Exploring the association between parenting stress and a child's exposure to adverse childhood experiences (ACEs)

Highlights

• Parenting stress, negative feelings related to the demands of parenting, is a primary risk factor for child maltreatment and neglect.

• The quantification of parenting stress and its subsequent association with ACEs is important to determine because of the significant negative impact ACEs may have on a child's long-term physical, emotional, and social well-being.

• Lowering parenting stress could influence the level of childhood trauma a child might experience.

Abstract

Nearly half of U.S. children age 0–17 have been exposed to adverse childhood experiences (ACEs), accounting for over 34 million of children nationwide. Parenting stress (negative feelings related to the demands of parenting) is a primary risk factor for child maltreatment and neglect; yet has been an overlooked factor for ACEs. Understanding the degree of parenting stress and its subsequent associations with ACEs will facilitate future designations of relevant interventions to keep children safe. We analyzed 2016 data from the National Survey of Children's Health to examine whether increased levels of parenting stress are associated with higher counts of ACEs among children. About 4.4% of caregivers reported “high parenting stress” and children living with them were three times more likely (OR: 3.05; 95% CI: 2.23–4.15) to experience four or more ACEs by the age of 18. Lowering parenting stress through parenting interventions could decrease the level of childhood trauma experienced by a child or may lessen one type of stress in a home where many other stressors exist.

Introduction

Early experiences in childhood impact how adults later parent their own children (Letourneau et al., 2019). Some adults may have experienced adverse childhood experiences (ACEs), events that occur in a child's life before the age of 18 and include trauma related to household dysfunction, neglect, or abuse (Felitti et al., 1998). Parents who have been exposed to ACEs are more likely to expose their own children to ACEs (Felitti et al., 1998; Larkin, Shields, & Anda, 2012; Letourneau et al., 2019). The effects of ACEs may be long-term, with poorer mental, physical, and behavioral outcomes in adulthood (Anda et al., 2006; Crouch, Strompolis, Bennett, Morse, & Radcliff, 2017; Felitti et al., 1998). Exposure to ACEs may also lead to a heightened propensity for various chronic conditions such as diabetes, heart disease, cancer, and depression (Anda et al., 2008; Brown et al., 2009; Brown et al., 2010; Brown, Thacker, & Cohen, 2013; Chapman et al., 2004; Chapman et al., 2013; Ford et al., 2011). ACEs may also lead to riskier behaviors in adulthood, increasing the likelihood of substance use, multiple sexual partners, domestic violence (victimization and perpetration), and suicide (Anda et al., 2008; Brown et al., 2010; Brown et al., 2017; Brown, Perera, Masho, Mezuk, & Cohen, 2015; Cannon, Anderson, Rivara, & Thompson, 2010; Chapman et al., 2004; Chapman et al., 2011; Crouch, Radcliff, Strompolis, & Wilson, 2018a; Crouch, Radcliff, Strompolis, & Wilson, 2018b; Danese et al., 2009; Felitti et al., 1998; Horwitz, Widom, McLaughlin, & White, 2001). Repeated and unmitigated exposure to adverse events during childhood may activate stress-related hormones in the brain, which may lead to toxic stress and the disruption of healthy brain development in children and adolescents (Shonkoff, 2016; Shonkoff et al., 2012).

Parenting stress, negative feelings related to the demands of parenting, is a well-documented risk factor for child maltreatment, neglect, and exposure to multiple traumatic events (Gonzalez & MacMillan, 2008). This stress has direct impacts on parenting behavior, the emotional health of the child, and the quality of caregiving (Bailey, DeOliveira, Wolfe, Evans, & Hartwick, 2012; Crnic, Gaze, & Hoffman, 2005; Deater-Deckard, 1998; Figner, Mackinlay, Wilkening, & Weber, 2009; Pereira et al., 2012; Whiteside-Mansell et al., 2007). Higher levels of parental stress may lead to a more chaotic family environment, contributing to behavior problems for children (Bagner et al., 2009; Coldwell, Pike, & Dunn, 2008). This parental stress can hinder the child's emotional development, as children in households with higher parental stress may experience lower levels of self-esteem and heightened anxiety levels (Fiese & Winter, 2010).

However, studies on the association between parenting stress and ACEs have largely focused on the parental exposure to ACEs, a parent's exposure to ACEs, leaving the relationship between parenting stress and their child's exposure to ACEs unanswered. Two studies found that parental exposure to ACEs was associated with parental stress (Ammerman et al., 2013; Steele et al., 2016). Parents who have had exposure to four or more ACEs were more likely to have difficulty with attachment to their children, which may result in child neglect (Murphy et al., 2014). Mothers with exposure to child maltreatment have been found to be less responsive to their infants, with the level of responsiveness mediated by parenting stress (Pereira et al., 2012). Yet, despite the essential role of caregivers' stress to children's safety, limited research has examined the association between parenting stress and the exposure of children to ACEs.

The purpose of this study was to examine whether increased levels of parenting stress are associated with higher counts of ACEs among children. “Parenting stress”, a type of overall parental stress, quantifies stressors resulting from individual child differences, such as children with difficult temperaments or children that are more reactive and not as adaptable (Ramos, Guerin, Gottfried, Bathurst, & Oliver, 2005). We hypothesized that children of parents experiencing parenting stress will be more likely to have four or more ACEs. Counts of ACEs with and without economic hardship ACE, are included, as parenting stress may be uniquely associated with economic hardship in the household (Reitman, Currier, & Stickle, 2002; Whiteside-Mansell et al., 2007). Research examining ACEs among children, rather than interviewing adults retrospectively, is helpful in developing current policy to mitigate ACE exposure. The findings from this study will advise and assist prevention and intervention efforts for parents, children, and families in the United States.