Abstract
The intergenerational continuity of child maltreatment (CM) is a growing public health concern. Identifying modifiable risk and protective factors involved in these cycles is crucial. A previous scoping review synthesized the literature on psychosocial factors associated with intergenerational CM up to 2018. Since then, a sizable number of studies have been published; this updated review aims to summarize this recent literature. We conducted a comprehensive search across five major databases (PsycINFO, Scopus, Medline, Social Work Abstracts, and ProQuest Dissertations/Theses) from November 2018 to November 2023. The primary inclusion criterion was documentation of intergenerational maltreatment, with studies reporting at least one psychosocial risk or protective factor. Included studies involved human participants, presented original findings, were written in English or French, and employed any research design. This updated review included 29 new studies. Findings indicate that caregivers’ individual (e.g., sociodemographic characteristics, psychopathology), relational (e.g., IPV, attachment), contextual (e.g., socioeconomic disadvantage), and historical factors (e.g., cumulative CM, out-of-home placement), along with characteristics of the second generation (e.g., sociodemographic characteristics, psychopathology), are involved in the intergenerational continuity of CM. The implications for practice suggest targeted interventions should address depression, PTSD, and emotional dysregulation in CM survivors, along with fostering secure, supportive family relationships, and positive parenting skills. Policy implications emphasize the need for enhanced support for child protection services in early CM identification, public policies to combat poverty, equitable childcare responsibilities, and funding for research in low-to-middle-income countries.
Keywords
Child maltreatment (CM; i.e., sexual abuse, physical abuse, emotional abuse, neglect, or exposure to intimate partner violence before the age of 18 years) is a widely recognized public health problem (Mathews, 2022). Its global prevalence ranges from 12.5% to up to 60.2% (Massullo et al., 2023; Moody et al., 2018; Pan et al., 2021). This wide range can be attributed to variations in age groups, methodologies, instruments used for data collection, and the categorizations of CM. (Massullo et al., 2023). CM is associated with decreased psychological well-being, increased psychological distress, and impaired daily activities (Afifi et al., 2014; Sheffler et al., 2020). A recent meta-analysis shed light on the heavy toll of CM on mental health: CM accounted for up to 40% of mental health disorders such as anxiety, depression, alcohol and drug misuse, self-harm, and attempted suicide. The consequences of these disorders are significant and include years spent coping with a long-term disability and years of life lost (Grummit et al., 2024). Therefore, the economic impact of CM, involving direct expenses incurred by society for the utilization of health services, child welfare programs, the criminal justice system, and education systems, cannot be overlooked (Mehta et al., 2023). In 2015, the total lifetime estimated cost per victim of nonfatal CM in the United States amounted to $830,928 (Peterson et al., 2018). This highlights the importance of making CM prevention a public health priority.
From a prevention standpoint, the intergenerational continuity of CM is important to address. During the last few years, these intergenerational cycles have been an exponentially growing area of research (Marshall et al., 2022; McKenzie et al., 2023; Zhang et al., 2024). Continuity of CM refers to situations where an adult who experienced CM has a child who also experiences CM, regardless of who the perpetrator is This highlights the existence of both direct and indirect patterns of intergenerational continuity (Baril & Tourigny, 2016; Berlin et al., 2011; Marshall et al., 2022). Thus, experiencing CM is a risk factor for CM occurring in the next generation (Assink et al., 2018; Russotti et al., 2021). The prevalence rates of this intergenerational continuity varied from 7% to 88% in a previous systematic scoping review published by Langevin et al. (2021).
To prevent intergenerational continuity of CM, it is essential to uncover the mechanisms involved. In a previous review (Langevin et al., 2021), the team conducted a thorough search of the literature and synthesized findings from studies published up to 2018. This review included 51 studies and demonstrated a range of factors associated with the continuity of CM, including individual (e.g. history of mental illness, maternal age, authoritarian attitudes in favor of violence), relational (e.g., safe, stable, and nurturing relationships/ support/ isolation, parenting stress), and contextual (e.g., children’s exposure to community violence, stressful life events) risk and protective factors (Langevin et al., 2021). However, several methodological shortcomings were identified. For example, many studies lacked justification for their sample size or their samples were not representative, few studies employed a prospective longitudinal design, and many studies were cross-sectional and/or employed secondary data analysis. Additionally, more than half of the studies did not utilize validated or published scales to measure CM (Langevin et al., 2021). Most studies were conducted in high-income and Western countries such as the United States or the United Kingdom (Langevin et al., 2021). As many studies have been published since 2018, the growing body of literature on the subject may provide additional information on mechanisms of continuity and address the methodological shortcomings identified previously.
Given the limitations of previous articles reviewed, and the increase in CM publications since the previous review, it is critical for prevention efforts to provide an updated review on the topic. This systematic review updates the work conducted by Langevin et al. (2021); the search period from November 2018 to November 2023 encompassed 5 years after the original review. This review aims to give an update on the current state of knowledge focusing on psychosocial risk and protective factors associated with the intergenerational continuity of CM and to critically assess the methodological quality of this recent literature.
Methods
Protocol and Registration
The review protocol was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist recommendations (Tricco et al., 2018). Given that the current review aimed to be a continuation of Langevin et al. (2021), a scoping review was selected. The protocol was registered in PROSPERO (#CRD42023488531).
Inclusion and Exclusion Criteria
The inclusion criteria mirrored those of the original review. We included studies on five forms of child maltreatment (sexual abuse, physical abuse, emotional abuse, neglect, and exposure to domestic violence), provided that one or more psychosocial risk or protective factors were quantitatively or qualitatively associated with their intergenerational continuity. Risk factors were defined as characteristics (e.g., traits, behaviors, symptoms, and sociodemographic variables) associated with an increased risk of intergenerational continuity of CM, and protective factors were defined as characteristics associated with a decreased risk of intergenerational continuity. Articles from any country and peer-reviewed publications of all types (theses, dissertations, and conference publications) were included. No restriction was placed on the demographic background of the participants. Only articles published in English and French between November 9, 2018 and November 9, 2023, were included. Articles that did not present original empirical findings were also excluded (e.g., book chapters and reviews).
Information Sources
Searches for eligible studies were conducted in the following databases: (a) Psychinfo (1806 version), (b) Medline (1946 to present version), (c) Social Work Abstracts, (d) Scopus, (e) Proquest Dissertations and Thesis. Additional strategies to identify relevant publications included hand-searching the reference lists of eligible studies and the use of AI-powered softwares (Connected Papers, and Research Rabbit).
Search Strategy
The search strategy used in Langevin et al. (2021)’s original article was constructed by a librarian and was updated in consultation with another librarian for use in the current study. The final search was run on November 9, 2023. A combination of the following keywords and subject headings was used in the searches: intergenerational continuity combined with terms about child maltreatment (physical, sexual, emotional abuse, and neglect), or exposure to violence (intimate partner violence), or family relations (parenting style, parent-child communication) and risk and protective factors. See Appendix 1 for the PsychInfo search strategy and the original article for detailed steps concerning the search strategy construction (Langevin et al., 2021).
Study Selection
In the initial step, search results were exported to Endnote 20 and Covidence. Once duplicates were removed, screening began. When articles were excluded the reason was documented. Two reviewers conducted an initial screening of article titles and abstracts, adhering to predefined inclusion/exclusion criteria until attaining full interrater agreement. Each reviewer then proceeded to screen the remaining titles and abstracts. The principal investigator assessed the full- texts for eligibility and consulted the other members of the team in case of uncertainty. Next, the reference lists of all articles included in the final search were reviewed. Finally, the title of the original review (Langevin et al., 2021) was entered into AI powered tools (Connected Papers, Research Rabbit) to identify similar studies, ensuring that no relevant articles were missing.
Data Extraction and Analysis
Data extraction from each included study encompassed various components: study characteristics (e.g., authors, year of publication, title, aims of the study, country of origin, and quality assessment), sample and participant characteristics (e.g., sample size, inclusion/exclusion criteria, and recruitment strategies employed), study design, relevant variables and their measures (e.g., types of maltreatment investigated, risk and protective factors explored), and main relevant study findings. After the extraction phase, studies included in this review were assessed for their methodological quality using the Mixed Methods Appraisal Tool (MMAT; Hong et al., 2018). Specifically, the qualitative or quantitative non-randomized evaluation criteria were used; item 3.5 (“During the study period, is the intervention administered (or exposure occurred) as intended?”) of the quantitative category was excluded given its irrelevance in the current review. The evaluation focused on aspects such as study design, sample characteristics, and measures employed. Based on the MMAT, studies received an overall quality rating of poor, fair, or good. The final step of this review involved conducting a qualitative synthesis by themes.
Results
Study Selection
The initial database search yielded 1,294 studies, supplemented by 13 articles from manual and AI searches combined. After removing 156 duplicates, an initial screening of records was conducted, resulting in the exclusion of another 1,014 articles. Following the full-text review of the remaining 137 articles, an additional 108 records were excluded (see Figure 1 for detailed reasons for exclusion). The final sample for data extraction comprised 29 studies.
Prisma flow diagram for updated systematic reviews.
Study Characteristics and Quality Assessment
Of the 29 studies included, 19 (65.5%) were conducted in North America (Canada = 7; US = 12), 4 (13.8%) in Western Europe (France = 1; UK = 2; Netherlands = 1), 3 (10.3%) in Asia (South Korea = 2; China = 1), 2 (6.9%) in Oceania (Australia), and 1 (3.4%) in Africa (Burundi); none were conducted in South America or Eastern Europe. Most studies were quantitative (n = 26; 89.7%), and the remaining 3 employed a cross-sectional qualitative design (10.3%; n = 7-23 caregivers). Longitudinal studies composed 41.2% of included studies (n = 12); secondary analysis of data was used in 31.0% of studies (n = 9). Sample sizes for quantitative studies ranged from 59 to 38,556 parent-child dyads with a median of 305 caregivers. Just under half of (41.4%) the studies examined the four primary CM types (physical, emotional, sexual abuse, and neglect) in both generations of interest, 27.6% studied at least two types of CM and 17.2% looked exclusively at one type of CM.
Based on the MMAT, just over half of the studies (51.7%) were rated as “fair” and the remainder (48.3%) were rated as “good”; none were deemed to be of “poor” quality. However, studies were not without limitations. Most studies (72.4%) measured parental histories of CM up to age 18, while two studies (6.9%) measured it only up to age 17. In contrast, only four studies (13.8%) provided a complete measure of second-generation CM (i.e., the children’s experiences of CM) up to age 18. Furthermore, as mentioned above, most articles did not measure all forms of CM, which may have obscured the interaction between specific forms of CM and risk/protective factors and the combined effects of co-occurring types of CM. Finally, the majority (69.2%) of quantitative study samples were either not representative of the population or the article did not provide sufficient evidence to determine sample representativeness. Notwithstanding these limitations, this body of work had important strengths; in all but two quantitative studies (7.7%), CM was assessed using valid measures. All studies were coded as having clear research questions that could be addressed with the data collected.
Risk and Protective Factors Associated with the Intergenerational Continuity of CM
Risk and protective factors associated with the intergenerational continuity of CM are organized in five categories: (a) Caregivers’ Individual Factors (n = 22 studies); (b) Caregivers’ Relational Factors (n = 12 studies); (c) Caregivers’ Contextual Factors (n = 6 studies); (d) Caregivers’ Historical Factors (n = 12 studies); and (e) Second-Generation Characteristics (n = 6 studies). Critical findings of included studies are presented in Table 1.
Summary of Critical Findings.
Note. CM = Child maltreatment; IPV = Intimate partner violence; CTQ = Childhood Trauma Questionnaire; PA = Physical abuse, PN = Physical neglect, EA = Emotional abuse, EN = Emotional neglect, SA = Sexual abuse, NG = Non-specified neglect; EIPV = Exposure to intimate partner violence; CPS = Child Protective Services; G1 = First generation (parent/caregivers); G2 = Second generation (children); MCMI=Maternal Child Maltreatment Interview; SES= Socioeconomic status ; AE-III = Assessing Environments Scale-III; CTS-PC = Parent–Child Conflict Tactics Scale; CTQ-SF = Childhood Trauma Questionnaire – Short Form; CTQ = Childhood Trauma Questionnaire; IPARAN = Instrument for identification of Parents At Risk for child Abuse and Neglect; OHC = Out-of-home care; LTVH = Lifetime Victimization and Trauma History; CEQ = Childbirth Experience Questionnaire; PTSD = Post-traumatic stress disorder; APS = Abusive Parenting Scale; ISPCAN = International Society for the Prevention of child Abuse & Neglect; ETISR-SF = Early Trauma Inventory Self-Report-Short Form; CTS2 = Revised Conflict Tactics Scale; CECA-Q = Childhood Experience of Care and Abuse Questionnaire; MCS = Modulation Coding Scheme; ACE = Adverse childhood experiences.
Caregivers’ Individual Factors
Individual factors are the most investigated category and were therefore subdivided in three categories: a) sociodemographic characteristics (n = 10 studies), b) emotional, behavioral, and physical problems (n = 17 studies), and c) attitudes, beliefs, and perceptions (n = 6 studies).
Sociodemographic Characteristics
One study found that the risk of intergenerational continuity was greater among female than male caregivers (McKenzie et al., 2022), while another revealed that the burden of out-of-home care on the risk of intergenerational continuity was greater for female than male participants (Font et al., 2020). Inconsistent findings emerged for the role of age. Miljkovitch and colleagues (2022) reported that among adult males with a history of child sexual abuse, those in older age groups were more likely to be perpetrators. Armfield and colleagues (2021) showed that a younger maternal age at birth increased the risk of second-generation substantiation with child protection services (CPS) in early childhood. However, five studies (Augustyn et al., 2019; Duindam et al., 2023; Langevin et al., 2020; Marshall, Fernet, & Langevin, 2023; Russotti et al., 2021) did not find an association between maternal age and intergenerational CM. Education was also not associated with the intergenerational continuity of child sexual abuse on the maternal side in Langevin et al. (2020). However, Augustyn et al. (2019) reported that maltreated adults who dropped out of high school were at increased risk of perpetrating CM as well as those with more precocious transitions (i.e. life events occurring earlier than expected, such as teenage maternity) overall; however, they did not find a specific association for early independent living. As a final sociodemographic characteristic, ethnicity was reported as non-significant in one study on intergenerational continuity of child sexual abuse (Marshall, Fernet, & Langevin, 2023), while Indigenous status was a risk factor for CM continuity in an Australian populational cohort (McKenzie et al., 2022).
Emotional, Behavioral, and Physical Problems
Several studies investigated the role of various emotional, behavioral, and physical health factors in the intergenerational continuity of CM with mixed findings. Caregivers’ depressive symptoms were systematically associated with an increased risk of intergenerational CM, either directly (e.g., Charak et al. (2021) and Choi et al. (2019) showing that depression mediated the association between parents and offspring CM) or indirectly through their negative impacts on positive parenting (e.g., Minnich et al. (2023) showing a sequential mediation from parents to offspring sexual abuse through depressive symptoms and their negative association with positive parenting). Two out of three studies found that PTSD symptoms significantly increased the risk of intergenerational CM, directly or indirectly through their effect on parenting (Langevin et al., 2020; Marshall, Fernet, & Langevin, 2023; Minnich et al., 2023). The related construct of dissociation, however, did not show any significance (Langevin et al., 2020; St-Laurent et al., 2019). Borderline personality pathology was associated with the continuity of non-specific CM, but not of specific types of CM (Paul et al., 2019). Langevin et al. (2020) found that maternal psychological distress increased the risk of intergenerational child sexual abuse. On the other hand, other studies examining mental health as a general category or psychological distress did not find any association with the intergenerational continuity of CM (Duindam et al., 2023; Marshall, Fernet, & Langevin, 2023; St-Laurent et al., 2019). Three studies (Augustyn et al., 2019; Capaldi et al., 2019; Duindam et al., 2023) did not find any association between alcohol and drug usage, while one (Minnich et al., 2023) found that alcohol use indirectly increased the risk of intergenerational child sexual abuse through its negative association with positive parenting. Armfield et al. (2021) found that a maternal smoking history and hospital admission for mental health or substance use problems increased the odds of having a substantiated report with CPS in early childhood.
Mixed findings also emerged regarding the role of externalizing behaviors. In adolescence, Augustyn et al. (2019) found that delinquency and externalizing problems were significant, but not aggression. In contrast, studies did not find any association with delinquency, anger, or temper inhibition problems in adulthood (Capaldi et al., 2019; Duindam et al., 2023). Emotion (dys)regulation was found significant directly or indirectly through its association with the quality of the mother-child relationship, with some nuances depending on CM types (Langevin, Gagné et al., 2023; Marshall, Fernet, & Langevin, 2023; Rodriguez et al., 2021). Parenting stress was not found significant (St-Laurent et al., 2019). In a qualitative study, mothers’ awareness of struggling to avoid role reversals and their perception of successfully overcoming challenges by expressing emotions and affection appeared protective against intergenerational continuity (Marshall, Fernet, Brassard et al., 2023). Coping was examined in one study that found that avoidance and problem-solving strategies were higher in mother-child dyads where intergenerational continuity of sexual abuse was found vs. discontinuity; social support coping did not differentiate between dyads (Langevin et al., 2020). Finally, trauma-specific reflective functioning was protective against intergenerational cycles of child sexual abuse, while general reflective functioning was not (Borelli et al., 2019).
Only two studies explored physical health-related factors. One found that prematurity/ dysmaturity was not significantly associated with intergenerational cycles of CM (Duindam et al., 2023). The other identified maternal declared disability increases the risk of second-generation substantiation with CPS (Armfield et al., 2021).
Attitudes, Beliefs, and Perceptions
In their qualitative interviews, Marshall, Fernet, Brassard et al. (2023) found that mothers with a history of child sexual abuse reporting explicit self-reflections about parenting, finding peer role models, and purposefully distinguishing their identities from that of their parents were less likely to be in CM continuity dyads; on the other hand, mothers expressing a lack of self-reflection about and confidence in parenting, as well as those voicing guilt for not having discussed their history of abuse with their children were more often in continuity dyads. Similarly, Jahng et al. (2020) found that parenting self-efficacy beliefs were protective against the intergenerational continuity of physical and emotional abuse in families with children presenting with an intellectual or developmental disability. In another qualitative inquiry (Yoo et al., 2020), at-risk parents expressed a will to reproduce positive models of parenting and not reproduce negative ones, leading to more positive environments for their children to grow up in. In the same study, parents reported that their biased perception of violence as being acceptable was, however, associated with an increased risk of CM continuity. Relatedly, Ni et al. (2018) showed that aggressive parental tendencies were a risk factor for moderate to severe physical abuse and emotional abuse, but not for mild physical abuse continuity. Non-significant associations were found for ambivalence toward parenthood and parental competence (Duindam et al., 2023), parental sense of empowerment, and perception of support offered (Langevin et al., 2020).
Caregivers’ Relational Factors
Relational factors are subdivided in four categories: (a) romantic relationships (n = 8 studies), (b) relationships with children (n = 5 studies), and (c) other relational factors (n = 2 studies).
Romantic Relationships
The most documented risk factor for intergenerational CM is IPV, with most studies finding significant associations (Adams et al., 2019; Choi et al., 2023; Labella et al., 2019; Langevin et al., 2020; Marshall, Fernet & Langevin, 2023; St-Laurent et al., 2019). However, one study found IPV to be non-significant (Duindam et al., 2023), and another one found non-significant associations for psychological IPV, but significant associations for physical IPV (Langevin et al., 2020). Secure romantic attachment was found protective against the perpetration of child sexual abuse for men with a history of child sexual abuse, while an insecure/disorganized attachment was a risk factor (Miljkovitch et al., 2022). This study also found some complex interactions between attachment to parents and to romantic partners, for instance the association between romantic attachment and sexual abuse perpetration was stronger for men with high insecure or disorganized attachment to their mother. On the other hand, Marshall, Fernet & Langevin, (2023) found maternal romantic attachment to be non-significant for the intergenerational continuity of child sexual abuse. Empathic communication in couples was found to be protective against the perpetration of CM among maltreated and married mothers of children with disabilities (Choi et al., 2023). Romantic competence was found to be non-significant in a model including IPV (Labella et al., 2019); expectations of partner support and isolation were also not significant in a network analysis (Duindam et al., 2023). Finally, two studies identified that a single-parent family was a significant risk factor for intergenerational CM (Langevin et al., 2020; Marshall, Fernet & Langevin, 2023), but one did not (Duindam et al., 2023).
Relationships with Children
In Marshall, Fernet, Brassard et al.’s (2023) qualitative study, intergenerational continuity mothers mentioned being highly (over)protective (e.g., disallowing participation in social activities) and struggling with boundaries and limit setting, while mothers in discontinuity dyads shared that they supervised and closely monitored their children without apparent overprotection. Discontinuity mothers also expressed having open communication about consent and sex with their children and educating them without violence. Conversely, poor supervision was found non-significant in Minnich et al. (2023), along with parental connectedness and inconsistent discipline. Nevertheless, these authors found that positive parenting was protective against intergenerational child sexual abuse; another study did find a significant protective effect of parent-child connectedness in Burundi (Charak et al., 2021). The quality of the relationship between mothers and their emerging adult children was found protective against the intergenerational continuity of several CM types in Langevin, Gagné et al. (2023), but was not found significant in a study specifically focusing on child sexual abuse (Marshall, Fernet & Langevin, 2023).
Other Relational Factors
Finally, one study found that family cohesion and conflict were not significantly associated with intergenerational child sexual abuse (Langevin et al., 2020). Another study found a protective effect of having more contacts with relatives for intergenerational CM (St-Laurent et al., 2019).
Caregivers’ Contextual Factors
Caregivers’ contextual factors are one of the least studied categories. Socioeconomic disadvantage was related to an increased risk of intergenerational CM in three studies (Armfield et al., 2021; Langevin, Gagné et al., 2023; St-Laurent et al., 2019); in one additional study, the effect trended toward significance (p = 0.051) (Langevin, Kern et al., 2023). Income was found significant in one study (Langevin et al., 2020) and non-significant in another one (Marshall, Fernet & Langevin, 2023), both on intergenerational child sexual abuse. Relatedly, Armfield et al. (2021) found that a lack of employment in mothers increased the risk of early childhood CPS substantiation. They found that having more than one child was also a risk factor. Finally, St-Laurent et al. (2019) did not report a significant association with intergenerational CM for residential instability or stressful events.
Caregivers’ Historical Factors
Caregivers’ historical factors are divided into three categories: (a) maltreatment characteristics (n = 10 studies), (b) CPS-related factors (n = 3 studies), and (c) family-of-origin characteristics (n = 1 study).
Maltreatment Characteristics
The timing, chronicity, co-occurrence, severity, and types of CM experienced by caregivers have been examined as potential factors associated with intergenerational CM. Three studies showed that experiencing CM during adolescence was a risk factor for intergenerational continuity (Armfield et al., 2021; Augustyn et al., 2019; McKenzie et al., 2022); one of them also identified being involved with CPS in infancy as a risk factor (Armfield et al., 2021), and another one showed that persistent CM throughout childhood was problematic (McKenzie et al., 2022). The co-occurrence of multiple CM subtypes in the parent’s childhood was found to increase the risk of intergenerational CM. (Duindam et al., 2023; McKenzie et al., 2022; St-Laurent et al., 2019). Two studies identified that greater severity of CM was associated with an increased risk of intergenerational continuity of CM (Capaldi et al., 2019; St-Laurent et al., 2019).
Regarding the types of CM, while Langevin, Gagné et al. (2023) found that all of them were associated with an increased risk of CM in the second generation, the mediation through maternal emotional dysregulation and parent-child relationship quality was only significant for neglect in the complete sample; nuances emerged in the multi-group analyses such as more significant indirect effects emerging in the deprived group compared to the nondeprived group (see the original article for details). Similarly, St-Laurent et al. (2019) only found neglect to be associated with intergenerational (dis)continuity trajectories. Conversely, Choi et al. (2019), when looking at CM subtypes in multivariate models, found emotional and sexual abuse to be associated with second-generation CM through postpartum depression, while emotional and physical neglect and physical abuse were not. Comparing child sexual abuse (dis)continuity dyads, Marshall, Fernet & Langevin (2023) found that only childhood exposure to IPV differentiated between them, as opposed to maternal histories of neglect or physical and emotional abuse. Conversely, Langevin et al. (2020) did not find that childhood exposure to IPV increased the risk of intergenerational child sexual abuse.
CPS-Related Factors
Out-of-home placement was associated with an increased risk of intergenerational CM (Armfield et al., 2021; Font et al., 2020; McKenzie et al., 2022). Furthermore, Armfield et al. (2021) found that abuse substantiation by CPS, but not a referral to CPS without substantiation, was associated with an increased risk of intergenerational CM.
Family-of-Origin Characteristics
In Marshall, Fernet, Brassard et al.’s (2023) qualitative study, discontinuity mothers, in contrast to continuity mothers, shared memories of receiving little supervision and feelings of loneliness in childhood. This suggests a possible protective effect of being attuned to these memories, as mothers may be better able to adjust their parenting to avoid similar challenges for their children if they are conscious of their own difficult memories around loneliness and lack of supervision.
Second-Generation Characteristics
Second-generation characteristics that were examined encompassed four categories: emotional and behavioral problems, physical health, parent-child relations, and sociodemographic characteristics. Warmingham and colleagues (2020) reported that emotional dysregulation was greater in children from continuity dyads compared to those in discontinuity dyads, while Islam et al. (2023) reported similar findings but regarding greater symptoms of psychopathology. In terms of physical health, Armfield et al. (2021) reported greater intergenerational continuity when infants spent more than 28 days hospitalized following birth, however, they did not find an association for children’s congenital conditions. Non-significant associations were found regarding the parent-child factors investigated in a study of intergenerational child sexual abuse: daughters’ perception of parenting and daughters’ knowledge of their mothers’ child sexual abuse history (Minnich, 2023).
Most studies looking at second-generation sociodemographic characteristics found non-significant associations including for sex/gender (Armfield et al., 2021; Choi et al., 2023; Langevin, Kern et al., 2023) and socioeconomic status (Islam et al., 2023). However, Islam and colleagues (2023) reported mixed findings based on the age group of second-generation participants (minors vs. adults). Gender and age were significant for adults but not minors, such that female and older adult participants were at greater risk of CM continuity than male and younger adult participants. Not being white was a risk factor only for minors (Islam et al. 2023).
Discussion
This updated scoping review, conducted 5 years after Langevin et al. (2021), aimed to synthesize recent findings on psychosocial risk and protective factors associated with intergenerational cycles of CM and to systematically assess the methodological quality of this literature. The 29 studies included factors across similar categories as Langevin et al. (2021), namely caregivers’ individual factors (i.e., sociodemographic characteristics, emotional/ behavioral/ physical problems, attitudes/ beliefs/ perceptions), relational factors (i.e., with romantic partners, children, or other close individuals), contextual factors, and historical factors (i.e., maltreatment characteristics, CPS factors, family-of-origin), as well as second-generation factors. Interestingly, this more recent body of work seemed to have higher methodological quality than the studies included in Langevin et al. (2021). Specifically, about half of the studies included in the current review received the highest rating of “good” and none were rated as “poor”; many included studies were longitudinal (41.2%), but secondary analyses of existing data were still common in recent years (31.0% of studies). Nevertheless, similar to Langevin et al. (2021), most samples of quantitative studies were not representative and rarely offered a complete overview of second generations’ CM experiences (i.e., second-generation participants were at least 18 years of age). Again, most studies were conducted in high income and/or Western countries. Specifically, 65.5% of studies were conducted in North America, with limited representation from Western Europe, Asia, Oceania, and Africa, and no studies from South America, Eastern Europe, or the Middle East and North African regions, highlighting significant global disparities. These findings underscore the need for more research in underrepresented regions to ensure that findings are globally relevant and culturally inclusive.
Caregiver’s Individual Factors
Studies included in this updated review identify being female as a risk factor for intergenerational CM. This could be explained by the fact that females still carry the greater burden of caregiving responsibilities in most cultures (Friedemann et al., 2014; Revenson et al., 2016). Interestingly, age, ethnicity, and education were often not significant, contrasting with Langevin et al. (2021) findings that younger parenting age was a risk factor for intergenerational CM. Lower variability in samples in terms of ethnicity, education, and age in recent research could explain this lack of association. These could also represent more distal risk factors with effects that are obscured when examining more closely related constructs such as parenting and mental health.
Results pertaining to caregivers’ emotional, behavioral, and physical problems point to emotional dysregulation, as well as depression and PTSD symptoms as being important risk factors for intergenerational CM, notably through their impact on parenting. These findings are consistent with those of Langevin et al. (2021), further supporting the need to target these aspects of well-being in prevention and intervention initiatives. Contrary to Langevin et al. (2021), where 75% of studies investigating this factor found significant associations, non-significant associations emerged for substance use in 60% of recent research, pointing to the necessity of further investigations delineating the conditions under which substance use may contribute to intergenerational CM. Similarly, many studies examining psychological distress as a general construct, and a study exploring dissociation did not find significant effects; mixed findings emerged regarding externalizing problems, with significant results only emerging when measured in the caregiver’s adolescence. These results highlight the need to include specific measures of mental health difficulties in future studies. This would allow for the disaggregation of effects across specific disorders, their symptoms, and timing on the intergenerational CM risk.
Finally, too few studies explored coping and physical health to draw firm conclusions about the salience of these factors. However, qualitative inquiries tended to support the protective effects of caregivers’ ability to reflect on their traumatic experiences (reflexivity) and trauma processing on intergenerational CM and the risk associated with a lack thereof. The role of trauma-specific reflective functioning was further supported by one quantitative study.
Caregivers’ Relational Factors
The proportion of studies investigating relational factors was smaller in the past 5 years compared to the prior years (Langevin et al., 2021). However, they remained the second most studied category of factors, with recent studies further supporting the protective effect of positive relational characteristics with romantic partners and the increased risk of intergenerational CM for parents with romantic difficulties, especially those who experienced IPV. Combining findings from the current review and Langevin et al. (2021), IPV, especially severe forms, may be considered a robust risk factor for intergenerational CM and therefore should be a priority in prevention initiatives. However, more studies are needed to clarify which other specific romantic relationship characteristics may protect against intergenerational CM, as each of the factors examined was the object of only one or two studies (e.g., attachment, support, communication) in the current and original review (Langevin et al., 2021). Similarly, caregiver-child relationship characteristics would warrant additional studies to confirm specific risk and protective factors that could be the focus of targeted interventions. Still, appropriate supervision and monitoring (as opposed to no supervision or overprotection and control) and parent-child connectedness or attachment are beginning to have strong empirical support as protective factors. Clearly, more studies are needed to explore how positive relationships, other than with a romantic partner or with children (e.g., grandparents, friends, and teachers), may protect against intergenerational CM, and conversely, how difficult relationships or social isolation may convey an increased risk.
Caregivers’ Contextual and Historical Factors and Second-Generation Characteristics
Contextual factors were among the least studied in the past 5 years, congruent with Langevin et al. (2021). Nevertheless, these factors appeared influential in most cases, with the increased socioeconomic disadvantage being almost systematically associated with the intergenerational continuity of CM in the current and the Langevin et al. (2021) review. Taken together, there appears to be strong empirical support for the implementation of public policies aiming to reduce socioeconomic disparities and to fight poverty if cycles of CM are to be prevented.
Though historical factors were included in other categories in Langevin et al. (2021), they were considered separately in the literature examined for this review, which highlights the conflicting findings and paucity of research on how diverse forms of CM may or may not be associated with intergenerational continuity. More studies statistically accounting for co-occurrent forms of CM are needed to clarify the unique contributions of each form to intergenerational cycles. On the other hand, considering findings from Langevin et al. (2021) and the current review, experiencing several forms of maltreatment and childhood adversities (i.e., cumulative adversity) may be considered an important risk factor. Similarly, the developmental timing of CM, namely during adolescence or infancy, showed a consistent positive association with intergenerational CM. Finally, the history of out-of-home placement systematically increased the risk of intergenerational continuity in recent studies.
Lastly, second-generation characteristics were examined more often over the past 5 years than in the literature reviewed for Langevin et al. (2021) and were therefore, placed in a separate section. Still, these factors showed weak and unreliable associations with cycles of CM, except maybe for emotional and physical health-related factors (e.g., psychopathology, emotion dysregulation, prolonged hospitalization after birth). It is important to note that most studies examining second-generation characteristics included in this review did not aim to understand the role of these factors in intergenerational cycles of CM, which should be considered when interpreting these findings. More studies are needed to better understand how children’s characteristics may represent risk or protective factors for the intergenerational continuity of CM.
Implications for Research and Practice
To summarize, considering findings from the current and the Langevin et al. (2021) review, several caregiver-related factors now have strong empirical evidence for their role in intergenerational cycles of CM: being female, PTSD and depression symptoms, emotional dysregulation, trauma reflexivity and processing (protective), IPV, appropriate supervision and monitoring (protective), caregiver-child connectedness or attachment (protective), socioeconomic disadvantage, cumulative adversity in childhood, CM in early childhood or adolescence. Furthermore, inconsistent findings were uncovered regarding several other caregiver-related factors, emphasizing the need for more research: substance use, externalizing behaviors, coping, physical health, specific characteristics of relationships (romantic and with children), relationships with extended family and friends, and the unique effects of CM forms. Similarly, more studies on second-generation characteristics are needed. Another crucial need pertains to studies in non-Western and low-to-middle-income countries that are virtually absent from past research on intergenerational CM (Bacchus et al., 2017), especially considering these populations experience high trauma loads (Yatham et al., 2018), and the presence of cultural differences in CM experiences and related social norms (Wadji et al., 2023). Finally, given many non-significant findings for other caregivers’ sociodemographic characteristics (e.g., education, ethnicity) and general psychological distress, researchers may wish to move away from studying these as risk or protective factors in intergenerational CM, and target more proximal or specific factors in their inquiries (Bartlett et al., 2017). Table 2 presents specific research and practice recommendations.
Implications for Research, Practice, and Policy.
CM = child management.
Conclusions
To conclude, this updated review, based on Langevin et al. (2021), included 29 new studies published in the past 5 years for a total combined sample of 80 studies. Findings indicate that caregivers’ individual, relational, contextual, and historical factors, and characteristics of the second generation were examined for their role in the intergenerational continuity of CM. Based on consistent findings across both reviews, targeted interventions addressing depression, PTSD, and emotional dysregulation in CM survivors, along with fostering secure, supportive family relationships and positive parenting skills appear essential. Enhanced support for child protection services in early CM identification and intervention and public policies to combat poverty are needed. To relieve mothers from the unequal burden of caring responsibilities that could explain their increased risk of intergenerational continuity of CM, it may be important to encourage fathers’ (or second parents’) participation in childcare, to recognize the importance of the community in childcare, and to fund accessible high-quality childcare services. More research is needed to clarify inconsistent findings and examine further promising but less studied mechanisms of intergenerational CM, and especially in non-Western and low-to-middle-income countries. An in-depth understanding of modifiable risk and protective factors associated with the intergenerational continuity of CM is key to the prevention of CM.
Supplemental Material
sj-docx-1-tva-10.1177_15248380251316908 – Supplemental material for Intergenerational Cycles of Maltreatment: An Updated Scoping Review of Psychosocial Risk and Protective Factors
Supplemental material, sj-docx-1-tva-10.1177_15248380251316908 for Intergenerational Cycles of Maltreatment: An Updated Scoping Review of Psychosocial Risk and Protective Factors by Rachel Langevin, Sara Abou Chabake and Sophie Beaudette in Trauma, Violence, & Abuse
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr. Rachel Langevin is supported by a Chercheur Boursier Junior 1 award from the Fonds de recherche du Québec – Santé (#310809) and a William Dawson Scholar Award from McGill University.
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