1
|
Hornor G. Child Sexual Abuse Victimization and Parenting. J Pediatr Health Care 2024; 38:438-449. [PMID: 38697699 DOI: 10.1016/j.pedhc.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/07/2023] [Accepted: 09/21/2023] [Indexed: 05/05/2024]
|
2
|
Leong RWE, Gill D, Barlas J, Lin PKF. Early Parenting Interactions and First-Time Mothers' Postnatal Depression and Parental Competence. Eur J Investig Health Psychol Educ 2024; 14:963-975. [PMID: 38667818 PMCID: PMC11049342 DOI: 10.3390/ejihpe14040063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Objectives: Schema Therapy, an approach that integrates cognitive-behavioural and attachment principles, helps us understand the impact of early interactions with caregivers on adult mental health. These early interactions can be assessed through Schema Therapy-informed tools; however, these tools have yet to be used with a postnatal population, which represents a period of vulnerability for new mothers. Therefore, the present study aimed to evaluate the impact of positive and negative early parenting interactions on a first-time mother's mental health and her sense of competence during the postnatal period, using recently revised and newly developed Schema Therapy-informed tools. Design: This is a cross-sectional study. Method: First-time mothers (N = 220) participated in an online survey within 12 months post-birth. Participants completed the Positive Parenting Schema Inventory (PPSI), Young Parenting Inventory-Revised (YPI-R2), Edinburgh Postnatal Depression Scale (EPDS), and Parenting Sense of Competence (PSOC) scale. The data were analysed using hierarchical multiple regression and mediational analysis. Results: Negative early interactions with mothers and fathers led to greater postnatal depressive symptomology, while positive early interactions with mothers led to fewer postnatal depressive symptoms. Mediation analyses revealed that postnatal depressive symptoms mediated early parenting interactions and participants' sense of parenting competence as a new mother. Conclusions: The protective effects of positive early interactions with caregivers can help first-time mothers' postnatal emotional adjustment and their sense of competence through diminished postnatal depressive symptoms. However, the enduring effects of negative early interactions with caregivers can contribute to a first-time mother's risk of developing postnatal depression and negatively affect her sense of parental competence.
Collapse
Affiliation(s)
| | | | - Joanna Barlas
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore 387380, Singapore; (R.W.E.L.); (D.G.); (P.K.F.L.)
| | | |
Collapse
|
3
|
Fu C, Li C, Wan X, Yang Y, Zhang S, Hu J. The Relationship Between Adverse Childhood Experiences and Postpartum Depression: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024:15248380241235639. [PMID: 38516894 DOI: 10.1177/15248380241235639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Although numerous factors have been found to influence postpartum depression (PPD), no previous meta-analysis have systematically explored whether it is affected by adverse childhood experiences (ACEs). This study aimed to explore the influence of ACEs and their subtypes on PPD. A systematic literature search was conducted using Web of Science, PubMed, Embase, Wan Fang, China Science and Technology Journal Database, Chinese Biomedical Database, and China National Knowledge Infrastructure, and literature was screened according to inclusion and exclusion criteria. Methodological quality assessment and data extraction were performed on the included studies. A random-effects model was used to pool the effects. In total, 24 studies were included, and 73 independent effects were extracted from them. The meta-analysis revealed that ACE was a risk factor for PPD (odds ratio [OR] = 2.31, 95% confidence interval [CI] [2.04, 2.63]). The subgroup analysis results showed that emotional abuse was the ACE subtype most strongly related to the occurrence of PPD (OR = 2.95, 95% CI [2.08, 4.20]), followed by emotional neglect (OR = 2.87, 95% CI [1.89, 4.36]) and sexual abuse (OR = 2.81, 95% CI [1.93, 4.09]). In addition, family member incarceration (OR = 2.62, 95% CI [1.51, 4.54]), physical abuse (OR = 2.31, 95% CI [1.67, 3.19]), and physical neglect (OR = 2.15, 95% CI [1.36, 3.39]) also have strong effects on PPD. ACE is a risk factor for PPD. Early screening of ACE plays an important role in the prevention and intervention of PPD.
Collapse
Affiliation(s)
- Congrui Fu
- Hebei Medical University, Shijiazhuang, China
| | - Cong Li
- Hebei Medical University, Shijiazhuang, China
| | - Xin Wan
- Clinical College of Hebei Medical University, Shijiazhuang, China
| | - Yu Yang
- Hebei Medical University, Shijiazhuang, China
| | | | - Jie Hu
- Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
4
|
Smith A, Bryson H, Gartland D, Mensah F, Wood CE, Price A. Mothers' experiences of emotional abuse from an intimate partner and its associations with children's developmental outcomes at 5 years. CHILD ABUSE & NEGLECT 2023; 146:106458. [PMID: 37866251 DOI: 10.1016/j.chiabu.2023.106458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 07/23/2023] [Accepted: 09/08/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Intimate partner violence (IPV) is associated with an increased risk of poorer child development. Existing research has focused on physical abuse with less known about the associations with emotional IPV. OBJECTIVE To describe the period prevalence of mother's experiences of emotional IPV during children's preschool years and associations with child mental, physical, social, and cognitive development. METHODS Secondary analysis of control group data (n = 194) from an Australian randomised trial (right@home), which recruited pregnant women experiencing social adversity from antenatal clinics in 2013-14. Women reported emotional abuse (Composite Abuse Scale) at child ages 3-5 years. Measures of child development at 5 years included: Strengths and Difficulties Questionnaire, Social Skills Improvement System, Pediatric Quality of Life Inventory, Clinical Evaluation of Language Fundamentals, School Entry Alphabetic and Phonological Awareness Readiness Test, NIH executive function subtests, sleep and health. The prevalence of emotional IPV from 3 to 5 years was estimated. Regression models compared developmental outcomes according to emotional IPV exposure, adjusted for child age, child gender, and maternal education. Missing data were accounted for using multiple imputation. RESULTS From 3-5 years, emotional IPV was experienced by 57% of women. Emotional IPV exposure was consistently associated with poorer child developmental outcomes. Differences were most apparent for SDQ internalising (mean difference 1.2, 95% CI 0.2 to 2.1) and externalising difficulties (1.2, 95% CI -0.1 to 2.4). CONCLUSIONS Emotional IPV was highly prevalent amongst families experiencing social adversity. Developing acceptable and effective identification processes and interventions that prioritise families experiencing co-occurring social adversities should be a public health priority.
Collapse
Affiliation(s)
- Ashlee Smith
- Centre for Community Child Health, Royal Children's Hospital, 50 Flemington Road, Parkville, VIC 3052, Australia.
| | - Hannah Bryson
- Melbourne Graduate School of Education, The University of Melbourne, Parkville 3052, VIC, Australia
| | - Deirdre Gartland
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
| | - Fiona Mensah
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Catherine E Wood
- Department of Psychological Sciences, School of Health Sciences, Swinburne University, Hawthorn, VIC 3122, Australia
| | - Anna Price
- Centre for Community Child Health, Royal Children's Hospital, 50 Flemington Road, Parkville, VIC 3052, Australia
| |
Collapse
|
5
|
Spinoni M, Singh Solorzano C, Grano C. The impact of prepartum pandemic-related perceived stress on anxiety symptoms in the postpartum: The role of perceived childbirth experiences. J Anxiety Disord 2023; 99:102762. [PMID: 37647729 DOI: 10.1016/j.janxdis.2023.102762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/19/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023]
Abstract
Postpartum anxiety is a significant component of postpartum maternal distress and is related to adverse outcomes for both the mother and the child. Although previous research reported higher anxiety symptoms in pregnant women during the Covid-19 pandemic, no studies evaluated the negative impact of pandemic-related perceived stress on postpartum anxiety symptomatology over time. This study aimed to examine the impact of prepartum pandemic-related stress on postpartum anxiety and to evaluate the role of subjective labor and delivery experiences on this relationship. A sample of 172 pregnant women completed an online questionnaire evaluating pandemic-related perceived stress and anxiety symptoms in the second or third trimester of pregnancy. In the postpartum, they completed a second questionnaire retrospectively evaluating their childbirth experience and assessing anxiety symptoms in the last two weeks. A mediation analysis was conducted. Prepartum pandemic-related perceived stress was significantly associated with postpartum anxiety symptoms. Moreover, childbirth experiences significantly and partially mediated this relationship. Findings highlighted the importance of evaluating perceived stress levels during pregnancy to prevent negative consequences on postpartum mental health. Clinicians need to foster better management of factors included in the childbirth experience that may potentially trigger or counteract anxiety risk.
Collapse
Affiliation(s)
- Marta Spinoni
- Department of Psychology, Sapienza University of Rome, Via Dei Marsi, 78, 00185 Rome, Italy
| | | | - Caterina Grano
- Department of Psychology, Sapienza University of Rome, Via Dei Marsi, 78, 00185 Rome, Italy.
| |
Collapse
|
6
|
Brittain K, Zerbe A, Phillips TK, Gomba Y, Mellins CA, Myer L, Abrams EJ. Impact of adverse childhood experiences on women's psychosocial and HIV-related outcomes and early child development in their offspring. Glob Public Health 2022; 17:2779-2791. [PMID: 34613893 PMCID: PMC8983791 DOI: 10.1080/17441692.2021.1986735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 09/04/2021] [Indexed: 12/15/2022]
Abstract
Adverse childhood experiences (ACEs) may have a critical influence on adult outcomes and subsequent offspring development, but few data have explored the effects of ACEs in low-resource settings where the burdens of childhood adversity and HIV are high. Among mothers living with HIV in Cape Town, we examined the effects of ACEs on maternal psychosocial and HIV-related outcomes, as well as early child development in their offspring aged 36-60 months. The World Health Organization's Adverse Childhood Experiences International Questionnaire was used to measure maternal reports of ACEs, and the Ages & Stages Questionnaire to screen for developmental delays in their offspring. Among 353 women (median age: 32 years), 84% reported ≥1 ACEs. Increased report of ACEs was strongly associated with depressive symptoms, hazardous alcohol use, intimate partner violence and self-reported suboptimal adherence to antiretroviral therapy. These associations were driven by more severe childhood experiences, including abuse, neglect and exposure to collective violence. Among 255 women who reported on their child's development, maternal ACEs were associated with poorer socioemotional development. These data suggest that childhood adversity has long-term effects on maternal outcomes as well as their children's socioemotional development and point to ACEs that might be targeted for screening and intervention.
Collapse
Affiliation(s)
- Kirsty Brittain
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Allison Zerbe
- ICAP at Columbia University, Mailman School of Public Health, New York, NY, USA
| | - Tamsin K. Phillips
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Yolanda Gomba
- Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Claude A. Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Landon Myer
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Elaine J. Abrams
- ICAP at Columbia University, Mailman School of Public Health, New York, NY, USA
- Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| |
Collapse
|
7
|
Masiano SP, Yu X, Tembo T, Wetzel E, Mphande M, Khama I, Mkandawire A, Chitani M, Liwimbi O, Udedi M, Mazenga A, Nyasulu P, Abrams E, Ahmed S, Kim MH. The relationship between adverse childhood experiences and common mental disorders among pregnant women living with HIV in Malawi. J Affect Disord 2022; 312:159-168. [PMID: 35752220 PMCID: PMC9892657 DOI: 10.1016/j.jad.2022.06.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/28/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) have been linked to common mental disorders (CMDs) such as anxiety and depressive thoughts. We examined the prevalence of ACEs and their association with CMDs among pregnant women living with HIV (PWLHIV) in Malawi-an HIV endemic resource-limited setting. METHODS This is a cross-sectional study of 798 PWLHIV enrolled in the VITAL Start trial in Malawi (10/2018 to 06/2021) (NCT03654898). ACE histories were assessed using WHO's Adverse Childhood Experiences International Questionnaire (ACE-IQ) tool. Depressive symptoms (somatic complaints, reduced vital energy, anxiety, and depressive thoughts) were assessed using WHO's Self Reporting Questionnaire 20-Item (SRQ-20) tool. Log-binomial regressions were used to examine the association between cumulative ACEs and each depressive symptom, as well as identify ACEs driving this association. RESULTS The mean age of our sample was 27.5 years. Over 95 % reported having experienced ≥1 ACE. On average, each participant reported four ACEs; 11 % reported sexual abuse. About 52 % and 44 % reported anxiety and depressive thoughts, respectively. In regressions, cumulative ACE scores were significantly associated with depressive symptoms-even after adjusting for multiple testing. This association was primarily driven by reports of sexual abuse. LIMITATIONS Data on maternal ACEs were self-reported and could suffer from measurement error because of recall bias. CONCLUSIONS ACEs are widespread and have a graded relationship with depressive symptoms in motherhood. Sexual abuse was found to be a primary driver of this association. Earlier recognition of ACEs and provision of trauma-informed interventions to improve care in PWLHIV may reduce negative mental health sequelae.
Collapse
Affiliation(s)
- Steven P Masiano
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi; Healthcare Delivery and Implementation Science Center, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Xiaoying Yu
- Department of Biostatistics & Data Science, School of Public Health and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Tapiwa Tembo
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - Elizabeth Wetzel
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi; Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Mtisunge Mphande
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - Innocent Khama
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - Angella Mkandawire
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - Mike Chitani
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - Olive Liwimbi
- Ministry of Health, Zomba Mental Hospital, Zomba, Malawi
| | - Michael Udedi
- Ministry of Health, NCDs and Mental Health Unit, Lilongwe, Malawi; University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, NC, USA
| | - Alick Mazenga
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - Phoebe Nyasulu
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - Elaine Abrams
- ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Pediatrics, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Saeed Ahmed
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi; Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Maria H Kim
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi; Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
8
|
Alhalal H, Alhalal E, Alhaizan M, Alghuson L, Alahmari M, Alkhayyal N, Akkour K. Intimate Partner Violence and Its Associations with Adverse Pregnancy Outcomes in Saudi Arabia: A Cross-Sectional Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP14457-NP14484. [PMID: 33858253 DOI: 10.1177/08862605211005144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Intimate partner violence (IPV) during pregnancy is a significant issue. Nevertheless, the prevalence of IPV and its adverse outcomes in pregnant women in Saudi Arabia are not well documented. This study examines the prevalence of IPV, its relationship with women's background characteristics, and its effect on adverse pregnancy outcomes. A cross-sectional study was conducted using a convenience sample of 684 women who were either pregnant or in the first six weeks postpartum in Riyadh, Saudi Arabia. IPV severity was measured using the Composite Abuse Scale. The results showed that 28.9% of the women included in this study experienced IPV. Smoking habit, income, polygamous marriage, presence of chronic diseases and sexual dysfunction, and number of children were significantly associated with IPV severity. In each one-unit increase in total IPV severity, the possibility of the occurrence of preterm labor, vaginal bleeding, dehydration, gestational diabetes, urinary tract infection, spontaneous abortion, and intrauterine growth retardation significantly increases. Furthermore, regarding the types of abuse, we found that for each one-unit increase in verbal abuse, the possibility of the occurrence of preterm labor, dehydration, urinary tract infection, and intrauterine growth retardation significantly increases. Moreover, for each one-unit increase in physical abuse and one-unit increase in controlling behavior, the possibility of the occurrence of intrauterine growth retardation significantly increases. The current results highlight the importance of paying substantial attention to IPV and its types as a health issue that increases the risk of adverse pregnancy outcomes in women. A clinical assessment during pregnancy is needed to identify and manage cases of IPV survivors and ultimately reduce their risk of IPV.
Collapse
Affiliation(s)
- Hani Alhalal
- King Saud University Medical City, Riyadh, Saudi Arabia
| | - Eman Alhalal
- King Saud University, Nursing College, Riyadh, Saudi Arabia
| | | | | | | | | | - Khalid Akkour
- King Saud University Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
9
|
Savopoulos P, Brown S, Anderson PJ, Gartland D, Bryant C, Giallo R. Intimate partner violence during infancy and cognitive outcomes in middle childhood: Results from an Australian community-based mother and child cohort study. Child Dev 2022; 93:e396-e411. [PMID: 35137950 DOI: 10.1111/cdev.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The cognitive functioning of children who experience intimate partner violence (IPV) has received less attention than their emotional-behavioral outcomes. Drawing upon data from 615 (48.4% female) 10-year-old Australian-born children and their mothers (9.6% of mothers born in non-English speaking countries) participating in a community-based longitudinal study between 2004 and 2016, this study examined the associations between IPV in infancy and cognition in middle childhood (at age 10). Results showed that IPV in the first 12 months of life was associated with lower general cognitive ability and poorer executive attention but not working memory skills. IPV in middle childhood (in the 10th year postpartum) was not associated with cognition. This study provides evidence for the long-term impact of early life exposure to IPV on children's cognition, and points to the importance of early intervention to optimize development.
Collapse
Affiliation(s)
- Priscilla Savopoulos
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Stephanie Brown
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Peter J Anderson
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Deirdre Gartland
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Christina Bryant
- School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Rebecca Giallo
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,La Trobe University, Bundoora, Victoria, Australia
| |
Collapse
|
10
|
FitzPatrick KM, Brown S, Hegarty K, Mensah F, Gartland D. Physical and Emotional Intimate Partner Violence and Women's Health in the First Year After Childbirth: An Australian Pregnancy Cohort Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP2147-NP2176. [PMID: 32608316 DOI: 10.1177/0886260520934426] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Intimate partner violence (IPV) can comprise physical, sexual, and emotional abuse, and is a widespread public health concern. Despite increasing recognition that women experience different types of IPV, the majority of research has focused on physical IPV. The present study aims to examine associations between different types of IPV (physical, emotional, physical, and emotional) and women's mental, physical, and sexual health by analyzing longitudinal data from a prospective pregnancy cohort of 1,507 first-time mothers in Melbourne, Australia. Questionnaires included validated measures of physical and mental health (Short Form Health Survey, Edinburgh Postnatal Depression Scale) and IPV (Composite Abuse Scale). Emotional IPV alone was the most commonly reported type of IPV (n = 128, 9.5%), followed by both physical and emotional IPV (n = 76, 5.7%), and then physical IPV alone (n = 30, 2.2%). Women reporting emotional IPV or physical and emotional IPV had increased odds of poor health compared with women reporting no IPV. Experience of physical and emotional IPV was most strongly associated with mental health issues, including depressive symptoms (adjusted odds ratio [OR] 4.6, 95% confidence interval [CI] = [2.9, 7.1]) and self-reported anxiety (adjusted OR 2.9, 95% CI = [1.9, 4.4]). Experience of emotional IPV alone was associated with poor mental health as well as physical factors, including poor general physical health (adjusted OR 1.9, 95% CI = [1.2, 3.1]), and pain during sex (adjusted OR 1.8, 95% CI = [1.2, 2.7]). Increased odds of poor body image were also observed for women reporting emotional IPV alone and physical and emotional IPV. These findings highlight the need for greater awareness of the diversity in women's experiences of IPV among health care providers. This includes understanding the prevalence of emotional IPV among new mothers, and the range of health problems that are more common for women experiencing IPV.
Collapse
Affiliation(s)
- Kelly M FitzPatrick
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- University of Melbourne, Victoria, Australia
| | - Stephanie Brown
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- University of Melbourne, Victoria, Australia
| | - Kelsey Hegarty
- University of Melbourne, Victoria, Australia
- Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- University of Melbourne, Victoria, Australia
- Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Deirdre Gartland
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| |
Collapse
|
11
|
Gartland D, Conway LJ, Giallo R, Mensah FK, Cook F, Hegarty K, Herrman H, Nicholson J, Reilly S, Hiscock H, Sciberras E, Brown SJ. Intimate partner violence and child outcomes at age 10: a pregnancy cohort. Arch Dis Child 2021; 106:1066-1074. [PMID: 33883191 DOI: 10.1136/archdischild-2020-320321] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/05/2021] [Accepted: 02/17/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Assess the mental health, physical health, cognitive and language development of 10-year old children in families where mothers have reported intimate partner violence (IPV) compared with children with no reported IPV exposure. DESIGN Prospective pregnancy cohort. Maternal report of IPV (Composite Abuse Scale) at 1, 4 and 10 years. Maternal and direct assessment of child mental health (probable psychiatric diagnosis, anxiety and emotional/behavioural difficulties), cognition (IQ and executive function), language (general, pragmatic and receptive) and physical health at 10 years. SETTING A subsample of 615 mother-child dyads drawn from a pregnancy cohort of 1507 nulliparous women recruited from six public hospitals in Melbourne, Australia. RESULTS Any IPV exposure from infancy to age 10 was associated with poorer child outcomes at age 10. Specifically, twice the odds of a probable psychiatric diagnosis, emotional/behavioural difficulties, impaired language skills (general and pragmatic), and having consulted a health professional about asthma or sleep problems. IPV exposure at age 10 associated with two to three times higher odds of all mental health outcomes, elevated blood pressure and sleep problems. Early life exposure alone (at 1 and/or 4 years) associated with three times higher odds of a general language problem and asthma at age 10. CONCLUSION The high prevalence of IPV and increased risk of poorer health and development among children exposed highlights the burden of ill health carried by children in families experiencing IPV. Fewer difficulties where exposure was limited to the early years builds the case for better identification, understanding and resourcing of effective early intervention.
Collapse
Affiliation(s)
- Deirdre Gartland
- Intergenerational Health Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia .,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Laura J Conway
- Intergenerational Health Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca Giallo
- Intergenerational Health Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Fiona K Mensah
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Fallon Cook
- Intergenerational Health Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,Centre of Family Violence Prevention, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Helen Herrman
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jan Nicholson
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.,School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sheena Reilly
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
| | - Harriet Hiscock
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Health Services Research Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Emma Sciberras
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Stephanie J Brown
- Intergenerational Health Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
12
|
Rodríguez-Soto NC, Buxó CJ, Morou-Bermudez E, Pérez-Edgar K, Ocasio-Quiñones IT, Surillo-González MB, Martinez KG. The impact of prenatal maternal stress due to potentially traumatic events on child temperament: A systematic review. Dev Psychobiol 2021; 63:e22195. [PMID: 34674245 PMCID: PMC8549868 DOI: 10.1002/dev.22195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 07/21/2021] [Accepted: 08/18/2021] [Indexed: 12/11/2022]
Abstract
The objective of the current study was to complete a systematic review of the relationship between prenatal maternal stress due to potentially traumatic events (PTEs) and child temperament. Eligible studies through June 2020 were identified utilizing a search strategy in PubMed and PsycInfo. Included studies examined associations between prenatal maternal stress due to PTE and child temperament. Two independent coders extracted study characteristics and three coders assessed study quality. Of the 1969 identified studies, 20 met full inclusion criteria. Studies were classified on two dimensions: (1) disaster-related stress and (2) intimate partner violence during pregnancy. For disaster-related prenatal maternal stress, 75% (nine out of 12) of published reports found associations with increased child negative affectivity, 50% (five out of 10) also noted associations with lower effortful control/regulation, and 38% (three out of eight) found associations with lower positive affectivity. When considering prenatal intimate partner violence stress, 80% (four out of five) of published reports found associations with higher child negative affectivity, 67% (four out of six) found associations with lower effortful control/regulation, and 33% (one out of three) found associations with lower positive affectivity. Prenatal maternal stress due to PTEs may impact the offspring's temperament, especially negative affectivity. Mitigating the effects of maternal stress in pregnancy is needed in order to prevent adverse outcomes on the infant's socioemotional development.
Collapse
Affiliation(s)
- Nayra C. Rodríguez-Soto
- University of Puerto Rico, Medical Sciences Campus, San Juan, PR
- Carlos Albizu University, San Juan, PR
| | - Carmen J. Buxó
- University of Puerto Rico, Medical Sciences Campus, San Juan, PR
| | | | | | | | | | | |
Collapse
|
13
|
Brown SJ, Gartland D, Woolhouse H, Giallo R, McDonald E, Seymour M, Conway L, FitzPatrick KM, Cook F, Papadopoullos S, MacArthur C, Hegarty K, Herrman H, Nicholson JM, Hiscock H, Mensah F. The maternal health study: Study design update for a prospective cohort of first-time mothers and their firstborn children from birth to age ten. Paediatr Perinat Epidemiol 2021; 35:612-625. [PMID: 33956353 DOI: 10.1111/ppe.12757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/22/2020] [Accepted: 01/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Maternal health is critical to the health and well-being of children and families, but is rarely the primary focus of pregnancy and birth cohort studies. Globally, poor maternal health and the exposure of women and children to family violence contribute to the perpetuation and persistence of intergenerational health inequalities. OBJECTIVES The Maternal Health Study was designed to investigate the contribution of social and obstetric risk factors to common maternal physical and psychological morbidities. Over time, our focus has expanded to include mother-child pairs and investigation of intergenerational trauma and family violence. POPULATION A total of 1507 first-time mothers were recruited in early pregnancy from six public hospitals in Melbourne, Australia, in 2003-2005. METHODS Women completed questionnaires or telephone interviews in early pregnancy (≤24 weeks); at 32 weeks' gestation; at three, six, nine, 12 and 18 months postpartum; and at four and ten years. At ten years, women and children were invited to participate in face-to-face interviews, which included direct assessment of children's cognitive and language development. A wide range of obstetric, social and contextual factors have been measured, including exposure to intimate partner violence (IPV) (1-year, 4-year and 10-year follow-up). RESULTS 1507 eligible women were recruited at a mean gestation of 15 weeks. At one year, four years and ten years postpartum, 90.0%, 73.1% and 63.2% of the original cohort took part in follow-up. One in three women in the study (34.5%) reported exposure to IPV in the first ten years of motherhood: 19% in the first 12 months postpartum, 20% in the year prior to four-year follow-up and 18.3% in the year prior to ten-year follow-up. CONCLUSION The study affords a unique opportunity to examine patterns of maternal and child health and health service use associated with exposure to IPV.
Collapse
Affiliation(s)
- Stephanie J Brown
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia.,Department of General Practice, The University of Melbourne, Melbourne, Vic., Australia
| | - Deirdre Gartland
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Hannah Woolhouse
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Rebecca Giallo
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Ellie McDonald
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Monique Seymour
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Laura Conway
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Kelly M FitzPatrick
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Fallon Cook
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Sandra Papadopoullos
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Christine MacArthur
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Melbourne, Vic., Australia.,Royal Women's Hospital, Melbourne, Vic., Australia
| | - Helen Herrman
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Jan M Nicholson
- Judith Lumley Centre, La Trobe University, Melbourne, Vic., Australia
| | - Harriet Hiscock
- Health Services, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Vic, Australia
| | - Fiona Mensah
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| |
Collapse
|
14
|
Conway LJ, Cook F, Cahir P, Brown S, Reilly S, Gartland D, Mensah F, Giallo R. Children's language abilities at age 10 and exposure to intimate partner violence in early childhood: Results of an Australian prospective pregnancy cohort study. CHILD ABUSE & NEGLECT 2021; 111:104794. [PMID: 33160647 DOI: 10.1016/j.chiabu.2020.104794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/15/2020] [Accepted: 10/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Approximately one in four children in Australia have mothers who experience intimate partner violence (IPV). These children are at risk of poor mental health. Less is known about their language outcomes, despite evidence that childhood adversity threatens neurodevelopment, and the home environment effects language development. OBJECTIVE This study aimed to examine the relationship between early childhood IPV exposure and language outcomes (receptive vocabulary, general language, pragmatic language) at age 10, including the influence of maternal depressive symptoms. PARTICIPANTS AND SETTING Participants were 615 mothers and their first-born child participating in a prospective, community-based pregnancy cohort study in Melbourne. METHODS Mothers reported their experience of IPV and depressive symptoms in the first and fourth year postpartum. At 10 years postpartum, children's receptive vocabulary was directly assessed and mothers reported on their child's general and pragmatic language skills. RESULTS Exposure to IPV was related to scores indicating poorer abilities in receptive vocabulary (d=-0.26, p = .009), general language (d = 0.23, p = .047) and pragmatic language skills (d = 0.41, p < .001) at age 10. After adjusting for maternal depressive symptoms, evidence remained for the relationship with pragmatic language (d=-0.32, p = .006), and a trend for receptive vocabulary (d=-0.20, p = .052). CONCLUSIONS At a community-level, children whose mothers experienced IPV during the child's first four years had poorer language skills in middle childhood than children whose mothers did not experience IPV. This is important because poor child language skills are associated with adverse outcomes across the lifespan including academic under-achievement and mental health problems. Clinical implications are discussed.
Collapse
Affiliation(s)
- Laura J Conway
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Rd, Parkville, VIC 3052, Australia.
| | - Fallon Cook
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - Petrea Cahir
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - Stephanie Brown
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Rd, Parkville, VIC 3052, Australia; South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Sheena Reilly
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Rd, Parkville, VIC 3052, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia
| | - Deirdre Gartland
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - Rebecca Giallo
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Rd, Parkville, VIC 3052, Australia; La Trobe University, Bundoora, Australia
| |
Collapse
|
15
|
Brunton R, Dryer R. Child Sexual Abuse and Pregnancy: A Systematic Review of the Literature. CHILD ABUSE & NEGLECT 2021; 111:104802. [PMID: 33218712 DOI: 10.1016/j.chiabu.2020.104802] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 09/07/2020] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Child sexual abuse is related to many negative outcomes but less known is the effect on pregnancy and childbirth. OBJECTIVE This review critically examined the literature on the occurrence of child sexual abuse and outcomes associated with this abuse during pregnancy and childbirth. METHODS Five databases were searched over 50 years using an iterative approach and the terms pregnancy, sexual abuse/assault, childbirth/labour, identifying 49 studies. RESULTS The prevalence of child sexual abuse in pregnant women ranged from 2.63% to 37.25 with certain characteristics more common with a higher (e.g., specific questions, low income) or lower (broad questions, higher education) prevalence. Compared to women with no history of abuse, child sexual abuse survivors may have more concerns with their care, greater health complaints, fear childbirth and have difficulties with delivery. They also had a higher likelihood of PTSD symptomology and anxiety, consumed more harmful substances (e.g., alcohol, cigarettes, and drugs) and had greater concerns with their appearance, poorer health, sleep and may also have a higher risk of re-victimisation. CONCLUSIONS The balance of evidence suggests that compared to non-abused women, women with a child abuse history have more adverse experiences with pregnancy, childbirth, and care, with their abuse history, likely contributes to harmful behaviours and psychopathology. However, variability in operationalisation and measurement of abuse may contribute to these findings so tentative conclusions are drawn. Future research should examine the generalisability of the findings (relating to scale limitations) and recommendations for screening (e.g., sensitive items, scoring). Clinical implications of the findings point to the need for early identification of women with a child abuse history as such women require trauma-sensitive care and consideration. A useful tool is the Pregnancy-related Anxiety Scale which provides insights into specific areas of concern.
Collapse
Affiliation(s)
- Robyn Brunton
- Charles Sturt University, School of Psychology, Bathurst, NSW 2795, Australia.
| | - Rachel Dryer
- Australian Catholic University, Strathfield, NSW 2135, Australia
| |
Collapse
|
16
|
Kamimura A, Nourian MM, Assasnik N, Nourian K, Franchek-Roa K. Childhood Abuse and Intimate Partner Violence Victimization Among Filipina and South Asian Women in the United States. ACTA ACUST UNITED AC 2020; 1:2-10. [PMID: 33786467 PMCID: PMC7784723 DOI: 10.1089/whr.2019.0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Intimate partner violence (IPV) is a common form of interpersonal violence and impacts the health and well-being of victims over their lifetime. Many victims of IPV experience multiple types of victimization throughout their lives, often starting in childhood. The prevalence of IPV victimization of women varies among different race/ethnic groups. The purpose of this project is to examine childhood abuse among Filipina and South Asian women living in the United States who had experienced IPV. Methods: Data were extracted from Lifecourse Experiences of Intimate Partner Violence and Help-Seeking among Filipina, Indian, and Pakistani Women: Implications for Justice System Responses 2007-2009 (San Francisco, CA) (ICPSR 29682). Data were collected from 143 women (87 Filipina and 56 South Asian (i.e., Indian or Pakistani) aged between 18 and 60 years who had been a victim of IPV and lived in the United States. Results: Although both Filipina and South Asian women who had experienced IPV reported a high prevalence of childhood abuse, Filipina women reported a higher prevalence than South Asian women. South Asian women were more likely to have first experienced IPV at a younger age and sought some form of IPV services as compared with Filipina women. The factors associated with experiencing all the types of IPV victimization included younger age at the first physical IPV victimization experience and higher educational attainment. Conclusions: Future research should examine the cumulative victimization of childhood abuse and IPV among Asian populations and its impact on health.
Collapse
Affiliation(s)
- Akiko Kamimura
- Department of Sociology, University of Utah, Salt Lake City, Utah
| | - Maziar M Nourian
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Kimiya Nourian
- School of Medicine, University of Utah, Salt Lake City, Utah
| | | |
Collapse
|
17
|
Gartland D, Giallo R, Woolhouse H, Mensah F, Brown S. Intergenerational Impacts of Family Violence - Mothers and Children in a Large Prospective Pregnancy Cohort Study. EClinicalMedicine 2019; 15:51-61. [PMID: 31709414 PMCID: PMC6833344 DOI: 10.1016/j.eclinm.2019.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 07/18/2019] [Accepted: 08/13/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Violence and other adversities commonly co-occur, yet are usually investigated individually. The primary objectives of this paper are to investigate: (i) the relationship between maternal exposure to violence (including childhood abuse and intimate partner violence) and postpartum mental and physical health; and (ii) the extent to which exposure to violence and poor maternal mental and physical health are associated with children's emotional-behavioral difficulties. METHODS Prospective pregnancy cohort (n = 1507) followed up to 4 year postpartum. Validated measures used: Composite Abuse Scale; Edinburgh Postnatal Depression Scale, SF-36, Child Maltreatment History Self Report; Strengths and Difficulties Questionnaire. Logistic regression was used to investigate associations between maternal childhood abuse, intimate partner violence (IPV), maternal health and child emotional and behavioral difficulties at age 4. OUTCOMES Two out of five women (41%) reported abuse in childhood, and almost one in three (29%) reported IPV during the first four years of motherhood. Women reporting both physical and sexual childhood abuse had markedly raised odds of IPV and poor physical and mental health at all time points (pregnancy, first year postpartum and four year postpartum). For the index child, violence exposures (maternal childhood abuse or IPV) and poor maternal physical or mental health were associated with higher odds of emotional/behavioral difficulties at age four. In multivariable models (adjusted for child gender and maternal age), cumulative exposures (multiple violence exposures or poor maternal mental or physical health at multiple time points) each independently added to increased odds of emotional-behavioral difficulties. Children of mothers who reported a history of childhood abuse but were not exposed to IPV had odds of difficulties similar to children of mothers not reporting any violence exposure, suggesting resilient outcomes where violence experiences are not repeated in the next generation. INTERPRETATION The clustering of risk (child and adult violence experiences) and the accumulation of risk within families (IPV, poor maternal health, child difficulties) highlight the need for effective early intervention to limit or ameliorate the impact of violence across the lifespan, and to break the intergenerational cycle of disadvantage.
Collapse
Affiliation(s)
- D. Gartland
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
- Corresponding author at: Intergenerational Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Vic., Australia.
| | - R. Giallo
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - H. Woolhouse
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - F. Mensah
- Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - S.J. Brown
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
- Department of Paediatrics, Department of General Practice, The University of Melbourne, Melbourne, Vic., Australia
| |
Collapse
|
18
|
Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort. Infant Behav Dev 2019; 57:101336. [PMID: 31404801 DOI: 10.1016/j.infbeh.2019.101336] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 12/17/2022]
Abstract
Pregnancy and the early post partum period are widely understood as a critical period for the infant's emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offspring aged 12 months. The study used longitudinal data from a prospective cohort study on Australian pregnant women and their children. Data were available for 282 mothers and their children. Maternal depressive and anxiety symptoms were measured in early pregnancy, trimester three of pregnancy, six and 12 months postpartum. Social and emotional development in children was measured using the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 12 months. Using growth curve analysis of 4 waves of repeated measurement to examine intercept and slope, we found that both initial maternal depression and anxiety symptom levels, and the growth of these symptoms over time, predicted more problems with children's social and emotional development. In the final model anxiety accounted for 19% of the variance in child socio-emotional problems and depression 23% of variance. The results emphasise the importance of perinatal maternal mental health as a potential risk factor for child development. This carries important implications for policy development, such as the need to build early identification and early intervention models in to the current clinical practice for perinatal care, specifically, to develop targeted screening, assessment and interventions to address maternal mental health issues for at-risk parents during pregnancy, and continuing monitoring of young children whose mothers have experienced perinatal mental health difficulties.
Collapse
|
19
|
Chamberlain C, Gee G, Brown SJ, Atkinson J, Herrman H, Gartland D, Glover K, Clark Y, Campbell S, Mensah FK, Atkinson C, Brennan SE, McLachlan H, Hirvonen T, Dyall D, Ralph N, Hokke S, Nicholson J. Healing the Past by Nurturing the Future-co-designing perinatal strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma: framework and protocol for a community-based participatory action research study. BMJ Open 2019; 9:e028397. [PMID: 31189682 PMCID: PMC6575864 DOI: 10.1136/bmjopen-2018-028397] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Child maltreatment and other traumatic events can have serious long-term physical, social and emotional effects, including a cluster of distress symptoms recognised as 'complex trauma'. Aboriginal and Torres Strait Islander (Aboriginal) people are also affected by legacies of historical trauma and loss. Trauma responses may be triggered during the transition to parenting in the perinatal period. Conversely, becoming a parent offers a unique life-course opportunity for healing and prevention of intergenerational transmission of trauma. This paper outlines a conceptual framework and protocol for an Aboriginal-led, community-based participatory action research (action research) project which aims to co-design safe, acceptable and feasible perinatal awareness, recognition, assessment and support strategies for Aboriginal parents experiencing complex trauma. METHODS AND ANALYSIS This formative research project is being conducted in three Australian jurisdictions (Northern Territory, South Australia and Victoria) with key stakeholders from all national jurisdictions. Four action research cycles incorporate mixed methods research activities including evidence reviews, parent and service provider discussion groups, development and psychometric evaluation of a recognition and assessment process and drafting proposals for pilot, implementation and evaluation. Reflection and planning stages of four action research cycles will be undertaken in four key stakeholder workshops aligned with the first four Intervention Mapping steps to prepare programme plans. ETHICS AND DISSEMINATION Ethics and dissemination protocols are consistent with the National Health and Medical Research Council Indigenous Research Excellence criteria of engagement, benefit, transferability and capacity-building. A conceptual framework has been developed to promote the application of core values of safety, trustworthiness, empowerment, collaboration, culture, holism, compassion and reciprocity. These include related principles and accompanying reflective questions to guide research decisions.
Collapse
Affiliation(s)
- Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
- Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Graham Gee
- Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Stephanie Janne Brown
- Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | | | - Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Deirdre Gartland
- Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Karen Glover
- Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Yvonne Clark
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sandra Campbell
- Centre for Chronic Disease Prevention, James Cook University, Cairns, Queensland, Australia
- Centre for Indigenous Health Equity Research, Central Queensland University, Rockhampton, Queensland, Australia
| | - Fiona K Mensah
- Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | | | - Sue E Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Helen McLachlan
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Tanja Hirvonen
- Centre for Remote Health, Flinders University, Darwin, Northern Territory, Australia
| | - Danielle Dyall
- Aboriginal Medical Services Alliance Northern Territory, Darwin, Northern Territory, Australia
| | - Naomi Ralph
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Stacey Hokke
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Jan Nicholson
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
20
|
Gartland D, Riggs E, Muyeen S, Giallo R, Afifi TO, MacMillan H, Herrman H, Bulford E, Brown SJ. What factors are associated with resilient outcomes in children exposed to social adversity? A systematic review. BMJ Open 2019; 9:e024870. [PMID: 30975671 PMCID: PMC6500354 DOI: 10.1136/bmjopen-2018-024870] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Children exposed to social adversity-hardship as a result of social circumstances such as poverty or intergenerational trauma-are at increased risk of poor outcomes across the life course. Understanding what promotes resilient outcomes is essential for the development of evidence informed intervention strategies. We conducted a systematic review to identify how child resilience is measured and what factors are associated with resilient outcomes. DESIGN Systematic search conducted in CINAHL, MEDLINE and PsychInfo from January 2004 to October 2018 using the keywords 'resilien* and child* in the title or abstract. Eligible studies: (1) described children aged 5-12 years; (2) identified exposure to social adversity; (3) identified resilience; and (4) investigated factors associated with resilience. OUTCOME MEASURES (1) approaches to identifying resilience and (2) factors associated with resilient outcomes. RESULTS From 1979 studies retrieved, 30 studies met the inclusion criteria. Most studies were moderate to high quality, with low cultural competency. Social adversity exposures included poverty, parent loss, maltreatment and war. Only two studies used a measure of child resilience; neither was psychometrically validated. Remaining studies classified children as resilient if they showed positive outcomes (eg, mental health or academic achievement) despite adversity. A range of child, family, school and community factors were associated with resilient outcomes, with individual factors most commonly investigated. The best available evidence was for cognitive skills, emotion regulation, relationships with caregivers and academic engagement. CONCLUSIONS While there is huge variation in the type and severity of adversity that children experience, there is some evidence that specific individual, relational and school factors are associated with resilient outcomes across a range of contexts. Such factors provide an important starting point for effective public health interventions to promote resilience and to prevent or ameliorate the immediate and long-term impacts of social adversity on children.
Collapse
Affiliation(s)
- Deirdre Gartland
- Intergenerational Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of General Practice and Primary Health Care, University of Melbourne, Carlton, Victoria, Australia
| | - Sumaiya Muyeen
- Intergenerational Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Rebecca Giallo
- Intergenerational Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of General Practice and Primary Health Care, University of Melbourne, Carlton, Victoria, Australia
| | - Tracie O Afifi
- Department of Community Health Sciences and Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Harriet MacMillan
- Departments of Psychiatry and Behavioural Neurosciences, and of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Eleanor Bulford
- Intergenerational Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Stephanie J Brown
- Intergenerational Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Department of General Practice and Primary Health Care, University of Melbourne, Carlton, Victoria, Australia
| |
Collapse
|
21
|
The impact of childhood trauma and psychophysiological reactivity on at-risk women's adjustment to parenthood. Dev Psychopathol 2018; 31:127-141. [PMID: 30585566 DOI: 10.1017/s0954579418001591] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Adverse childhood experiences (ACEs) have an impact on women's adaptation to parenthood, but mechanisms are poorly understood. Autonomic nervous system reactivity was tested as a potential mediating mechanism in a sample of 193 at-risk primiparous women. ACEs were measured retrospectively during pregnancy. A baby cry-response task was administered during pregnancy while indicators of sympathetic reactivity (pre-ejection period; PEP) and parasympathetic reactivity (respiratory sinus arrhythmia; RSA) were recorded. Parenting self-efficacy, anxiety, and depressive symptoms were measured during pregnancy and 1 year after giving birth. Harsh discipline was measured 2 years after giving birth. Structural equation modeling was employed to test whether baseline PEP and RSA and reactivity mediated links between ACEs and postnatal outcomes, adjusted for prenatal variables. High ACEs predicted less RSA reactivity (p = .02), which subsequently predicted increases in depressive symptoms (p = .03). The indirect effect was not significant (p = .06). There was no indirect link between high ACEs and harsh parenting through PEP nor RSA (n = 98). The parasympathetic nervous system may be involved in negative affective responses in the transition to parenthood among women exposed to childhood trauma.
Collapse
|
22
|
Maternal violence experiences and risk of postpartum depression: A meta-analysis of cohort studies. Eur Psychiatry 2018; 55:90-101. [PMID: 30445371 DOI: 10.1016/j.eurpsy.2018.10.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/16/2018] [Accepted: 10/18/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Most of original studies indicated maternal violence experiences is associated with adverse obstetric outcomes, to date, but it is not clear that the association of maternal violence experiences and the risk of postpartum depression (PPD). We aimed to assess the association between maternal violence experiences and risk of developing PPD by performing a meta-analysis of cohort studies. METHODS PubMed, Google Scholar, Cochrane Libraries and Chinese databases were searched through December 2017 to identify studies that assessed the association between violence and PPD. Meta-analysis was conducted by the RevMan software and Stata software. Potential heterogeneity source was explored by subgroup analysis and potential publication bias was assessed by Begg's funnel plots and Egger's linear regression test. RESULTS Overall, women experiencing any violence events compared with the reference group were at a higher risk of developing PPD (odds ratio [OR] = 2.04; 95% confidence interval [CI]: 1.72-2.41). Additionally, different types of violence events such as sexual (OR = 1.56; 95%CI: 1.35-1.81), emotional (OR = 1.75; 95%CI: 1.61-1.89), and physical violence (OR = 1.90; 95%CI: 1.36-2.67), as well as domestic (OR = 2.05; 95%CI: 1.50-2.80) or childhood violence (OR = 1.59; 95%CI: 1.34-1.88) also increased the risk of developing PPD. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. CONCLUSIONS Maternal violence experiences are significantly associated with risk of developing PPD. These finding highlight the necessary to protect women from any types of violence and formulate preventive strategies to promote the maternal mental health.
Collapse
|
23
|
Dahlen HG, Munoz AM, Schmied V, Thornton C. The relationship between intimate partner violence reported at the first antenatal booking visit and obstetric and perinatal outcomes in an ethnically diverse group of Australian pregnant women: a population-based study over 10 years. BMJ Open 2018; 8:e019566. [PMID: 29695386 PMCID: PMC5922470 DOI: 10.1136/bmjopen-2017-019566] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/17/2018] [Accepted: 02/15/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Intimate partner violence (IPV) is a global health issue affecting mainly women and is known to escalate during pregnancy and impact negatively on obstetric and perinatal outcomes. The aim of this study is to determine the incidence of IPV in a pregnant multicultural population and to determine the relationship between IPV reported at booking interview and maternal and perinatal outcomes. DESIGN This is a retrospective population-based data study. We analysed routinely collected data (2006-2016) from the ObstetriX system on a cohort of pregnant women. SETTING AND PARTICIPANTS 33 542 women giving birth in a major health facility in Western Sydney. PRIMARY OUTCOMES Incidence of IPV, association with IPV and other psychosocial variables and maternal and perinatal outcomes. RESULT 4.3% of pregnant women reported a history of IPV when asked during the routine psychosocial assessment. Fifty-four per cent were not born in Australia, and this had increased significantly over the decade. Women born in New Zealand (7.2%) and Sudan (9.1%) were most likely to report IPV at the antenatal booking visit, with women from China and India least likely to report IPV. Women who reported IPV were more likely to report additional psychosocial concerns including Edinburgh Postnatal Depression Scale scores > 13 (7.6%), thoughts of self-harm (2.4%), childhood abuse (23.6%), and a history of anxiety and depression (34.2%). Women who reported IPV were more likely to be Australian born, smoke and be multiparous and to have been admitted for threatened preterm labour (Adjusted Odds Ratio (AOR) 1.8, 95% CI 1.28 to 2.39). CONCLUSIONS A report of IPV at the first antenatal booking visit is associated with a higher level of reporting on all psychosocial risks, higher antenatal admissions, especially for threatened preterm labour. More research is needed regarding the effectiveness of current IPV screening for women from other countries.
Collapse
Affiliation(s)
- Hannah Grace Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Ingham Institute, Liverpool, New South Wales, Australia
| | - Ana Maria Munoz
- Blacktown Mount Druitt Hospitals, Blacktown, New South Wales, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Charlene Thornton
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
24
|
Physical, sexual and social health factors associated with the trajectories of maternal depressive symptoms from pregnancy to 4 years postpartum. Soc Psychiatry Psychiatr Epidemiol 2017; 52:815-828. [PMID: 28451700 DOI: 10.1007/s00127-017-1387-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Few studies have examined the course of maternal depressive across pregnancy and early parenthood. The aim of this study was to identify the physical, sexual and social health factors associated with the trajectories of maternal depressive symptoms from pregnancy to 4 years postpartum. METHOD Data were drawn from 1102 women participating in the Maternal Health Study, a prospective pregnancy cohort study in Melbourne, Australia. Self-administered questionnaires were completed at baseline (<24 weeks gestation), and at 3-, 6-, 12-, and 18 months, and 4 years postpartum. RESULTS Latent class analysis modelling identified three distinct classes representing women who experienced minimal depressive symptoms (58.4%), subclinical symptoms (32.7%), and persistently high symptoms from pregnancy to 4 years postpartum (9.0%). Risk factors for subclinical and persistently high depressive symptoms were having migrated from a non-English speaking country, not being in paid employment during pregnancy, history of childhood physical abuse, history of depressive symptoms, partner relationship problems during pregnancy, exhaustion at 3 months postpartum, three or more sexual health problems at 3 months postpartum, and fear of a partner since birth at 6 months postpartum. CONCLUSIONS This study highlights the complexity of the relationships between emotional, physical, sexual and social health, and underscores the need for health professionals to ask women about their physical and sexual health, and consider the impact on their mental health throughout pregnancy and the early postpartum.
Collapse
|