{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:21:08Z","timestamp":1784132468472,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Parental adverse childhood experiences (ACEs) are linked to negative outcomes in children, including emotional and behavioral problems, developmental delays, and higher risk for psychopathology. Most research focuses on school-aged children or community samples, with few studies examining preschool-aged children in child psychiatric care. Understanding parental ACEs in this population is crucial, as early childhood is a sensitive developmental period, and intergenerational effects may be particularly pronounced in children already presenting with psychiatric symptoms. Background\/Objectives: The goal of this study was to analyze how parents of patients in an early childhood (0\u20135.9 yrs) mental health outpatient clinic differ from the general population in terms of the frequency of ACEs. In addition, we investigated the connection between mental health disorders in young children and the specific ACE scores of their parents. Methods: A total of 116 caregivers (34.45 years (SD = 5.28)) and their children (71.6% boys, 28.4% girls) at an average age of 3.99 years (SD = 1.35, range = 0.31\u20135.95) were included in the analysis. The legal guardians completed the 10-item ACE questionnaire. The young children were diagnosed as part of outpatient treatment using the DC:0\u20135 classification system. We analyzed the ACE scores and diagnoses descriptively and in comparison to a community sample. Results: An average value of 2.38 parental ACEs was reported by our sample, and 68.1% (n = 79) reported at least one ACE. The high-risk group with four or more ACEs comprised 30.2% (n = 35). The most common diagnosis in young children was the Disorder of Dysregulated Anger and Aggression of Early Childhood, followed by global developmental delay. Adjustment disorder was third in terms of frequency. Among the examined child psychiatric diagnoses, adjustment disorder showed a significant correlation with parents being affected by the ACE category of neglect (OR = 2.54; 95% CI: 1.012\u20136.369; p = 0.047). Conclusions: Parents who presented their children at an early childhood mental health outpatient clinic reported significantly more ACEs as compared to representative data on ACEs in adulthood. These results highlight the need for further studies with larger samples to enable a more in-depth analysis of the general intergenerational transmission processes and the differential transmission of specific ACEs to specific diagnoses in preschool-aged children.<\/jats:p>","DOI":"10.3390\/children12101420","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:17:35Z","timestamp":1761056255000},"page":"1420","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Parental Adverse Childhood Experiences (ACEs) in an Early Childhood Mental Health Outpatient Clinic in Germany: Prevalence and Associations with Child Psychiatric Diagnoses"],"prefix":"10.3390","volume":"12","author":[{"given":"Franziska","family":"Laqua","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Saarland University, 66123 Saarbr\u00fccken, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5620-1563","authenticated-orcid":false,"given":"Eva","family":"M\u00f6hler","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Saarland University, 66123 Saarbr\u00fccken, Germany"},{"name":"Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0207-3015","authenticated-orcid":false,"given":"Jens","family":"Joas","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Saarland University, 66123 Saarbr\u00fccken, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9052-0779","authenticated-orcid":false,"given":"Frank W.","family":"Paulus","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Saarland University, 66123 Saarbr\u00fccken, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0749-3797(98)00017-8","article-title":"Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study","volume":"14","author":"Felitti","year":"1998","journal-title":"Am. J. Prev. Med."},{"key":"ref_2","first-page":"635","article-title":"The Prevalence and Consequences of Adverse Childhood Experiences in the German Population","volume":"116","author":"Witt","year":"2019","journal-title":"Dtsch. \u00c4rztebl. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e20180023","DOI":"10.1542\/peds.2018-0023","article-title":"Parents\u2019 Adverse Childhood Experiences and Their Children\u2019s Behavioral Health Problems","volume":"142","author":"Schickedanz","year":"2018","journal-title":"Pediatrics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1177\/1077559516659556","article-title":"Intergenerational Effects of Childhood Trauma: Evaluating Pathways Among Maternal ACEs, Perinatal Depressive Symptoms, and Infant Outcomes","volume":"21","author":"McDonnell","year":"2016","journal-title":"Child Maltreat."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2185414","DOI":"10.1080\/20008066.2023.2185414","article-title":"Intergenerational Associations of Adverse and Positive Maternal Childhood Experiences with Young Children\u2019s Psychosocial Well-Being","volume":"14","author":"Zhu","year":"2023","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e2020044131","DOI":"10.1542\/peds.2020-044131","article-title":"Maternal Adverse Childhood Experiences and Child Behavior Problems: A Systematic Review","volume":"148","author":"Cooke","year":"2021","journal-title":"Pediatrics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3251","DOI":"10.1177\/15248380221126186","article-title":"Intergenerational Transmission of Parental Adverse Childhood Experiences and Children\u2019s Outcomes: A Scoping Review","volume":"24","author":"Zhang","year":"2023","journal-title":"Trauma Violence Abus."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Racine, N., Deneault, A.-A., Thiemann, R., Turgeon, J., Zhu, J., Cooke, J., and Madigan, S. (2023). Intergenerational Transmission of Parent Adverse Childhood Experiences to Child Outcomes: A Systematic Review and Meta-Analysis. Child Abus. Negl., 106479.","DOI":"10.1016\/j.chiabu.2023.106479"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1080\/08039488.2025.2469737","article-title":"Adverse Childhood Experiences in Children with Neurodevelopmental Disorders and Their Parents","volume":"79","author":"Davidsson","year":"2025","journal-title":"Nord. J. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e20172826","DOI":"10.1542\/peds.2017-2826","article-title":"Parental Adverse Childhood Experiences and Offspring Development at 2 Years of Age","volume":"141","author":"Folger","year":"2018","journal-title":"Pediatrics"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1038\/nn1276","article-title":"Epigenetic Programming by Maternal Behavior","volume":"7","author":"Weaver","year":"2004","journal-title":"Nat. Neurosci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1146\/annurev.neuro.24.1.1161","article-title":"Maternal Care, Gene Expression, and the Transmission of Individual Differences in Stress Reactivity Across Generations","volume":"24","author":"Meaney","year":"2001","journal-title":"Annu. Rev. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.jaac.2017.03.001","article-title":"Intergenerational Transmission of Maternal Childhood Maltreatment Exposure: Implications for Fetal Brain Development","volume":"56","author":"Buss","year":"2017","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.chiabu.2018.07.037","article-title":"The Intergenerational Transmission of Child Maltreatment: A Three-Level Meta-Analysis","volume":"84","author":"Assink","year":"2018","journal-title":"Child Abus. Negl."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Altpeter, A., Dixius, A., and M\u00f6hler, E. (2024). Parents of Child Psychiatric Patients Report More Adverse Childhood Experiences Compared with Community Samples. Children, 11.","DOI":"10.3390\/children11121427"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1007\/s10802-023-01100-w","article-title":"A Developmental Psychopathology Perspective on Adverse Childhood Experiences (ACEs): Introduction to the Special Issue","volume":"51","author":"Hawes","year":"2023","journal-title":"Res. Child Adolesc. Psychopathol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1038\/npp.2015.252","article-title":"Early Adverse Experiences and the Developing Brain","volume":"41","author":"Bick","year":"2016","journal-title":"Neuropsychopharmacology"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"B\u00f6deker, K., Watrin-Avino, L.M., Martin, A., Schlensog-Schuster, F., Janssen, M., Friese, L., Licata-Dandel, M., Mall, V., Teich-B\u011blohradsk\u00fd, J., and Izat, Y. (2023). Assessment and Diagnostic Classification Using DC:0-5 in Early Childhood Mental Health Clinics: The Protocol for the Developmental Psychiatry Diagnostic Challenges Study (DePsy). Children, 10.","DOI":"10.3390\/children10111770"},{"key":"ref_19","unstructured":"Zero to Three (Organization) (2016). DC: 0-5: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Zero to Three."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1026\/0942-5403\/a000318","article-title":"Psychische St\u00f6rungen bei Vorschulkindern: Unterschiede zwischen den DC: 0\u20135 und ICD-10 Klassifikationssystemen","volume":"29","author":"Hussong","year":"2020","journal-title":"Kindh. Entwickl."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e10-4","DOI":"10.1055\/s-0030-1263161","article-title":"The reliable, valid and economic assessment of early traumatization: First psychometric characteristics of the German version of the Adverse Childhood Experiences Questionnaire (ACE)","volume":"61","author":"Wingenfeld","year":"2011","journal-title":"Psychother. Psychosom. Med. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s10578-011-0237-2","article-title":"Comparison of ICD-10 and DC: 0-3R Diagnoses in Infants, Toddlers and Preschoolers","volume":"42","author":"Equit","year":"2011","journal-title":"Child Psychiatry Hum. Dev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jad.2023.01.128","article-title":"Parental Anxiety and Offspring Development: A Systematic Review","volume":"327","author":"Sweeney","year":"2023","journal-title":"J. Affect. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.neuroscience.2015.09.029","article-title":"Parenting Begets Parenting: A Neurobiological Perspective on Early Adversity and the Transmission of Parenting Styles across Generations","volume":"342","author":"Lomanowska","year":"2017","journal-title":"Neuroscience"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1017\/S0954579412000764","article-title":"Linking Prenatal Maternal Adversity to Developmental Outcomes in Infants: The Role of Epigenetic Pathways","volume":"24","author":"Monk","year":"2012","journal-title":"Dev. Psychopathol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1037\/0002-9432.77.4.624","article-title":"Emotional Availability in a Sample of Mothers with a History of Abuse","volume":"77","author":"Moehler","year":"2007","journal-title":"Am. J. Orthopsychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s00702-016-1525-6","article-title":"Sex-Specific Differences in Adrenocortical Attunement in Mothers with a History of Childhood Abuse and Their 5-Month-Old Boys and Girls","volume":"123","author":"Fuchs","year":"2016","journal-title":"J. Neural Transm."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/j.1467-8624.2009.01397.x","article-title":"From External Regulation to Self-Regulation: Early Parenting Precursors of Young Children\u2019s Executive Functioning","volume":"81","author":"Bernier","year":"2010","journal-title":"Child Dev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1521\/bumc.66.1.39.23374","article-title":"Mother-Daughter Relationships and Child Sexual Abuse: A Pilot Study of 35 Dyads","volume":"66","author":"Schechter","year":"2002","journal-title":"Bull. Menn. Clin."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1111\/cdev.13764","article-title":"Parental Sensitivity and Child Behavioral Problems: A Meta-Analytic Review","volume":"93","author":"Cooke","year":"2022","journal-title":"Child Dev."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/10\/1420\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:41:44Z","timestamp":1761057704000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/10\/1420"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,21]]},"references-count":30,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["children12101420"],"URL":"https:\/\/doi.org\/10.3390\/children12101420","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,21]]}}}