Intergenerational transmission of maternal childhood maltreatment, prenatal substance exposure, and internalizing and externalizing symptoms in early adolescence at age 12.

BACKGROUND Few studies have examined the intergenerational impact of maternal childhood maltreatment (MCM) in the context of prenatal substance exposure (PSE). This study investigates whether PSE is part of the pathway of MCM or an independent risk factor affecting offspring psychopathology. METHODS Participants were 284 birth mother-child (44% male) dyads, primarily Black, low-income, enrolled at birth. Exposure to alcohol, tobacco, marijuana, or cocaine in utero was assessed at 1 month postpartum. MCM was assessed at child age 4, and maternal psychological distress and offspring maltreatment at child age 10. Mother- and child-reported internalizing and externalizing symptoms were assessed at child age 12 using the Child Behavior Checklist and the Youth Self-Report. Structural equation modeling was conducted to test sequential mediation pathways examining the direct and indirect associations of MCM with child internalizing and externalizing symptoms via PSE, maternal psychological distress, and offspring maltreatment, adjusting for covariates. RESULTS MCM was directly related to adolescent-reported internalizing and externalizing symptoms, whereas PSE was directly related to adolescent-reported externalizing symptoms. MCM and PSE were indirectly related to mother-reported internalizing and externalizing symptoms via maternal psychological distress. Only PSE was related to offspring maltreatment at 10 years, and offspring maltreatment was related to both mother- and adolescent-reported internalizing and externalizing symptoms at 12 years. CONCLUSIONS MCM and PSE may increase offspring vulnerability to psychopathology, highlighting the importance of evaluating historical risks that mothers may transmit from their own childhood maltreatment and prenatal substance use in assessing offspring psychopathology.