The far-reaching consequences of child abuse

Charité study shows connection between early trauma of mothers and health problems of their children

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Berlin, 24.02.2023

Stressful childhood experiences of a mother can have an impact on the mental and physical health of her children. Researchers at Charité – Universitätsmedizin Berlin have now reported this in the journal The Lancet Public Health*. According to the report, maltreatment in the mothers’ childhood is associated with a higher risk of diseases such as asthma, autism or depression for the following generation. Early support for affected mothers could help to counteract this.

Childhood maltreatment is a particularly serious risk factor for health problems, as it entails a variety of consequences for a person’s entire life. These include physical, psychological, behavioural and also social effects that can continue into the period of pregnancy and parenthood. For example, critical childhood experiences for parents can affect their children’s development and health.

Higher risk for asthma, ADHD, autism and depression

In the study that has now been published, a research team led by Prof. Dr. Claudia Buß from the Institute of Medical Psychology at the Charité University Hospital shows that children of mothers who experienced maltreatment as a child are more likely to have health problems. The researchers define maltreatment as physical, emotional and sexual abuse or neglect by a parent or caregiver that leads to physical or emotional harm or the threat of harm to a child. They analysed data from over 4,300 American mothers and their children from 21 long-term cohorts. Mothers reported on the experiences they had in their childhood. In addition, diagnoses of their biological children up to the age of 18 were reported or identified at study appointments. This valuable data base from two linked generations enabled the researchers to show meaningful correlations.

According to the findings, children of mothers who reported negative experiences have a higher risk of developing asthma, attention deficit hyperactivity disorder (ADHD) and autism. These children are also more likely to have symptoms and behaviours associated with depression and anxiety disorders, called internalising disorders. In addition, daughters of these mothers have a higher risk of developing obesity than their sons. “All these correlations are independent of whether the mother received the same respective diagnosis,” explains Prof. Buß, lead author of the study. “This argues against a genetic transmission of the respective disease risk.”

First study to investigate multiple diseases

The mechanisms of how exactly the risk is transferred to the following generation have not yet been sufficiently deciphered. There are indications that negative experiences in childhood can influence maternal biology during pregnancy, for example through stress hormones. This can affect the development of the foetus. Such biological changes are more pronounced if the mother has developed a mental illness as a result of the traumatic experiences, for example depression. Impaired mental health in the mother can also affect how she interacts with her child after birth, which is likely to be equally important for intergenerational effects.

“To our knowledge, this is the first study to examine multiple conditions simultaneously in relation to early maternal trauma in a large socio-demographic and ethnically diverse sample. So far, this has mainly been done for individual diseases,” explains Dr. Nora Moog, also from the Institute of Medical Psychology at Charité and first author of the publication. Accordingly, the researchers were able to show that affected children were more likely to develop several physical and psychological conditions. Also, the more severe the maternal experiences in childhood were, the higher the risk. “At the same time, I would like to emphasise that our findings do not mean that all children of mothers with adverse childhood experiences automatically develop health problems,” Prof. Buß classifies the findings. “Although the risk is increased, it does not necessarily have to result in a disease.”

Identify and support those affected at an early stage

“I assume that adequate support for the mothers under stress can positively influence their health as well as that of their children. For this, it is very important that we identify affected mothers and children at an early stage,” says Prof. Buß. For example, doctors could also address the parents’ childhood experiences during prenatal or paediatric check-ups and establish contact to various support programmes or counselling centres. Two generations would then benefit from early help: the parent who has experienced abuse and possibly suffers from health consequences, and the child, in whom illnesses could be prevented.

In order to develop new, targeted therapeutic measures, a better understanding of how exactly the higher risk of disease is transferred to the following generation is necessary. The research team is currently working on this. In addition, they would like to find out through follow-up studies which children remain resistant, i.e. do not suffer any consequences over a generation: What distinguishes them and their mothers as well as their social environment? Furthermore, the father’s childhood experiences have received relatively little attention so far. However, there are indications that these can also be passed on to the next generation, whereby the transmission mechanisms partly differ from those of the mothers. The researchers would also like to investigate these research questions in more detail in the future.

* Moog N et al. Intergenerational transmission of the consequences of maternal exposure to childhood maltreatment – a United States nationwide observational study of multiple cohorts in the ECHO program. The Lancet Public Health 2023 Feb 23. doi: 10.1016/S2468-2667(23)00025-7

About the study

The international research team analysed the data of 4,337 American mothers from 21 long-term cohorts on their childhood experiences. In addition, the diagnoses of their biological children up to the age of 18 were included. The cohort data were provided by the Environmental influences on Child Health Outcomes (ECHO) research programme. ECHO includes a total of 69 cohorts in the USA and is supported by the National Institutes of Health (NIH). Prof. Dr. Claudia Buß from the Institute of Medical Psychology at the Charité led the study. She is head of a research group in the ECHO consortium and is funded by a Starting Grant from the European Research Council (ERC) as well as by the German Research Foundation (DFG) and the Federal Ministry of Education and Research (BMBF).


Original publication

Institute for Medical Psychology