Implications of Intergenerational Trauma: Associations Between Caregiver ACEs and Child Internalizing Symptoms in an Urban African American Sample

Objective: The link between adverse childhood experiences (ACEs) and negative mental health outcomes is well established. However, the intergenerational link between caregiver ACE history and their child's psychosocial outcomes is understudied, particularly within minoritized groups. This study aimed to delineate relations between caregiver ACE exposure and their child's depression and posttraumatic stress disorder (PTSD) symptoms by proposing a serial mediation of caregiver PTSD, family management problems, and child ACEs. Method: Two hundred seventy-three caregiver (M-age = 39.27; 88% female) and adolescent (M-age = 14.26; 57% female) dyads from low-income urban communities completed electronic questionnaires measuring PTSD symptoms and ACEs. Child participants also completed a measure of depression and family management problems. Regression and serial mediation analyses were conducted to examine associations among these variables. Results: Caregiver ACEs were significantly associated with their child's PTSD symptoms but were not related to their child's depression scores. Serial mediation analyses indicated that child ACEs mediated the relation between caregiver ACEs and their child's PTSD symptoms. Evidence for an overall indirect effect via caregiver PTSD, family management problems, and child ACEs was not found. No indirect effects between caregiver ACEs and child depression were found. Conclusions: Findings demonstrate that higher levels of caregiver ACE exposure are associated with their child's PTSD symptoms in a sample of African American dyads living in urban, high-burden communities. These results suggest a need for ACE screening during medical visits and provides guidance for future clinical interventions. The distinct intergenerational consequences for caregivers with ACEs and their children's psychosocial wellbeing warrant further study. Clinical Impact Statement Adverse childhood experiences (ACEs) have a deleterious influence on mental health, yet the impact of this exposure on future generations' functioning, particularly within urban, African American populations, remains crucial to explore. Findings suggest caregiver exposure to ACEs are associated with their child's PTSD symptoms. Thus, caregivers and children should be screened for ACEs and subsequent consequences at medical visits. Special attention should be paid to families with caregivers who report exposure to prior trauma and appropriate referrals should be made to mitigate intergenerational consequences of ACEs.