Abstract
Introduction
Child maltreatment can have devastating psychological and neurobiological consequences. Major areas in which damage can occur include behavioral and affect regulation, attachment relationships, development of identity and self-esteem, peer relationships, and academic performance and adaptation. 1 Consequences may extend into adulthood and include internalizing and externalizing behavior problems, post-traumatic stress, alcohol abuse, obesity, chronic pain, and sexually transmitted infections, 2 unemployment, poverty, and social assistance usage, 3 as well as impairments in attention, abstract reasoning, 4 working memory, 5 problem-solving, 6 verbal and nonverbal fluency, verbal and nonverbal inhibition, and directed attention. 7
To prevent abuse and neglect and the associated consequences, it is critical to determine all the factors that operate in concert to cause maltreatment. The etiology of child abuse and neglect is generally viewed as complex and multiply determined.
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Estimates of intergenerational transmission of maltreatment vary widely, underscoring the methodological limitations inherent to studying parenting across generations and the lack of clarity in this field of study (see Table 1). Importantly, existing reviews have only included a focus on either social science research
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Summary of Methods and Findings of Original Research Papers Included in This Review.
Abbreviations: BPI, Behavior Problems Index; CIDI-SF, Composite International Diagnostic Interview–Short Form; DSM-IV,
The purpose of this article is to review the evidence on the role of childhood maltreatment in predicting later abusive and neglectful behavior in order to identify possible mechanisms and interactions influencing the continuity and discontinuity of harmful parenting practices across generations. This article goes beyond existing reviews by examining a growing body of biological research that focuses on understanding the consequences of abuse and neglect as well as the genetic contributions to parenting behavior, while also addressing the specific social mechanisms that might promote or disrupt harmful parenting practices, with special attention on the role of stress. Importantly, we address the interaction between social factors (“nurture”) and biological factors (“nature”), explaining how it is the gene–environment (G×E) interplay that may drive intergenerational patterns of abuse and neglect, rather than either social or biological factors alone. This is the first review to the authors’ knowledge that utilizes a critical transdisciplinary approach to understanding the intergenerational transmission of maltreatment.
Methods
Literature searches were conducted in an iterative manner in several major interdisciplinary databases, including JSTOR, EBSCO, Google Scholar, OVID, ProQuest, Project Muse, PubMed, and Scopus. Search terms included “intergenerational or transgenerational,” “child abuse or child neglect or child maltreatment,” “early life stress,” “parenting continuity,” “early life stress biology,” “epigenetic embedding,” and “epigenetic inheritance.” Reference lists of seminal articles and existing reviews were examined for additional sources. The review focused specifically on the intergenerational transmission of maltreatment as well as on the general social and biological causes and consequences of maltreatment. We also included sources focused on the general transmission of parenting behavior across generations, or in other words, the ways that the parenting styles of one generation influence the parenting behavior of the next generation.
After screening out irrelevant articles (eg, studies focused very generally on child maltreatment without attention to multiple generations; or studies focused on early-life stresses with no relation to abuse or neglect), 59 original research studies were included for further examination and review. Each study was summarized and critically appraised for its limitations to the present review, and the practical implications of the findings were considered during ongoing collaborative discussions among the authors. The characteristics of the studies were outlined in a table to easily compare and interpret results (see Table 1). Additionally, we reviewed 38 relevant reviews, systematic reviews, and meta-analyses. The findings were synthesized in order to determine whether childhood maltreatment is an important predictor of later abusive and neglectful parenting and to identify mechanisms explaining the transmission of maltreatment across generations.
Can Childhood Maltreatment Predict Parenting Practices Later in Life?
Existing research indicates that childhood maltreatment is an important consideration in determining the potential for child abuse and neglect along with many other factors. Rates of maltreatment in families headed by individuals with childhood histories of abuse and neglect are higher than the general population. 67 One study found that 6.7% of parents with a history of childhood abuse were referred for maltreating their own child. 22 This was compared to under 1% of parents without such histories. 22 Other studies report even higher rates of maltreatment among parents with childhood histories of abuse and neglect, but these higher estimates are usually reflective of the sample and design. For example, studies conducted with samples of parents already identified as abusive or neglectful tend to produce higher estimates of intergenerational transmission, as well as studies employing a retrospective design. 68
Although researchers have used a wide range of methods to classify maltreatment histories and the perpetration of abuse and neglect, existing research often fails to adequately capture the heterogeneity of maltreatment experiences. Individual experiences of abuse and neglect are diverse in nature (eg, severity, duration, developmental period, relationship to perpetrator) and so are the children who experience the abuse (eg, age, gender, genetic makeup). Understanding the specific characteristics of maltreatment that are most associated with the continuity of harmful parenting is an important yet understudied area. Treating parents with a history of maltreatment in their own childhoods as a homogenous group may mask important differences and sequelae.
Furthermore, experiencing child maltreatment may impact future parenting in nuanced ways. Instead of replicating exact types or forms of maltreatment from their childhoods, it is possible that parents with a history of abuse and neglect may simply have a diminished capacity to cope with the everyday stresses and challenges of raising children (see 69,70 ). This is supported by biological studies which show that experiencing abuse or neglect in childhood can have long-lasting effects on the biological systems that allow individuals to cope with stressful situations, altering the behavioral response to stress in adulthood. 71 This may result in these parents engaging in suboptimal caregiving practices that do not necessarily meet the threshold to qualify as maltreatment yet are still detrimental to child development.
Whether the mechanism for intergenerational inheritance for child abuse and neglect is biological, behavioral, and/or mediated by the social environment is difficult to tease apart because these factors are closely correlated and interconnected. Nevertheless, the evidence is strong that these intergenerational patterns exist, and as such it is important to consider all the factors that might drive them to better inform prevention policies. Below we examine the social and biological factors that might contribute to transgenerational patterns of abuse and neglect in an integrative way, organized within the following categories: social support, poverty and structural disadvantage, mental health and emotion regulation, the biology of childhood abuse from an early-life stress perspective, genetic predispositions and individual differences, epigenetic embedding of maltreatment, epigenetic inheritance of maltreatment, and timing of maltreatment. These categories were selected after careful consideration and a synthesis of existing literature to identify prominent themes. It is important to note that these categories were chosen not because they encompass all the factors contributing to the transmission of child abuse and neglect, but as a means of organizing the many interconnected factors influencing parenting across generations.
Mechanisms to Explain Intergenerational Transmission of Maltreatment
Social Support
The synthesis of the literature suggests that social support and positive relationships are potential mechanisms that influence the discontinuation of maltreatment across generations. Social support refers to the various forms of assistance that individuals receive from family members and others and may include emotional support, instrumental support, and informational support. 72 Social support can enhance resilience to stress and may play a role in optimizing the neurochemical response during and after exposure to a stressor. 73 Individuals who experience maltreatment in childhood may be better able to cope with their traumatic experiences as well as the daily stressors involved in parenting if they have access to social support, such as friends who make them feel cared for, family members who help with childcare and housekeeping, and community services that offer information about positive parenting strategies. Whereas social support appears to act as a buffer against negative outcomes, 23,74 social isolation is associated with an increased risk of perpetrating abuse and neglect among parents with a history of child maltreatment. 8,23 In the absence of social support, individuals with a history of maltreatment may be more likely to engage in abusive and neglectful behaviors when parenting.
The question remains of why some maltreatment survivors develop strong social support systems whereas others are unable to establish such relationships. As discussed further below, likely the answer lies at least partially in G×E interactions 74 and individual differences (including sex differences) of susceptibility and resilience to early-life experiences. 10,75
Poverty and Structural Disadvantage
Child maltreatment is only one risk factor in what is typically a constellation or accumulation of risk in the lives of disadvantaged families. 39,76 A major environmental stressor in the lives of maltreated children is often poverty and marginalization, and all the accompanying hardships such as poor housing and unemployment. 76 Poverty can undermine parenting and heighten the risk of child maltreatment because of the stress caused by living in poor conditions with insufficient resources. 77 The relationship between child maltreatment and poverty and marginalization is generally uncontested. Eckenrode and colleagues 25 examined the relationship between income inequality in US counties and county-level child maltreatment rates. This analysis demonstrated a strong positive linear relationship between county income inequality and maltreatment rates, and this relationship was even stronger in counties with moderate to high levels of child poverty. More broadly, child development is negatively impacted by not only parents’ level of socioeconomic disadvantage but also grandparents’ level of socioeconomic disadvantage, 43 and there appears to be significant intergenerational continuity of economic hardship. 3,33,54
It is possible that any intergenerational transmission of parenting is explained in part by the intergenerational transmission of socioeconomic status, with families experiencing economic hardship at greater risk of maltreatment across generations because of their impoverished and stressful living conditions. Children who experience maltreatment and live in the context of socioeconomic
Mental Health and Emotion Regulation
Mental health status in adulthood is another factor that may influence the risk of maltreatment perpetration among individuals who were abused or neglected in childhood. Certain experiences of maltreatment can result in persistent changes to mental, emotional, and behavioral functioning, and these changes have consequences that extend to future parenting. Examining continuity in parenting across 2 generations, Neppl and colleagues
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found that harsh parenting is associated with the development of externalizing behaviors (eg, aggression) in children, and further that these externalizing behaviors continue into adulthood and predict harsh parenting of the next generation. Research also suggests that maternal childhood maltreatment predicts children’s exposure to maltreatment only in combination with maternal depression.
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Children whose mothers were maltreated in childhood but did not suffer from depression late in pregnancy were
Some evidence suggests that the relationship between experiencing and perpetrating childhood abuse is mediated by emotional disorders. In a sample of 83 mothers living in high stress, high-risk environments, with high levels of lifetime trauma exposure, researchers found an association between greater levels of maternal childhood abuse and increased current child abuse potential; and this association was mediated by emotion dysregulation and negative affect. 57 The influence of mental health and emotion regulation on parenting behavior has also been studied from a biological perspective. Biological studies (discussed in detail below) clearly show that early-life stress in the form of abuse or neglect can have life-long consequences for mental health and the ability to deal with everyday stressors. However, it is not fully understood how mental health and emotions influence the transmission of parenting across generations, as some studies have found that mental health status does not change the relationship between a history of child maltreatment and later maltreatment perpetration. 8,20
Biology of Childhood Abuse From an Early-Life Stress Perspective
Experiencing abusive environments is stressful, especially for children, and long-term exposure to stress during childhood and adolescence can affect one’s ability to deal with stress in adulthood. Stress affects a variety of biological functions and often this is related to changes of activity in the hypothalamic–pituitary–adrenal (HPA) axis, 78 a neuronal and hormonal biological system that regulates the brain’s response to stress. Specifically, childhood abuse or neglect has been shown to have profound influences on several components of HPA regulation. Heim and colleagues 32 found that women with a history of childhood abuse exhibited increased adrenocorticotropic hormone (ACTH), an HPA regulator, in response to stress and that this was linked to major depression. These women also demonstrated increased cortisol and increased heart rates in response to psychosocial stress. 32 Rodent and nonhuman primate animal models have provided further evidence that early-life stress results in increased expression of HPA hormones, particularly of the corticotropin-releasing hormone (CRH). 19,50 . The main function of CRH is to stimulate the production of ACTH, which at increased levels results in physiological and behavioral changes that closely parallel symptoms of depression and anxiety. 79 Similarly, neglectful mothering results in increased CRH expression and enhanced stress-induced activation of the HPA axis in rats. 11,80 These changes in activity of the HPA’s components can have adverse effects on one’s emotional stability 16,54,81 and propensity for violent behavior, 82,83 and might present a biological link to neglectful or abusive parenting cycles. In fact, parents who have been maltreated in childhood experience higher levels of stress 58 and a lower capacity for emotional control, factors that reduce the likelihood of sensitive parenting 48 and increase child abuse potential. 27
The effects of childhood abuse on the HPA might be further exacerbated by socioeconomic disadvantage, one of the main social factors associated with childhood abuse and neglect. Socioeconomic status is strongly correlated with mental health outcomes (eg, negative emotions, depression, anxiety) and this relationship seems to be at least in part mediated through changes in biological stress response systems. 84 Importantly, the responses of the HPA axis to childhood stress vary among individuals and between sexes. Because the HPA axis is a hormonal system, there are inherent hormonal sex differences in its regulation. 85 While some evidence suggest that girls have a naturally stronger HPA axis response to social stress in childhood, 86 other studies found that young men have higher HPA axis responses to psychological stress in adulthood. 87 Nevertheless, systematic reviews show that the presence of sex differences varies largely across studies, 86 likely because of methodological discrepancies but also because of individual differences within the same sex (see section below).
Genetic Predispositions and Individual Differences
Genetic predispositions can influence the psychological and biological effects of stressful environments. 88 Although we all share the same set of genes in our DNA, genetic variants (single-nucleotide polymorphisms [SNPs]) can differ across individuals and, in some cases, have been shown to affect how an individual will respond to their environment. These G×E interactions have been implicated in a variety of HPA functions. For instance, individuals with an SNP in the serotonin transporter-linked polymorphic region (5-HTTLPR) are at greater risk for severe depression and suicide, 16,29,54,81 when in negative social environments. This is dependent on both the genotype and the environment, as the presence of the SNPs or the social risk factors alone does not result in increased risk. Similarly, SNPs of genes involved in neuronal signaling (primarily in dopamine and serotonin signaling, neurotransmitters that influence mental health and behavior), such as 5-HTTLPR, catechol-O-methyltransferase, monoamine oxidase A, and the dopamine D4 receptor, when combined with adverse environmental factors, have been shown to increase antisocial behavior and impulsive violence. 82 Furthermore, SNPs have been implicated in predispositions to addictions, which are related to other psychiatric diseases by common neurobiological pathways, including those that modulate reward, behavioral control, and anxiety or stress response. 83 Depression, high stress levels, antisocial behavior, and substance abuse are often correlated with abusive or neglectful parenting styles, 12,31,36,89 and G×E interactions influencing these traits are important to consider when studying the biological transmission of maltreating behavior.
Epigenetic Embedding of Maltreatment
It is possible that inability of the nervous system to cope with stress might play a role in abusive parenting, but the question remains about how childhood experiences affect HPA function into adulthood. To explore the possibility of biological factors playing a role in intergenerational transmission of abuse and neglect, it is important to consider the mechanisms that might perpetuate early-life effects. One possible mechanism is epigenetic embedding, a molecular process that can induce stable, long-term alterations in gene function 65 in response to the environment. There are a large variety of epigenetic modifications, which are interconnected in complex pathways that are often not well understood, and the placement and effect of these marks can depend on genetic background. 37,74,90,91 Importantly, epigenetic marks have been shown to be both stable and transient, allowing biological changes to become long term, but reversible.
The first evidence that maternal behavior produces stable epigenetic alterations was provided by Meaney and colleagues.
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This study found that rat mothers vary in how much they lick and groom their pups and offspring who receive less of this maternal care show significantly higher stress levels. Importantly, pups that receive less licking and grooming grow up to provide their offspring with less maternal care, while pups that received more maternal care grow up to provide their pups with higher levels of licking and grooming.
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Weaver and colleagues
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found that rat pups that experienced lower maternal care show changes in the epigenetic regulation of the glucocorticoid receptor (
Although the research on the epigenetic effects of abuse and neglect is much more extensive in rodent models, there are also human studies showing that early-life stress and abuse can result in epigenetic alteration of HPA axis genes. The nature and ethics of human research create challenges in comprehensively investigating epigenetic changes in the brain, but studies on human blood and saliva have shown that childhood abuse and maternal depression result in epigenetic alteration of HPA axis genes.
41,46,52
Interestingly, Klengel and colleagues
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found that the susceptibility to epigenetic changes in HPA axis genes due to early-life stress is dependent on genetic predisposition. Humans have 2 genetic variants of the
Although epigenetic mechanisms that perpetuate the effects of early-life stress into adulthood might be conserved across species, 45 none of the studies described so far provide evidence that biological effects associated with the experience of abuse and neglect can be inherited transgenerationally. In fact, as discussed in the next section, the biological barriers to epigenetic transmission, the lack of evidence for true transgenerational epigenetic inheritance, and the cross-fostering experiments in rats mentioned above 62 suggest that the epigenetic effects on HPA regulation are experience-based and acquired anew every generation.
Epigenetic Inheritance of Maltreatment
For epigenetics to drive a perpetuating cycle of abusive and neglectful behavior, these marks would have to be heritable, being transmitted from parents to children. Intergenerational epigenetic inheritance is a controversial topic, since a large body of research shows that to ensure that a single-cell embryo develops into an adult human with many different cell types, epigenetic marks need to be almost completely erased during gamete formation and after fertilization (for review, see 96 ). Furthermore, it is hard to rule out the effects of direct exposure, since, in a pregnant mother, 3 generations (ie, the mother, the fetus, and the fetus’ germline) are directly exposed to the same environmental conditions. This means that studies must go as far as the fourth generation to distinguish true epigenetic inheritance from direct exposure effects. Since epigenetic changes are transient by nature, they could be reversed by the third or fourth generation. Although some research in humans argues for inheritance of environmentally induced epigenetic marks, 56,61 this research is still unable to address all the caveats mentioned above.
However, several studies show that intergenerational inheritance of epigenetic marks occurs in plants and invertebrates and suggests that it might occur in mammals and humans as well. In fruit flies and mice, epigenetic changes induced by paternal diet are passed on to the next generation.
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Interestingly, the same epigenetic patterns that are inherited in the fly correlate with obesity in humans and mice, suggesting that this intergenerational transmission of epigenetic marks might also occur in mammals (including humans;
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). Dias and Ressler
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found that traumatic exposure associated with an odor results in changes in DNA methylation of the odorant receptor
Whether the effects of stressful experiences are inherited epigenetically or not, Yehuda and colleagues 61 found significant sex differences in these inheritance patterns. While female and male holocaust survivors both showed the same epigenetic alterations in the HPA axis, the effects on their offspring were strongly dependent on the sex of the parent. Children whose mothers or both parents survived the holocaust had epigenetic alterations that correlated with higher HPA axis reactivity and higher anxiety, while children whose father was the only parent affected had epigenetic alterations that correlated with decreased HPA axis reactivity and increased emotional detachment. 61
Timing of Maltreatment
The timing of early-life experiences has recently started to emerge as another important factor that moderates later-life outcomes. The effects of maltreatment depend not only on all the genetic and social factors mentioned above but also on the timing of the traumatic experience. Children’s brains are more sensitive to specific experiences during certain windows in development (known as critical periods), meaning that if maltreatment occurs during this window, it might have larger effects. 64,88,97 For instance, Thornberry and Henry 59 suggest that childhood-limited maltreatment is not associated with an increased risk of becoming a perpetrator of maltreatment, whereas adolescent maltreatment and continuous maltreatment through childhood and adolescence are associated with a significant increase in the odds of becoming a perpetrator. Consistent with a dose–response model, maltreatment that occurred in adolescence tended to be more chronic and severe (ie, victims experienced higher levels of abuse for longer periods) compared to childhood-limited maltreatment. 59 Other research also points to the harmful impact of chronic, daily maltreatment, noting that it can cause significantly more damage to developmental health than single dramatic occurrences of abuse. 71 In line with this are findings from the biological literature that show that the timing (ie, when in life, and for how long) of early-life stress strongly influences the later-life biological effects. 42,66 This suggests that more temporary and less severe forms of abuse and neglect—depending on developmental timing—may have a less significant impact on later parenting practices. Importantly, the environment later in life can ameliorate the effects of childhood abuse. Supportive romantic relationships in adulthood have been shown to have a protective influence that might prevent intergenerational transmission of abuse. Conger and colleagues 17 found that warm, positive, and nurturing communication by a partner was associated with a lower risk of harsh parenting among individuals with a history of experiencing harsh parenting in their own childhoods. Similarly, Schofield and colleagues 98 conducted a meta-analysis and found that safe, stable, and nurturing adult relationships moderated the association between parents’ history of maltreatment in childhood and their abusive behaviors toward children, such that these relationships acted as a buffer or protective factor.
Methodological Challenges
Studying the intergenerational transmission of maltreatment is challenging and as a result, the body of existing research has significant limitations. Social science studies differ significantly in their methodology and do often not adhere to standards in the field (eg, selecting a representative sample, prospective rather than retrospective data, clear definition of maltreatment). 63 This is important because study quality is negatively associated with the strength of support for the intergenerational transmission of child maltreatment. 67 Similarly, the studies listed in this review vary widely in methods and findings (see Table 1). Some of the main methodological challenges of social science studies include cross-sectional designs that rely on retrospective reports and are subject to recall bias; 18 reliance on child protection records that miss a large population of children for whom maltreatment goes unreported and might not reflect the reality of children’s experiences 76 ; lack of distinction between substantiated and unsubstantiated cases in child protection records 24 ; inconsistent definitions of intergenerational continuity (self-reported vs child protection records; and lack of information on whether children experienced maltreatment from a parent directly).
Future research should use multiple sources of information to assess maltreatment experiences. In fact, one of the few studies to use multiple sources of information to measure intergenerational maltreatment found differences in the results depending on the source of information, with researchers noting that relying on only one source of information may lead to incorrect conclusions. 99
Methodological inconsistencies in defining maltreatment also have trickle-down effects that hamper genetics research. The search for genetic or epigenetic variants that might influence maltreatment relies on consistent measures of maltreatment, and the inheritance of such factors relies on the biological parent being the perpetrator. In addition, the fact that some genetic variants are more sensitive than others to abuse adds another layer of complication (for further reading on the differential susceptibility hypothesis, see 75 ). This means that some children who experience abuse might not show any biological effects, resulting in more heterogeneous study cohorts that are more difficult to analyze. If the characterization of behavioral phenotypes or abusive experiences is inconsistent, the correlations obtained in these studies might be erroneous.
Another limitation is that few social science studies on intergenerational maltreatment include a representative sample; most focus on clinical samples and/or relatively homogenous populations. Interestingly, one of the few studies to use a population-based sample reported not only a low prevalence of parental history of maltreatment but also a low rate of intergenerational transmission of abuse. 23
It is also important to note several broader issues with studying parenting practices. Holden and Miller 100 point out that it has long been assumed by researchers that parenting is unchanging and stable across time and children. However, parents may interact with children in the family in various ways and may also structure children’s physical and social worlds quite differently, depending on factors such as age, sex, birth order, and temperament. Parents may also change their behavior depending on the context, even the time of day. Methodologically, it is very difficult to assess the variability of parenting behavior because it is dependent on so many factors. 100
Furthermore, from a biological perspective, it is extremely challenging to study biological changes in the human brain because brain tissue is rarely available. Biological changes in blood or saliva might not reflect changes in the brain, since these tissues are composed by completely different cell types. It is also hard to differentiate biological changes that are intergenerationally inherited from biological changes that are acquired anew every generation due to parenting behavior or other external factors. Furthermore, to rule out the effects of direct exposure to the stressful experience (of the parent, embryo or reproductive cells), studies must follow progeny for at least 3 to 4 generations, to study maternal or paternal inheritance, respectively. Lastly, due to the ethics associated with human research, experimental evidence relies on model organisms and it is difficult to know how well these findings translate to humans.
Discussion
This article presents an examination of the literature on the intergenerational transmission of maltreatment, focusing specifically on (1) understanding whether it is an important factor to consider when determining risk of future maltreatment and (2) understanding the social and biological mechanisms that might explain continuity and discontinuity of abusive and neglectful parenting.
Although the social and biological literature reviewed here seems to lend strong support for a history of child abuse predicting abusive or neglectful parenting practices, there is a large amount of individual variation in this relationship. Maltreatment experiences are diverse in nature, as are the children who endure abuse and neglect. Types of maltreatment can cooccur concurrently or consecutively, 26 and experiences vary in terms of age at onset, the number of development periods in which the incidents occur, the impact on developmental milestones, 1 and the severity of the incidents. 101 Given the vast variability in child maltreatment experiences, dichotomous measures reflecting the presence or absence of maltreatment in childhood are insufficient. 8 Children also have unique biological compositions that influence the way they interact with the world, while the environment influences their biology. 88 Biological consequences of abuse and neglect are dependent on developmental timing 42 and genetic predispositions. 9,30,34,35 From an ecological perspective, human development occurs through this complex process of a biopsychological human interacting with the environment. 78,102 The literature clearly demonstrates that the developmental processes that ultimately influence parenting style in adulthood are complex; single experiences or characteristics cannot explain harmful parenting practices in isolation. Recognizing the diversity of individual experiences will enrich efforts to respond to the unique needs and deficits of children who are maltreated and their caregivers. It is imperative for research to move forward in a way that examines and acknowledges these variations in order to determine which specific dimensions of maltreatment and what specific individual and contextual factors increase the propensity for harmful parenting toward the next generation.
If cycles of maltreatment and abuse have a biological underpinning, the regulation of stress response systems might constitute a plausible mechanism. Experiencing maltreatment in childhood is stressful, and it appears to have short- and long-term effects on how individuals respond to future stressful situations. It is possible for abuse and neglect to diminish the biological capacity of an individual to cope with daily stressors, such as school difficulties in childhood, romantic relationship formation in adolescence, and parenting in adulthood. Parents who cannot cope with the daily stressors involved in childrearing may find it challenging to manage feelings of frustration or anger and meet the basic physical and emotional needs of their developing children.
It is important to acknowledge that while we know maltreatment can change children’s biology, we also know that the effects of abuse and neglect on stress responses are reversible in the context of nurturing environments. Intervening early to prevent recurrent maltreatment and promote nurturing caregiving may help children to cope with stress in adaptive ways that will continue into adulthood. It is also critical that the consequences of maltreatment be addressed, as these consequences may mediate the relationship between a history of abuse and neglect and later perpetration. Maltreated children and youth need help early in life and as they grow older and transition to adulthood, in order to succeed academically, secure employment, delay childbearing, and enter supportive romantic relationships and friendships. These are all protective factors that may help prevent the continuation of harmful and maltreating parenting practices. 15,22,40
For future studies on intergenerational maltreatment, it will be important to use complex measures of abuse and neglect and examine maltreatment prospectively over several generations. Incorporating biological information into these studies would complement the analysis of what factors are involved in transmission of maltreatment, and perhaps help explain some of the large variance in findings.
Footnotes
Acknowledgments
Declaration of Conflicting Interests
Funding
ORCID iD
