Maternal Child Abuse Research Articles

Predicting Maternal Physical Child Abuse Risk Beyond Distress and Social Support: Additive Role of Cognitive Processes

Although personal vulnerabilities, such as distress, have been identified as factors that elevate physical child abuse risk, relatively less literature has clarified the added contribution of parents’ maladaptive cognitive processes that can theoretically impact a parent’s physical discipline decisions and abuse risk. Moreover, the existing literature has been dominated by the use of single measures of hypothesized predictors and parental abuse risk to investigate their association. Indeed, measures of such predictors often evidence considerable conceptual or item overlap with the measure of the intended dependent variable of physical abuse risk, which could artificially magnify observed associations. Therefore, the current study employed multiple indicators for risk factors while also assessing parental child abuse risk in a number of ways, including the perspective of more than one informant. A sample of 95 mothers reported on their distress and social support as well as on the cognitive processes of empathic ability and negative attributions of child behavior whereas children reported on their parents’ positive and negative parenting. Results indicated that, beyond the major role of distress, mothers’ social support buffered the relation between distress and abuse risk, and low empathy and negative child attributions further exacerbated maternal abuse risk. Findings are discussed in terms of the need for continued research on such therapeutically meaningful cognitive processes capitalizing on more comprehensive assessment approaches for the variables of interest that can be applied to child abuse prevention efforts.

Maternal Childhood Maltreatment and Offspring Emotional and Behavioral Problems

This study examined hostility and harsh discipline of both mothers and fathers as potential mechanisms explaining the association between a maternal maltreatment history and her offspring's internalizing and externalizing problems. Prospective data from fetal life to age 6 were collected from a total of 4,438 families participating in the Generation R Study. Maternal maltreatment was assessed during pregnancy using a self-administered questionnaire. Mothers and fathers each reported on their psychological distress and harsh discipline when the child was 3 years. Children's internalizing and externalizing problems were assessed by parental reports and child interview at age 6. Findings from structural equation modeling showed that the association between a maternal maltreatment history and her offspring's externalizing problems was explained by maternal hostility and harsh discipline and, at least partially, also by paternal hostility and harsh discipline. Child interview data provided support for both these indirect paths, with associations largely similar to those observed for parent reports.

Implementation of mother-training program to improve parenting in pre-school age children: a randomized-controlled trial.

Background:Preventing child abuse is an area of evaluation that should be deeply considered. The enhancing skill of maternal child care is also useful in this field.Aim:The aim of this study was to assess the impact of a training strategy to improve parenting in the families identified as at risk of child maltreatment.Materials and Methods:This randomized and controlled trial was conducted in 60 mothers allocated in the experimental and controlled group by a simple random allocation in Amirkola Children's Hospital in North Iran from January 2009 to December 2009. Mean score of maternal child abuse before and after intervention has been assessed by Conflict Tactics Scale for Parent and Child. Data analysis was based on the independent t-test, the paired t-test and one way analysis of variance.Results:The mean and standard deviation of maternal child abuse score in the experimental group before and after intervention were 30.21 ± 1.21 and 23.31 ± 1.52, respectively, (P < 0.001, t = 6.63), but no difference was found in the control group.Conclusions:The training program on maternal skills to prevent child abuse was a powerful resource. Therefore, healthcare providers in the field of pediatric about parenting skills should be taught with a specific consideration.

Intimate Partner Violence Victimization, Maternal Child Maltreatment, and the Mediating Impact of Changes in Family Structure

To examine the mediating effect of family structure in the relationship between paternal Intimate Partner Violence (IPV) and maternal child maltreatment. The method was quantitative analysis of secondary data. Changes in family structure fully mediated the relationship between IPV victimization and maternal child physical abuse (Δ = .069) and partially mediated the impact of IPV on maternal child psychological abuse (Δ = .051). Households wherein IPV occurs are not only unsafe for children because of potential abuse by the perpetrators, they also create dynamics that increase the risk of child maltreatment by the IPV victim. Treating only substance abuse or managing only child maltreatment may be insufficient if these issues are the direct or indirect result of domestic violence. Programs that integrate services are urgently necessary to address the overlap of child abuse and domestic violence.

Maternal childhood abuse predicts externalizing behaviour in toddlers: A prospective cohort study

To investigate the impact of maternal childhood abuse on toddlers' behaviour and assess the potential mediation of maternal mental distress for this pathway. This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health. The study sample consisted of 25,452 children and their mothers. Maternal childhood abuse was investigated as a potential predictor for child externalizing behaviour at 36 months of age. Maternal mental distress at child age 18 months was assessed as a potential mediator. Hierarchical linear regressions were used for analyses. Childhood emotional abuse alone was reported by 8.3% of the mothers and physical and/or sexual abuse by 8.9%. Mothers with childhood abuse experiences were younger, less educated, more at risk for adult abuse and mental distress, and fewer were married or lived with a partner compared with women not reporting childhood abuse. Children of mothers with childhood abuse experiences showed significantly more externalizing behaviour even after adjusting for maternal age, education, single motherhood, gender and adult abuse experiences. When maternal mental health was entered into the model, the associations remained statistically significant, but were substantially attenuated. Maternal childhood abuse consistently predicted increased externalizing behaviour in the offspring, and this study suggests that childhood abuse impacts subsequent generations. Multiple pathways are possible, but this study identified increased maternal mental distress as a possible pathway between maternal childhood abuse and increased externalizing behaviour in the offspring.

Maternal Child Abuse and its Association with Maternal Anxiety in the Socio-Cultural Context of Iran

The prevalence of parental violence has been an area of major public concern. There are few available data detailing the ways parents and other caregivers discipline children, particularly in low and middle income countries. This study focuses on the prevalence of different types of maternal child abuse and its association with maternal anxiety in the socio-cultural context of Iran. Participants in this cross-sectional study consisted of 562 mothers with the last child aged from 1 month to 12 years old who attended the Amirkola Children's Referral Hospital in Mazandaran Province, Iran, seeking healthcare services for their children. Demographic characteristics of the mothers, their children and reactions to conflicts with children were evaluated by a validated version of Conflict Tactics Scale for Parent and Child. Also, the relationship between maternal anxiety and child abuse was assessed using the Spielberger State-Trait Anxiety Inventory. The association between variables was examined by Pearson correlation coefficient, independent t-test, one-way ANOVA, and multivariate regression. The prevalence of mother-to-child corporal punishment, severe physical abuse and very severe physical abuse were 436 (78%), 260 (46%) and 180 (32%), respectively. Verbal emotional abuse was reported by 506 (90%) participants and nonverbal emotional abuse was reported in 374 (67%) cases. A correlation was observed between child abuse and mothers' age (p=0.02), as well as with the number of children in the family (p=0.03), and the mothers' trait anxiety (p<0.001). Overall, the assessment of maternal child abuse should be an important focus for evaluation in mothers with anxiety and vice versa, when child abuse is suspected, maternal psychological assessment should be essential.

Unraveling the Longstanding Scars of Early Neurodevelopmental Stress

Early neurodevelopment, both in utero and in the postnatal phase, is a time when stressors can produce long-lasting changes that significantly increase the risk of mental health problems in adulthood (1). Pregnancy complications such as depression in the mother and childhood trauma can impact on neurodevelopment and increase the likelihood of psychiatric illnesses, such as major depression together with anxiety and personality disorders. Large-scale prospective studies indicate that the increased risk of these disorders following early adversity persists into old age. It is equally clear that not everyone who experiences early stressors develops psychiatric illness in adulthood and neither is there a relationship between any specific stress and a particular psychiatric disorder. If we are to ameliorate the impact of early stress, it is important that we gain an increased understanding of the manner in which such stress impacts on biological development and the psychosocial and genetic factors that help decrease the toxic effects of stress. In this regard, two articles in this issue of Biological Psychiatry focus on the underlying persistent neuronal alterations in subjects who have been exposed to, albeit qualitatively different and potent, early-life stressors (2,3). Interestingly, both articles highlight an important role for the amygdala in these effects. Olsavsky et al. (2) provide evidence in a functional magnetic resonance imaging experiment that altered activation of the amygdala plays a role in long-term behavioral problems in maternally deprived children that had been subsequently adopted (children were aged between 6 and 15 years at the time of scanning). Behaviorally, they found that this cohort had indiscriminate friendliness, which can be defined as an uncharacteristic reduced reticence and atypical approach behaviors towards adults, including strangers, being unable to distinguish adopted mothers from strangers and that this was also demonstrable in terms of amygdala discrimination to both types of stimuli. Interestingly, there was a positive correlation between age at adoption and hence duration of maternal deprivation and extent of the amygdala discrimination and behavioral response in terms of indiscriminate friendliness. On the other hand, Rifkin-Graboi et al. (3) takes a different approach, but once again, this study highlights the role of the amygdala in the long-term effects of early-life stress. They show that microstructural changes in the right amygdala (as assessed within the first 2 weeks of life) can be induced as a result of depression in the mother. The study adds further to our understanding of the toxic effect of maternal depression on the developing fetus. It is also worth noting that recent studies are pointing to a link between maternal childhood maltreatment and maternal antenatal depression (4), thus continuing the cycle of stress-induced effects across the generations with the cooccurrence of both insults significantly increasing the risk of offspring adversity. The mechanism for both of these associations is unclear and may include genomic and environmental influences both during fetal development and postnatally. Experimental studies in animals involving gestation stress or in early life are proving invaluable in uncovering key changes in the neurodevelopment of limbic structures, including alteration in amygdala size, neuronal activity, and expression of key stress-related genes (5). Moreover, starting with the work of Levine et al. (6) in Stanford and Meaney et al. (7) in McGill, a growing body of preclinical data in both rodents and nonhuman primates has been focused on understanding the consequences of alterations in maternal care in early life to both the susceptibility and resilience to psychopathology [see (1) for review].

Maternal history of child abuse moderates the association between daily stress and diurnal cortisol in pregnancy: a pilot study

Previous research on the association between maternal daily stress and cortisol in pregnancy has yielded inconsistent findings. However, past studies have not considered whether stressful experiences in childhood impact maternal cortisol regulation in pregnancy. In this pilot study, we aimed to examine whether the association between maternal daily stress and cortisol differed according to maternal history of child abuse. Forty-one women provided salivary cortisol samples at wake-up, 30 min after wake-up, and bedtime for 3 days at three times over second and third trimesters of pregnancy. On each day of cortisol collection women reported their daily stress. Women reported child abuse experiences prior to age 18 years by completing 15 items from the Adverse Childhood Experiences Scale. Twenty-one percent (N = 9) of women reported a history of child sexual abuse (CSA), 44% (N = 18) reported a history of non-sexual child abuse and 34% (N = 14) reported no history of child abuse. Hierarchical Linear Modeling (HLM) analyses revealed that stress in the day prior was associated with increases in morning cortisol in women with CSA histories compared to women with non-sexual abuse histories or no history of child abuse. Increases in evening cortisol were associated with increases in daily stress in women with CSA histories compared to women with non-sexual abuse histories or no history of child abuse. Results reveal a dynamic association between daily stress and cortisol in pregnancy and suggest that patterns differ according to maternal child abuse history.

Multiple Mediators of the Relationships Among Maternal Childhood Abuse, Intimate Partner Violence, and Offspring Psychopathology

The aim of the study was to examine whether maternal depression, mothers' and fathers' parenting, child physical punishment and negative life events (NLE) mediate the effect of maternal childhood abuse (CA), intimate partner violence (IPV) and cumulative violence (both CA and IPV) on Spanish children's and adolescents' psychopathology. Furthermore, multiple mediator models examine whether IPV mediates the effect of CA on the contextual and family factors mentioned above. Three hundred and eighteen Spanish outpatients aged 7 to 18 and their parents were assessed using a structured interview and other instruments for measuring the study variables. Structural equation models (SEMs) showed multiple pathways explaining psychopathological problems among offspring of mothers who suffered CA, IPV and both of these violent experiences. In particular, mothers' depression mediated the link between maternal CA, IPV, cumulative violence and children's externalizing, and total behavior problems. Child NLE was an important pathway between maternal CA and total behavior problems, as well as between cumulative violence and both externalizing and total problems. IPV contributed to explaining the link between maternal CA and contextual and family factors, such as child physical punishment and NLE, which were in turn, associated with children's behavior problems. Findings show the complex interconnections between different types of violence and their harmful effects on the mental health of women and their offspring, as well as the need to extend our knowledge on this subject.

Association of maternal exposure to childhood abuse with elevated risk for autism in offspring.

Adverse perinatal circumstances have been associated with increased risk for autism in offspring. Women exposed to childhood abuse experience more adverse perinatal circumstances than women unexposed, but whether maternal abuse is associated with autism in offspring is unknown. To determine whether maternal exposure to childhood abuse is associated with risk for autism in offspring and whether possible increased risk is accounted for by a higher prevalence of adverse perinatal circumstances among abused women, including toxemia, low birth weight, gestational diabetes, previous induced abortion, intimate partner abuse, pregnancy length shorter than 37 weeks, selective serotonin reuptake inhibitor use, and alcohol use and smoking during pregnancy. Nurses' Health Study II, a population-based longitudinal cohort of 116 430 women. Nurses with data on maternal childhood abuse and child's autism status (97.0% were of white race/ethnicity). Controls were randomly selected from among children of women who did not report autism in offspring (participants included 451 mothers of children with autism and 52 498 mothers of children without autism). Autism spectrum disorder in offspring, assessed by maternal report and validated with the Autism Diagnostic Interview-Revised in a subsample. Exposure to abuse was associated with increased risk for autism in children in a monotonically increasing fashion. The highest level of abuse was associated with the greatest prevalence of autism (1.8% vs 0.7% among women not abused, P = .005) and with the greatest risk for autism adjusted for demographic factors (risk ratio, 3.7; 95% CI, 2.3-5.8). All adverse perinatal circumstances except low birth weight were more prevalent among women abused in childhood. Adjusted for perinatal factors, the association of maternal childhood abuse with autism in offspring was slightly attenuated (risk ratio for highest level of abuse, 3.0; 95% CI, 1.9-4.8). We identify an intergenerational association between maternal exposure to childhood abuse and risk for autism in the subsequent generation. Adverse perinatal circumstances accounted for only a small portion of this increased risk.

Maternal Childhood Abuse, Intimate Partner Violence, and Child Psychopathology

This study examined the mediator role of mothers' mental health in the relationship among maternal childhood abuse (CA), intimate partner violence (IPV), and offspring's psychopathology, and explored whether mediational pathways were moderated by children's sex. Participants were 327 Spanish outpatient children, 8 to 17 years old, and their mothers. Mothers' global psychological distress and depressive symptoms mediated the associations between mothers' violence history and children's externalizing problems. However, only depressive symptoms fully mediated these relationships. Children's sex did not have a moderating role in adjusted paths. Mothers' depressive symptoms are an important mechanism by which maternal violence experiences could affect externalizing problems in Spanish children.

Testing a cascade model of linkage between child abuse and negative mental health among battered women in Japan

This study examined the following hypotheses: (1) a child abuse history (CAH), domestic violence (DV), and child abuse by an intimate partner might have a crucial and specific influence but act differently on women's negative mental health; (2) CAH, DV, child abuse by an intimate partner, and negative mental health might be predictors of maternal child abuse, with complex interactions. A self-administered questionnaire survey was conducted among a sample of mothers (N=304) and their children (N=498) staying in 83 Mother–Child Homes in Japan to assess the women's CAH and DV experiences, along with their current mental health problems, including dissociated, depressed, and traumatic symptoms. A structural equation modeling (SEM) was adapted to test whether a complex theoretical model fits the actual relationship among a set of observed measures. Our model confirmed the linkage with broader aspects of violence within the family such as CAH and DV, focusing on women's mental health problems reported by them. In addition, CAH, DV, child abuse by intimate partner, and maternal mental health might have a crucial and specific but act influence on maternal child abuse.

Genetic Influences on Measures of Parental Negativity and Childhood Maltreatment

Behavioral genetics research has revealed that approximately 25% of the variance in measures of the family environment, including parenting, is attributable to genetic factors. However, precisely which candidate genes are associated with the family environment is largely unknown. The current study addresses this gap in the literature by analyzing data drawn from the National Longitudinal Study of Adolescent Health. Results provide some evidence that three genes of the dopaminergic system (Dopamine D2 receptor gene [DRD2], Dopamine D4 receptor gene [DRD4], and Dopamine transporter gene [DAT1]) are associated with variation in measures of maternal negativity, paternal negativity, and childhood maltreatment for Caucasian males. We speak to what these findings mean for criminological theory and research that focuses on family socialization as an important factor in the etiology of crime and related antisocial behaviors.

Intergenerational transmission of maltreatment and psychopathology: the role of antenatal depression

Maternal experience of childhood maltreatment and maternal antenatal depression are both associated with offspring childhood maltreatment and offspring adjustment problems. We have investigated the relative impact of maternal childhood maltreatment and exposure to depression in utero on offspring maltreatment and psychopathology. The sample included 125 families from the South London Child Development Study. A prospective longitudinal design was used. Data on maternal childhood maltreatment, maternal antenatal depression (36 weeks of pregnancy), offspring childhood maltreatment (age 11 years) and offspring adolescent antisocial behaviour and depression (ages 11 and 16 years) were obtained from parents and offspring through clinical interview. Mothers who experienced childhood maltreatment were significantly more likely to be depressed during pregnancy [odds ratio (OR) 10.00]. Offspring of mothers who experienced only childhood maltreatment or only antenatal depression were no more at risk of being maltreated or having psychopathology; however, offspring of mothers who experienced both maternal childhood maltreatment and antenatal depression were exposed to significantly greater levels of childhood maltreatment and exhibited significantly higher levels of adolescent antisocial behaviour compared with offspring not so exposed. Furthermore, maternal childhood maltreatment accounted for a significant proportion of the variance in offspring childhood maltreatment in only those offspring exposed to depression in utero. Maternal childhood maltreatment and maternal antenatal depression are highly associated. The co-occurrence of both insults significantly increases the risk of offspring adversity. The antenatal period is an optimum period to identify vulnerable women and to provide interventions.

Maternal early life risk factors for offspring birth weight: findings from the add health study.

The aim of this study was to examine the pathways that link mothers' early life socio economic status (SES) and mothers' experience of childhood maltreatment with birth weight among their later born offspring. Data were drawn from a nationally representative longitudinal survey of school-aged respondents, initially enrolled during adolescence in Wave I (1994-1995) and Wave II (1996) of the National Longitudinal Study of Adolescent Health and followed-up in adulthood in Wave III (2001-2002). Data on offspring birth weight were obtained from nulliparous females (N = 1,897) who had given birth between Waves II and III. Analyses used structural equation modeling to examine the extent to which early life maternal risk predicted offspring birth weight, and demonstrated that maternal childhood SES and maternal childhood maltreatment predicted offspring birth weight through several mediated pathways. First, maternal adolescent substance use and prenatal cigarette use partially mediated the association between maternal childhood SES and offspring birth weight. Second, maternal adolescent depressive symptoms and adult SES partially mediated the association between maternal childhood SES and offspring birth weight. Third, adult SES partially mediated the association between maternal childhood SES and offspring birth weight. Fourth, maternal adolescent substance use and prenatal cigarette use partially mediated the association between maternal childhood maltreatment and offspring birth weight. Finally, maternal adolescent depressive symptoms and adult SES partially mediated the association between maternal childhood maltreatment and offspring birth weight. To our knowledge, this is the first study to identify maternal childhood maltreatment as an early life risk factor for offspring birth weight among a nationally representative sample of young women, and to demonstrate the mechanisms that link childhood SES and maltreatment to offspring birth weight. These findings suggest the importance of designing and implementing prevention and intervention strategies to address early life maternal social conditions in an effort to improve inter generational child health at birth.

Maternal experiences of childhood abuse and intimate partner violence: Psychopathology and functional impairment in clinical children and adolescents

Objectives The current study examined the independent effects of mothers’ childhood abuse (CA) and intimate partner violence (IPV) on psychopathology and functional impairment in children; and the potential moderating and mediating role of individual and family factors in these relationships. Additionally, this study explored the potential cumulative effects of both maternal CA and IPV on children's outcomes. Method The sample included 547 Spanish children and adolescents aged between 8 and 17 years, and their parents, who had accessed mental health services. The assessment was based on structured interviews with the children and their parents. Statistical analyses were carried out through hierarchical multiple, negative-binomial and logistic regressions, and Structural Equation Models. Results Children whose mothers experienced CA and those whose mothers suffered physical IPV showed increased DSM-IV disruptive disorders and externalizing behavior problems, respectively. Children who directly observed physical IPV and also suffered physical punishment by parents showed increased internalizing problems. IPV had effects, either direct or indirect by physical punishment, on children's externalizing problems. Cumulative effect analyses indicated that the prevalence of disruptive disorders was highest in children whose mothers had suffered both CA and IPV. Conclusion Spanish children whose mothers have suffered CA, IPV or both, are at high risk of serious conduct problems, whereas children exposed to IPV and who were also physically abused are at greater risk of internalizing problems. Physical punishment of children contributes in part to explain externalizing problems of IPV-exposed children. These findings indicate potential targets of assessment and intervention for families seeking help in mental health services.

The Impact of Maternal Childhood Abuse on Parenting and Infant Temperament

The impact of maternal history of maltreatment and psychopathology on mother-child relationship, parenting, and infant temperament was evaluated. Women completed self-report measures addressing childhood trauma, psychopathology, infant-parent relationship, parenting, and infant temperament. Maternal physical abuse was associated with poorer mother-child interactions, increased vigilance, and difficulty recovering from distress among infants, whereas a history of emotional abuse was linked with less interactional dysfunction, lower levels of infant frustration, and more pleasure. Maternal depression was associated with infant temperament and attitudes about parenting. These findings suggest that maternal history of childhood abuse and psychopathology are important determinants of parenting and infant temperament.

Depression and anger as risk factors underlying the relationship between maternal substance involvement and child abuse potential

Objective This study examines how emotion regulation deficits in the area of anger arousal and reactivity are associated with child abuse potential in mothers with substance use and depressive disorders in order to identify targeted areas for prevention and treatment. Methods A sample of 152 urban mothers was interviewed on measures of substance use, diagnosis of depression, anger arousal and reactivity, and child abuse potential. Results Linear hierarchical regressions revealed that anger arousal and reactivity exceeded diagnostic and demographic variables in predicting maternal child abuse potential. Additionally, anger arousal and reactivity was found to be a partial mediator of the relationship between diagnostic category and child abuse potential. Conclusions Findings are discussed in relation to a multifaceted model of child abuse potential which broadens the existing literature to include an examination of depression and emotion regulation in order to more fully understand how substance use and child abuse potential are linked. Practice implications Models and approaches which help clients to manage and regulate difficult feeling states, specifically anger, could be helpful, and may be most readily applied in such populations.

Home Visitation and Young Children: An Approach Worth Investing In? and commentaries

Home Visitation and Young Children: An Approach Worth Investing In? and commentaries

The impact of maternal childhood abuse on maternal and infant HPA axis function in the postpartum period

Early life trauma, particularly child abuse, has been associated with aberrations in hypothalamic-pituitary-adrenal (HPA) axis functioning in adulthood. However, the relationship of early abuse and later adult neuroendocrine changes may be moderated by additional factors such as comorbid psychopathology and recent life stress. Parental exposure to child abuse may have transgenerational effects, with offspring of abuse victims showing similar neuroendocrine profiles as their mothers. The majority of previous studies in this area focus on adult offspring, and the degree to which the effects of parental child abuse can be detected earlier in the development of the offspring remains obscure. The current study utilized a clinical sample of women with a history of MDD (N=126), to examine the effects of maternal early life sexual and physical abuse (Childhood Trauma Questionnaire (CTQ)) on both maternal and infant salivary cortisol levels during a laboratory stress paradigm at 6 months postpartum. Maternal child abuse was associated with steeper declines in cortisol in the mothers and lower baseline cortisol in their infants. Comorbid maternal PTSD, current maternal depressive symptoms, and recent life stressors were significant moderators of maternal cortisol change. Maternal abuse history was associated with increases in cortisol levels in those mothers who experienced these additional stressors. Similarly, a history of early maternal abuse and comorbid PTSD was associated with greater increases in infant cortisol levels. Maternal childhood abuse was associated with HPA axis function in both the mother and the infant during the postpartum period.