Cascades of Risk Linking Intimate Partner Violence and Adverse Childhood Experiences to Less Sensitive Caregiving During Infancy

Mother-Infant Dyadic Synchrony and Interaction Patterns After Infant Cardiac Surgery

OBJECTIVE

Parents and their infants with complex congenital heart disease (CHD) face relational challenges, including marked distress, early separations, and infant hospitalizations and medical procedures, yet the prevalence of parent-infant interaction difficulties remains unclear. Using a standardized observational paradigm, this study investigated mother-infant dyadic synchrony, interactional patterns, and associated predictors in mother-infant pairs affected by CHD, compared with typically-developing pairs.

METHODS

In this prospective, longitudinal cohort study, mothers and their infants requiring cardiac surgery before age 6-months (n=110 pairs) and an age- and sex-matched Australian community sample (n=85 pairs) participated in a filmed, free-play interaction at 6.9±1.0 months. Mother-infant dyadic synchrony, maternal and infant interactional patterns, and relational risk were assessed using the Child-Adult Relationship Experimental (CARE) Index. Maternal and infant predictors were assessed at 32 weeks gestation, 3- and 6-months postpartum.

RESULTS

Most mother-infant interactions were classified as "high risk" or "inept" (cardiac: 94%, control: 81%; p=.007). Dyadic synchrony (p<.001), maternal sensitivity (p=.001), and infant cooperativeness (p=.001) were lower for cardiac than control pairs. Higher maternal traumatic stress at 6-months postpartum predicted lower dyadic synchrony for mother-infant pairs affected by CHD (B=-.04, p=.03). Dyadic synchrony was higher among older infants in the total (B=.40, p=.003) but not cardiac sample (B=.24, p=.06).

CONCLUSIONS

Relational difficulties were almost universal among mother-infant pairs affected by CHD and were also high in the Australian community sample. Widespread education initiatives are recommended to increase awareness of heightened mother-infant relational risk in congenital heart care and well-child settings, alongside relationally-focused prevention and early intervention programs.

Prospective Associations Between Early Childhood Intimate Partner Violence Exposure and Middle Childhood Internalizing and Externalizing Psychopathology

Co-occurring adversities are common for young children with child protective services (CPS) involvement, with high rates of intimate partner violence (IPV) exposure in this population. Despite extensive research linking childhood IPV exposure to later psychopathology, fewer studies have examined the prospective associations between IPV exposure and psychopathology using a dimensional approach. Here, we conducted secondary analyses of data from a randomized controlled trial of a parenting intervention for CPS-involved children, examining the associations between early childhood IPV exposure (i.e., threat), co-occurring deprivation, and middle childhood internalizing and externalizing symptoms. Adversity variables were coded from data collected when children were infants (N = 249, M_age = 7.97 months) through 48-month assessments; internalizing and externalizing psychopathology were modeled as latent variables reflecting the mean of data from yearly assessments between ages 8 to 10. Results of our structural equation model demonstrated that, accounting for the effects of co-occurring deprivation, IPV exposure was significantly associated with both internalizing, β = .38, p = .001, and externalizing, β = .26, p = .019, symptoms. Results suggest links between early childhood IPV exposure (i.e., threat) and later psychopathology. Findings support screening and intervention efforts to mitigate the developmental sequelae of IPV exposure among CPS-involved children.

Effects of maternal trauma and associated psychopathology on atypical maternal behavior and infant social withdrawal six months postpartum

Maternal psychopathology given a history of maltreatment and domestic violence exposure increases the risk for child psychopathology. Infant social withdrawal is one warning sign of adverse developmental outcomes including child anxiety and depression. It remains unclear how maternal trauma-related psychopathology might affect infant social withdrawal six-months postpartum.

METHODS

One-hundred ninety-five women and their six-month-old infants were studied in an at-risk community sample. Maternal trauma history, posttraumatic stress (PTSD) and major depressive (MDD) disorders were assessed. Maternal and infant behaviors were coded from videotaped interactions.

RESULTS

Maternal trauma was correlated with atypical maternal behavior (AMB) and infant social withdrawal (p ≤ .001). PTSD and MDD, and comorbid PTSD/MDD predicted increased AMB (p ≤ .001) but only maternal MDD was predictive of infant social withdrawal (p ≤ .001). Effects of maternal MDD on infant withdrawal were mediated by AMB.

CONCLUSIONS

At six-months postpartum, maternal MDD was associated with infant withdrawal. AMB is an important target for early intervention.

Next Steps in Untangling the Web of Violence: A Research Agenda

In this commentary, we outline four key trends in violence and trauma research and describe needed research to advance our ability to understand, prevent, and respond these problems. The trends are the move toward evidence-based policy, the recognition of the importance of trauma dosage, the shift to strengths-based approaches, and increased attention to race, gender, and other personality and community characteristics regarding health disparities and culturally appropriate interventions. For each trend, we have identified needed research areas, taking care to identify low-resource and high-resource studies that can help us reduce the burden of trauma.

Sexual violence and Australian women: A longitudinal analysis of psychosocial and behavioral outcomes

RATIONALE

Sexual violence (SV) is associated with adverse psychosocial and behavioural outcomes with revictimization likely. However, there are significant gaps in the current literature in regard to (a) whether over time women's levels of distress/behaviour change, and (b) whether social support mediates the relationship between SV and adverse outcomes.

METHODS AND RESULTS

This study aimed to address these two issues by analysing data from the Australian Longitudinal Women's Health Survey, surveys 4 (2006) to 8 (2018). Using repeated-measures data analytic procedures we found that women who had suffered SV, in comparison to women with no SV history, had greater anxiety, depression, stress, a lower mental health-related quality of life and less life satisfaction. Moreover, their level of distress remained higher at all time points, in comparison to the other group. Women with a SV history were also more likely to suffer re-victimization, consume more cigarettes and illicit drugs than other women. Moreover, SV predicted all psychosocial outcomes (except life satisfaction) 12 years later, with social support mediating these relationships. SV predicted drug status; however social support did not mediate this relationship.

CONCLUSIONS

These findings suggest that for women who have experienced SV their distress levels remain elevated. The findings also provide additional insights into the long-term impact of SV in Australian women with social support being identified as a resource that may assist in reducing some of the negative psychological outcomes associated with SV.