Breaking the Cycle: Risk and Resilience in the Early Transmission of Psychopathology

Abstract: Theoretical Background: Despite the increased risk of mental disorders in the offspring of parents with mental illness, the complex interplay of risk and protective factors in this transgenerational transmission remains unclear. Objective: The aim of the current study was to empirically test a theoretical model of transmission of psychopathology in early childhood. Method: We derived a subsample of 1,167 parents (92.13 % female, age M = 31.4, SD = 5.85) with elevated depressive and anxiety symptoms on the PHQ-4 and their children aged 0 – 3 years from the KID 0 – 3 main study, a German epidemiological study. Based on the theoretical model of transmission of psychopathology, the following factors were included in a structural equation model (SEM) to cross-sectionally predict children’s negative emotionality as an outcome: parent characteristics (parental depression and anxiety symptoms, doubts in parenting competence); characteristics of the parent–child interaction (bonding difficulties, child abuse and neglect); child characteristics (child, parental substance abuse disability); the familial context (financial hardship, domestic violence, no partnership); and social environment (social support, professional support services). We also tested the model in our representative sample of N = 8,063 respondents and conducted multi-group SEM with respondent age and child sex as group variables. Results: There was a significant path between parental depression and anxiety and child negative emotionality, with bonding difficulties as a mediator. A strong association was also found between domestic violence, child abuse and neglect, and child negative emotionality. The uptake of professional support services tended to be associated with fewer bonding difficulties and less child abuse and neglect. Discussion and Conclusion: This study provides empirical evidence on the interplay of multiple risk and protective factors in the intergenerational transmission of mental illness in early childhood. Practical implications can be drawn for prevention work that focuses on the risk factors identified here.