhood abuse on adult-child caregivers' depressive symptoms and (b) the moderating effects of self-acceptance and mastery on this mediational association.Results: Key findings indicated that in the caregivers of mothers, maternal childhood abuse was negatively associated with emotional closeness between an adult child caregiver and perpetrating mother care recipient. In turn, low emotional closeness was associated with higher depressive symptoms in the adult child caregiver. A lack of psychological resources such as self-acceptance and mastery strengthened the effect of maternal childhood abuse on depressive symptoms. In the caregivers of fathers, we did not find any significant indirect effect of parental childhood abuse on adult-child caregivers' depressive symptoms.Conclusion: Further research is needed to explore this phenomenon in light of the heterogeneity of contemporary families. Practitioners are encouraged to employ a trauma-informed approach when working with adults with a history of parental childhood abuse who are caregiving for their perpetrator to maximize the caregivers' health and well-being.

Relationship trajectories of pregnant women with their parents and postpartum depression: A hospital-based prospective cohort study in Japan

BACKGROUNDS

A history of childhood abuse and subsequent poor relationship with parents in adulthood among pregnant women is a known risk factor for postpartum depression (PPD). Although parent-daughter relationship can change during pregnancy, little is known whether the trajectories have an impact on PPD. The aim of this study is to examine whether trajectories of parent-daughter relationship during pregnancy are associated with PPD in Japanese mothers.

METHODS

In a hospital-based prospective cohort study conducted in Japan, 4,772 women were followed from their first visit to their 1-month postpartum check-up (follow-up rate: 77.4%). Parent-daughter relationship was assessed whether participants were satisfied with their parents at first visit and after delivery. We defined four parent-daughter relationship trajectory categories: consistently satisfied, improving, deteriorating, and consistently unsatisfied. PPD was assessed by the Edinburgh Postnatal Depression Scale. Logistic regression model was applied to adjust covariates.

RESULTS

There were 129 (2.7%), 122 (2.6%), and 181 (3.8%) cases of improving, deteriorating, and consistently unsatisfied relationship, respectively. Compared to the group that was consistently satisfied, pregnant women of the deteriorating and consistently unsatisfied group showed 2.81 (95% CI: 1.73-4.55) and 2.39 (95% CI: 1.58-3.62) times, respectively, more likely to show PPD after adjustment for confounders.

CONCLUSION

Women who felt that their relationship with parents "deteriorated" or was "consistently unsatisfactory" during pregnancy showed significant risk of PPD. Paying attention to the pregnant women's feelings about the relationship with their parents and promoting positive change may help predict and prevent PPD.

The dimensionality of adverse childhood experiences: A scoping review of ACE dimensions measurement

OBJECTIVE

Despite extensive research, the concept of adverse childhood experiences (ACEs) is not fully developed and there is low agreement on how the concept should be defined and measured. The purpose of this study was to 1) identify different conceptual dimensions associated with ACEs, such as timing or frequency; and 2) determine how these dimensions have been operationalized and analyzed to this point, in order to advance the conceptual understanding of ACEs.

METHODS

We conducted a scoping review of empirical journal articles on ACEs published after the original ACE-Study in 1998 to summarize the use of dimensions for the 10 conventional ACE domains. We used a PRISMA methodology to identify articles that assessed at least two of the 10 conventional ACE domains and at least two ACE dimensions. A standardized data extraction spreadsheet was used to record basic article information and specifics on ACE domains and dimensions.

RESULTS

Of 15,417 initial search results, 61 articles met all selection criteria. We identified four primary dimensions used for most ACE domains: frequency, timing, perception, and the role of the perpetrator. Additionally, we found several secondary and domain-specific dimensions, which relate to the intensity of the adverse event.

DISCUSSION

We identified the most commonly used ACE dimensions, but these lack standardized phrasing of items and response options. The inclusion of ACE dimensions may increase the accuracy of the association between ACEs and health outcomes and provide for more tailored treatment plans for people who have experienced ACEs. Future research should include a more comprehensive list of ACE domains and aim to develop a clearly articulated, standardized approach to assessing and analyzing ACE dimensions.

Caregiving for Parents Who Harmed You: A Conceptual Review

Objectives: This paper aims to provide a conceptual review of prior research on the effect of a history of parental childhood maltreatment on the experiences and outcomes of adult-child caregivers who provide care to their perpetrating parents.Methods: We performed a search using several databases including PsycINFO, ScienceDirect, and Academic Search Premier (EBSCO) for relevant papers and reviewed reference sections of selected papers.Results: Histories of childhood maltreatment are associated with adverse psychological health in adult-child caregivers and reduced frequencies of providing support to their parents. The potential factors affecting the experiences and outcomes of such caregivers include contemporaneous relationships with perpetrating parents; caregivers' sense of choice about providing care; opportunities for posttraumatic growth; and participating in care through the end of life.Conclusions: Caregiving for perpetrating parents can be particularly challenging due to complex, intersecting factors; thus, healthcare practitioners' increased awareness of and knowledge about such caregivers are crucial to provide effective support.Clinical Implications: We highlighted the importance of ensuring caregivers' sense of choice and assessing their posttraumatic growth. In caregiving at the end of life, we noted the importance of using a trauma-informed approach when interacting with caregivers and their family members during illness and bereavement.

Adverse childhood experiences among previously homeless African American women

OBJECTIVE

To learn how adverse childhood experiences (ACEs) impacted the life course trajectory of formerly homeless and at-risk African American women.

DESIGN

Intersectionality and life course theory informed this qualitative pilot study, based on an instrumental case study design.

SAMPLE

Forty previously homeless and at-risk African American women, who were graduates from a long-term transitional living facility in Milwaukee, Wisconsin.

MEASUREMENTS

Focus group interviews and one individual interview provided data about participants' life experiences prior to, during, and following their time at the transitional living facility, which provided supportive wrap-around services. Interviews were audiotaped, transcribed, and line-by-line thematic analysis was conducted to identify themes. Fifteen focus group participants also completed ACE questionnaires.

RESULTS

Participants reported a high prevalence of multiple ACEs, and three themes were identified: childhood experiences with family conflict, childhood experiences of abuse, and negative coping mechanisms. One-hundred percent of women had experienced at least one ACE, based on ACE questionnaire responses.

CONCLUSIONS

ACEs affect various parts of patient's lives as adults. For nurses and other healthcare professionals, connecting with community resources provides the opportunity to strategically approach health improvement with wrap-around resources to improve health outcomes.

The moderating role of three-generation households in the intergenerational transmission of violence

BACKGROUND & OBJECTIVE

Considering the increasing trends in multi-generational living arrangements, the current study aimed to test the intergenerational transmission of violence hypothesis in three-generational households. We also examined whether and how living in a three-generation household would moderate the negative effect of childhood maltreatment on adults' abusive and neglectful parenting behaviors.

METHOD

We conducted secondary data analysis using data from the Wisconsin Families Study. The study sample included 727 low-income parents of young children, most of whom were African American women with, on average, a high school diploma. We estimated a series of ordinary least squares regression models.

RESULTS

Our findings indicated that parents who reported a history of childhood abuse, neglect, and witnessing domestic violence showed more frequent use of psychological aggression, physical aggression, and neglectful behavior against their children. Living in a three-generation household played a protective role: The negative effects of a) a history of childhood abuse on the use of neglectful parenting and b) witnessing domestic violence on the use of psychological aggression were reduced for respondents living in a three-generation household (b = -0.11; b = -0.33, ps < 0.05, respectively).

CONCLUSION

The risk of the intergenerational transmission of violence may decrease in three-generation households where parents of young children can meet their needs by sharing family resources or easing the burden of childcare. Further research is needed to identify and specify factors and contexts associated with the beneficial effects of multi-generational living arrangements.

Psychological Maltreatment and Spiritual Wellbeing in Turkish College Young Adults: Exploring the Mediating Effect of College Belonging and Social Support

The purpose of this study is to examine whether college belonging and social support mediate the association between childhood psychological maltreatment and spiritual wellbeing among college young adults. The sample of the present study included 493 college young adults (33% male), ranging in age between 18 and 39 years (M = 21.35, SD = 2.56). The results showed that psychological maltreatment not only had a direct predictive effect on spiritual wellbeing but also an indirect predictive effect on spiritual wellbeing through college belonging and social support. These findings present important implications for research and practices by providing an in-depth understanding of the association between psychological maltreatment and spiritual wellbeing among Turkish college students.

Different Types of Childhood Experience with Mothers and Caregiving Outcomes in Adulthood

OBJECTIVE AND BACKGROUND

The current study examines the types of childhood experiences with mothers (i.e., maternal abuse, affection, discipline) among caregivers of aging mothers, and investigates whether membership in specific latent classes, particularly maternal maltreatment, is associated with psychological functioning among caregivers.

METHOD

Using data from the Midlife in the United States (MIDUS), we used the Bolck, Croon, and Hagenaars (BCH) approach of latent class analysis (LCA) to predict distal outcomes.

RESULTS

We identified four latent classes (prevalence rate noted): "Affectionate and authoritative" (65%), "affectionate and permissive" (11%), "emotionally abusive and neglectful" (8%), and "emotionally/physically abusive and authoritative" (16%). Caregivers in the "emotionally/physically abusive and authoritative" class endorsed high probabilities of both maternal affection and abuse and were most negatively affected across the three psychological functioning outcomes (i.e., self-rated mental health, psychological distress, and psychological well-being).

CONCLUSION AND IMPLICATIONS

In support of the life course perspective, our findings emphasized the importance of examining adult children caregivers' early life experiences with aging mothers and how those experiences can impact the psychological effects of caregiving. This study suggests specific practice implications; for example, assessment tools for evaluating caregiver burden should consider life course factors such as caregivers' childhood experiences with aging parents.