Family support and mental health in pregnant women experiencing interpersonal partner violence: an analysis of ethnic differences

Characteristics of the Family Support Network of Pregnant Adolescents and Its Association with Gestational Weight Gain and Birth Weight of Newborns

It has been proposed that, in the Mexican culture, family support can be a factor that contributes to protect the maternal and child health of pregnant adolescents. There may be complex associations between family support and the circumstances of a pregnancy during adolescence. The aim of the study was to analyze the association between the family support network (FSN) characteristic and the maternal and neonatal outcomes in Mexican adolescents. A cross-sectional study was conducted, and 352 pregnant adolescents participated; their FSN during pregnancy was assessed. The gestational weight gain and birth weight/length of newborns were registered. The size of the FSN was described and divided into quartiles; the main members for each quartile were identified. Then, sociodemographic and clinical variables were compared by FSN quartiles. Logistic regression models were performed to assess the association of FSN size and pregnancy and neonatal outcomes. Our results indicate that the mean age was 15 ± 1 year old. The primary support member in the FSN was the mother of the adolescent in each quartile, except for quartile 3, where the primary support was the mother-in-law. In quartile 3 there was a significantly lower gestational weight gain compared to quartile 4 (11.8 ± 5 vs. 13 ± 5 kg, p = 0.054). According to the regression model, a higher risk of small for gestational age (OR 2.99, CI 95% 1.25⁻7.15) newborns was found in quartile 3. We conclude that the maternal and neonatal outcomes did not differ between quartiles of FSN size, except for quartile 3. Small for gestational age newborns were observed when a non-blood relative was present in the FSN. The quality rather than the network size might be more important for improving pregnancy outcomes.

Coercive Control and the Stay-Leave Decision: The Role of Latent Tactics Among a Sample of Abused Pregnant Women

Prior research on intimate partner violence (IPV) and a survivor's decision whether to remain in or leave a violent relationship has often been framed by the question "why do they stay?" This study looks reframe the discussion and examine one facet of this stay-leave decision: abusers' use of coercive control tactics. Using a qualitative approach with a sample of pregnant women exposed to IPV, we sought to expand on the current knowledge by looking at coercive control more broadly via an open-ended assessment. Interview responses show that (a) coercive control was experienced by most of the women in this sample and (b) coercion most often took the form of "latent" or hidden control, including such tactics as providing incentives, showing remorse, and making promises. However, such latent coercive tactics are rarely assessed in IPV survivors and represent an important factor deserving of further research and recognition.

Racial/ethnic differences moderate associations of coping strategies and posttraumatic stress disorder symptom clusters among women experiencing partner violence: a multigroup path analysis

BACKGROUND

Past research underscores the key role of coping strategies in the development, maintenance, and exacerbation of posttraumatic stress disorder (PTSD) symptoms. The goal of the current study was to extend existing literature by examining whether race/ethnicity moderates the relations among coping strategies (social support, problem-solving, avoidance) and PTSD symptom clusters (intrusion, avoidance, numbing, arousal).

METHODS

Participants were 369 community women (134 African Americans, 131 Latinas, 104 Whites) who reported bidirectional aggression with a current male partner. Multigroup path analysis was utilized to test the moderating role of race/ethnicity in a model linking coping strategies to PTSD symptom clusters.

RESULTS

The strength and direction of relations among coping strategies and PTSD symptom clusters varied as a function of race/ethnicity. Greater social support coping was related to more arousal symptoms for Latinas and Whites. Greater problem-solving coping was related to fewer arousal symptoms for Latinas. Greater avoidance coping was related to more symptoms across many of the PTSD clusters for African Americans, Latinas, and Whites, however, these relations were strongest for African Americans.

CONCLUSION

Results provide support for the moderating role of race/ethnicity in the relations among coping strategies and PTSD symptom clusters, and highlight potential targets for culturally informed PTSD treatments.

What do Australian Women Experiencing Intimate Partner Abuse Want From Family and Friends?

We analyzed the views of a diverse sample of women (N = 254) living in the state of Victoria, Australia, who were experiencing fear of an intimate partner. We explored the women's views about their interactions with their family and friends to examine what women who have experienced fear of a partner or ex-partner want from their family and friends. The themes identified provide potentially useful guidance for what might be helpful and unhelpful communication strategies and behaviors for families and friends. Women experiencing intimate partner abuse find informal support invaluable, provided it is delivered in a helpful fashion. Helpful support is affirming, encouraging, validating, and understanding, and delivered with positive regard, empathy, and respect. Social contact and interaction are particularly appreciated, as is instrumental support such as financial help, housing, and child care. Women value both support that is directly related to abuse and support related to other areas of life.

Pregnant women experiencing IPV: impact of supportive and non-supportive relationships with their mothers and other supportive adults on perinatal depression: a mixed methods analysis

The current study explored the views of women experiencing interpersonal violence (IPV) and their relationship with their mothers or other supportive adult, and determines how this relationship affected perinatal depressive symptoms. The sample consisted of 30 urban and rural pregnant women enrolled in a larger ongoing randomized controlled trial. Data from quantitative instruments that measured depressive symptoms were examined in combination with qualitative interview data collected at baseline and six months post-natal. Women describing positive relationships with their mothers or another supportive adult reported statistically significant lower depressive symptoms scores (p < .05).

Co-occurring intimate partner violence and mental health diagnoses in perinatal women

OBJECTIVES

To describe the co-occurrence of intimate partner violence (IPV) and mental health burden among perinatal mothers attending well-baby visits with their infants in the first year of life. We compare rates of depression, anxiety disorder, and substance abuse diagnoses between mothers who reported IPV within the past year to those who did not.

METHODS

This cross-sectional study of 188 mothers of infants (under 14 months) was conducted in an urban hospital pediatric clinic. Participants reported demographics and IPV and completed a semistructured psychiatric diagnostic interview.

RESULTS

Mothers reporting IPV were more likely to be diagnosed with mood and/or anxiety diagnoses (p<0.05, Fisher's exact test), specifically current depressive diagnoses (p<0.01, Fisher's exact test) and panic disorder (p<0.05, Fisher's exact test). There was a trend for more posttraumatic stress disorder (PTSD) (p<0.06) among abused mothers. Substance abuse and dependence, age, race, insurance status, employment, education, and family arrangements did not differ between groups. Prior major or minor depression increases the odds for perinatal depression threefold (OD 3.18).

CONCLUSION

These findings have implications for practitioners who encounter perinatal women. Findings suggest providers should explore signs and symptoms of depression and anxiety disorders among women reporting IPV. Similarly, when perinatal mothers report symptoms of depression, PTSD, or panic disorder, practitioners should be alert to the possible contributory role of IPV.

Intimate Partner Violence and Posttraumatic Stress Disorder Among High-Risk Women: Does Pregnancy Matter?

Interviews from 655 women participating in the Chicago Women’s Health Risk Study (CWHRS) were used to assess prevalence and factors associated with intimate partner violence (IPV) and posttraumatic stress disorder (PTSD). Black women had the highest rate of IPV overall and among pregnant women, and had decreased odds of PTSD compared to Black nonpregnant women. Hispanic pregnant women, however, had decreased odds of IPV and PTSD compared to Hispanic nonpregnant women. Disparities in IPV by race/ ethnicity and pregnancy status complicate the study of IPV and PTSD and have implications for the public health community.

Impact of intimate partner violence on pregnant women's mental health: mental distress and mental strength

The mental health consequences of living with intimate partner violence (IPV) are substantial. Despite the growing awareness of the incidence of depression and PTSD in women experiencing IPV, few studies have examined prospectively the experience of IPV during pregnancy and the impact of the abuse on women's mental health. As a component of a larger clinical trial of an intervention for pregnant abused women, 27 women participated in a qualitative study of their responses to the abuse in the context of pregnancy and parenting. Results indicate that women's changing perceptions of self was related to mental distress, mental health, or both mental distress and mental health.

Pathways linking intimate partner violence and posttraumatic disorder

Intimate partner violence (IPV), which includes physical violence, sexual violence, and psychological or emotional abuse, is a significant public health threat. The Centers for Disease Control and Prevention (CDC) estimate that each year 1.5 million women are physically assaulted and/or raped by an intimate partner. However, because many victims of IPV are repeatedly abused, a more accurate accounting of the extent of violence suggests that approximately 4.8 million intimate partner physical assaults and rapes are perpetrated annually against women in the United States. The article discusses a survey involving 3,429 English-speaking women enrolled in a health maintenance organization (HMO) for 3 or more years. The findings are 46% of participants who were screened reported a lifetime history of any IPV and 14.7% reported a history within the past 5 years, including physical, sexual, and nonphysical types.

An examination of the perceived social support levels of women in methadone maintenance treatment programs who experience various forms of intimate partner violence

BACKGROUND

Intimate partner violence (IPV) has emerged as a serious problem among women in drug treatment programs. Research has underscored the importance of social support for abused women as well as women who use substances.

OBJECTIVES

The main objectives of this study were to describe the perceived social support levels and examine the associations between various forms of IPV and perceived levels of available social support perceived levels among a sample of women in drug treatment programs.

METHODS

Face-to-face, structured interviews were conducted with randomly selected 416 women on methadone.

RESULTS

The prevalence of physical, sexual, and injurious IPV in the sample was 39%, 31%, and 16% respectively, and the combined IPV prevalence was 44.5%. Findings from multiple linear regression models revealed that lower levels of perceived social support were significantly associated with physical aggression (beta = -4.71; p = .0001), sexual assaults (beta = -4.10; p = .003), and injurious attacks (beta = -4.03; p = .022). Respondents perceived highest levels of social support from their "significant others" (mean = 5.64; standard deviation [SD] = 1.27) and lowest levels of social support from friends (mean = 4.20; SD = 1.48). The average network size was 2.7 individuals.

IMPLICATIONS

Findings from this study highlighted significantly lower levels of perceived social support levels for drug-using women in the context of IPV experiences. Interventions with these women should focus on strengthening social support networks that enable help seeking for both IPV and substance abuse issues.

Variations in Parenting Stress in African-American Battered Women

The negative consequences of children's exposure to intimate partner violence (IPV) have been well documented; however, less is known about the effects of contextual factors such as parenting stress, parenting behaviors, and mothers' psychological functioning on exposed children. A total of 172 African-American mothers and their children (4 to 12 years of age) were recruited from battered women's shelters for the present study. Mothers filled out questionnaires assessing family violence, family contextual variables, and children's outcomes, and children reported on their own depressive symptoms. Results from a cluster analysis indicated substantial variability in women's experiences of parenting stress with regard to both type and quantity. Across each of the six clusters, women significantly differed in parenting behaviors and general psychological distress, and their children varied concomitantly in severity of internalizing and externalizing problems. These patterns suggest the need for individualized interventions, with a particular focus on parenting stress, to better serve the needs of women and children experiencing IPV.

The future of research on intimate partner violence: person-oriented and variable-oriented perspectives

This article uses the distinction between the person and the variable orientations as a frame for structuring (1) research on IPV, (2) results of this research, and (3) an agenda for future research. The main tenet of this agenda is that causes, processes, and effects of IPV are person and context specific; therefore, results that relate variables to each other are of limited value if it can be shown that the processes that take place, the meaning of the variables, the profile of the transgressors and the women who experience IPV depend on time, environment, and research design. Examples of valuable variable-oriented research are given; examples of the growing contribution made by person-oriented research are given as well. Sample theories are sketched out, for the variable-oriented, the person-oriented, and the theoretical research arenas, the need for future research is derived from inconsistencies and shortcomings in both current research and theory. Sample research questions are proposed. The contributions made by the authors of this Special Section are embedded within the discussion of research and theory of IPV. It is shown that each of the contributions is valuable within a particular segment of the research landscape.