Mothers' Experience of Intimate Partner Violence and Subsequent Offspring Attachment Security Ages 1-5 Years: A Meta-Analysis

"My Cross to Bear": Mothering in the Context of Intimate Partner Violence Among Pregnant Women in Mexico

Intimate partner violence (IPV) during pregnancy negatively affects both maternal and infant health, yet gaps remain in understanding factors that maintain violence and/or promote resilience within the context of mothering. Nine focus groups were conducted with pregnant and/or IPV-exposed women (n  =  17) and service providers (n  =  26) working with these women in Nuevo León, Mexico. Thematic analysis of the focus group data revealed the detrimental impact of cultural norms that prioritize the relationship with women's partners, marriage, and family above women's dignity. Participants also identified ways that values regarding motherhood function as motivation for women to pursue a life without violence.

Intimate Partner Violence Against Women Before, During, and After Pregnancy: A Meta-Analysis

Intimate partner violence (IPV) against pregnant women negatively impacts women's and infants' health. Yet inconsistent results have been found regarding whether pregnancy increases or decreases the risk of IPV. To answer this question, we systematically searched for studies that provided data on IPV against women before pregnancy, during pregnancy, and after childbirth. Nineteen studies met our selection criteria. We meta-analyzed the nineteen studies for the pooled prevalence of IPV across the three periods and examined study characteristics that moderate the prevalence. Results showed the pooled prevalence estimates of IPV were 21.2% before pregnancy, 12.8% during pregnancy and 14.7% after childbirth. Although these findings suggest a reduction in IPV during pregnancy, our closer evaluation of the prevalence of IPV after childbirth revealed that the reduction does not appear to persist. The prevalence of IPV increased from 12.8% within the first year after childbirth to 24.0% beyond the first year. Taken together, we should not assume pregnancy protects women from IPV, as IPV tends to persist across a longer-term period. Future studies are needed to investigate if IPV transits into other less obvious types of violence during pregnancy. Moderator analyses showed the prevalence estimates significantly varied across countries by income levels and regions.

Mothering in the Aftermath of Reproductive Coercion and Abuse

A partner's reproductive coercion and abuse (RCA) can significantly undermine women's physical health and psychological wellbeing. Yet little research has explored how RCA affects experiences of mothering and relationships with children. Based on an analysis of interviews with 30 Australian mothers, we found that RCA affected mothering in complex ways. Many struggled with feeling detached, resentful, and guilty toward their children, while some found mothering an emotionally and morally restorative experience after the RCA. All felt compelled to conceal their abuse from their children and others. The findings have implications for how healthcare practitioners can support mothers in the aftermath of RCA.

Infant and preschool attachment, continuity and relationship to caregiving sensitivity: findings from a new population-based Australian cohort

BACKGROUND

Here, we report new prevalence and temporal stability data for child attachment and parental caregiving behaviour, from infancy (1 year) to preschool (4 years).

METHODS

Attachment (SSP) and caregiving data (MBQS) were from observations of parents and their infants and preschoolers, who represent the third generation of participants within an Australian longitudinal cohort.

RESULTS

At 1 year (n = 314 dyads) and at 4 years (n = 368 dyads), proportions assessed secure were 59% and 71%, respectively. Proportions assessed avoidant were 15% and 11%; ambivalent 9% and 6%, and disorganised 17% and 12%, at 1 and 4 years. Continuity of attachment pattern was highest for the infant secure group. Of dyads initially classified disorganised in infancy, 36% remained so at the preschool assessment. Attachment and caregiving continuities across the infancy-preschool period were highest for the stable secure attachment group and lowest for the stable insecure attachment group. Loss of secure attachment to mother by age 4 years correlated with decreased maternal caregiving sensitivity, and acquisition of secure status by age 4 was associated with increased maternal sensitivity. We found no difference in caregiving sensitivity scores for mothers and fathers for female and male preschool children.

CONCLUSIONS

The contemporary infant and preschool attachment proportions we report here closely mirror the patterns of those reported in prior decades, with an inclination towards secure base relationships. Our findings alert practitioners anew to the responsiveness of early attachment status to change in caregiving responsiveness and support ongoing investment in early identification of disorganised attachment.

Interparental Coercive Control and Child and Family Outcomes: A Systematic Review

Coercive control (CC) is a core facet of intimate partner violence (IPV) and involves asserting power, dominance, and control over another person. Although the adverse impacts of childhood exposure to interparental IPV have been well documented, the outcomes of childhood exposure to interparental CC have not been systematically examined. This study aimed to address this gap by reviewing available empirical evidence on interparental CC and child and family outcomes. Articles were identified by searching electronic databases using keywords relating to CC, children and parents, and child wellbeing outcomes. The final review included 51 studies that reported on adverse outcomes pertaining to parenting and family relationships (k = 29), child internalizing and externalizing problems (k = 7), social-emotional development (k = 5), and physical/health development (k = 17). Specifically, studies reported that CC was associated with increased parental psychopathology, poorer family functioning, harsher parenting and higher levels of child abuse, strained parent-child relationships, children used as tools and co-victims of CC, increased risk of child internalizing and externalizing problems, limited socializing opportunities, increased bullying, poorer perinatal outcomes, limited access to healthcare, and increased risk of child mortality. Evidence identified CC as a unique contributor to adverse child wellbeing outcomes, independent of exposure to IPV more broadly. Results indicated that the impacts of childhood exposure to CC are complex, far reaching, and, in some cases, devastating. The limitations of the findings, as well as implications for practice, policy, and research are discussed.

Early life stress, prenatal secondhand smoke exposure, and the development of internalizing symptoms across childhood

BACKGROUND

Prior findings relating secondhand tobacco smoke (SHS) exposure and internalizing problems, characterized by heightened anxiety and depression symptoms, have been equivocal; effects of SHS on neurodevelopment may depend on the presence of other neurotoxicants. Early life stress (ELS) is a known risk factor for internalizing symptoms and is also often concurrent with SHS exposure. To date the interactive effects of ELS and SHS on children's internalizing symptoms are unknown. We hypothesize that children with higher exposure to both prenatal SHS and ELS will have the most internalizing symptoms during the preschool period and the slowest reductions in symptoms over time.

METHODS

The present study leveraged a prospective, longitudinal birth cohort of 564 Black and Latinx mothers and their children, recruited between 1998 and 2006. Cotinine extracted from cord and maternal blood at birth served as a biomarker of prenatal SHS exposure. Parent-reported Child Behavior Checklist (CBCL) scores were examined at four timepoints between preschool and eleven years-old. ELS exposure was measured as a composite of six domains of maternal stress reported at child age five. Latent growth models examined associations between SHS, ELS, and their interaction term with trajectories of children's internalizing symptoms. In follow-up analyses, weighted quintile sum regression examined contributions of components of the ELS mixture to children's internalizing symptoms at each time point.

RESULTS

ELS interacted with SHS exposure such that higher levels of ELS and SHS exposure were associated with more internalizing symptoms during the preschool period (β = 0.14, p = 0.03). The interaction between ELS and SHS was also associated with a less negative rate of change in internalizing symptoms over time (β=-0.02, p = 0.01). Weighted quintile sum regression revealed significant contributions of maternal demoralization and other components of the stress mixture to children's internalizing problems at each age point (e.g., age 11 WQS β = 0.26, p < 0.01).

CONCLUSIONS

Our results suggest that prior inconsistencies in studies of SHS on behavior may derive from unmeasured factors that also influence behavior and co-occur with exposure, specifically maternal stress during children's early life. Findings point to modifiable targets for personalized prevention.

Social control and self-control: factors linking exposure to domestic violence and adolescents' Internet gaming addiction

Although many studies have investigated the influencing factors of adolescents' Internet gaming addiction, few have investigated the influence factor of exposure to domestic violence, and even fewer have used the General Strain Theory to explain the influence path of exposure to domestic violence on adolescents' Internet gaming addiction. Based on the GST, this study sought to uncover further insights into the effect of exposure to family violence on adolescents' Internet gaming addiction, and the mediating role of social control-specifically, parental attachment-and self-control in the association between exposure to family violence and adolescents' Internet gaming addiction. Adopting a multi-stage cluster random sampling method, we conducted this study with 2,110 adolescents from Liangshan Yi Autonomous Prefecture in Sichuan Province, China. The results suggest that adolescents' exposure to domestic violence directly affects their addiction to Internet games and indirectly affects it by decreasing social control and self-control. The study not only supplements and improves the explanatory framework of General Strain Theory, but makes a significant contribution to research on the causes of Internet gaming addiction.

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.

Childhood exposure to parental violence, attachment insecurities, and intimate partner violence perpetration among Arab adults in Israel

BACKGROUND

Extensive research supports the existence of a "cycle of violence" that links exposure to parental violence during childhood (i.e., witnessing interparental violence and child maltreatment) with intimate partner violence (IPV) perpetration. However, there is still a need to explore the mechanisms through which early exposure to parental violence may foster IPV perpetration during adulthood.

OBJECTIVE

In this study, we examine the mediating role of attachment insecurities and gender differences in the relationship between exposure to parental violence during childhood and IPV perpetration during adulthood.

METHOD, PARTICIPANTS, AND SETTING

We conducted a cross-sectional survey among a representative sample of 604 married Arab adults (M age = 33.5, SD = 6.52; 50.1 % women) in Israel using a self-administered questionnaire.

RESULTS

Exposure to physical violence, both as a victim and indirectly as a witness in childhood, was found positively correlated with adulthood IPV perpetration, with effect sizes ranging from weak (f² = 0.01) to moderate (f² = 0.15). Further, attachment-related avoidance was found to mediate the association between witnessing interparental physical violence and IPV perpetration. Gender differences were found in this relationship, with a stronger association indicated among male participants than among females.

CONCLUSION

Exposure to physical violence may be understood as a risk factor for IPV perpetration directly and indirectly through the development of attachment-related avoidance.

Reduced Posttraumatic Stress in Mothers Taking Part in Group Interventions for Children Exposed to Intimate Partner Violence

This study investigated whether interventions for children exposed to intimate partner violence combining parallel groups for children and mothers contribute to positive outcomes for partaking mothers. The study included 39 mothers in a long-term within-subject design without a control group in a Swedish naturalistic setting. Maternal psychological health was assessed pre- and posttreatment and at 6-month and 12-month follow-up. Mothers reported medium- to large-sized decrease in psychological symptoms, including symptoms of posttraumatic stress, postintervention (p = < .001 d = 0.45-0.96). During the follow-up period, sustained and further decrease of symptoms was reported (p = < .001 d = 0.58-1.60). Mothers also reported decreased exposure to violence. Results indicate that these child-focused programs have major and sustainable positive effects on mothers' psychological health.

Attachment Neuroscience and Martin Luther King, Jr.’s Nonviolence Philosophy: Implications for the 21st Century and Beyond

This article focuses on the psychology of principled nonviolent activism, specifically ideas associated with Martin Luther King, Jr.’s philosophy of nonviolence and how they are compatible with attachment theory and related areas of modern neuroscience (e.g., attachment/social neuroscience and interpersonal neurobiology). The proposed Kingian Neuro-Relational Theory (KNRT) recognizes King as having a relational development approach to social justice. KNRT offers a way of understanding King’s ideas to aid research and develop strategies for reducing many forms of societal violence, with eventual outcomes of improving mental and physical health via stress reduction, and subsequent creation of a more socially just world. KNRT is an integrative, multidisciplinary approach, incorporating the philosophy of nonviolence, attachment theory, social neuroscience, ecological systems theory, and personalistic philosophy. The theory highlights developmental and clinical implications of moving beyond tactical/pragmatic nonviolent activism (nonviolent direct action) to activism via embracing nonviolence as a principled way of life (nonviolent daily interactions). This theory is building on an earlier project that conveyed how King’s philosophy of nonviolence is related to modern–day diversity and inclusion efforts.

Maternal trauma but not perinatal depression predicts infant-parent attachment

Understanding if maternal depression is a predictor of infant-parent attachment classification is important to furthering knowledge about the early pathways and predictors of socio-emotional development. Yet few studies that have utilised the Strange Situation Procedure, the gold standard for measurement of infant-parent attachment, have examined antenatal depression as a predictor of attachment, and none has also included a measure of maternal trauma. This study uses data on 224 women recruited in early pregnancy and followed up until 12 months postpartum. Maternal depression was measured in pregnancy using the Structured Clinical Interview for the DSM and repeat Edinburgh Postnatal Depression Scale as well as Stressful Life Events scale across pregnancy and postpartum including items on domestic violence. A past history of trauma was measured using the Childhood Trauma Questionnaire. Attachment was measured using the Strange Situation Procedure (SSP) at 12 months postpartum. We found that maternal depression was not associated with insecure or disorganized attachment. However, a maternal history of childhood trauma and current domestic violence both predicted insecure-avoidant attachment at 12 months, whereas increased number of stressful life events prior to conception and in pregnancy was associated with insecure-resistant attachment. Neither trauma, past or current, nor depression predicted disorganized attachment. In the first study to have included measures of antenatal depression, maternal childhood trauma, and current stressful events as predictors of infant attachment measured using the SSP, we found maternal experiences of past and current trauma but not depression were significant predictors of infant-parent attachment security.

Who is Being Screened for Intimate Partner Violence in Primary Care Settings? Secondary Data Analysis of a Cluster Randomised Trial

OBJECTIVES

To assess sociodemographic differences in postpartum women screened for intimate partner violence and who disclosed to their Maternal and Child Health nurses.

METHODS

Secondary analyses of survey data from women participating in a cluster randomised trial. The trial tested a nurse-designed, enhanced violence screening model-versus routine screening among eight community nurse clinics in Melbourne, Australia. Self-completion anonymous surveys were sent to all clinic attendees who had given birth in the previous eight months. We measured intimate partner violence with the Composite Abuse Scale and other sociodemographic variables. Multivariable logistic regression was used to analyse characteristics of screened versus unscreened women and those who did or did not disclose.

RESULTS

91 clinics (163 nurses) participated in the trial. 2621/10,472 (25%) women responded to the survey. Notable characteristics, such as level of intimate partner violence (AdjOR 1.14, CI 0.94-1.40), parity (AdjOR 1.13, CI 0.94-1.35), education (AdjOR 1.20 CI 0.91-1.58) and being born in Australia (AdjOR 0.94, CI 0.86-1.03) made no significant difference to screening. However, nurses were significantly less likely to screen women with a lower income than those with a higher one (AdjOR 0.59, CI 0.40-0.87) with a dose response relationship. Women on the lowest levels of income were significantly more likely to disclose abuse (AdjOR 3.06, CI 1.02-9.17), indicating missed opportunities for nurses to provide timely care.

CONCLUSIONS FOR PRACTICE

Despite being required to screen all women, nurses are almost twice as likely to screen more affluent women, who would be less likely to be experiencing or disclose intimate partner violence.

Impact of Intimate Partner Violence on Parenting and Children's Externalizing Behaviors: Transactional Processes Over Time

This study used longitudinal data to examine the transactional associations between mothers’ spanking and mother–child relationship quality with children’s externalizing behaviors in the context of intimate partner violence (IPV). Data came from a sample of 1,152 low-income mothers with children age 10–14 years. Results showed that past-year IPV triggered transactional associations by increasing children’s externalizing behaviors which, in turn, increased spanking and subsequently more externalizing behaviors. Transactional associations were also found for relationship quality. All outcomes used were mothers-reported except relationship quality. Implications for practice include the importance of the mother–child dyad and their reciprocal processes in assessment and treatment.

Screening for intimate partner violence in the early postpartum period: Maternal and child health and social outcomes from birth to 5-years post-delivery

BACKGROUND

Intimate partner violence (IPV) during pregnancy is a substantial public health concern, yet little is known about the developmental trajectory of these women and their children after birth.

OBJECTIVE

The objective was to examine maternal and child health as well as social outcomes from birth to 5-years post-delivery associated with a positive (vs. negative) maternal IPV screen around the time of delivery.

PARTICIPANTS AND SETTING

Manitoban women giving birth to a live singleton infant from January 1, 2003 to December 31, 2006 were followed from birth to 5-years post-delivery (analytic sample: N = 40,051).

METHODS

Administrative databases from the Manitoba Centre for Health Policy provided data for the study. Descriptive statistics and logistic regression were used to examine relationships between IPV screen response around the time of birth (i.e., current, or history of, violence between parenting partners) with maternal and child health as well as social outcomes.

RESULTS

Women screening positive for IPV had increased odds of diagnosed mood/anxiety disorders, personality disorders, substance use disorders, diabetes, respiratory morbidity, and intentional/non-intentional injury hospitalizations (adjusted odds ratio [AOR] range 1.81-5.59, p < .01). Children of women screening positive for IPV had increased odds of diagnosed attention deficit-hyperactivity disorder, lower respiratory infections, and injury hospitalizations (AOR range 1.53-2.00, p < .01), child welfare organization contact (AOR = 8.84, p <  .01), and of being more developmentally vulnerable at kindergarten across domains of functioning (AOR range 1.69-1.93, p <  .01) than children of mothers screening negative for IPV.

CONCLUSION

A positive IPV screen was associated with poorer maternal and child health, increased child and family services contact, and children being more developmentally vulnerable in the 5-years after delivery.