The effects of IPV and mental health symptoms on HPA axis functioning during early pregnancy

Maternal HPA axis dysregulation during early pregnancy can negatively affect maternal functioning. However, findings are mixed regarding how intimate partner violence (IPV), a common traumatic stressor, impacts HPA axis regulation during pregnancy. Interactions between IPV and mental health symptoms as they influence cortisol production are rarely examined, especially among pregnant women. Therefore, this study examined the impact of IPV, mental health symptoms, and their interactions on the maternal HPA axis during early pregnancy; 255 pregnant women, oversampled for experiences of IPV, completed a laboratory stressor and measures of depressive and post-traumatic stress symptoms (PTSS) at 15-18 weeks of pregnancy. Participants provided saliva samples following the Trier Social Stress Test that were assayed for cortisol; the area under the curve with respect to ground (AUCg) was computed as a measure of cortisol reactivity. The interactive effects of IPV, depressive symptoms, and PTSS on AUCg were significant, but the main effects were not. At low levels of depressive symptoms, the association between IPV and AUCg was negative; at moderate levels of depressive symptoms, it was not significant, and at high levels, it was positive. At low and moderate levels of PTSS, the effects of IPV on cortisol AUCg were not significant, but at high levels, the association was positive. IPV during early pregnancy was associated with both hyperactive and blunted stress reactivity, depending on the type and severity of mental health symptoms. These patterns of dysregulation of the HPA axis may have differential effects both for women's functioning throughout pregnancy as well as for the offspring.

Economic Hardship Predicts Intimate Partner Violence Victimization During Pregnancy

Objective

Intimate partner violence (IPV) during pregnancy is associated with negative physical and mental health consequences for both mothers and infants. Economic hardship is often exacerbated during pregnancy and is associated with increased rates of IPV in non-pregnant samples. However, temporal associations between economic hardship and IPV victimization have not been well characterized during pregnancy. The present study used data collected at the weekly level to examine the interindividual and intraindividual effects of economic hardship on IPV victimization during pregnancy and determine whether longitudinal changes in IPV across pregnancy vary based on level of economic hardship.

Method

Two hundred ninety-four women reported on weekly experiences of IPV and economic hardship (i.e., food insecurity and other money problems) during weeks 17-40 of pregnancy. Participants were oversampled for low income and IPV exposure. Binary logistic multilevel models were used to test study hypotheses.

Results

Greater economic hardship on average during pregnancy predicted increased odds of IPV victimization. Within-person increases in economic hardship also predicted increased odds of IPV victimization in the same week. Although IPV victimization tended to decrease on average over the course of pregnancy, there was a significant time by economic hardship interaction such that IPV decreased more gradually for women reporting high levels of economic hardship.

Conclusions

The present study examined weekly patterns of IPV victimization across pregnancy in a low-income community sample. Results suggest that policies aimed at increasing families' economic security during the perinatal period may reduce the individual and societal burden of IPV.

Developmental Consequences of Intimate Partner Violence on Children

Numerous studies associate childhood exposure to intimate partner violence (IPV) with adverse adjustment in the domains of mental health, social, and academic functioning. This review synthesizes this literature and highlights the critical role of child self-regulation in mediating children's adjustment outcomes. We discuss major methodological problems of the field, including failure to consider the effects of prenatal IPV exposure and the limitations of variable-oriented and cross-sectional approaches. Finally, we present a comprehensive theoretical model of the effects of IPV on children's development. This model includes three mechanistic pathways-one that is unique to IPV (maternal representations) and two that are consistent with the effects of other stressors (maternal mental health and physiological functioning). In our model, the effects of these three pathways on child adjustment outcomes are mediated through parenting and child self-regulation. Future research directions and clinical implications are discussed in the context of the model. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 19 is May 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Geotemporal analysis of perinatal care changes and maternal mental health: an example from the COVID-19 pandemic

Our primary objective was to document COVID-19 induced changes to perinatal care across the USA and examine the implication of these changes for maternal mental health. We performed an observational cross-sectional study with convenience sampling using direct patient reports from 1918 postpartum and 3868 pregnant individuals collected between April 2020 and December 2020 from 10 states across the USA. We leverage a subgroup of these participants who gave birth prior to March 2020 to estimate the pre-pandemic prevalence of specific birthing practices as a comparison. Our primary analyses describe the prevalence and timing of perinatal care changes, compare perinatal care changes depending on when and where individuals gave birth, and assess the linkage between perinatal care alterations and maternal anxiety and depressive symptoms. Seventy-eight percent of pregnant participants and 63% of postpartum participants reported at least one change to their perinatal care between March and August 2020. However, the prevalence and nature of specific perinatal care changes occurred unevenly over time and across geographic locations. The separation of infants and mothers immediately after birth and the cancelation of prenatal visits were associated with worsened depression and anxiety symptoms in mothers after controlling for sociodemographic factors, mental health history, number of pregnancy complications, and general stress about the COVID-19 pandemic. Our analyses reveal widespread changes to perinatal care across the US that fluctuated depending on where and when individuals gave birth. Disruptions to perinatal care may also exacerbate mental health concerns, so focused treatments that can mitigate the negative psychiatric sequelae of interrupted care are warranted.

Conflict Appraisals and Trauma Symptoms in Children Exposed to Intimate Partner Violence

Children exposed to intimate partner violence (IPV) are at risk for posttraumatic stress symptoms (PTSS) and alterations in hypothalamic-pituitary-adrenal (HPA) axis functioning. The current study investigated children's threat and self-blame appraisals about parental conflict as potential mechanisms leading to these adverse outcomes. Parent-child relationships were also examined. The sample consisted of 119 10-year-olds and their mothers who were recruited from the community as part of a larger study of IPV. Children's reports of IPV directed at their mother in the past year were not associated with PTSS; however, IPV exposure was associated with attenuated cortisol output in response to a social stressor. IPV exposure was also associated with greater threat appraisals and poorer quality parent-child relationships. These results provide further evidence that witnessing IPV is threatening for children, has negative consequences for parent-child relationships, and can impact children's HPA axis functioning.

Behavioral coping phenotypes and associated psychosocial outcomes of pregnant and postpartum women during the COVID-19 pandemic

The impact of COVID-19-related stress on perinatal women is of heightened public health concern given the established intergenerational impact of maternal stress-exposure on infants and fetuses. There is urgent need to characterize the coping styles associated with adverse psychosocial outcomes in perinatal women during the COVID-19 pandemic to help mitigate the potential for lasting sequelae on both mothers and infants. This study uses a data-driven approach to identify the patterns of behavioral coping strategies that associate with maternal psychosocial distress during the COVID-19 pandemic in a large multicenter sample of pregnant women (N = 2876) and postpartum women (N = 1536). Data was collected from 9 states across the United States from March to October 2020. Women reported behaviors they were engaging in to manage pandemic-related stress, symptoms of depression, anxiety and global psychological distress, as well as changes in energy levels, sleep quality and stress levels. Using latent profile analysis, we identified four behavioral phenotypes of coping strategies. Critically, phenotypes with high levels of passive coping strategies (increased screen time, social media, and intake of comfort foods) were associated with elevated symptoms of depression, anxiety, and global psychological distress, as well as worsening stress and energy levels, relative to other coping phenotypes. In contrast, phenotypes with high levels of active coping strategies (social support, and self-care) were associated with greater resiliency relative to other phenotypes. The identification of these widespread coping phenotypes reveals novel behavioral patterns associated with risk and resiliency to pandemic-related stress in perinatal women. These findings may contribute to early identification of women at risk for poor long-term outcomes and indicate malleable targets for interventions aimed at mitigating lasting sequelae on women and children during the COVID-19 pandemic.

Conducting Virtual Assessments in Developmental Research: COVID-19 Restrictions as a Case Example

Developmental researchers face considerable challenges regarding maximizing data collection and reducing participant attrition. In this article, we use our experiences implementing our study on the effects of timing of prenatal stress on maternal and infant outcomes during the COVID-19 pandemic as a framework to discuss the difficulties and solutions for these challenges, including the development of two types of virtual assessments. Specific information regarding use of virtual platforms, confidentiality, engaging children during video conferencing, and modifying the major assessments of our research are discussed. Feasibility data are presented, and data analytic challenges regarding statistical inference are outlined. Finally, we conclude with some of the unintended positive consequences for our research that resulted from making these modifications to our original methods.

Longitudinal prospective study examining the effects of the timing of prenatal stress on infant and child regulatory functioning: the Michigan Prenatal Stress Study protocol

INTRODUCTION

A considerable literature implicates prenatal stress as a critical determinant of poor psychological functioning in childhood and beyond. However, knowledge about whether the timing of prenatal stress differentially influences the development of child outcomes, including psychopathology, is virtually unknown. The primary aim of our study is to examine how the timing of prenatal stress differentially affects early childhood regulatory functioning as a marker of psychopathology. Our second aim is to examine the mediating effects of maternal physiological and psychological factors during pregnancy. Our third aim is to examine the moderating effects of postnatal factors on child regulatory functioning. Our project is the first longitudinal, prospective, multimethod study addressing these questions.

METHODS AND ANALYSIS

Our ongoing study recruits pregnant women, oversampled for intimate partner violence (a common event-based stressor allowing examination of timing effects), with data collection starting at pregnancy week 15 and concluding 4 years post partum. We aim to have n=335 mother-child dyads. We conduct a granular assessment of pregnancy stress (measured weekly by maternal report) in order to reveal sensitive periods during fetal life when stress particularly derails later functioning. Pattern-based statistical analyses will be used to identify subgroups of women who differ in the timing of their stress during pregnancy and then test whether these patterns of stress differentially predict early childhood self-regulatory outcomes.

ETHICS AND DISSEMINATION

Due to the high-risk nature of our sample, care is taken to ensure protection of their well-being, including a safety plan for suicidal ideation and a safety mechanism (exit button in the online weekly survey) to protect participant data privacy. This study was approved by Michigan State University Institutional Review Board. Dissemination will be handled by data sharing through National Institute of Child Health and Human Development Data and Specimen Hub (DASH), as well as through publishing the findings in journals spanning behavioural neuroendocrinology to clinical and developmental psychology.

Intimate partner violence and positive parenting across early childhood: Comparing self-reported and observed parenting behavior

The current study examined self-reported and observed positive (i.e., nurturing, sensitive, and responsive) parenting behavior among women who experienced intimate partner violence (IPV) during pregnancy and through their early parenting years. Mother-child dyads were assessed during the third trimester of pregnancy and each year postpartum until age 4. Latent growth curve models of self-reported positive parenting suggested that IPV experienced during pregnancy was related to women reporting more gradual reductions in positive parenting between ages 1 and 4 and higher levels of positive parenting behavior at age 4. However, IPV experienced during pregnancy was associated with lower levels of observed positive parenting at age 4. These findings suggest that mothers who experience IPV during pregnancy may positively distort their perceptions of their positive parenting during early childhood, such that it is inconsistent with actual parenting behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Child Appraisals of Interparental Conflict: The Effects of Intimate Partner Violence and Parent-Child Relationship Quality

Children's appraisals of interparental violence, including appraisals of high threat and low coping efficacy, are robust predictors of behavioral and emotional problems. However, few studies have examined the factors that account for children's use of these maladaptive appraisals, particularly among children exposed to more severe forms of interparental conflict. The current study examines parent-child relationship quality as a mediator of the effect of intimate partner violence (IPV) exposure on children's appraisals of conflict. Participants were 118 mother-child dyads (54 girls and 64 boys), recruited from three Midwestern counties. Consistent with previous reports, child exposure to IPV, as reported by children's mothers, predicted higher threat and lower coping efficacy appraisals. In addition, mediation analyses showed child reports of parent-child relationship quality mediated the association between IPV and coping efficacy, but not the effects of IPV on threat appraisals. The role of parent-child relationships in shaping cognitive appraisals in the context of IPV exposure can have implications for prevention and intervention efforts as well as public policy.

Exposure to intimate partner violence in utero and infant internalizing behaviors: Moderation by salivary cortisol-alpha amylase asymmetry

Guided by the main tenets of contemporary models of the developmental origins of health and disease, this study evaluated whether individual differences in reactivity of the hypothalamic-pituitary-adrenal (HPA) axis and Sympathetic Nervous System (SNS) moderate the effect of prenatal exposure to trauma on internalizing and externalizing behaviors during infancy. Participants were a community sample of 182 mothers (M age=25years, 43% Caucasian, 33% Black/African American, 24% Biracial/Other) and their infants (59% girls; M age=11.8months). Each mother completed questionnaires that assessed IPV experienced during pregnancy and also reported on her infant's behavior problems. Infant saliva samples (later assayed for cortisol and sAA) were collected before and after a frustrating task (i.e., arm restraint). Results revealed that the association between in utero IPV and infant internalizing behaviors was most pronounced for infants with asymmetrical HPA-SNS (i.e., high-cortisol and low-sAA) reactivity to frustration, and least pronounced for infants with symmetrical HPA-SNS (i.e., low-cortisol and low-sAA or high-cortisol and high-sAA) reactivity to frustration. Higher levels of externalizing behavior, in contrast, were associated with higher levels of prenatal IPV but unrelated to either cortisol or sAA reactivity to stress. Findings replicate documented associations between maternal IPV exposure during pregnancy and offspring risk. Moreover, findings advance our understanding of individual differences in the developmental origins of health and disease and provide additional evidence that assessing multiple stress biomarkers contributes to a more comprehensive understanding of individual vulnerability to adversity.

Main and Moderating Influence of Temperament Traits on the Association Between Intimate Partner Violence and Trauma Symptoms

Trauma symptoms are common among survivors of intimate partner violence (IPV), although not all women who experience IPV develop trauma symptoms. One of the factors that may influence whether women develop trauma symptoms upon exposure to IPV is temperament. In this study, we examined the main and moderating effects of temperament traits (constraint, negative emotionality, and positive emotionality) on the association between IPV and trauma symptoms in a sample of young adult women ( N = 654) using a Bayesian approach to multiple linear regression to address significant non-normality in the data. Our results indicated that each temperament trait incrementally predicted trauma symptoms over and above the effects of IPV and other negative life events. Results further indicated that both negative emotionality and constraint moderated the influence of IPV on trauma symptoms such that IPV was positively associated with trauma symptoms at high levels of these traits but not at low levels. However, these effects differed depending on the type of violence experienced (physical, sexual, or psychological). These results extend previous research on the influence of temperament traits to the context of IPV; this underscores the importance of incorporating temperament in the study of IPV, as well as in the study of traumatic stress more generally.

Is maternal depression related to side of infant holding?

Studies show that 65–85% of mothers hold their infants on the left side of their own body and that this left-bias may be reduced or reversed when mothers have symptoms similar to depression or dysphoria (de Château, Holmberg, & Winberg, 1978). No studies, however, have used diagnostic criteria to assess the mother’s psychological state. The current study examined the relationship between maternal report of depressive symptoms on the Beck Depression Inventory and holding-side bias in a high-risk sample of 177 mothers participating with their infants in a larger longitudinal study of mother–infant relationships and domestic violence. Mothers classified as nondepressed showed a significant left-bias; those classified as depressed showed a nonsignificant right-bias; mothers who reported experiencing domestic violence also showed a reduced left-bias. The results are interpreted in terms of current theory and research on lateralised hemispheric activation and depression.

Abusive Partners and Ex-Partners

This study examined how being abused by a current partner versus an ex-partner might affect psychological well-being and social support in a community sample of 398 women, half of whom had experienced abuse in the past 6 months. The impact of emotional and physical abuse was influenced by partner status, with emotional abuse being more detrimental to women abused by current partners and physical abuse being more detrimental to women abused by ex-partners. Emotional support was negatively related to depression in women abused by current partners, whereas practical support was negatively related to depression in women abused by ex-partners. The implications for interventions with abused women are discussed.

Infant adrenocortical reactivity and behavioral functioning: relation to early exposure to maternal intimate partner violence

Prenatal stress negatively affects fetal development, which in turn may affect infant hypothalamic-pituitary-adrenal (HPA) axis regulation and behavioral functioning. We examined effects of exposure to a traumatic stressor in families [intimate partner violence (IPV)] on both infants' HPA axis reactivity to stress and their internalizing and externalizing behaviors. Infants (n = 182, 50% girls, x age = 11.77 months) were exposed to a laboratory challenge task designed to induce frustration and anger (i.e. arm restraint). Saliva samples were taken pre-task and 20 and 40 min post-task and then assayed for cortisol. Mothers reported on their pregnancy and postpartum IPV history, current mental health, substance use and their infants' behaviors. Structural equation modeling revealed that prenatal, but not postnatal, IPV was independently associated with infant cortisol reactivity and problem behavior. Maternal mental health predicted infant behavioral functioning but not infant HPA axis reactivity. These findings are consistent with the prenatal programing hypothesis; that is, early life stress affects later risk and vulnerability for altered physiological and behavioral regulation.

National Institutes of Health Pathways to Prevention Workshop: the role of opioids in the treatment of chronic pain

This National Institutes of Health (NIH) Pathways to Prevention Workshop was cosponsored by the NIH Office of Disease Prevention (ODP), the NIH Pain Consortium, the National Institute on Drug Abuse, and the National Institute of Neurological Disorders and Stroke. A multidisciplinary working group developed the workshop agenda, and an evidence-based practice center prepared an evidence report through a contract with the Agency for Healthcare Research and Quality to facilitate the workshop discussion. During the 1.5-day workshop, invited experts discussed the body of evidence, and attendees had opportunities to provide comments during open discussion periods. After weighing evidence from the evidence report, expert presentations, and public comments, an unbiased, independent panel prepared a draft report that identified research gaps and future research priorities. The report was posted on the ODP Web site for 2 weeks for public comment. This article is an abridged version of the panel's full report, which is available at https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/opioids-chronic-pain/workshop-resources#final report.

Relational trauma in the context of intimate partner violence

The relational model of trauma (Scheeringa & Zeanah, 2001) proposes that infants' trauma symptoms may be influenced by their mothers' trauma symptoms and disruptions in caregiving behavior, although the mechanisms by which this occurs are less well understood. In this research, we examined the direct and indirect effects of a traumatic event (maternal intimate partner violence [IPV]), maternal trauma symptoms, and impaired (harsh and neglectful) parenting on infant trauma symptoms in a sample of mother-infant dyads (N=182) using structural equation modeling. Mothers completed questionnaires on IPV experienced during pregnancy and the child's first year of life, their past-month trauma symptoms, their child's past-month trauma symptoms, and their parenting behaviors. Results indicated that the effects of prenatal IPV on infant trauma symptoms were partially mediated by maternal trauma symptoms, and the relationship between maternal and infant trauma symptoms was fully mediated by neglectful parenting. Postnatal IPV did not affect maternal or infant trauma symptoms. Findings support the application of the relational model to IPV-exposed mother-infant dyads, with regard to IPV experienced during pregnancy, and help identify potential foci of intervention for professionals working with mothers and children.

PTSD symptoms in young children exposed to intimate partner violence

Intimate partner violence (IPV) places infants and young children at risk for development of trauma symptoms. However, this is an understudied consequence of IPV because young children pose particular difficulties for assessment of trauma symptoms. The authors collected maternal reports on mothers' and children's posttraumatic stress disorder (PTSD) symptoms and IPV yearly, from ages 1 to 7. Approximately half of the children exposed to IPV at each time period developed some trauma symptoms, and frequency of IPV witnessed was associated with PTSD symptoms. Maternal and child PTSD symptoms were correlated, suggesting that young children may be particularly vulnerable to relational PTSD due to their close physical and emotional relationship with their parents.

Assessment and psychotherapy with women experiencing intimate partner violence: integrating research and practice

Intimate partner violence (IPV) is a serious, pervasive problem; however, professional literature focused on psychotherapy for women experiencing IPV is limited. This article delineates reasons why there is a dearth of literature on this topic. It then provides guidelines for assessment and practice, focusing on issues and approaches unique to women experiencing IPV. For assessment, the therapist should gather information on the type of IPV the client experiences, the relationship dynamics involved, and the availability of the client's social support network. Discussion of the client's developmental history, including any history of child maltreatment and violence in early dating relationships is also relevant. Assessment of the client's current mental health functioning is essential and will include a consideration of common psychological sequelae that can result from IPV. Treatment should include safety planning as well as reducing minimization of the abuse. In addition, treatment should address potential IPV-related emotion dysregulation and splitting.

Understanding the "ghosts in the nursery" of pregnant women experiencing domestic violence: Prenatal maternal representations and histories of childhood maltreatment

Selma Fraiberg and colleagues (1975) conceptualized the "ghosts in the nursery" as experiences from a mother's past that influenced her ability to form a warm and attuned relationship with her child. Contemporary infant mental health interventions often ask the mother to reflect on her own history of attachment relationships to gain insight into as well as to strengthen her developing relationship with her child. This study investigated the association between a mother's history of childhood maltreatment (CM) and her subsequent prenatal maternal representation during the third trimester of pregnancy. Controlling for domestic violence (DV), distorted prenatal representations were associated with higher rates of self-reported childhood physical neglect. In addition, DV moderated the relationship between representations and CM, such that women who were exposed to DV during pregnancy and had distorted prenatal representations were least likely to report childhood physical and sexual abuse. Implications are discussed in relation to infant mental health interventions which rely on a parent's ability to psychologically access and reflect on childhood histories to more sensitively parent her own child.

Women survivors of intimate partner violence and post-traumatic stress disorder: prediction and prevention

A considerable body of research has demonstrated that women who are abused by their male romantic partners are at substantially elevated risk for the development of post-traumatic stress disorder (PTSD). This article reviews recent literature regarding intimate partner violence (IPV) and resultant PTSD symptoms. The article is intended to be an introduction to the topic rather than an exhaustive review of the extensive literature in this area. Factors that enhance and reduce the risk for PTSD, including social support, coping styles, and types of abusive behavior experienced, are described. In addition, the unique risks associated with IPV for women who have children are discussed. Prevention efforts and treatment are briefly reviewed.

Is it necessary to discuss person-oriented research in community psychology?

A brief overview of the person orientation is provided. It is then argued that research in community psychology, similar to every other field in psychology, has mainly focused on variables, not individuals. Suggestions are provided for how the person orientation can be applied to understanding settings and environments as well as the theoretical and methodological contributions community psychologists can make to further person oriented methods.

Women's appraisals of intimate partner violence stressfulness and their relationship to depressive and posttraumatic stress disorder symptoms

Intimate partner violence (IPV) increases risk for depressive and posttraumatic stress disorder (PTSD) symptoms. Most studies use a dose-response approach to examine the impact of IPV on mental health, but they often fail to explain mental health outcome specificity as well as to assess the impact of women's subjective appraisals. The present research examined women's IPV stressfulness appraisals and their psychological functioning (depressive and PTSD symptoms). Results indicate that IPV stressfulness appraisals are associated with depressive symptoms over and above frequency and severity of IPV. PTSD symptoms were associated with frequent and stressful IPV. Women who experienced highly frequent and highly stressful IPV were most likely to display comorbid depressive and PTSD symptoms. Results underscore the importance of women's subjective experiences and the heterogeneity of women's responses to IPV.

New Directions for Research on Intimate Partner Violence and Children

This article provides an overview to the Special Section in this issue on intimate partner violence (IPV) and children. The argument is made that the field needs to pay more attention to issues of theory, definitions, and methodology. The contributors to the Special Section each make a unique contribution to one of these topics. Their articles document that increased focus on definition and theory, methodologies involving laboratory studies, data collection at multiple time-points, person-oriented approaches, and diverse samples of children exposed to IPV will begin to increase the research sophistication of the field. We argue that the field needs comparability of definitions for the same/similar phenomena under investigation, more sophisticated, testable hypotheses, a better understanding of the short- and long-term consequences of exposure to IPV, and, finally, a more refined picture of the mechanisms by which exposure to IPV affects particular children.

Domestic violence, maternal parenting, maternal mental health, and infant externalizing behavior

This study examined whether maternal functioning mediated the relationship between domestic violence (DV) and infant externalizing behavior. Participants were 203 mother-infant dyads. Support was found for a partially mediated model in which maternal functioning mediated the relationship between current DV and infant externalizing behaviors. Past DV was directly associated with infants' externalizing behavior. Results suggest the need for early intervention and prevention efforts for families living with DV.

Variable-oriented and person-oriented perspectives of analysis: The example of alcohol consumption in adolescence

This article presents person-oriented and variable-oriented approaches to data analysis. To illustrate these two approaches and the types of information they provide the researcher, data from 3,558 control group youth from the National Cross-Site Evaluation of High Risk Youth Programs were analysed. The relationship, over time, between parent attitudes and gender as it relates to youth alcohol consumption were examined. Data were analysed and compared using a variable-oriented approach (repeated measures ANOVA) and a person-oriented approach (Configural Frequency Analysis). Data analysis demonstrated that variable- and person-oriented approaches provide the researcher with different information that can be complementary. The ANOVA identified an overall trend that accounted for little variance; the CFA explained why this was the case by identifying groups of respondents whose behaviour was different from the overall trend. The implications of these results and the use of both types of approaches are discussed.

Trauma symptoms among infants exposed to intimate partner violence

OBJECTIVE

To determine whether infants have a traumatic response to intimate partner violence (male violence toward their female partner; IPV) experienced by their mothers, two questions were explored: (1) Is the number of infant trauma symptoms related to the infant's temperament and the mother's mental health? (2) Does severity of violence moderate those relationships?

METHODOLOGY

Forty-eight mothers reported whether their 1-year-old infants experienced trauma symptoms as a result of witnessing episodes of IPV during their first year of life. Mothers also reported on their own trauma symptoms that resulted from experiences of IPV.

RESULTS

For those infants experiencing severe IPV and whose mothers exhibit trauma symptoms, we were able to predict whether infants exhibited trauma symptoms (b = .53, p < .01). This was not true for children who witnessed less severe IPV (b= -.14, ns). Maternal depressive symptoms and difficult infant temperament did not predict infant trauma symptoms for either group of infants.

CONCLUSION

Mothers report that infants as young as 1-year-old can experience trauma symptoms as a result of hearing or witnessing IPV. The significant relationship between infant and maternal trauma symptoms, especially among those infants experiencing severe IPV, are consistent with the theory of relational PTSD. Findings suggest that interventions for mothers and families need to consider the influence of the severity of IPV on very young children.

Stability and change in mothers' internal representations of their infants over time

This study examined predictors of stability and change in women's maternal representations of their children. Participants were 180 women, recruited from the community, half of whom had experienced domestic violence during pregnancy. Maternal representations of were assessed with the Working Model of the Child Interview (WMCI; Zeanah, Benoit, Hirshberg, Barton, & Regan, 1994) during the last trimester of pregnancy and again at the child's first birthday. Results indicated that when collapsed into balanced and non-balanced categories, 71% of the sample was stable over time, and women who had balanced representations had significantly more stable representations than women who had non-balanced representations (p < .001). Income, single parenthood, abuse status, and depressive symptomatology predicted change. In addition, women who became non-balanced postnatally benefited from having balanced representations while pregnant to buffer the quality of their interactions with their children.

The influence of community violence on the functioning of women experiencing domestic violence

The relationships among women's experiences of domestic violence, community violence, and their mental health functioning were explored (N = 94). Social contagion theory was used to argue for the link between community violence and family violence. Results revealed that women's experiences of domestic violence were not related to community violence. Furthermore, women's mental health functioning was solely associated with their experiences of domestic violence, not with community violence. Results are discussed in terms of an ecological model of domestic violence and future directions for exploring linkages between neighborhood characteristics and individual experiences.

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

This study investigated the relationship between family support and mental health in a community sample of pregnant women experiencing interpersonal partner violence (IPV). This study also examined how family support may differentially affect mental health in Black and White women experiencing IPV. A total of 110 participants (32 Black and 78 White) were obtained from the first time period of a longitudinal study examining the effects of domestic violence on women. The model was supported (chi2 = 142.55; df = 72, p > .001, RMSEA = .07). Black women had better mental health than White women. However, ethnicity was not a significant predictor of family support. Implications from this study highlight the need for further research on the role of family support in the lives of physically abused women as well as the need to incorporate cross cultural perspectives when examining this issue.

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.

Validation of the subtle and overt psychological abuse scale: an examination of construct validity

The Subtle and Overt Scale of Psychological Abuse (Marshall, 1999a) is a measure designed to examine previously unevaluated forms of psychological abuse. The scale was originally divided into seven subscales (overt: dominance, indifference, monitoring and discrediting; subtle: undermining, discounting, isolating). A sample of 172 women was used to evaluate the construct validity of this measure. In other words, the internal structure of the measure, its relation to other measures of physical and psychological abuse, and its relationship to other psychological outcomes. Empirical and theoretical approaches were used to replicate and examine the dimensions of this scale. Results revealed that this scale represents a unidimensional construct that is highly correlated to other measures of psychological abuse. Implications for future research and practice are discussed.

The social networks of women experiencing domestic violence

The research literature has demonstrated that battered women living in shelters experience impaired social support. This study examines this phenomenon among battered women living in the community. This study compared a group of pregnant battered women (n = 145) and a group of pregnant nonbattered women (n = 58) in terms of their structural [e.g., total number of supporters, network members in violent relationships with their partners (an index of homophily or nonhomophily) and functional (e.g., emotional)] social support. Four reasons for impaired support in battered women were proposed and examined, including social isolation, failure to disclose abuse, homophily, and low SES. Only homophily was related to impaired support among battered women. In addition, the relationship between structural and functional support and mental health outcomes (e.g., depression, self-esteem) was examined. Criticism, practical support, homophily, and disclosure were all significant predictors of mental health for battered women. Implications for community-based interventions are discussed in the context of current intervention strategies with battered women.

The Impact of Maternal Characteristics and Contextual Variables on Infant-Mother Attachment

This prospective study examined the effects of maternal characteristics, social support, and risk factors on infant-mother attachment in a heterogeneous sample. Two hundred and six women between the ages of 18 and 40 were interviewed during their last trimester of pregnancy and 1 year postpartum. Structural equation modeling revealed that maternal attachment experiences were significantly related to prenatal representations of the infant and of the self as a mother, which were significantly related to infant-mother attachment assessed by the Strange Situation. Maternal risk factors were significantly related to prenatal representations, and social support from other women predicted infant-mother attachment. The overall model indicated a good fit. Thus, both individual and contextual factors were important in explaining infant attachment security.

Predicting the psychosocial effects of interpersonal partner violence (IPV). How much does a woman's history of IPV matter?

Women's (N=205) IPV experiences were assessed during their pregnancies, in the year before their pregnancies, and with their previous partners. The study explored whether psychosocial indicators and severity of violence could be predicted from a woman's continuity and history of IPV. Two 4-group classifications-partner (IPV experiences across partners) and time (history of IPV experiences)-and one 2-group classification (IPV or no IPV in the past 6 months) were compared. Both four-group classifications accounted for more variance than did the two-group. Within the four-group classifications, most of the significant differences on psychosocial outcomes and severity of IPV were between the no IPV and chronic IPV groups (IPV experiences with two partners and across three different time periods). However the groups that also fared poorly were those who experienced recent IPV and continuity of IPV across time with their current partners.