Typologies of intimate partner violence-maternal parenting and children's externalizing problems: The moderating effect of the exposure to other forms of family violence

Prevalence and factors associated with depression and anxiety among young school-going adolescents in the Western Cape Province of South Africa

INTRODUCTION

Between 10 and 20% of children and adolescents globally experience common mental health conditions such as depression or anxiety. Given the dearth of mental health services in low- and middle-income countries, most mental health conditions among adolescents remain undiagnosed and untreated. In South Africa, few studies have explored the prevalence of depression and anxiety among young adolescents aged 10-14 years. This study examined the prevalence of, and factors associated with depression and anxiety among young school-going adolescents in the Western Cape Province of South Africa.

METHODS

A cross-sectional study was conducted in 10 schools in the Western Cape Province from February to July 2022. Data were collected using a tablet-based survey and included sociodemographic items, the Generalized Anxiety Disorder 7-item scale (GAD-7), the Patient Health Questionnaire for Adolescents (PHQ-A) and other psychosocial measures. The prevalence of depression and anxiety was estimated based on cut-off scores for the GAD-7 and PHQ-A. Multivariable logistic regression models were used to investigate the associations between sociodemographic and psychosocial factors, and depression and anxiety.

RESULTS

Of the 621 adolescents, 33.5% (n = 208) reported experiencing symptoms of depression and 20.9% (n = 130) symptoms of anxiety potentially indicative of a diagnosis. The results of the multivariable logistic regression model indicate that being in a higher grade in school (AOR = 1.65, CI:1.43-1.92), any lifetime alcohol use (AOR = 1.62, CI:1.04-2.64), other drug use (AOR = 2.07, CI:1.06-4.04), and witnessing violence among adults at home (AOR = 2.12, CI:1.07-1.41) were significantly associated with experiencing depressive symptoms. Being in a higher grade in school (AOR = 1.69, CI: 1.42-2.01), poor emotional regulation skills (AOR = 1.03, CI: 1.00-1.07), and the use of cannabis (AOR = 1.03, CI: 1.00-1.07) were significantly associated with experiencing anxiety symptoms.

CONCLUSION

These findings add to our understanding of school-going adolescents' pressing mental health needs and suggest that mental health adolescent and caregiver interventions may be required to address mental health symptoms and associated risk factors.

Mother-child reporting discrepancies of child physical abuse: Associations with internalizing and externalizing symptoms

BACKGROUND

Mother-child discrepancies frequently occur in reports of child physical abuse. Such report discrepancies raise important challenges for interpreting and integrating data from multiple informants in forensic and clinical settings.

OBJECTIVES

The main goal of this study was to identify patterns of mother-child discrepancies in reporting CPA using latent profile analysis. We then tested differences between profiles on mothers' mental health problems and children's internalizing and externalizing symptoms.

PARTICIPANTS AND SETTING

Participants were 159 mother-child dyads with police-documented exposure to intimate partner violence.

METHOD

Participants were recruited from Child Protective Services and shelter residences from all regions of Portugal. After obtaining informed consent, assessment protocols were administered separately to mothers and children.

RESULTS

We identified two convergent profiles (mother-child agreement on reports of both high and low exposure to CPA) and one divergent profile (the child reported significantly higher exposure to CPA than the mother). Mothers from the divergent profile reported more depressive and post-traumatic stress symptoms than mothers from the convergent profiles. Children of the divergent profile and one of the convergent profiles (mother-child agreement on high exposure to CPA) showed the highest internalizing and externalizing symptoms.

CONCLUSIONS

These results illustrate how examining informant discrepancies in the assessment of abusive parenting practices increases our understanding of children's psychological adjustment in high-risk contexts.

Discrepancies in Mother-Child Reports of Child's Exposure to Intimate Partner Violence: Associations With Externalizing Symptoms

The type and frequency of children's exposure to intimate partner violence (IPV) are considered as key variables in understanding children's heightened risk of externalizing symptoms. Notably, children's exposure to IPV has been primarily measured using mothers' reports of their own victimization. However, mothers and children might differently perceive children's exposure to physical IPV. To date, no research has investigated multi-rater reporting discrepancies in child's exposure to physical IPV and whether such discrepancies would be linked to externalizing symptoms. This study aimed to identify patterns of mother-child discrepancies in child's exposure to physical IPV and examine whether those patterns would be associated with children's externalizing symptoms. Participants were mothers who have experienced police-reported male-perpetrated IPV and their children (n = 153; 4-10 years). Latent profile analysis identified three profiles of mother-child discrepancies: a concordant group reporting high IPV exposure; a discordant group with mothers and children reporting high and low child's IPV exposure, respectively; a second discordant group with mothers and children reporting low and moderate IPV exposure, respectively. Profiles of mother-child discrepancies were differentially associated with children's externalizing symptoms. Findings suggest that discrepancies among informants' ratings of children's IPV exposure might have important implications for measurement, assessment, and treatment.

The influence of maternal reflective functioning and parenting behavior on infant development in the context of perinatal intimate partner violence: a study protocol

BACKGROUND

Intimate partner violence (IPV) affects 25% of children under the age of five worldwide, yet the impact of perinatal IPV and its underlying mechanisms on infant development remains poorly understood. IPV indirectly affects infant development through the mother's parenting behavior, but research on maternal neuro and cognitive processes, such as parental reflective functioning (PRF), is scarce, despite its potential as an unfolding mechanism. The objective of our study, Peri_IPV, is to examine the direct and indirect pathways linking perinatal IPV and infant development. We will analyze the direct impact of perinatal IPV on mothers' neuro and cognitive parental reflective functioning (PRF) and parenting behavior during the postpartum period, the direct impact of perinatal IPV on infant development, and whether maternal PRF mediates the link between perinatal IPV and parenting behavior. We will also explore the mediation role of parenting behavior in the association between perinatal IPV and infant development and whether the impact of perinatal IPV on infant development occurs through the links between maternal PRF and parenting behavior. Finally, we will examine the moderation role of mother's adult attachment in the impact of perinatal IPV on maternal neuro and cognitive PRF and parenting behavior during the postpartum period, as well as on infant development.

METHODS

Our study will use a multi-method, prospective design to capture different levels of PRF, parenting behavior, and infant development. Three-hundred and forty pregnant women will participate in a 4-wave longitudinal study from the 3rd trimester of pregnancy to 12 months postpartum. In the 3rd trimester and 2 months postpartum, women will report on their sociodemographic and obstetric characteristics. In all assessment waves, mothers will complete self-reported measures of IPV, cognitive PRF, and adult attachment. At 2 months postpartum, women's neuro PRF will be monitored, and at 5 months postpartum, their parenting behavior will be assessed. The infant-mother attachment will be assessed at 12 months postpartum.

DISCUSSION

Our study's innovative focus on maternal neuro and cognitive processes and their impact on infant development will inform evidence-based early intervention and clinical practices for vulnerable infants exposed to IPV.

Interventions Focused by Nurses for Reducing Negative Effect of Traumatic Experience on Victims of Sexual Violence: A Scoping Review

Sexual violence has increased quite rapidly. Sexual violence can be in the form of physical or verbal violence. The impact of sexual violence causes a traumatic experience that causes physical problems, psychological problems, loss of the future, and causes the risk of death. Nurses have an important role in reducing the impact of sexual violence on victims. The purpose of this study is to describe nursing interventions to reduce the impact of traumatic experiences experienced by victims of sexual violence. This study used a scoping review method. The literature used in this study is from CINAHL, PubMed, and Scopus. Keywords in this study are sexual violence, traumatic experience, impact, and victims. Search strategy used PRISMA Extension for Scoping Reviews to select articles for this study. The inclusion criteria were that the sample was female victims of sexual violence, studies employed a randomized control trial or quasi-experimental research design, and the publication period was of the last 10 years (2013-2022). We found 10 articles that matched the inclusion and exclusion criteria. The findings from this scoping review show that nursing interventions can reduce the impact of traumatic experiences on victims of sexual violence. There are three methods of nursing intervention, namely cognitive behavior, counseling, and web-based intervention. The samples are from developing and developed countries. The range of the samples are from 35-1250 respondents. Nursing interventions focus on victims in order to improve mental health and reduce the traumatic impact experienced by victims of sexual violence. The activities carried out were psychoeducation, keeping a daily journal, and discussions related to the traumatic experiences experienced. Nurses as health workers have a role to provide comprehensive nursing care to victims of sexual violence by taking into account the characteristics and impact of trauma experienced by victims of sexual violence.

Effect of Attachment and Child Health (ATTACHTM) Parenting Program on Parent-Infant Attachment, Parental Reflective Function, and Parental Depression

High-risk families exposed to toxic stressors such as family violence, depression, addiction, and poverty, have shown greater difficulty in parenting young children. In this study, we examined the effectiveness of ATTACHTM, a 10−12 session manualized one-on-one parental Reflective Function (RF)-based parenting program designed for high-risk families. Outcomes of parent-child attachment and parental RF were assessed via the Strange Situation Procedure (SSP) and Reflective Function Scale (RFS), respectively. The protective role of ATTACHTM on parental depression was also assessed. Data were available from caregivers and their children < 6 years of age who participated in five pilot randomized control trials (RCTs) and quasi-experimental studies (QES; n = 40). Compared with the control group, caregivers who received the ATTACHTM-program demonstrated a greater likelihood of secure attachment with their children (p = 0.004) and higher parental RF [self (p = 0.004), child (p = 0.001), overall (p = 0.002)] in RCTs. A significant improvement in parental RF (p = 0.000) was also observed in the QES within ATTACHTM group analysis. As attachment security increased, receiving the ATTACHTM program may be protective for depressed caregivers. Results demonstrated the promise of ATTACHTM for high-risk parents and their young children.

Household Chaos Moderates Indirect Pathways Involving Domestic Violence, Parenting Practices, and Behavior Problems among Preschool Children

PURPOSE

This study examined the moderating role of household chaos in indirect pathways involving domestic violence (DV), parenting practices (punitive discipline and responsive), and preschool children's internalizing and externalizing symptoms. We hypothesized that high levels of household chaos would amplify links between domestic violence and parenting difficulties, and that parenting difficulties would in turn predict child behavior problems.

METHOD

Participants in this multimethod (survey, semi-structured interview, child protection records) study included 274 preschool children (M _age = 50.86 months) and their primary caregivers who were assessed in the home at two time-points spaced 6 months apart. Child welfare documentation of moderate-severe maltreatment within the last 6 months was present for 52% of children, 44% were in households characterized by DV, and most families qualified for public assistance. Hypotheses were tested using path analysis with manifest variables within a structural equation modeling framework.

RESULTS

All models provided excellent fit to the data. DV was associated with punitive discipline practices only when household chaos was high. Punitive discipline practices in turn predicted greater child externalizing symptoms 6 months later. Follow-up analyses revealed that the moderating role of chaos was specific to DV, rather than general to other forms of adversity (child maltreatment, lifetime contextual stressors, traumatic events). This interaction between DV and chaos was salient even when controlling for exposure to other adversities and demographic covariates.

CONCLUSIONS

Results point to multiple potential targets of intervention that may ultimately buffer children from the risk posed by experiencing DV in the home.

Intimate partner violence indirectly dysregulates child diurnal adrenocortical functioning through positive parenting

Data were drawn from an ongoing study of preschoolers (N = 221). Mothers self-reported experiences of intimate partner violence (IPV) and parenting practices, and collected three saliva samples (waking, midday, and bedtime) on themselves and their child on 2 consecutive days. Saliva samples were later assayed for cortisol. Bootstrapped mediation analyses revealed IPV to indirectly impact child diurnal cortisol through positive parenting. Specifically, greater exposure to IPV was associated with reduced positive parenting and subsequently heightened child waking cortisol levels. IPV did not indirectly impact child diurnal cortisol via autonomy supporting parenting or maternal diurnal cortisol. These findings suggest a possible pathway by which mother's experience of IPV indirectly influences child physiological regulation via maternal positive parenting.

Intimate partner violence indirectly dysregulates child diurnal adrenocortical functioning through positive parenting

Data were drawn from an ongoing study of preschoolers (N = 221). Mothers self-reported experiences of intimate partner violence (IPV) and parenting practices, and collected three saliva samples (waking, midday, and bedtime) on themselves and their child on two consecutive days. Saliva samples were later assayed for cortisol. Bootstrapped mediation analyses revealed IPV to indirectly impact child diurnal cortisol through positive parenting. Specifically, greater exposure to IPV was associated with reduced positive parenting and subsequently heightened child waking cortisol levels. IPV did not indirectly impact child diurnal cortisol via autonomy supporting parenting or maternal diurnal cortisol. These findings suggest a possible pathway by which mother's experience of IPV indirectly influences child physiological regulation via maternal positive parenting.