This revised application seeks funds to conduct the first large scale, prospective assessment of the interqenerational transmission of neglect and abuse (G1->G2->G3), using substantiated cases of childhood neglect and abuse and a comparison group (matched on the basis of age, sex, race/ethnicity, and approximate family social class) who have been followed up into adulthood. Under the Neglect RFA (RFA-OD-99-006), we are currently conducting a """"""""Thirty-Year Follow-Up of Neglected Children"""""""" (HD40774), assessing medical and health status, economic consequences, service utilization patterns (past and current), recollections of childhood neglect, and environmental toxins in the home. As a competing continuation, this application maintains its focus on the consequences of childhood neglect and now proposes to follow the children of the original participants. Little prospective evidence of the intergenerational transmission of physical abuse exists and even less is known about the transmission of childhood neglect. Using data already collected during previous waves of the study and during the initial NICHD funding period, we propose to collect new information to address complex questions surrounding the intergenerational transmission of neglect and abuse. We define the G1 generation as parents and non-parent perpetrators of neglect and/or abuse toward the G2 individuals we have been studying since 1986. Thus, we hope to determine if G2 individuals who were neglected or abused in childhood in turn will continue the cycle of maltreatment toward their G3 offspring (G1->G2->G3). We focus primarily on G2's behavior toward biological G3 offspring, but we include non-biological G3 children as well. We also include G2 individuals without children in order not to over- or under-estimate the extent of transmission. There are five broad goals: (1) to test the hypothesis that there is an intergenerational transmission of neglect and abuse; (2) to examine potential mechanisms in the intergenerational transmission of childhood neglect and abuse and to determine whether these mechanisms differ for the transmission of neglect as compared to abuse; (3) to assess whether certain G3 offspring characteristics are associated with increased risk for neglect and abuse by G2 parents; (4) to determine whether hypothesized protective factors in G2 parents provide a buffer against the transmission of neglect and abuse; and (5) to determine whether certain biomeasures (cortisol reactivity, Epstein-Barr Virus antibodies, and C-reactive protein) serve as potential biomarkers for the stress associated with childhood neglect or abuse in the G3 offspring. Using multiple methods and sources of information to determine neglect and abuse, we propose to conduct in-person interviews with all G2 adults (neglected, abused, and controls) who have children (N =753) and a subset of their children (G3) (N = 1406). Telephone interviews will also be conducted with G2 individuals who do not have children (N = 143). Using a new sampling technique for blood collection, we will assess cortisol reactivity, Epstein-Barr Virus (EBV) antibodies, and C-reactive protein (CRP) in G3 children. We will also collect official record information from child protection system agencies regarding maltreatment by G2 individuals or others directed at G3. This study's cohort design permits discovery of results with clear implications for the development of intervention and prevention programs. Findings regarding individuals who break the cycle of abuse have practical implications for the treatment and prevention of child maltreatment and theoretical importance for understanding the mechanisms and processes involved in the intergenerational transmission. Given the increasing interest in understanding the """"""""mind-body"""""""" connection, this assessment of biomeasures in the G3 offspring may provide further insight into the impact of these childhood experiences.
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