Intergenerational transmission of adverse childhood experiences: Differential maternal and paternal associations with offspring mental health in Chinese school-aged children by multi-method.

Maternal ACEs were significantly associated with higher risks of offspring depressive symptoms across multiple measurement approaches.

• Maternal family dysfunction, exposure to ≥1 or ≥2 cumulative ACEs, threat- and deprivation-related ACEs, abuse-related ACEs were all significantly associated with offspring depressive symptoms
• Odds ratios ranged between 1.46 and 1.81 for binary (depressive symptoms present/absent) outcomes in maternal-child pairs
• Maternal ACEs also predicted higher continuous depression scores in offspring (β ranging from 0.28 to 1.02)
• Maternal ACEs were not significantly associated with offspring anxiety symptoms in terms of odds ratios, though they did predict higher anxiety scores continuously

Paternal ACEs showed only marginal associations with offspring mental health outcomes.

• Only a marginal association was observed between paternal threat-related ACEs and offspring depression scores (β: 0.43, 95% CI: 0.00, 0.86)
• No significant associations were found between paternal ACEs and offspring depressive symptoms as a binary outcome
• The contrast with maternal findings highlights distinct maternal versus paternal intergenerational influence patterns
• The study used five complementary ACEs approaches across both maternal-child and paternal-child pairs

Network analysis identified different central ACE nodes in maternal versus paternal intergenerational networks.

• Physical abuse was identified as the central node in the maternal-child network
• Both physical abuse and sexual abuse were identified as central nodes in the paternal-child network
• Network analysis was one of five complementary ACEs approaches employed: single adversity model, accumulating risk model, dimensional model, Latent Class Analysis, and network analysis
• The authors concluded that maternal physical abuse and paternal physical and sexual abuse appear to be key intergenerational risks

A latent class of 'emotional abuse, physical abuse and emotional neglect' (EPE cluster) derived from Latent Class Analysis was significantly associated with offspring depressive symptoms.

• The EPE cluster was identified through Latent Class Analysis of maternal ACEs
• The EPE cluster was significantly associated with higher risks of offspring depressive symptoms with OR ranging between 1.46 and 1.81
• This finding was specific to maternal-child pairs
• LCA was one of five complementary ACEs measurement approaches used in the study

The association between parental ACEs and offspring mental health was moderated by parental resilience, offspring sex, and offspring age.

• Stratification analyses revealed effect modification by parental resilience, offspring's sex, and offspring's age
• The study specifically aimed to examine whether the parental ACEs–offspring mental health association was moderated by these factors
• Parental resilience was identified as a potential buffering factor in the intergenerational transmission pathway
• These moderating effects were examined across the cross-sectional sample of n = 6146 school-aged children

The study used a large cross-sectional sample of school-aged children in China with multiple complementary ACEs measurement approaches.

• The sample consisted of n = 6146 participants from the 2023 Healthy Development and Influencing Factors Survey of School-aged Students in a city of Guangdong Province, China
• Parental ACEs were self-reported for the period between 0 and 18 years using the Kaiser-CDC ACEs Scale
• Offspring depression was assessed with the Patient Health Questionnaire-9 (PHQ-9) and anxiety with the 7-item Generalized Anxiety Disorder Instrument (GAD-7)
• Five complementary ACEs approaches were applied: single adversity model, accumulating risk model, dimensional model (threat- and deprivation-related ACEs), Latent Class Analysis, and network analysis
• The study was cross-sectional, limiting causal inference

The dimensional model distinguished threat-related and deprivation-related maternal ACEs as separately associated with offspring depression outcomes.

• Both threat-related ACEs (experiences involving harm or danger) and deprivation-related ACEs (experiences involving absence of expected inputs) were significantly associated with offspring depressive symptoms in maternal-child pairs
• ORs for these dimensional ACE categories ranged between 1.46 and 1.81
• For paternal pairs, only threat-related ACEs showed a marginal association with offspring depression scores (β: 0.43, 95% CI: 0.00, 0.86)
• The dimensional model was applied alongside four other ACEs measurement frameworks