History Of Childhood Physical Abuse Research Articles

The effects of a defendant's childhood physical abuse on lay support for sentencing: The moderating role of essentialism.

Research suggests that a defendant's history of experiencing childhood abuse, and its effects on their life and later decision-making, may impact public support for a defendant's sentencing, particularly mitigation. However, no existing research has examined how and why sentencing support may vary based on the time period when the abuse occurs during a defendant's childhood. This experiment, using a sample of the U.S. public (N=400), examines how the age at which a defendant's childhood physical abuse occurs affects lay support for the goals of their sentencing. We hypothesized that participants with higher levels of social and biological trait essentialism would moderate their increased support for more punitive sentencing goals-particularly when a defendant was abused earlier, rather than later, in childhood. Results suggest that social essentialism is associated with increased support for restoration and rehabilitation toward defendants with histories of childhood physical abuse, potentially indicating that the public views the effects of child abuse as more of a social, versus biological, process which may affect support for utilitarian punishment goals.

Antipsychotic effects on anthropometric outcomes in anorexia nervosa: a retrospective chart review of hospitalized children and adolescents

BackgroundOff-label antipsychotic use is not uncommon in youth with anorexia nervosa (AN), aiming to enhance suboptimal weight restoration, yet its efficacy remains debated, especially in youth.MethodsRetrospective chart review of consecutively admitted inpatients (ages 8–18 years) with restricting/binge-purge AN, comparing youth with versus without antipsychotic treatment regarding baseline factors, treatment, and anthropometric outcome characteristics including all patients and matched subgroups. Matched subsamples were also compared regarding faster versus slower weight change (median split). Furthermore, within-subject analyses compared weight gain trajectories before versus after antipsychotic use in antipsychotic-treated youth. These results were then compared in a pre-/post design with the matched control group without antipsychotic treatment, using the mean duration until antipsychotic use in the antipsychotic-treated group as the dividing timeline, controlling for a potential order effect, in that later rather than earlier antipsychotic treatment for AN may be more successful.ResultsOf 294 youth with AN (median age = 15.2 (interquartile range = 14.0, 16.6) years, females = 96.6%, restricting subtype = 81.0%, hospitalization duration = 98.2 ± 43.2 days), 44 (15.0%) underwent 52 antipsychotic trials (olanzapine = 63.5%). In multivariable analyses, antipsychotic use was independently associated with younger age, childhood physical abuse history, comorbid borderline personality traits, and lower pre-antipsychotic weight gain (p < 0.0001). In unmatched groups, antipsychotic-treated versus non-treated youth had significantly lower discharge anthropometric parameters, longer inpatient treatment, and lower weight change/week (p < 0.001–p = 0.005), without significant differences between olanzapine and non-olanzapine antipsychotics (p = 0.27–0.44). Non-significant antipsychotic effects on weight outcomes were confirmed in (1) matched subgroups of antipsychotic-treated versus non-treated youth (n = 43 each), (2) youth with faster versus slower weight gain (n = 21 vs. n = 22), and (3) antipsychotic-treated youth when comparing weight change before versus after antipsychotic use (n = 31). Moreover, in antipsychotic-treated youth, weight change/week remained significantly lower versus matched non-antipsychotic-treated youth (n = 31) both before (p = 0.053) and after (p = 0.006) the median time (5 weeks) until antipsychotic use.ConclusionsIn this naturalistic study, clinician's antipsychotic choice, given to a more severely ill subgroup of adolescents with AN, did not significantly improve overall worse weight change trajectories during inpatient treatment, even in matched subgroups. Randomized trials in individuals reflecting real-world samples are needed to evaluate the utility of antipsychotic treatment in youth with AN.

Pathways to recovery among survivors of childhood physical abuse: What is important to promote complete mental health

BackgroundDespite the numerous adverse health and social consequences of childhood physical abuse (CPA), some of those with a history of CPA manage to thrive in adulthood and achieve complete mental health (CMH). CMH is defined as the absence of mental illness in combination with happiness and/or life satisfaction, as well as high levels of social and psychological well-being. Objectives(1) To identify pathways linking CPA to CMH in adulthood; and (2) To estimate the magnitude of risk and protective factors associated with CMH among those exposed to CPA. Participants and SettingA sample of 17,216 respondents from the 2012 Canadian Community Health Survey-Mental Health was selected, including 853 with a history of CPA. MethodsPath analysis was used to estimate indirect and direct pathways between CPA, risk and protective factors, and CMH. Multivariable logistic regression was used to investigate the magnitude of effects of the same risk and protective factors on CMH among CPA survivors. ResultsAfter controlling for sociodemographic factors, the association between CPA and CMH was mediated by lifetime depression, anxiety, substance misuse, chronic pain, and presence of a confidant. The strongest predictors of past year CMH among those with a history of CPA was lifetime depression (OR = 0.19; 95 % CI 0.12–0.30) and presence of a confidant (OR = 3.77; 95 % CI = 1.67–8.55). ConclusionsIt is important to consider external factors, such as social support, in addition to mental health factors, such as depression and anxiety, to promote resiliency among those with a history of CPA.

History of childhood physical abuse is associated with gut microbiota diversity among adult psychiatric inpatients

BackgroundTraumatic life events are associated with the development of psychiatric and chronic medical illnesses. This exploratory study examined the relationship between traumatic life events and the gut microbiota among adult psychiatric inpatients. Methods105 adult psychiatric inpatients provided clinical data and a single fecal sample shortly after admission. A modified version of the Stressful Life Events Screening Questionnaire was used to quantify history of traumatic life events. 16S rRNA gene sequencing was used to analyze the gut microbial community. ResultsGut microbiota diversity was not associated with overall trauma score or any of the three trauma factor scores. Upon item-level analysis, history of childhood physical abuse was uniquely associated with beta diversity. Linear Discriminant Analysis Effect Size (LefSe) analyses revealed that childhood physical abuse was associated with abundance of distinct bacterial taxa associated with inflammation. LimitationsThis study did not account for dietary differences, though diet was highly restricted as all participants were psychiatric inpatients. Absolute variance accounted for by the taxa was small though practically meaningful. The study was not powered for full subgroup analysis based on race and ethnicity. ConclusionsThis study is among the first to demonstrate a relationship between childhood physical abuse and gut microbiota composition among adult psychiatric patients. These findings suggest that early childhood adverse events may have long-conferred systemic consequences. Future efforts may target the gut microbiota for the prevention and/or treatment of psychiatric and medical risk associated with traumatic life events.

Filial Caregiving and Chinese Adults' Depressive Symptoms: Do Early-Life Parent-Child Relationships Matter?

This study investigated the association between caregiving time and depressive symptoms among Chinese adult children aged 45 and above, and whether early-life relationships with parents moderated the association. We used data from the 2011, 2013, and 2018 waves of China Health and Retirement Longitudinal Study (CHARLS) and the 2014 CHARLS Life History Survey, which included 4781 respondents with living mothers and 2710 respondents with living fathers. Results from multilevel models showed that caregiving time for mothers or fathers was not significantly associated with adults' depressive symptoms in general. However, more caregiving time for mothers was significantly associated with more depressive symptoms among respondents experiencing more frequent maternal childhood physical abuse. Altogether, childhood maltreatment may affect levels of caregiving stress decades later. Filial caregivers with a history of childhood physical abuse may require support.

Association of childhood abuse with behavioral weight-loss outcomes: Examining the mediating effect of binge eating severity.

The study aims were to (1) document the relationship between a history of childhood abuse and weight change during behavioral obesity treatment and (2) estimate the indirect effect of childhood abuse on weight change through binge eating severity. Participants (n = 431) were enrolled in a behavioral weight-loss intervention. Childhood physical and emotional abuse history and current binge eating severity were self-reported. Percent weight loss at 6 months was calculated using measured weight. Adjusted mediation models examined whether there was an indirect effect of childhood physical and emotional abuse on 6-month percent weight loss that operated through binge eating severity. After covariate adjustment, childhood physical abuse, but not emotional abuse, predicted a lower percent weight loss (B = -1.78%; 95% CI: -3.10% to -0.47%). Although childhood physical and emotional abuse were positively related to baseline binge eating severity, binge eating severity did not mediate the associations between either childhood abuse type and percent weight loss. Individuals with a childhood physical abuse history had a lower percent weight loss than those without such histories during behavioral obesity treatment. This effect was not explained by binge eating severity. Individuals with a history of childhood abuse may benefit from trauma-informed obesity care.

Childhood physical abuse and subsequent violent victimization among people who use illegal drugs in Vancouver, Canada.

BackgroundViolent victimization is common among people who use illegal drugs (PWUD) and is a source of significant health-related harm. However, little attention has been paid to how antecedent childhood trauma among PWUD may contribute to the risk of victimization in adulthood.ObjectiveThis study sought to examine the relationship between childhood physical abuse and victimization by physical assault among adult PWUD.Participants and settingData were derived from three prospective cohorts of PWUD in Vancouver, Canada between 2005 and 2018.MethodsChildhood physical abuse was assessed using the Childhood Trauma Questionnaire. Generalized linear mixed modeling was used to estimate the relationship between childhood physical abuse and subsequent violent victimization, after adjustment for potential confounders.ResultsAmong 2960 PWUD, including 1018 (34.39%) female participants, 1030 (34.8%) participants reported a history of moderate to severe childhood physical abuse, and 949 (32.06%) participants reported recent violent victimization at baseline. In a multivariate analysis, childhood physical abuse (Adjusted Odds Ratio [AOR] = 1.34, 95% confidence interval [CI]: 1.23–1.46) remained independently associated with violent victimization after adjustment for potential confounders.ConclusionsThis study found a high prevalence of childhood physical abuse and that this was associated with a higher risk of subsequent violent victimization among PWUD in this setting. Greater support for PWUD with a history of childhood physical abuse is needed to decrease existing vulnerability to violence, including screening for and treatment of childhood trauma and related violence prevention.

Childhood Trauma and Maladaptive Daydreaming: Fantasy Functions and Themes In A Multi-Country Sample

ABSTRACT We analyzed responses of 539 adults who met an evidence-based criterion for probable maladaptive daydreaming (MD). Their reported childhood traumata were associated with the utilization of MD to distract from painful memories. A history of childhood physical and emotional neglect as well as emotional abuse was associated with daydreaming aimed to regulate emotional pain. Childhood exposure to physical and emotional abuse was associated with an increased likelihood of daydreaming about an idealized version of their original families. Themes of emotional suffering were associated with exposure to childhood emotional abuse. A range of morbid imageries and trauma-related reenacting behaviors featured in the fantasies of our respondents. Childhood emotional abuse was related to daydreaming about death, physical violence as a victim, being a captor, being rescued, and being a rescuer. Childhood sexual abuse was correlated with themes of sexual violence as a victim, being a captive, and being rescued. Childhood emotional neglect was linked with daydreaming about taking revenge, and a childhood history of physical abuse was associated with current fantasies about being captive. MD fantasy among adults exposed to childhood trauma may not only serve as mere coping mechanisms but potentially manifest a pathological preoccupation with unresolved childhood adversities.

Parental Reflective Functioning correlates to brain activation in response to video-stimuli of mother–child dyads: Links to maternal trauma history and PTSD

Parental Reflective Functioning is a parent's capacity to infer mental states in herself and her child. Parental Reflective Functioning is linked to the quality of parent-child attachment and promotes parent-child mutual emotion regulation. We examined neural correlates of parental reflective functioning and their relationship to physical abuse.Participants were mothers with (n = 26) and without (n = 22) history of childhood physical abuse. Parental reflective functioning was assessed by coding transcripts of maternal narrative responses on interviews. All mothers also underwent magnetic resonance imaging while watching video clips of children during mother–child separation and play.Parental reflective functioning was significantly lower among mothers with histories of childhood physical abuse. When mothers without history of childhood physical abuse watched scenes of separation versus play, brain activation was positively correlated with parental reflective functioning in the ventromedial prefrontal cortex, and negatively associated with the dorsolateral prefrontal cortex and insula. These associations were not present when limiting analyses to mothers reporting abuse histories.Regions subserving emotion regulation and empathy were associated with parental reflective functioning; yet these regions were not featured in maltreated mothers. These data suggest that childhood physical abuse exposure may alter the psychobiology that is linked to emotional comprehension and regulation.

Efficacy of Adjunctive Infliximab vs Placebo in the Treatment of Adults With Bipolar I/II Depression

To our knowledge, no study has previously evaluated whether individuals with bipolar depression enriched a priori on the basis of biochemical and/or phenotypic immuno-inflammatory activation would differentially respond to an anti-inflammatory agent for the treatment of depressive symptoms. To assess the antidepressant efficacy of adjunctive infliximab, a monoclonal antibody targeting tumor necrosis factor, in adults with bipolar I and bipolar II depression and inflammatory conditions. This 12-week, randomized, double-blind, placebo-controlled, parallel-group trial of 60 participants was conducted at 2 outpatient tertiary care sites in Canada and the United States. Eligible adults (aged 18-65 years) met DSM-5-defined criteria for bipolar I or bipolar II depression and exhibited pretreatment biochemical and/or phenotypic evidence of inflammatory activation. Participants were enrolled between October 1, 2015, and April 30, 2018. Data analysis was performed from May 1 through July 31, 2018, using modified intent-to-treat analysis. Patients were randomized to receive 3 intravenous infusions of infliximab therapy or placebo at baseline and at weeks 2 and 6 of the 12-week study. The primary efficacy outcome was baseline-to-end point (ie, week-12) change in Montgomery-Asberg Depression Rating Scale (MADRS) total score. History of childhood maltreatment, as assessed by the Childhood Trauma Questionnaire, was used for exploratory analyses as 1 of several secondary outcomes. A total of 60 participants were randomized to infliximab (n = 29 [48%]; mean [SD] age, 45.0 [11.7] years; 20 of 28 female [71%]) or to placebo (n = 31 [52%]; mean [SD] age, 46.8 [10.2] years; 26 of 30 female [87%]) across study sites. Overall baseline-to-end point change in MADRS total score was observed across treatment × time interaction (χ2 = 10.33; P = .04); reduction in symptom severity was not significant at week 12 (relative risk, 1.09; 95% CI, 0.80-1.50; df = 1; P = .60). As part of a secondary analysis, a significant treatment × time × childhood maltreatment interaction was observed in which infliximab-treated individuals with childhood history of physical abuse exhibited greater reductions in MADRS total score (χ2 = 12.20; P = .02) and higher response rates (≥50% reduction in MADRS total score) (χ2 = 4.05; P = .04). Infliximab did not significantly reduce depressive symptoms compared with placebo in adults with bipolar depression. Results from secondary analyses identified a subpopulation (ie, those reporting physical and/or sexual abuse) that exhibited a significant reduction in depressive symptoms with infliximab treatment compared with placebo. ClinicalTrials.gov identifier: NCT02363738.

Recurrence of Depression in Relation to History of Childhood Trauma and Hair Cortisol Concentration in a Community-Based Sample

Background: Childhood trauma represents a risk factor for developing depression with increased rates of recurrence. Mechanisms involved include a disturbed regulation of the hypothalamic–pituitary–adrenal (HPA) axis. Hair cortisol concentration (HCC) is a measure of long-term HPA axis activity with less interference from circadian and confounding factors. However, no study has so far used HCC to investigate the role of childhood trauma in recurrent pattern of depressive symptoms. Methods: A community-based sample of 500 participants was recruited, and depression was assessed at 3 time points using the Revised Clinical Interview Schedule. The Childhood Trauma Questionnaire was administered to identify a history of childhood trauma. Hair samples were obtained from 144 participants for analysis of cortisol. Results: Patients with recurrent depression had higher rates of childhood trauma compared to participants with no depression. Participants with current-only depression had increased HCC compared to the no depression group, while this was absent in participants with recurrent depression. Within the depressed group (both current-only and recurrent depression), those with a history of childhood physical abuse had lower HCC when compared to those with no such history. Conclusions: Our findings show that retrospectively reported childhood trauma is associated with protracted trajectories of depression and a distinct pattern of long-term HPA axis activity.

Relationship of abuse by religious authorities to depression, religiosity, and child physical abuse history in a college sample.

Discussion of sexual abuse by religious authorities has been plagued by allegations of false memories and misreports, often attributed to media attention. An analysis of a historical archive with information on abuse by religious and other authority figures and coexisting psychopathology is extremely useful to the current debate on outcomes of sexual abuse. The present study utilizes a database from the late 1970s that contains data on physical abuse and sexual abuse by various perpetrator types as well as on symptoms of depression, anxiety, and religiosity in a college population sample. Students alleging sexual abuse by religious authorities were as symptomatic (depressed and anxious) as students abused by parents and were more symptomatic than controls. Further, those abused by religious authorities showed greater variance in religiosity and a greater likelihood of breaking ties with their religious communities. Students self-labeling as physically abused by parents were more at risk for sexual abuse by religious authorities. Religious authorities often play complex roles in social and family life. These complexities then may produce parallel complexities in the patterns of symptoms. The intensity of the trauma from abuse by religious authorities may make it more difficult to study, treat, and recover from sexual abuse. Additional research is needed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Children’s Disclosure of Physical Abuse - The Process of Disclosing and the Responses from Social Welfare Workers

ABSTRACT Children experiencing physical abuse by their parents are left with several difficult decisions. The present study aims at exploring the process of disclosing the abuse and the responses from social welfare workers from a child perspective, in a Swedish context. Data was obtained from in depth interviews with 15 children with a history of child physical abuse. A qualitative content analysis was conducted in order to capture the children's experiences. Disclosing abuse was described as a process including several judgements from the child. Children describe their everyday life before disclosing, with an escalation of violence making them think they have to act in order to prevent further abuse. They made several well-thought decisions and selected a trustworthy recipient. The decision to disclose was often made out of fear, but the fear could remain after the disclosure, not knowing what will happen next. Children seem to lose control over how their abuse narratives are handled after disclosing. The recipient and social welfare worker was acting but not informing or consulting the child. Children emphasize the importance of trustworthy and competent adults when disclosing physical abuse. Ethical issues and implications for practice are discussed. Practitioner messages Disclosure is to be seen as a process, including several judgements by the child. Children emphasize the importance of trustworthy and competent adults when choosing to disclose physical abuse. Social welfare workers should inform and include children in their decision making.

Flourishing despite a cancer diagnosis: factors associated with complete mental health in a nationally-representative sample of cancer patients aged 50 years and older

Objectives: This study investigated the association between cancer and complete mental health (CMH). CMH includes optimal functioning as well as the absence of psychopathology.Methods: Secondary data analyses of the nationally representative 2012 Canadian Community Health Survey-Mental Health. This study used bivariate and logistic regression analyses to estimate the odds ratios of CMH among community dwellers aged 50 and older with current cancer (n = 438), previous cancer (n = 1,174) and no cancer history (n = 9,279). CMH had three elements: (1) absence of mental illness, addictions and suicidal thoughts in the past year; (2) almost daily happiness or life satisfaction in the past month; (3) psychosocial well-being. Control variables included socio-demographics, health behaviours, current physical health and lifetime history of mental illness and childhood maltreatment.Results: Adults aged 50 and over with current cancer had a much lower prevalence of CMH (66.1%) than those with previous cancer (77.5%) and those with no cancer history (76.8%). After adjusting for 17 variables, the odds of CMH among those with current cancer remained substantially lower (OR = 0.63; 95% CI = 0.49–0.79) than those without cancer. Among those who had ever had cancer, the odds of CMH were higher for female, white, married, and older respondents, as well as those with higher socioeconomic status, and no history of childhood physical abuse, substance abuse, depression or anxiety disorder.Conclusions: Those with former cancer have comparable odds of CMH to those with no cancer history, suggesting a high level of resilience among cancer survivors.

Physical neglect in childhood as a predictor of violent behavior in adolescent males

Research has established that childhood maltreatment experiences are associated with negative outcomes in adolescence, including violent and antisocial behavior (Chapple et al., 2005). Neglect is the most prevalent form of childhood maltreatment (U.S. DHHS, 2012), the consequences of which require further investigation. This study used archival data to explore whether childhood physical neglect increased the likelihood of violent behavior in a random sample of 85 males between the ages of 12–19 held at a long-term detention facility in the Northeastern United States.An anonymous survey gathered background information and data regarding childhood physical neglect and violent behavior in adolescence. A step-wise hierarchal regression model controlled for the effects of age, self-esteem, personal competency, depression, chemical drug use, family violence and a childhood history of physical abuse. Results showed that a history of childhood physical neglect was the strongest predictor of violent adolescent behavior in this sample when the data was tested for all moderator and mediator effects.

The relation between mental health, homosexual stigma, childhood abuse, community engagement, and unprotected anal intercourse among MSM in China

The aim of the study was to explore the relation of various factors with unprotected anal intercourse (UAI) and provide some insight for HIV intervention on Chinese men who have sex with men (MSM). The current cross-sectional study recruited 365 MSM in Dalian, China. More than half of the respondents (117 respondents, 51.8% of the sample) had engaged in UAI. The multivariable logistic regression model suggested that poorer mental health (AOR: 7.16; 95% CI: 3.14–16.31), self-stigma (AOR: 1.53; 95% CI: 1.00–2.34), and experience(s) of physical abuse in childhood (AOR: 5.85; 95% CI: 1.77–19.30) were significantly and positively related to UAI. Community engagement was negatively associated with UAI (p < 0.05). It appears it is necessary to incorporate mental health services, eliminate the stigma against homosexuality, and facilitate MSM-related community engagement into intervention strategies to prevent UAI among Chinese MSM. Targeted UAI interventions in the subgroup with a history of childhood physical abuse should also be of great concern.

Comparison of Modes of Administration of Screens to Identify a History of Childhood Physical Abuse in an Adolescent and Young Adult Population

BackgroundChildhood physical abuse is a major public health issue with negative consequences to health and well-being manifested in childhood and adolescence, and persisting into adulthood. Yet much childhood physical abuse is not identified when it occurs and little is known about how to screen for it. MethodsTo address this gap, the effectiveness of 4 modes of administration of screens to identify childhood physical abuse were compared in a sample of 506 adolescents and young adults aged 12-24 years seeking general health services at a primary care clinic. Comparisons were made between paper and pencil screen, audio computer-assisted self-interview screen, face-to-face structured screen (all 3 using the same measure), and face-to-face unstructured interview. FindingsOverall, 44.5% of the sample disclosed that they had been physically abused. Compared to paper and pencil screen, the odds of reporting physical abuse were 1.5 (95% confidence interval [CI]: 0.92, 2.58) and 4.3 (95% CI: 2.49, 7.43) higher among participants using face-to-face structured screen and face-to-face unstructured interview methods, respectively. The face-to-face unstructured interview identified significantly more reports than the paper and pencil screen. ConclusionsAlthough the unstructured interview was the most effective mode for screening for childhood physical abuse, additional research is needed to confirm whether this holds true in other health care settings. Further research should examine how a health provider's training, experience, and comfort level might influence the identification of physical abuse disclosure in primary care settings using face-to-face unstructured interview.

The relationship between childhood physical abuse and suicidal ideation among Chinese university students: Possible moderators

This study examined the relationship between childhood physical abuse and adolescent suicidal ideation in Hong Kong, China. Emotional competence and resilience were investigated as possible moderators of the relationship between physical abuse and suicidal ideation. A cross-sectional survey using convenience sampling was conducted and a total of 268 valid self-administered questionnaires were completed by the participating university students. The results indicate that physical abuse in childhood is significantly associated with greater suicidal ideation among young people at university. Higher levels of emotional competence and resilience are shown to moderate the relationship between physical abuse and suicidal ideation. To decrease Chinese adolescent suicidal ideation arising out of childhood physical abuse, preventative measures are suggested; these involve enhancing adolescents' emotional competence and resilience by providing training for children and young people who are at risk. The results also suggest that there should be programs that encourage adolescents with a history of childhood physical abuse to join training groups to enhance their emotional competence and resilience in the context of Chinese communities.

Is Epigenetic Stress the Link Between Childhood Maltreatment and Borderline Personality Disorder?

Is Epigenetic Stress the Link Between Childhood Maltreatment and Borderline Personality Disorder?

Physical, sexual and social health factors associated with the trajectories of maternal depressive symptoms from pregnancy to 4years postpartum.

Few studies have examined the course of maternal depressive across pregnancy and early parenthood. The aim of this study was to identify the physical, sexual and social health factors associated with the trajectories of maternal depressive symptoms from pregnancy to 4years postpartum. Data were drawn from 1102 women participating in the Maternal Health Study, a prospective pregnancy cohort study in Melbourne, Australia. Self-administered questionnaires were completed at baseline (<24weeks gestation), and at 3-, 6-, 12-, and 18 months, and 4years postpartum. Latent class analysis modelling identified three distinct classes representing women who experienced minimal depressive symptoms (58.4%), subclinical symptoms (32.7%), and persistently high symptoms from pregnancy to 4years postpartum (9.0%). Risk factors for subclinical and persistently high depressive symptoms were having migrated from a non-English speaking country, not being in paid employment during pregnancy, history of childhood physical abuse, history of depressive symptoms, partner relationship problems during pregnancy, exhaustion at 3months postpartum, three or more sexual health problems at 3months postpartum, and fear of a partner since birth at 6months postpartum. This study highlights the complexity of the relationships between emotional, physical, sexual and social health, and underscores the need for health professionals to ask women about their physical and sexual health, and consider the impact on their mental health throughout pregnancy and the early postpartum.