Factors affecting the association between maternal adverse childhood experiences and preschool children’s behavioural problems: a systematic review of mediators and moderators

Background Adverse childhood experiences (ACEs) are pernicious events (e.g., physical abuse) that occur before 18 years of age within the household. Mothers’ ACEs are associated intergenerationally with their preschool children’s (two-to-five-year-old) behavioural problems, impacting lifelong mental health trajectories. Mediators (e.g., mental health) may explain how mothers’ ACEs exert their influence on children's behavioural development whereas moderators (e.g., child sex) may affect the strength and direction of the association, revealing potential points of intervention. Therefore, this study aimed to: (1) identify mediators and moderators of this association; and (2) describe and compare moderation and mediation outcomes. Methods This review (#CRD42022307214) extracted data from peer-reviewed literature formally analyzing at least one moderating or mediating variable of the association between maternal ACEs and preschool children’s behavioural problems using MEDLINE, Embase, APA PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, SCOPUS, and Web of Science databases (n = 7). Validity was assessed using the Joanna Briggs Institute checklists. Results Thirteen full-text studies with moderate-to-high validity were identified. Most studies examined mediating variables, with unanimous support for mediation through maternal depression. The mediating roles of adult attachment styles and anxiety were conflicting. No studies examined environmental factors (e.g., neurotoxins). Conclusions Mothers’ depression is a significant contributor to children’s behavioural problems in the context of ACEs and should be a target of early intervention to prevent lifelong challenges. Future research should focus on examining more moderating variables and consider the roles of environmental factors. More research is needed on the moderating and mediating roles of genes.