The impact of childhood sexual abuse and other forms of childhood adversity on adulthood parenting

A Scoping Study of Parents With a History of Childhood Sexual Abuse and a Theoretical Framework for Future Research

Transitioning to a parenting role is a complex psychological process that can be stressful for a parent with a history of childhood sexual abuse (CSA). Over the past decade, important advances have been made in identifying the effects of childhood trauma on parents' relationships with their children. This article presents a new theoretical framework that emerged from a scoping study of parenting experiences among adults who experienced CSA. The methods of Arksey and O'Malley were used to conduct the scoping study, and the guidelines for theory construction and model building developed by Jaccard and Jacoby were adopted. Only peer-reviewed published journal articles in English that studied exclusively CSA and its effects on parenting among individuals aged 18 years or older were included. Three resources for collecting data were used: (1) internet databases including PsycINFO and PubMed, (2) reference lists of review articles, and (3) the citation index functionality of Google Scholar for review articles. Forty-six articles were included in the scoping study. These studies mainly focused on mothers and their relationships with their children. No articles considered the age(s) at which parents experienced CSA and potential effects on parenting outcomes. In addition, there is limited knowledge about fathers with a history of CSA and their relationship with their children. The development of a theoretical framework designed through a methodologically driven identification of gaps in the body of knowledge provides a foundation for future research in this area.

Association between childhood trauma, intimate partner violence, and perceived parental competence among women abusing amphetamine-type stimulant

INTRODUCTION

This cross-sectional study examines the correlation between childhood trauma, intimate partner violence (IPV), and parenting self-efficacy among women who reported using amphetamine-type stimulants (ATS) in an institutional drug rehabilitation center.

METHODS

A total of 106 participants were recruited by purposive sampling, of which 88 were mothers. Questionnaires were used to collect sociodemographic data and study variables.

RESULTS

Most of these women had experienced emotional abuse, sexual abuse, and physical neglect in their childhood. IPV assessments revealed that 70.5% (n = 74) and 30.5% (n = 32) had experienced physical and sexual violence, respectively. In terms of parenting competency, they scored 79.5% for self-efficacy and 54.4% for parenting satisfaction. Childhood emotional abuse significantly increases the odds of individuals experiencing sexual violence by 20.9%.

DISCUSSION

We found that childhood trauma and IPV did not have a significant relationship with parenting efficacy. Conversely, childhood emotional abuse and physical abuse were negatively correlated to parenting satisfaction. It is imperative that any form of childhood abuse be recognized and stopped early to reduce the harm it brings to women later in life.

Correlates and Predictors of Mothers' Adaptation and Trauma Symptoms Following the Unveiling of the Sexual Abuse of Their Child

Child sexual abuse (CSA) can severely affect the mental health of children and their parents. While correlates of recovery have been documented in children, factors exacerbating parents' adaptation to their child's unveiling of CSA deserves further attention. Parents' history of abuse has been inconsistently identified as a predictor of their distress in reaction to their child's abuse disclosure. This study proposes a mediation model that explores various processes underlying mother's psychological distress (posttraumatic stress disorder [PTSD], dissociation, and their comorbidity) following their children's unveiling of CSA. It investigates the influence of mother's own CSA, as well as of her exposure to additional forms of past and current victimization, on her reaction to the child's CSA disclosure, while considering coping mechanisms as mediators (avoidance, problem solving, search for social support, and feeling of guilt). Data were collected through self-report measures completed by 298 mothers of children who had recently disclosed CSA. Path analyses revealed that mother's exposure to interparental violence as a child acted as a primary predictor of dissociation and of its comorbidity with PTSD, while a history of CSA was directly and exclusively linked to dissociation. Being exposed to recent partner violence was indirectly related to trauma symptoms, with coping mechanisms acting as mediators. This study outlines the relationship between mother's psychological distress and her cumulative, past, and current exposure to various forms of victimization. Exposure to interparental violence as a child represents a particularly important factor for identifying mothers most in need of support, as it is a significant predictor of dissociation and of its comorbidity with PTSD.

Couple and parenting functioning of childhood sexual abuse survivors: a systematic review of the literature (2001-2018)

In this review, 55 unique empirical studies of the impacts of a history of CSA on couple and parenting functioning were identified and analyzed according to assumptions considered in an earlier review. Overall, this current systematic review supported earlier assumptions that CSA survivors would evidence insecure attachments in their adult couple relationships; that CSA survivors would be less likely to marry and more likely to divorce; and that partners would also experience difficulties in relation to their partnership with a CSA survivor. Assumptions about parenting functioning included: that CSA survivors would have different attitudes toward their children; that CSA survivors would function poorly as parents; and that children of CSA survivors would be at increased risk for sexual abuse. Evolutions in the literature since that first review included methodological improvements, as well as the inclusion of male survivors in some studies. More sophisticated statistical modeling allowed for a greater understanding of mediators and moderators in the relationship between CSA and later interpersonal functioning in couple relationships and in parenting. Recommendations for future research and clinical implications were proposed.

Transmission of Intergenerational Parenting Attitudes and Natural Mentorship: Associations Within the LONGSCAN population

BACKGROUND

Evidence suggests that families transmit child maltreatment and parenting attitudes. Natural mentorship may mediate intergenerational parenting attitudes' risk for maltreatment but has not been studied.

OBJECTIVE

To compare parenting attitudes between adolescents exposed to or at risk for maltreatment and their caregivers and to determine if natural mentorship mediates differences in parenting attitudes' maltreatment risk.

PARTICIPANTS AND SETTING

The study included 779 children and their caregivers from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) study, METHODS: Standardized measures assessed parenting attitudes, natural mentorship and demographic characteristics. Repeated measures, multivariable logistic regressions were used to predict low risk parenting attitudes for maltreatment among adolescents with and without natural mentors.

RESULTS

In adjusted analysis, natural mentorship did not predict an adolescent having low risk parenting attitudes when their caregivers had moderate or high risk attitudes: appropriate empathy adjusted odds ratio [aOR] = 1.26; 95% confidence interval [CI] 0.52 -3.01; appropriate expectations aOR = 1.35; CI 0.62-2.93; physical punishment rejection aOR = 1.74; CI 0.78-3.88; and appropriate roles aOR = 1.11; CI 0.57-2.18. Low risk caregiver parenting attitudes for appropriate empathy related to adolescents having low risk empathy attitudes (aOR = 2.89; CI 1.31-6.37). Male gender, African American race and Hispanic ethnicity were negatively associated with an adolescent having low risk parenting attitudes for maltreatment.

CONCLUSIONS

Natural mentorship did not mediate adolescent parenting attitudes. While prevention and intervention strategies should include natural mentoring given positive health impacts, services must be cognizant of and designed for gender, racial and ethnic diversity.

Intergenerational effects of childhood maltreatment: A systematic review of the parenting practices of adult survivors of childhood abuse, neglect, and violence

A history of maltreatment in childhood may influence adults' parenting practices, potentially affecting their children. This systematic review examines 97 studies investigating associations of parental childhood victimization with a range of parenting behaviors that may contribute to the intergenerational effects of abuse: abusive parenting, problematic parenting, positive parenting, and positive parental affect. Key findings include: (1) parents who report experiencing physical abuse or witnessing violence in the home during childhood are at increased risk for reporting that they engage in abusive or neglectful parenting; (2) a cumulative effect of maltreatment experiences, such that adults who report experiencing multiple types or repeated instances of victimization are at greatest risk for perpetrating child abuse; (3) associations between reported childhood maltreatment experiences and parents' problematic role reversal with, rejection of, and withdrawal from their children; (4) indirect effects between reported childhood maltreatment and abusive parenting via adult intimate partner violence; and (5) indirect effects between reported childhood maltreatment and lower levels of positive parenting behaviors and affect via mothers' mental health. Thus, childhood experiences of maltreatment may alter parents' ability to avoid negative and utilize positive parenting practices. Limitations of this body of literature include few prospective studies, an overreliance on adults' self-report of their childhood victimization and current parenting, and little examination of potentially differential associations for mothers and fathers.

Parenting stress and its correlates in an infant mental health unit: a cross-sectional study

Background: An infant's development is closely linked to the relationship they have with their parents. Parenting stress, affective disorder, and an upbringing with substance-abusing parents can affect parenting quality and increase the risk of children developing behavioral, mental and social problems. The overall aim of the study was to investigate how parents of children attending an outpatient Infant Mental Health (IMH) unit rate their own psychological health and parenting stress, and to explore predictors of parenting stress.Methods: The sample comprised 197 parents, 129 mothers and 68 fathers, referred with their infant/toddler to an outpatient IMH unit for interplay treatment. On admission, the parents completed self-report questionnaires concerning their own mental health problems and parenting stress.Results: The mothers reported significantly more psychiatric symptoms and parenting stress than the fathers. Fathers with substance-abusing parents had often experienced divorce in the family of origin, had a low level of education, and had often experienced trauma. Depression was a predictor for parenting stress for both mothers and fathers.Conclusion: The parents' situation was strained, presenting a variety of psychiatric symptoms and high levels of parenting stress, making assessment of parental health before starting treatment important. The mothers' situations were more serious compared with the fathers', and for both parents depression was a significant predictor for parenting stress. To increase the chances of a positive treatment outcome for the child, both parents should be included in the treatment.

Parenting in the context of historical childhood trauma: An interpretive meta-synthesis

BACKGROUND

Parents with childhood trauma histories are more likely to experience difficulties with child-rearing. The literature often pathologizes the parenting behaviours of parents with abuse histories, meaning strengths sometimes are neglected OBJECTIVE: This article presents a meta-synthesis of qualitative studies into the parenting experiences of survivors of childhood abuse. This analysis was undertaken to develop awareness of the experiences of this population, with the hope findings would be of use to policy-makers and professionals supporting parents and their children.

METHOD

Following a systematic search and process of quality appraisal, 11 papers were subjected to an interpretive meta-synthesis, utilising a meta-ethnographic method.

RESULTS

Three themes were generated. Forming a Parental Identity Through the Lens of Trauma related to how parents and authors of the primary studies tended to interpret all parenting experiences, especially challenges, in terms of the effects of childhood abuse. Protecting Against Cycles of Abuse related to many parents fearing they would be unable to protect children from harm. The Need for Safe Support was concerned with how parents often felt they needed support but experienced this as unsafe.

CONCLUSIONS

Results pointed to how ambivalence towards professional input should typically be regarded as understandable in the context of lived-experience of abused parents. Professionals should seek to avoid pathologizing parental difficulties and support parents by normalising and making sense of difficult emotional reactions in order to support engagement and promote containing parent-child interactions. Trauma-informed approaches to therapy could usefully be employed by services and agencies working with parents to support children.

Testing the cycle of maltreatment hypothesis: Meta-analytic evidence of the intergenerational transmission of child maltreatment

It has long been claimed that "maltreatment begets maltreatment," that is, a parent's history of maltreatment increases the risk that his or her child will also suffer maltreatment. However, significant methodological concerns have been raised regarding evidence supporting this assertion, with some arguing that the association weakens in samples with higher methodological rigor. In the current study, the intergenerational transmission of maltreatment hypothesis is examined in 142 studies (149 samples; 227,918 dyads) that underwent a methodological quality review, as well as data extraction on a number of potential moderator variables. Results reveal a modest association of intergenerational maltreatment (k = 80; d = 0.45, 95% confidence interval; CI [0.37, 0.54]). Support for the intergenerational transmission of specific maltreatment types was also observed (neglect: k = 13, d = 0.24, 95% CI [0.11, 0.37]; physical abuse: k = 61, d = 0.41, 95% CI [0.33, 0.49]; emotional abuse: k = 18, d = 0.57, 95% CI [0.43, 0.71]; sexual abuse: k = 18, d = 0.39, 95% CI [0.24, 0.55]). Methodological quality only emerged as a significant moderator of the intergenerational transmission of physical abuse, with a weakening of effect sizes as methodological rigor increased. Evidence from this meta-analysis confirms the cycle of maltreatment hypothesis, although effect sizes were modest. Future research should focus on deepening understanding of mechanisms of transmission, as well as identifying protective factors that can effectively break the cycle of maltreatment.

Maternal and Child Sexual Abuse History: An Intergenerational Exploration of Children's Adjustment and Maternal Trauma-Reflective Functioning

Objective: The aim of the current study was to investigate associations, unique and interactive, between mothers’ and children’s histories of childhood sexual abuse (CSA) and children’s psychiatric outcomes using an intergenerational perspective. Further, we were particularly interested in examining whether maternal reflective functioning about their own trauma (T-RF) was associated with a lower likelihood of children’s abuse exposure (among children of CSA-exposed mothers).

Methods: One hundred and eleven children (M_age = 9.53 years; 43 sexual abuse victims) and their mothers (M_age = 37.99; 63 sexual abuse victims) participated in this study. Mothers completed the Parent Development Interview (PDI), which yielded assessments of RF regarding their own experiences of abuse, and also reported on their children’s internalizing and externalizing symptoms.

Results: Children of CSA-exposed mothers were more likely to have experienced CSA. A key result was that among CSA-exposed mothers, higher maternal T-RF regarding their own abuse was associated with lower likelihood of child CSA-exposure. Mothers’ and children’s CSA histories predicted children’s internalizing and externalizing symptoms, such that CSA exposure for mother or child was associated with greater symptomatology in children.

Conclusion: The findings show that the presence of either maternal or child CSA is associated with more child psychological difficulties. Importantly in terms of identifying potential protective factors, maternal T-RF is associated with lower likelihood of CSA exposure in children of CSA-exposed mothers. We discuss these findings in the context of the need for treatments focusing on increasing T-RF in mothers and children in the context of abuse to facilitate adaptation and reduce the intergenerational risk.

Parenting after a history of childhood maltreatment: A scoping review and map of evidence in the perinatal period

Background and aims

Child maltreatment is a global health priority affecting up to half of all children worldwide, with profound and ongoing impacts on physical, social and emotional wellbeing. The perinatal period (pregnancy to two years postpartum) is critical for parents with a history of childhood maltreatment. Parents may experience ‘triggering’ of trauma responses during perinatal care or caring for their distressed infant. The long-lasting relational effects may impede the capacity of parents to nurture their children and lead to intergenerational cycles of trauma. Conversely, the perinatal period offers a unique life-course opportunity for parental healing and prevention of child maltreatment. This scoping review aims to map perinatal evidence regarding theories, intergenerational pathways, parents’ views, interventions and measurement tools involving parents with a history of maltreatment in their own childhoods.

Methods and results

We searched Medline, Psychinfo, Cinahl and Embase to 30/11/2016. We screened 6701 articles and included 55 studies (74 articles) involving more than 20,000 parents. Most studies were conducted in the United States (42/55) and involved mothers only (43/55). Theoretical constructs include: attachment, social learning, relational-developmental systems, family-systems and anger theories; ‘hidden trauma’, resilience, post-traumatic growth; and ‘Child Sexual Assault Healing’ and socioecological models. Observational studies illustrate sociodemographic and mental health protective and risk factors that mediate/moderate intergenerational pathways to parental and child wellbeing. Qualitative studies provide rich descriptions of parental experiences and views about healing strategies and support. We found no specific perinatal interventions for parents with childhood maltreatment histories. However, several parenting interventions included elements which address parental history, and these reported positive effects on parent wellbeing. We found twenty-two assessment tools for identifying parental childhood maltreatment history or impact.

Conclusions

Perinatal evidence is available to inform development of strategies to support parents with a history of child maltreatment. However, there is a paucity of applied evidence and evidence involving fathers and Indigenous parents.

Does Parents' Own History of Child Abuse Moderate the Effectiveness of the Promoting First Relationships® Intervention in Child Welfare?

To better understand how and for whom parenting intervention may improve family outcomes in child welfare services, we examined whether parents' own history of child abuse moderated the indirect effects of the Promoting First Relationships® (PFR) intervention on toddlers' secure base behavior via parental sensitivity. Parents ( N = 247) and their toddlers (10-24 months) involved with child protective services were randomized to PFR or a control intervention. Results showed that the PFR group demonstrated greater parental sensitivity at postintervention than the control group, which in turn led to higher levels of toddler secure base behavior at 6-month follow-up. Findings from a moderated mediation model indicated that these intervention effects were only evident for parents who experienced physical abuse in their childhood. Parents' history of sexual or emotional abuse did not significantly moderate outcomes. These results provide evidence for a key mechanism of change in PFR informed by attachment theory and suggest that PFR intervention effects may be stronger in parents at higher risk of the intergenerational transmission of abuse.

Effects of Child Sexual Abuse on the Parenting of Male Survivors

Research shows that child sexual abuse (CSA) can have detrimental effects on adult functioning. While much research regarding the effects of CSA on parenting of mothers is available, there is a dearth of information on how CSA impacts fatherhood. This literature review finds that the parenting experiences of male survivors are characterized by self-perceptions as adequate parents, deficient parenting as measured by standardized instruments, conceptualization of parenting as an intergenerational legacy and potential healing experience, fear of becoming an abuser, and physical and emotional distance from their children. These themes are strongly related to social discourses on intergenerational cycle of violence theories. Fatherhood is not exclusively problematic for male survivors and can be a healing experience and a source of strength for some survivors. Based on literature concerning male survivors who are parents, narrative therapy is recommended as a therapeutic model to explore how fathers who are survivors challenge dominant discourses around legacies of family violence, intergenerational parenting deficiencies, and victimization. Restorying fatherhood as a healing opportunity is essential when working with fathers who are male survivors and their families.

A Review of Child Sexual Abuse: Impact, Risk, and Resilience in the Context of Culture

Child sexual abuse is a problem with both a national and worldwide prevalence. In this review, the authors note that while empirical research has clearly shown the negative impact of child sexual abuse on social, psychological, and sexual functioning later in life, it has also been reported that some individuals remain asymptomatic despite a history of experiencing child sexual abuse. This implies that negative outcomes later in life are not inevitable and illustrates the critical need to elucidate how resilience may moderate the negative impacts of child sexual abuse. In addition to emphasising the role of resilience, this review also underscores the important role that cultural context plays in understanding child sexual abuse, as there are known risk factors and protective factors specific to different cultures. Similarly, one's culture may also influence whether abuse is reported and addressed, and the topic is given special attention in this paper because it is not widely discussed within the existing literature. The impact of child sexual abuse on mental health, sexual health, and social functioning is also discussed.

Child Maltreatment Screening and Anticipatory Guidance: A Description of Pediatric Nurse Practitioner Practice Behaviors

INTRODUCTION

Given the number of children affected by child maltreatment and the dire consequences that can develop, prompt identification of child maltreatment is crucial. The purpose of this study was to describe pediatric nurse practitioner (PNP) practice behaviors related to screening and providing anticipatory guidance for child maltreatment and its psychosocial risk factors.

METHOD

The Risk Assessment Survey was developed for this study by 12 PNPs, all of whom were members of NAPNAP's Child Maltreatment Special Interest Group to ensure face validity; all 12 PNPs were content experts in child maltreatment. The content of the survey was derived from key characteristics from the evidence on child maltreatment. The survey was emailed to the more than 8500 NAPNAP members.

RESULTS

Two hundred forty-three PNPs responded to the survey, which represents a response rate of 3%. Approximately half of the participants (n = 121; 51%) stated that they never/rarely ask parents questions about domestic violence, more than one-fourth (n = 71; 30%) reported that they never/rarely ask parents questions about discipline, and half of the responding PNPs (n = 120; 50%) reported that they perform an ano-genital exam at well visits.

DISCUSSION

This study demonstrates that a significant number of PNPs do not routinely screen for child maltreatment and psychosocial risk factors. This is especially true in regards to sexual abuse screening and anticipatory guidance.

The association between historical childhood sexual abuse and later parenting stress: a systematic review

An individual's own experiences of childhood and being parented are likely to be key determinants of their later parenting experiences. Childhood sexual abuse (CSA) is arguably the most toxic experience to occur in childhood and therefore may be particularly likely to impact on parenting stress in the context of parenting one's own children. This paper aims to review studies investigating associations between earlier CSA and later parenting to determine the size and consistency of the effects, identify any mediators and moderators of the relationship, and assess the quality of the evidence base. PsycINFO, Academic Search Complete, CINAHL, MEDLINE, Web of Science, PubMed and PILOTS were searched from date of inception until 4th March 2016 and 14 studies met the inclusion criteria. Seven studies indicated a degree of direct association between experiencing CSA and later parenting stress, two studies found no association and five studies suggest that other variables such as locus of control and current stressors may affect the relationship between CSA and parenting stress. Additionally, 10 studies suggest an indirect relationship between CSA and parenting stress through current level of depression. Results suggest the existence of a relationship between CSA and parenting stress though this association is mostly mediated by other variables, including depression and other stressors. Clearer definitions of CSA and use of validated questionnaires are essential to progress this field of research.

Maternal Child Sexual Abuse Is Associated With Lower Maternal Warmth Toward Daughters but Not Sons

Mothers with a history of child sexual abuse report less warmth toward their children, but whether this association differs by child gender is unknown. We examined the association of maternal child sexual abuse and warmth across child gender, accounting for depression, post-traumatic stress disorder, and child physical abuse. We verbally administered self-report measures to a cross-sectional sample of 154 mothers with a child between 8 and 12 years old. Eighty-five mothers based warmth responses on a son, and 69 on a daughter. We conducted a hierarchical multiple regression, including child gender, maternal child sexual abuse, child physical abuse, depression, post-traumatic stress disorder, and 4 two-way interaction terms with child gender. Maternal depression predicted decreased warmth, regardless of child gender, and maternal child sexual abuse predicted decreased warmth, but only toward daughters. Given previous research suggesting that maternal warmth predicts child well-being, the current finding may represent an important avenue of intergenerational transmission of risk in girls.

Child abuse history in teen mothers and parent-child risk processes for offspring externalizing problems

This study examined whether child abuse history in teen mothers impacts offspring externalizing problems indirectly, through its influence on attachment and maternal hostility. In a longitudinal sample of 112 teen mother-child dyads, mothers reported on their own abuse experiences, attachment and maternal hostility were assessed via direct observations, and externalizing problems were measured using maternal reports. Compared with mothers with no abuse history, mothers with a history of sexual and physical abuse were more likely to have an insecurely attached infant, which predicted higher externalizing problems in preschool, which in turn predicted subsequent increases in externalizing problems in Grade 3. Furthermore, relative to the no abuse history group, mothers with a history of sexual and physical abuse showed more hostility toward their child at preschool, which in turn predicted elevated externalizing problems in Grade 3. Mothers' history of either sexual or physical abuse alone did not have significant indirect effects on externalizing problems. Fostering secure attachment and reducing risk for maternal hostility might be important intervention goals for prevention programs involving at-risk mothers with abuse histories.

Child Sexual Abuse, Baby Gender, and Intergenerational Psychic Transmission: An Exploratory, Projective Psychoanalytic Approach

The aim of this article is to present a French psychoanalytic model of how and to what extent the sequellae of sexual abuse by a male during a girl's childhood are transmitted to the next generation, as a function of the gender of the abused mother's children. The authors conducted a qualitative exploratory study based on the longitudinal follow-up of a woman who had two boys and a girl. They focused on the impact of two general sequellae: separation anxiety and negativity-disqualification of the paternal and/or male figures. From the methodological standpoint, they used a clinical interview to assess the mother, and a projective tool, a storytelling test, to assess the child's personality using content analysis. The results confirm both the merits of the theoretical framework and the relevance of the projective methodology for grasping sequellae transmitted to the child. The sequellae turned out to be markedly different for the two baby genders: rejection for the male, overprotection and ghostly encryption for the female. Avenues for using this tool and model in future quantitative, comparative studies are suggested.

Epigenetic Alterations Associated with War Trauma and Childhood Maltreatment

Survivors of war trauma or childhood maltreatment are at increased risk for trauma-spectrum disorders such as post-traumatic stress disorder (PTSD). In addition, traumatic stress has been associated with alterations in the neuroendocrine and the immune system, enhancing the risk for physical diseases. Traumatic experiences might even affect psychological as well as biological parameters in the next generation, i.e. traumatic stress might have transgenerational effects. This article outlines how epigenetic processes, which represent a pivotal biological mechanism for dynamic adaptation to environmental challenges, might contribute to the explanation of the long-lasting and transgenerational effects of trauma. In particular, epigenetic alterations in genes regulating the hypothalamus-pituitary-adrenal axis as well as the immune system have been observed in survivors of childhood and adult trauma. These changes could result in enduring alterations of the stress response as well as the physical health risk. Furthermore, the effects of parental trauma could be transmitted to the next generation by parental distress and the pre- and postnatal environment, as well as by epigenetic marks transmitted via the germline. While epigenetic research has a high potential of advancing our understanding of the consequences of trauma, the findings have to be interpreted with caution, as epigenetics only represent one piece of a complex puzzle of interacting biological and environmental factors. Copyright © 2015 John Wiley & Sons, Ltd.

Influence of interpersonal violence on maternal anxiety, depression, stress and parenting morale in the early postpartum: a community based pregnancy cohort study

BACKGROUND

Research has shown that exposure to interpersonal violence is associated with poorer mental health outcomes. Understanding the impact of interpersonal violence on mental health in the early postpartum period has important implications for parenting, child development, and delivery of health services. The objective of the present study was to determine the impact of interpersonal violence on depression, anxiety, stress, and parenting morale in the early postpartum.

METHODS

Women participating in a community-based prospective cohort study (n = 1319) completed questionnaires prior to 25 weeks gestation, between 34-36 weeks gestation, and at 4 months postpartum. Women were asked about current and past abuse at the late pregnancy data collection time point. Postpartum depression, anxiety, stress, and parenting morale were assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale, the Spielberger State Anxiety Index, the Cohen Perceived Stress Scale, and the Parenting Morale Index, respectively. The relationship between interpersonal violence and postpartum psychosocial health status was examined using Chi-square analysis (p < 0.05) and multivariable logistic regression.

RESULTS

Approximately 30% of women reported one or more experience of interpersonal violence. Sixteen percent of women reported exposure to child maltreatment, 12% reported intimate partner violence, and 12% reported other abuse. Multivariable logistic regression analysis found that a history of child maltreatment had an independent effect on depression in the postpartum, while both child maltreatment and intimate partner violence were associated with low parenting morale. Interpersonal violence did not have an independent effect on anxiety or stress in the postpartum.

CONCLUSION

The most robust relationships were seen for the influence of child maltreatment on postpartum depression and low parenting morale. By identifying women at risk for depression and low parenting morale, screening and treatment in the prenatal period could have far-reaching effects on postpartum mental health thus benefiting new mothers and their families in the long term.

The impact of childhood abuse history, domestic violence and mental health symptoms on parenting behaviour among mothers in Japan

BACKGROUND

To assess the impact of childhood abuse history, domestic violence experiences and mental health symptoms on the parenting behaviour of mothers in Japan who have separated from violent husbands or partners.

METHODS

A self-administered questionnaire survey was conducted on a sample of mothers (n = 304) and their children (n = 498) residing in 83 mother-child homes in Japan. The survey assessed the mothers' childhood abuse history (physical, psychological and sexual abuse and neglect history), domestic violence experiences, current mental health symptoms (dissociative, depressive and traumatic symptoms) and parenting behaviours after moving into the homes to separate from a violent husband or partner.

RESULTS

The mothers' childhood abuse history and experience of domestic violence were not associated with their not playing with their children. In contrast, the mothers' dissociative and depressive symptoms were significantly associated with not playing with their children. Although there was no association between the mothers' total childhood abuse history and not praising their children, their childhood physical abuse history was significantly associated with their not praising their children. The dissociative and depressive symptoms were also associated with no praise. Interestingly, the experience of domestic violence showed an inverse association with no praise.

CONCLUSIONS

Mental health symptoms, more specifically dissociative and depressive symptoms, are associated with a decrease in parenting quality. Mothers who were physically abused as children are less likely to praise their own children, independent of maternal mental health symptoms. In contrast, mothers who experienced domestic violence but subsequently separated from their violent husbands or partners are more likely to praise their children. The treatment of mental health symptoms, particularly dissociative and depressive symptoms, therapy for childhood abuse history and separation from violent husbands or partners might be effective ways to enhance the quality of parenting in Japan.