Maternal experience of abuse in childhood and depressive symptoms in adolescent and adult offspring: a 21-year longitudinal study. Roberts, Chen e.a. - 2015 - Artikel

What are the objectives of this study?

The effects of child maltreatment have been researched and documented. Childhood abuse is prevalent in many families and is related to poorer mental health across the lifespan. Effects of childhood adversities on mental health disparities in offspring is rarely studied. Maternal childhood abuse could have an influence on mental health in their offspring when they reach adolescence or adulthood. The risk for offspring depression could be influences by three interrelated mechanisms.

1. Women that have experienced abuse in their childhood are at greater risk of poor mental health. This is linked with insensitive and inconsistent parenting behaviour. This can lead to insecure attachment of the child and depression in offspring.
2. Childhood abuse is related to characteristics in families, linked to depression. This includes a lower socioeconomic status (SES) and divorce.
3. Women that experienced abuse during childhood are more likely to have children that are abuse.

It remains unknown which mechanism is responsible for the connection between maternal experience of abuse and the risk for depression in offspring.

What methods did they use?

Data from wo large cohorts of women (N = 8,882) and their offspring (N = 11,402) was examined. Participants filled in web-based questionnaires to see whether negative childhood experiences are associated with depressive symptoms in adolescence of adult offspring. Maternal childhood abuse was measured by the Childhood Trauma questionnaire. Offspring depressive symptoms were measured by the Depression Symptoms Scale of the McKnight Risk Factor Survey. Three mediators by which maternal abuse could be related with offspring depressive symptoms were investigated. These pathways include: maternal mental health, family characteristics and offspring’s own experience of abuse.

The risk of offspring high depressive symptoms was investigated with maternal exposure to childhood maltreatment. Maternal exposure to childhood abuse was treated as an independent variable. To decide whether offspring of women exposed versus unexposed to maltreatment during childhood were at an increased risk of persistent and high depressive symptoms, these symptoms were treated as a dependent variable. After that, the association between maternal exposure to childhood abuse and offspring’s risk of high depressive symptoms was clarified by the three potential mediators.

What were the results they obtained?

It was found that offspring of women that endured more severe negative childhood experiences were more likely to develop high -and persistent depressive symptoms. One-fourth of the offspring had mothers reporting no exposure to any form childhood maltreatment. About 5% reported severe abuse. These mothers were more likely to have taken antidepressants recently (27.7% versus 11.6%). Offspring of woman that experienced severe abuse, were more likely to report experiences of childhood abuse than offspring of mothers that did not report abuse.

Maternal mental health accounted for 20.9% of these symptoms and offspring’s exposure to abuse accounted for 30.3%.  The difference between depressive symptoms in offspring were evident at age 12 and persisted through age 31 years. Greater maternal childhood abuse was related to an increased predominance of highly depressive symptoms in offspring.

What are the conclusions of the study?

It is the first time that the association between maternal childhood abuse and depressive symptoms in adult -and adolescent offspring is documented. Maternal abuse might be related with both a higher risk for depressive symptoms as more problematic depressive symptoms. Offspring with depressive symptoms from mothers that experienced child abuse were more likely to report suicidal ideation and more depression severity. More social withdrawal, anxiety, somatic complaints, aggression and externalized behaviour is reported. Increased depression in the offspring peaks at the ages 20-34.

Evidence for the relationship between childhood adversity and mental health of offspring is found. Negative childhood experiences influence the mental health of the offspring of the victim well into adulthood. Offspring vulnerability to abuse and maternal mental health accounts for 50% of the increased risk of development of highly depressive symptoms among woman with an abused mother. Therefore, improving maternal mental health and parenting practices will reduce the risk for offspring to develop depressive symptoms in these families.

What were the strengths and limitations of this study?

It was found that the own exposure of offspring’s abuse accounted for the elevated risk for depressive symptoms. It is well-known that children of abused parents are more likely to maltreat their children which leads to mental -and physical problems across the lifespan. However, there is not much evidence to support the claim that offspring of abused versus non-abused parents are at risk of a worse state of mental health. This study contributes to existing research suggesting the consequences of childhood abuse across generations.

The sample existed from mostly white women, and therefore has a racial constraint. Also, these were woman in the nursing profession where only people that finished their education were included. Woman subjected to child maltreatment might be unlikely to finish their education. These severe cases were not included in the result. This sampling bias might cause an underestimation of the true relationship between maternal childhood abuse and severity of depression in offspring’s adulthood.

Summary:

• Childhood abuse is prevalent in many families and is related to poorer mental health across the lifespan. Effects of childhood adversities on mental health disparities in offspring is rarely studied. Maternal childhood abuse could have an influence on mental health in their offspring when they reach adolescence or adulthood.
• It remains unknown which mechanism is responsible for the connection between maternal experience of abuse and the risk for depression in offspring.
• It is the first time that the association between maternal childhood abuse and depressive symptoms in adult -and adolescent offspring is documented. Maternal abuse might be related with both a higher risk for depressive symptoms as more problematic depressive symptoms.

Study note:

• Make sure you can explain what mechanisms are involved in the mediating process of the influence of child maltreatment in parents on their offspring’s mental health in adulthood.
• How can the connection between depressive symptoms in the offspring of maltreated mothers also be explained? This is explained in the discussion section of the article.