Maternal Child Abuse Research Articles

Trauma exposure, PTSD, and parenting in a community sample of low-income, predominantly African American mothers and children.

Trauma and posttraumatic stress disorder (PTSD) are associated with problematic parenting and incidence of trauma and PTSD in children of affected parents. In communities impacted by frequent trauma, parenting may be particularly important to children's PTSD risk. The authors examined relationships among maternal and child trauma and mental health, as well as problematic parenting. The authors recruited 112 mother-child dyads (50 girls, 62 boys; ages 8-12 years old) from a community sample of low-income, primarily African American families. They examined rates of trauma exposure and PTSD symptoms in mothers and children, the association of maternal trauma and PTSD with self-reported child abuse potential and parenting stress (i.e., parental distress, dysfunctional parent-child interactions, and perceived child difficulty), and the impact of maternal trauma, PTSD, and parenting on child trauma and PTSD. Rates of trauma and PTSD symptoms were relatively high for mothers and children and included community and family violence. Maternal trauma and PTSD predicted child abuse potential, but only maternal PTSD predicted parental distress. Neither maternal trauma nor PTSD predicted parent-reported dysfunctional parent-child interactions or child difficulty. Maternal child abuse potential and child self-reported trauma, but not maternal trauma or PTSD, significantly predicted child self-reported PTSD. Parenting stress was not associated with child PTSD. Trauma and PTSD in parents may impact parental distress and child abuse potential, potentially increasing children's risk for not only the experience of child abuse, but also PTSD. Child and family interventions should consider child and parental trauma and PTSD as important factors to address. (PsycINFO Database Record

Association between maternal childhood maltreatment and mother-infant attachment disorganization: Moderation by maternal oxytocin receptor gene and cortisol secretion

This study examined maternal oxytocin receptor (OXTR, rs53576) genotype and cortisol secretion as moderators of the relation between maternal childhood maltreatment history and disorganized mother-infant attachment in the Strange Situation Procedure (SSP). A community sample of 314 mother-infant dyads completed the SSP at infant age 17 months. Self-reported maltreatment history more strongly predicted mother-infant attachment disorganization score and disorganized classification for mothers with more plasticity alleles of OXTR (G), relative to mothers with fewer plasticity alleles. Maltreatment history also more strongly predicted mother-infant attachment disorganization score and classification for mothers with higher SSP cortisol secretion, relative to mothers with lower SSP cortisol secretion. Findings indicate that maltreatment history is related to disorganization in the next generation, but that this relation depends on maternal genetic characteristics and cortisol.

Predictors of sensitive parenting in urban slums in Makassar, Indonesia

ABSTRACTIn the context of urban slums in Makassar in Indonesia, this study aimed to test whether maternal sensitivity was predicted by maternal history of childhood maltreatment, and whether this association was mediated by current partner conflict and current cumulative sociodemographic risk. A total of 98 mothers and their 2–4-year-old children were videotaped in a naturalistic observation. Maternal sensitivity was coded using the Ainsworth scales. In addition, mothers were interviewed to assess childhood trauma, current partner conflict, and current sociodemographic risk. There was a significant negative correlation between maternal experienced childhood maltreatment and observed maternal sensitivity. Current partner conflict and sociodemographic risk did not mediate the association between childhood maltreatment and maternal sensitivity.

Maternal depression in the intergenerational transmission of childhood maltreatment and its sequelae: Testing postpartum effects in a longitudinal birth cohort.

Mothers who have experienced childhood maltreatment are more likely to have children also exposed to maltreatment, a phenomenon known as intergenerational transmission. Factors in the perinatal period may contribute uniquely to this transmission, but timing effects have not been ascertained. Using structural equation modeling with 1,016 mothers and their 2,032 children in the Environmental Risk Longitudinal Twin Study, we tested the mediating role of postpartum depression between maternal childhood maltreatment and a cascade of negative child outcomes, specifically child exposure to maltreatment, internalizing symptoms, and externalizing symptoms: (a) adjusting for later maternal depression, (b) comparing across sex differences, and (c) examining the relative role of maltreatment subtypes. Mothers who had been maltreated as children, especially those who had experienced emotional or sexual abuse, were at increased risk for postpartum depression. In turn, postpartum depression predicted children's exposure to maltreatment, followed by emotional and behavioral problems. Indirect effects from maternal childhood maltreatment to child outcomes were robust across child sex and supported significant mediation through postpartum depression; however, this appeared to be carried by mothers' depression beyond the postpartum period. Identifying and treating postpartum depression, and preventing its recurrence, may help interrupt the intergenerational transmission of maltreatment and its sequelae.

Mothers' Personal and Interpersonal Function as Potential Mediators Between Maternal Maltreatment History and Child Behavior Problems.

This study examined maternal depressive symptoms, social support, parenting, and adult attachment as mediators explaining the relation between maternal childhood maltreatment and child behavior in offspring. We assessed a community sample of 96 mother-child dyads. At child age 16 months, mothers self-reported maltreatment history, adult attachment, depressive symptoms, and social support, and maternal sensitivity was assessed via 2 hr of direct behavioral observation. Maternal reports of child behavior were collected at 5 years. Single and parallel mediation models were constructed. Only maternal depressive symptoms mediated the relation between maternal maltreatment history and children's internalizing problems. Maternal sensitivity emerged as a suppressor variable. With respect to the relation between maternal maltreatment history and children's externalizing problems, when entered singly, maternal depressive symptoms, social support, and avoidant attachment emerged as mediators. When examined in parallel, only maternal depressive symptoms and avoidant attachment accounted for unique mediating variance. Findings have implications with respect to important maternal factors that might be targeted to reduce the probability of maladaptive child behavior.

MATERNAL TRAUMA AFFECTS PRENATAL MENTAL HEALTH AND INFANT STRESS REGULATION AMONG PALESTINIAN DYADS.

We examined how diverse and cumulated traumatic experiences predicted maternal prenatal mental health and infant stress regulation in war conditions and whether maternal mental health mediated the association between trauma and infant stress regulation. Participants were 511 Palestinian mothers from the Gaza Strip who reported exposure to current war trauma (WT), past childhood emotional (CEA) and physical abuse, socioeconomic status (SES), prenatal mental health problems (posttraumatic stress disorder and depression symptoms), and perceived stress during their secondtrimester of pregnancy as well as infant stress regulation at 4 months. While all trauma types were associated with high levels of prenatal symptoms, CEA had the most wide-ranging effects and was uniquely associated with depression symptoms. Concerning infant stress regulation, mothers' CEA predicted negative affectivity, but only among mothers with low WT. Against hypothesis, the effects of maternal trauma on infant stress regulation were not mediated by mental health symptoms. Mothers' higher SES was associated with better infant stress regulation whereas infant prematurity and male sex predisposed for difficulties. Our findings suggest that maternal childhood abuse, especially CEA, should be a central treatment target among war-exposed families. Cumulated psychosocial stressors might increase the risk for transgenerational problems.

Alterations of hair cortisol and dehydroepiandrosterone in mother-infant-dyads with maternal childhood maltreatment

BackgroundChild maltreatment (CM) has severe effects on psychological and physical health. The hypothalamic-pituitary-adrenal (HPA) axis, the major stress system of the body, is dysregulated after CM. The analysis of cortisol and dehydroepiandrosterone (DHEA) in scalp hair presents a new and promising methodological approach to assess chronic HPA axis activity. This study investigated the effects of CM on HPA axis activity in the last trimester of pregnancy by measuring the two important signaling molecules, cortisol and DHEA in hair, shortly after parturition. In addition, we explored potential effects of maternal CM on her offspring’s endocrine milieu during pregnancy by measuring cortisol and DHEA in newborns’ hair.MethodsCM was assessed with the Childhood Trauma Questionnaire (CTQ). Cortisol and DHEA were measured in hair samples of 94 mothers and 30 newborns, collected within six days after delivery. Associations of maternal CM on her own and her newborn’s cortisol as well as DHEA concentrations in hair were analyzed with heteroscedastic regression models.ResultsHigher CM was associated with significantly higher DHEA levels, but not cortisol concentrations in maternal hair. Moreover, maternal CM was positively, but only as a non-significant trend, associated with higher DHEA levels in the newborns’ hair.ConclusionsResults suggest that the steroid milieu of the mother, at least on the level of DHEA, is altered after CM, possibly leading to non-genomic transgenerational effects on the developing fetus in utero. Indeed, we observed on an explorative level first hints that the endocrine milieu for the developing child might be altered in CM mothers. These results need extension and replication in future studies. The measurement of hair steroids in mothers and their newborns is promising, but more research is needed to better understand the effects of a maternal history of CM on the developing fetus.

Childhood Maltreatment and Psychological Well-Being in Later Life: The Mediating Effect of Contemporary Relationships with the Abusive Parent.

Parental childhood maltreatment has a negative impact on psychological well-being in adulthood. However, little is known about whether and how contemporary relationships with an abusive parent might explain the long-term harmful effects. Thus, this study aims to examine the mediating effect of later-life relationships with an abusive parent on the association between parental childhood maltreatment and psychological well-being. Using the 2004-2005 Wisconsin Longitudinal Study, this study analyzed a total of 1,696 adults aged 65 years. A series of ordinary least squares regression and mediational analyses were performed. Key findings showed that maternal childhood neglect and abuse were associated with decreased emotional closeness with mothers, which was, in turn, associated with diminished psychological well-being. In addition, childhood neglect was associated with less frequent exchanges of social support with mothers, which was, in turn, associated with diminished psychological well-being. This study suggests that, despite childhood maltreatment, parent-child relationships persist throughout life, and the continuing relationship with an abusive parent may undermine adult victims' psychological well-being. When intervening with mental health issues of adults who have experienced childhood maltreatment, their unresolved issues with the parent should be properly addressed.

Maternal Exposure to Childhood Abuse is Associated with Mate Selection: Implications for Autism in Offspring.

Maternal experience of childhood abuse has been associated with offspring autism. To explore whether familial tendency towards autistic traits-presumably related to genetic predisposition-accounts for this association, we examined whether women who experienced childhood abuse were more likely to select mates with high levels of autistic traits, and whether parental autistic traits accounted for the association of maternal abuse and offspring autism in 209 autism cases and 833 controls. Maternal childhood abuse was strongly associated with high paternal autistic traits (severe abuse, OR=3.98, 95% CI=1.26, 8.31). Maternal and paternal autistic traits accounted for 21% of the association between maternal abuse and offspring autism. These results provide evidence that childhood abuse affects mate selection, with implications for offspring health.

Maternal History of Childhood Abuse and Risk of Asthma and Allergy in 2-Year-Old Children.

Exposure to child abuse (CA) is associated with an increased risk of developing asthma and allergies; it is unknown if that risk is present across generations. This study investigated if 2-year-old children born to mothers with a history of CA were at an increased risk of receiving a diagnosis of asthma or allergies. Data from 1,551 participants were collected as part of the All Our Babies (AOB) study, a prospective pregnancy cohort. During pregnancy, each woman provided information about her own history of CA, and at 24 months postpartum, she provided information about her child's medical diagnoses. Symptoms of maternal depression and anxiety were assessed during pregnancy and at 24 months postpartum. Unadjusted models showed that compared to children born to mothers without a history of CA, 2-year-old children born to mothers with a history of CA were more likely to have had a diagnosis of asthma (7.4% vs 4.2%, p = .016) or allergy (15.6% vs 9.2%, p < .001). Maternal symptoms of depression assessed in late pregnancy and symptoms of depression and anxiety at 24 months postpartum were significant mediators of the relationship between maternal CA and 2-year-old asthma diagnosis. Maternal symptoms of depression and anxiety assessed in late pregnancy were also significant mediators of the relationship between maternal CA and 2-year-old allergy diagnosis. The results indicate that maternal exposure to CA is associated with increased risk of asthma and allergy in their 2-year-old children; symptoms of maternal depression and anxiety were identified as pathways linking the variables.

Relationship Transitions and the Risk for Child Maltreatment.

Family structure as a risk for child maltreatment has long been viewed as a static state in the child maltreatment literature. Drawing on data from the Fragile Families and Child Wellbeing Study, the author uses a series of individual fixed-effects models to investigate whether particular types of relationship transitions over children's first decade of life are associated with increased risk for maternal and paternal child abuse and maternal neglect. Findings question and confirm a number of long-standing theoretical and empirical findings from the child maltreatment literature. Results indicate that transitions to being single are associated with increased risk for maternal child abuse and neglect. In addition, the frequency and severity of paternal harsh parenting may be closely linked with the nature of fathers' relationship transitions. Last, results largely do not provide support for the theory that the presence of social (nonbiological) fathers increases mothers' risk for engaging in child abuse or neglect.

The Great Recession and risk for child abuse and neglect

This paper examines the association between the Great Recession and four measures of the risk for maternal child abuse and neglect: (1) maternal physical aggression; (2) maternal psychological aggression; (3) physical neglect by mothers; and (4) supervisory/exposure neglect by mothers. It draws on rich longitudinal data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of families in 20 U.S. cities (N=3177; 50% African American, 25% Hispanic; 22% non-Hispanic white; 3% other). The study collected information for the 9-year follow-up survey before, during, and after the Great Recession (2007–2010). Interview dates were linked to two macroeconomic measures of the Great Recession: the national Consumer Sentiment Index and the local unemployment rate. Also included are a wide range of socio-demographic controls, as well as city fixed effects and controls for prior parenting. Results indicate that the Great Recession was associated with increased risk of child abuse but decreased risk of child neglect. Households with social fathers present may have been particularly adversely affected. Results also indicate that economic uncertainty during the Great Recession, as measured by the Consumer Sentiment Index and the unemployment rate, had direct effects on the risk of abuse or neglect, which were not mediated by individual-level measures of economic hardship or poor mental health.

Intergenerational Effects of Childhood Trauma: Evaluating Pathways Among Maternal ACEs, Perinatal Depressive Symptoms, and Infant Outcomes.

Maternal adverse childhood experiences (ACEs) have been associated with negative physical and mental health outcomes in adulthood. Less is known regarding how maternal ACEs relate to perinatal depressive symptoms or the intergenerational effect of maternal childhood trauma history on birth outcomes and infant functioning. To address this gap, an at-risk sample of 398 pregnant women was recruited from Women, Infants, and Children health clinics. Participants completed a prenatal ( M = 4.84 months before due date) and postnatal ( M = 6.76 months after birth) assessment and provided birth outcome data. At the prenatal assessment, mothers completed an ACEs measure which assessed experiences of childhood maltreatment and household dysfunction. Self-report measures of maternal depressive symptoms were obtained at both time points. Mothers reported on infant socioemotional functioning at 6 months. Maternal ACEs predicted higher levels of prenatal depressive symptoms. Childhood maltreatment experiences, in particular, predicted higher postnatal depressive symptoms and a smaller reduction in depressive symptoms across the perinatal period. Regarding intergenerational associations, maternal childhood maltreatment directly predicted higher levels of maladaptive infant socioemotional symptoms, whereas maternal household dysfunction indirectly related to infant socioemotional symptoms through maternal age at first pregnancy and infant birth weight. Limitations and future directions are discussed.

Maternal Childhood Maltreatment History and Child Mental Health: Mechanisms in Intergenerational Effects

The objectives of this study were to examine whether a maternal history of maltreatment in childhood has a detrimental impact on young children’s mental health and to test theoretically and empirically informed pathways by which maternal history may influence child mental health. Mother–child dyads (N = 187) were evaluated between birth and 64 months of age via home and laboratory observations, medical and child protection record reviews, and maternal interviews to assess maternal history of childhood maltreatment and microsystem and exosystem measures of the caregiving context, including child maltreatment, maternal caregiving quality, stress exposures, and social support. When the children were 7 years of age, mothers and teachers reported on child emotional and behavioral problems. Analyses examined whether the caregiving context variables linked maternal maltreatment history with child emotional and behavioral problems, controlling for child sex (54% male), race/ethnicity (63% White), and family sociodemographic risk at birth. Maltreated mothers experienced greater stress and diminished social support, and their children were more likely to be maltreated across early childhood. By age 7, children of maltreated mothers were at increased risk for clinically significant emotional and behavioral problems. A path analysis model showed mediation of the effects of maternal childhood maltreatment history on child symptoms, with specific effects significant for child maltreatment. Interventions that reduce child maltreatment risk and stress exposures and increase family social support may prevent deleterious effects of maternal childhood maltreatment history on child mental health.

History of Childhood Abuse and Intergenerational Support to Mothers in Adulthood

The authors examined the association between maternal childhood abuse and the frequency of providing social support to mothers when the victim is an adult and investigated the mediating effects of internal working models (self‐esteem, positive relations with others) and maladaptive coping. Using data from the National Survey of Midlife Development in the United States II, they analyzed a sample of 887 adult children using a structural equation modeling approach. The results showed that maternal childhood abuse was associated with providing less frequent emotional support to mothers, although the authors did not find significant mediating effects of internal working models and maladaptive coping in the association between child abuse and intergenerational support giving. The findings suggest implications for theory, practice, and policy to address specific concerns and possible challenges that adults with a history of childhood abuse may experience in the relationship with their mothers.

EMOTIONAL AVAILABILITY IN MOTHER-CHILD INTERACTION: THE EFFECTS OF MATERNAL DEPRESSION IN REMISSION AND ADDITIONAL HISTORY OF CHILDHOOD ABUSE.

The association between maternal depression and adverse outcomes in children is well established. Similar links have been found for maternal childhood abuse. One proposed pathway of risk transmission is reduced maternal emotional availability. Our aim was to investigate whether sensitive parenting is impaired in mothers with depression in remission, and whether among these mothers childhood abuse has an additional impact. The mother-child interaction of 188 dyads was assessed during a play situation using the Emotional Availability Scales, which measure the overall affective quality of the interaction: maternal sensitivity, structuring, nonhostility, and nonintrusiveness. Mothers with depression in remission were compared to healthy mothers. Children were between 5 and 12 years old. Group differences and impact of additional childhood abuse were analyzed by one-factorial analyses of covariance and planned contrasts. Mothers with depression in remission showed less emotional availability during mother-child interaction compared to healthy control mothers. Specifically, they were less sensitive and, at trend-level, less structuring and more hostile. Among these mothers, we found an additional effect of severe maternal childhood abuse on maternal sensitivity: Mothers with depression in remission and a history of severe childhood abuse were less sensitive than remitted mothers without childhood abuse. Our data suggest that depression impacts on maternal emotional availability during remission, which might represent a trait characteristic of depression. Mothers with depression in remission and additional severe childhood abuse were particularly affected. These findings may contribute to the understanding of children's vulnerability to develop a depressive disorder themselves.

MATERNAL EXPERIENCE OF ABUSE IN CHILDHOOD AND DEPRESSIVE SYMPTOMS IN ADOLESCENT AND ADULT OFFSPRING: A 21-YEAR LONGITUDINAL STUDY.

Intergenerational effects of child abuse have been documented, but it is unknown whether maternal childhood abuse influences offspring mental health in adolescence or adulthood. To examine whether maternal experience of childhood abuse is associated with depressive symptoms in adolescent and young adult offspring, we linked data from two large longitudinal cohorts of women (N = 8,882) and their offspring (N = 11,402), and we examined three possible pathways by which maternal experience of abuse might be associated with offspring depressive symptoms: maternal mental health, family characteristics, and offspring's own experience of abuse. Offspring of women who experienced severe versus no childhood abuse had greater likelihood of high depressive symptoms (RR = 1.78, 95% CI = 1.47, 2.16) and persistent high depressive symptoms (RR = 2.47, 95% CI = 1.37, 4.44). Maternal mental health accounted for 20.9% and offspring's exposure to abuse accounted for 30.3% of the elevated risk of high depressive symptoms. Disparities in offspring depressive symptoms by maternal abuse exposure were evident at age 12 years and persisted through age 31 years. Findings provide evidence that childhood abuse adversely affects the mental health of the victim's offspring well into adulthood. As offspring exposure to abuse and maternal mental health accounted for more than 50% of the elevated risk of high depressive symptoms among offspring of women who experienced abuse, improving maternal mental health and parenting practices may reduce offspring risk for depressive symptoms in these families.

Focusing "upstream" to Address Maternal and Child Health Inequities: Two Local Health Departments in Washington State Make the Transition.

Two local health departments (LHDs) in Washington State, Spokane Regional Health District and Clark County Public Health, are transitioning their Maternal and Child Health (MCH) services from an individual-focused (mother-child dyads/family) home visiting model to a population-focused, place-based model. This paper describes the innovative process and strategies these LHDs used in applying existing MCH funding in new ways. The pilot communities selected in both jurisdictions for the initial transition were communities experiencing disproportionately high rates of maternal smoking, child abuse and neglect, births to single women, and low-income women on Medicaid. Available evidence suggested that the reach and effectiveness of existing, individual-level MCH approaches were not adequately improving these indicators in these communities. Using a population-based approach that addressed policy factors as well as social, organizational, and behavioral change; both counties developed neighborhood level initiatives directed at the root causes of health inequities. The approach included developing meaningful community partnerships, capacity building, and creation of a shared vision for community change. Both LHDs and their partners engaged county-wide groups in neighborhood selection, jointly established priority intervention areas, and actively engaged communities focused on reducing specific health inequities. With existing funding resources, the two county LHDs dramatically changed their practice to better address underlying conditions that threaten MCH. Early successes from these pilots have contributed to important local and state system-level changes in MCH programming as well as effective community-level efforts to reduce health inequities.

Impact of maternal childhood abuse history on child’s attachment problems

Abstract Background: The aim of this study was to investigate the independent impact of maternal childhood abuse history (MCAH), after controlling for maternal past, current parenting, and paternal past parenting, and

Emotional Dysregulation and Negative Affect Mediate the Relationship Between Maternal History of Child Maltreatment and Maternal Child Abuse Potential

Risk for committing child abuse is frequently attributed to an intergenerational “cycle of violence” through which abuse as a child increases risk for committing abuse as a parent. While this hypothesis has support, more research is needed to understand the factors that account for this pattern of risk. Given literature suggesting that adults with a history of child maltreatment have increased risk for a wide range of psychopathology, this study examined the role of two behavioral endophenotypes, emotional dysregulation and negative affect, in the association between maternal experiences of childhood maltreatment and maternal child abuse potential among 83 low-income, primarily African-American mothers of elementary school age children. Results indicate that a mother’s experience of abuse as a child predicts later risk for abusive parenting as measured by child abuse potential scores. However, our data also indicate that the relationship between maternal experience of child abuse and later child abuse potential is mediated by maternal emotional dysregulation and negative affect.