Pediatrics, August 2018, VOLUME 142 / ISSUE 2
by Adam Schickedanz, Neal Halfon, Narayan Sastry, Paul J. Chung
BACKGROUND AND OBJECTIVES: Adverse childhood experiences (ACEs) include stressful and potentially traumatic events associated with higher risk of long-term behavioral problems and chronic illnesses. Whether parents’ ACE counts (an index of standard ACEs) confer intergenerational risk to their children’s behavioral health is unknown. In this study, we estimate the risk of child behavioral problems as a function of parent ACE counts.
METHODS: We obtained retrospective information on 9 ACEs self-reported by parents and parent reports of their children’s (1) behavioral problems (using the Behavior Problems Index [BPI]), (2) attention-deficit/hyperactivity disorder diagnosis, and (3) emotional disturbance diagnosis from the 2013 Panel Study of Income Dynamics (PSID) core interview and the linked PSID Childhood Retrospective Circumstances Study and 2014 PSID Child Development Supplement. Multivariate linear and logistic regression models were used to estimate child behavioral health outcomes by parent retrospective ACE count.
RESULTS: Children of parents with a history of 4 or more ACEs had on average a 2.3-point (95% confidence interval [CI]: 1.3–3.2) higher score on the BPI, 2.1 times (95% CI: 1.1–3.8) higher odds of hyperactivity, and 4.2 times (95% CI: 1.7–10.8) higher odds of an emotional disturbance diagnosis than children of parents with no ACEs. Maternal ACEs revealed a stronger association with child behavior problems than paternal ACEs. Relationships between parents’ 9 component ACEs individually and children’s BPI scores revealed consistently positive associations. Mediation by parent emotional distress and aggravation were observed.
CONCLUSIONS: Parents with greater exposure to ACEs are more likely to have children with behavioral health problems.
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