Intergenerational transmission of stress: risk factors and underlying mechanisms

La trasmissione intergenerazionale dello stress: fattori di rischio e meccanismi sottostanti

A. Biaggi, C.M. Pariante

Section of Stress, Psychiatry and Immunology & Perinatal Psychiatry, King’s College London, Institute of Psychiatry, Department of Psychological Medicine, London, UK.


Herein, the authors review recent research on the intergenerational transmission of stress linked to childhood maltreatment. This is particularly important because the World Health Organization has recently recognized that “there is an association between maltreatment in childhood and the risk of later becoming a perpetrator of violence or other antisocial behaviour as a teenager or adult”. This issue has very important consequences that need to be considered, not only in terms of the psychological health of individuals but also in terms of the high costs for the society. Moreover, the document on the “Grand Challenges in Global Mental Health” has recently emphasized the pressing need to identify “modifiable social and biological risk factors across the life course”. Indeed, very little research has been conducted with the aim to study this complex phenomenon and to determine the main risks factors and underlying mechanisms. This challenge has to be addressed urgently in order to promote adequate interventions that can interrupt the intergenerational transmission of stress.

Materials and methods
A narrative review of the literature has been performed on this topic: we collected the latest studies about the intergenerational transmission of stress, using PubMed and Psych Info databases. We have focused on all those concerning the bio-psycho-social mechanisms involved in the intergenerational transmission of stressful experiences, with the aim to provide a general overview of this complex issue.

Existing research has highlighted that children of mothers who experienced maltreatment during childhood have an increased risk of being maltreated and developing antisocial behaviour during adolescence. Recent studies have also pointed out that there is an association between maternal childhood maltreatment and antenatal depression. Moreover, antenatal depression is associated with an increased risk of maltreatment in offspring. These associations may be partly mediated by biological mechanisms, as the experience of childhood maltreatment induces lasting changes in the mechanisms of stress response, which in turn alter the uterine environment during pregnancy and increase the risk of antenatal depression. This abnormality in the uterine environment has further negative effects on both mother and child that may explain the association with maltreatment in the offspring. Within this framework, antenatal depression seems to be the vehicle for intergenerational transmission of maltreatment and stress.

Pregnancy is a crucial time when the intergenerational transmission of childhood exposure to stress and maltreatment can occurs. To this end, preventive interventions with the objective to reduce antenatal depression could interrupt the intergenerational transmission of stress and psychopathology with positive implications on the psychological health of the future generations. Clearly, further research is needed to study in depth the risk factors, the underlying mechanisms and the role of the protective factors, in order to leverage not only on preventive and therapeutic measures, but also on interventions finalized to promotion, with the aim to develop and strengthen natural resources within the families.

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