Maternal Abuse Research Articles

Child maltreatment: An intergenerational cascades model of risk processes potentiating child psychopathology

BackgroundChild maltreatment poses substantial risk for compromised mental health in children. Further, child abuse and neglect are potentiated within a cascade of intergenerational and current familial risk processes that require clarification to inform understanding of adverse outcomes and direct prevention and intervention efforts. ObjectiveUsing a multi-informant design, the current study applied an intergenerational cascades approach to examine the interconnected pathways among several familial risk factors associated with child maltreatment and its consequences. ParticipantsParticipants were 378 children (aged 10−12) and their mothers from economically disadvantaged, ethnically diverse backgrounds. The sample included maltreated children recruited via CPS records and demographically comparable non-maltreated children. MethodsStructural equation modeling (SEM) was conducted to test sequential mediation pathways examining the independent and cascading effects of maternal history of childhood maltreatment, maternal adolescent childbearing, current maternal depression, and the child’s lifetime history of maltreatment on the child’s internalizing and externalizing symptoms. ResultsMultigenerational developmental cascades were identified. Maternal history of maltreatment predicted chronic maltreatment for offspring, which in turn predicted greater internalizing (β = .167, p = .03) and externalizing symptoms (β = .236, p = .005) in late childhood. Similarly, children born to mothers who began childbearing in adolescence were more likely to experience chronic maltreatment during childhood and develop subsequent symptoms. Effects were found over and above a parallel cascade from maternal maltreatment to offspring psychopathology via a maternal depression pathway. ConclusionFindings reveal targets to prevent or ameliorate progressions of intergenerational risk pathways.

Maternal Opioid Abuse and Neonatal Abstinence Syndrome in the United States

In the past decade, the United States has experienced an increase in deaths related to nonmedical and medical opioid overdose. This is due to a number of factors including an increase in recreational opioid use, and the over prescription of opioids for various conditions such as during pregnancy, injury, and illness. The over utilization of opioids during pregnancy in the United States has led to an increase in adverse neonatal birth outcomes including poor fetal growth, preterm birth, stillbirth, neonatal abstinence syndrome in neonates, and an increase in maternal mortality among mothers. These are dire consequences that should not be ignored. This paper discusses opioid abuse during pregnancy and its effects on neonates in the United States. It also discusses some challenges associated with the diagnosis of neonatal abstinence syndrome and provides recommendations for addressing the issue Additionally, it discusses what mothers can do to prevent neonatal abstinence syndrome.

Neonatal abstinence syndrome and intra‐uterine growth restriction secondary to maternal antimigraine drug abuse

Substance use and abuse among pregnant women is a major public health issue. Headache during pregnancy is a frequent event due to hormonal imbalance. Combination products containing butalbital with caffeine and an analgesic, acetaminophen, aspirin, or codeine are prescribed for the treatment of migraine and tension-type headaches. We report here a case of barbiturate Neonatal Abstinence Syndrome (NAS) and caffeine-related Intra Uterine Growth Restriction (IUGR) due to maternal abuse of a combination drug made from butalbital, caffeine and propyphenazone (Optalidon®), diagnosed after suggestive clinical features.

Socio-psychological criteria for mutual selection of adoptive parents and children deprived of parental care as prognostic signs of the mental health of their future family

Socio-psychological criteria for mutual selection of adoptive parents and children deprived of parental care as prognostic signs of the mental health of their future family

Sexual dream and family relationships in frequent sexual dreamers and healthy volunteers.

Early life family relationships affect the sexuality in adulthood, and these influences might be reflected in sexual dreams. The present study was designed to investigate the exact associations between family relationships and sexual dream experience. We therefore invited 62 frequent sexual dreamers (dreamers) and 104 healthy volunteers (controls) to answer the Sexual Dream Experience Questionnaire (SDEQ) and the Family Relationship Questionnaire (FRQ). Compared to controls, dreamers scored higher on all SDEQ factors and sexual dream frequency, higher on FRQ Paternal Abuse, and lower on FRQ General Attachment and Maternal Freedom Release. In controls, Paternal Abuse was associated with Joyfulness, Maternal Dominance with Aversion, and Maternal Abuse with dream frequency (–). In dreamers, Paternal Abuse was associated with Aversion, Bizarreness and dream frequency, and Maternal Freedom Release with Aversion (–). In conclusion, there were pronounced associations between sexual dreams and family relationships in frequent sexual dreamers. Paternal Abuse in particular was associated with sexual dream experience. Adverse family relationships might induce frequent sexual dream occurrence, and family therapy or early intervention of Paternal Abuse might alleviate the negative sexual dream experience.

Prevalence and associated factors of child abuse and its effects on anxiety and depression among children in Sierra Leone: Results of the 2017 Multiple Indicator Cluster Survey

The study aimed to estimate the prevalence and factors associated with child abuse and its effects on anxiety and depression among children (5 to 14 years) in Sierra Leone. We analysed data from the 2017 Sierra Leone Multiple Indicator Cluster Survey (MICS), in which 9 165 mothers or caretakers of children aged 5 to 14 years responded to questions on child disciplining methods, attitude towards violence, and on anxiety and depression of their children. We used logistic regression to investigate the association between household and maternal variables and child abuse and its effects on anxiety and depression. Results indicate that the prevalence of psychological abuse was 85.7%, moderate physical abuse was 66.1%, and severe physical abuse was 54.4%. Further, 13.0% of children had anxiety and 9.4% had depression. In the final logistic regression model, poorer wealth status and rural residence were associated with severe child physical abuse. Endorsing physical punishment of children by the mothers or female caregivers was associated with all three types of abuse (psychological, moderate, and severe physical abuse). Multiple child abuse types were associated with anxiety and depression. Most children in Sierra Leone experienced child abuse, and multiple child abuse types were associated with poor mental health. Interventions to prevent child abuse should support parents in adopting child-friendly parenting practices.

Applying Fairbairn's Object Relations Theory to the Psychological Development of Anders Breivik

The author summarizes the trauma/dissociation model of W.R.D. Fairbairn and applies it to the psychological development of Anders Breivik, the Norwegian mass murderer. Fairbairn's model focuses on the absolute dependency of the infant on its mother for all of its physical and psychological needs. Maternal indifference, neglect, or outright abuse is so catastrophic to the child's sense of security that he/she has to dissociate intolerable events. When dissociation is repeatedly deployed, the memories of parental failures gradually coalesce and form internal self and object structures that mirror the intolerable events that the child experienced. These unconscious views of self and other influence the central ego's perception of reality and are responsible for transferences, reenactments, and projection of the inner relational patterns onto external objects. The author concludes that Breivik's developmental history was acted out in his displaced rage toward innocent victims after being radicalized in adulthood by racist rhetoric on the internet.

Behavioral Intervention in Mother–Child Dyads with Physical Child Abuse: Matching Theory in Clinical Setting

Although mother–child interactions under circumstances of child abuse can be understood by the models of matching theory, the parameters of the hyperbolic, strict, and generalized equations are sensitive to the changes derived from behavioral interventions that focus on the restructuring of interactive patterns. The objective of this research is to determine the impact, under the formulations of the matching theory, of a parent–child interaction therapy intervention in cases with a history of child abuse. The ages of the children ranged from 4 to 9 years, and the ages of the mothers ranged from 24 to 39 years. All dyads attended the Psychological Services Center of the National Autonomous University of Mexico (UNAM) and presented with a history of abuse. Under a single case ABC research design, dyadic interactions were observed at baseline (phase A) and compared with follow-up observations (phase C). To evaluate the adjustment of social attention to child behavior, three propositions derived from the matching theory were used, namely, hyperbolic, strict, and generalized equations. The results indicate that the majority of the interactions tend toward the undermatching of child behavior with respect to maternal attention and that the parameters of the generalized equation better describe the impact of an intervention focused on the restructuring of social exchanges on dyads with abuse. The findings are discussed within the context of social interactions in which the maternal and child behaviors are adjusted according to the reinforcing proportions of each to account for maternal synchronization and child abuse.

Intergenerational Continuity in Child Maltreatment: Explicating Underlying Mechanisms.

The current study examined direct and indirect effects of a mother's history of childhood physical and sexual abuse on her child's officially reported victimization. This prospective, longitudinal study followed a community-based sample of 499 mothers and their children. Mothers (35% White/non-Latina, 34% Black/non-Latina, 23% Latina, and 7% other) were recruited and interviewed during pregnancy, and child protective services records were reviewed for the presence of the participants' target child between birth and age 3.5. Whereas both types of maternal maltreatment history doubled the child's risk of child protective services investigation, mothers' sexual abuse history conferred significantly greater risk. Pathways to child victimization varied by type of maternal maltreatment history. Mothers who had been physically abused later demonstrated interpersonal aggressive response biases, which mediated the path to child victimization. In contrast, the association between maternal history of sexual abuse and child victimization was mediated by mothers' substance use problems. Study implications center on targeting child maltreatment prevention efforts according to the mother's history and current problems.

Association between maternal adverse childhood experiences and child’s self-rated academic performance: Results from the K-CHILD study

BackgroundDespite the number of studies showing the link between maternal adverse childhood experiences (ACEs) and offspring’s neural development and mental health, little is known about the impacts of maternal ACEs on offspring’s academic performance in the adolescent period. ObjectiveTo examine the associations between maternal ACEs and self-rated academic performance in adolescent offspring. Participants and SettingData from the population-based Kochi Child Health Impact of Living Difficulty (K-CHILD) study, conducted in 2016, was analyzed. Participants included 10,810 children in fifth grade, eighth grade, and eleventh grade living in Kochi prefecture, Japan, and data from maternal respondents were used (n = 7964). MethodsMaternal ACEs, childhood social economic status, current mental health, current socioeconomic status and maternal maltreatment of child were assessed by mothers. Self-rated academic performance was reported by children using a 5-point Likert scale. Ordinal logistic regression analyses were performed, which excluded children with lower self-esteem to avoid measurement bias on self-rated academic performance due to low self-esteem. ResultsA higher number of maternal ACEs had a dose-response relationship with lower self-rated academic performance in adolescent offspring after adjusting for confounder (p trend <0.001). Specifically, adolescents of mothers who experienced parent loss were more likely to report lower self-rated academic performance (OR = 1.31; 95 %CI = 1.16−1.47), whereas adolescents of mothers who experienced maltreatment in childhood showed no association (OR = 1.10, 95 %CI = 0.99−1.22). ConclusionsMaternal ACEs, and especially maternal parent loss, were associated with lower self-rated academic performance in adolescent offspring. Further study is needed to elucidate the possible mechanism underlying this association.

Intergenerational maltreatment and child emotion dysregulation

BackgroundChildhood maltreatment has been related to adverse outcomes on social, cognitive, and biological development with sequelae present throughout the lifespan. As such, caregivers maltreated in childhood may face a different set of challenges and interpersonal stressors in rearing their children. Parental history of maltreatment has the potential to increase the risk of parental depression and exposure to maltreatment in the next generation, both of which can have a negative effect on children’s development. ObjectiveThe purpose of this study is to investigate maternal depression and child experiences of maltreatment as mediators of the relationship between mothers’ own maltreatment experiences and child emotion dysregulation in children aged 10–12. Participants and setting378 low-income mothers and their children were recruited to participate in a research summer camp from 2004–2007. MethodMothers self-reported on their experiences of maltreatment in childhood and current depressive symptoms. Current generation child maltreatment information was coded from Child Protective Services records. Child emotion dysregulation (rated by camp counselors) was the outcome measure in this study. Structural equation modeling was employed to test associations between maternal maltreatment and child emotion dysregulation. ResultsMaternal history of maltreatment related to both child maltreatment (β = .24, SE = .052, p < .001) and greater maternal depressive symptoms (β = .28, SE = .049, p < .001). Only child maltreatment mediated the effect of mothers’ maltreatment on child emotion dysregulation (95 %CI: .005–.023). ConclusionsIn this low-income sample, the rate of intergenerational maltreatment is high and represents a pathway of influence that increases risk for maladaptive socioemotional child development.

Family relationships and personality disorder functioning styles in paranoid schizophrenia

Dysfunctional family relationships are prominent factors influencing personality development and psychiatric disorder progression, but the detailed relationships between personality disorders and family relationships in schizophrenia are less studied. In this study, we invited 92 paranoid schizophrenia patients and 76 healthy volunteers to answer the Family Relationship Questionnaire (FRQ) and the Parker Personality Measure (PERM). Compared to controls, patients scored higher on Paternal/ Maternal Abuse, but lower on General Attachment, Paternal Encouragement and Paternal/ Maternal Freedom Release. Patients also scored higher on all PERM styles except the Obsessive-Compulsive. In controls, Paternal Freedom Release predicted Paranoid (-), Maternal Abuse predicted Schizoid, General Attachment predicted Schizotypal (-), Histrionic (-) and Narcissistic (-), Paternal Abuse predicted Antisocial, and Maternal Freedom Release predicted Avoidant (-). While in patients, Paternal Abuse predicted Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Dependent, and Passive-Aggressive. In conclusion, there were prominent family relationships and personality problems in schizophrenia, and the family relationships, especially paternal abuse, were associated with personality disorder functioning styles. Therefore, the intervention of paternal abuse in the early life might beneficial to reducing personality disorder traits in schizophrenia.

Female-Perpetrated Child Sexual Abuse: Prevalence Rates in Germany

ABSTRACTResearch on female-perpetrated child sexual abuse, especially maternal sexual abuse, is scarce. Prevalences are assumed to be lower compared to male-perpetrated abuse; however, representative studies including female perpetrators are rare. Experiences of male- and female-perpetrated child sexual abuse were examined in a representative German sample. Questions included experiences of hands-on and penetrative sexual abuse. The perpetrator-victim relationship was assessed to calculate prevalences of maternal sexual abuse. A total of 2516 participants (54.53% female, 14–91 years) were questioned and prevalences, as well as group differences between victims of male perpetrators compared to female perpetrators, were calculated. Overall, 10.5% of all participants reported experiences of child sexual abuse. Female perpetrators were involved in 9.9% of the cases, i.e. 1.0% of all participants. Victims of female perpetrators were significantly more often male. A quarter of the adult female perpetrators were the mother figure of the child. The findings suggest that the share of female perpetrators in cases of child sexual abuse is rather small; concurrently, female perpetration is insufficiently recognized. Especially male victims seem to be at risk for sexual abuse by female perpetrators. Contacts for children especially within the professional support system need to be aware of the existence of female perpetrators.

Early Life Trauma Has Lifelong Consequences for Sleep And Behavior

Sleep quality varies widely across individuals, especially during normal aging, with impaired sleep contributing to deficits in cognition and emotional regulation. Sleep can also be impacted by a variety of adverse events, including childhood adversity. Here we examined how early life adverse events impacted later life sleep structure and physiology using an animal model to test the relationship between early life adversity and sleep quality across the life span. Rat pups were exposed to an Adversity-Scarcity model from postnatal day 8–12, where insufficient bedding for nest building induces maternal maltreatment of pups. Polysomnography and sleep physiology were assessed in weaning, early adult and older adults. Early life adversity induced age-dependent disruptions in sleep and behavior, including lifelong spindle decreases and later life NREM sleep fragmentation. Given the importance of sleep in cognitive and emotional functions, these results highlight an important factor driving variation in sleep, cognition and emotion throughout the lifespan that suggest age-appropriate and trauma informed treatment of sleep problems.

Early Life Stress

Early Life Stress Stress and daily hassles are a normal part of day-to day-life. The amount of control that is experienced strongly contributes to resilience and coping. Children very frequently do not experience control over the stressors within their lives. Starting from pregnancy, they are subjected - via the maternal endocrine system - to a variety of stressors ranging from normal stress regarding the transition to parenthood to maternal abuse or torture. This article collects research of the last two decades regarding the influence of stress on the developing brain. Both, animal and human studies will shed light on the effect of pre- and postnatal stress demonstrating an influence of early life stressors reaching far into adulthood. A direct influence of stress on multiple developmental characteristics has been postulated and shown. The results of this review will underline the necessity of early life programs focusing stress reduction and resilience in children and their parents. Also, a need for programs targeting stress reduction in pregnancy will be demonstrated and emphasized.

CHILD ABUSE AND ADULT MENTAL HEALTH: DOES GENDER MATTER?

Numerous studies have demonstrated that child abuse is associated with poor adult mental health, but few have investigated the extent to which the frequency of different types of abuse increase mental health conditions, especially at the nexus of gender. The present study examines whether parental abuse frequency and abuse perpetrator have distinct effects for men and women on three mental health outcomes—depressive symptoms, generalized anxiety, and global self-reported mental health. Data came from three waves of the National Survey of Midlife Development in the United States (MIDUS), comprising a baseline sample of 3,032 adults aged 25-74. Estimating a series of mixed effects models revealed that maternal abuse and frequent abuse during childhood were associated with poorer adult mental health during our 20-year observation period, net of childhood and adult risk factors. Specifically, maternal emotional abuse raised the risk of depression, anxiety, and lower self-rated mental health, and was more strongly associated with depression and anxiety for women than men. Compared to adults who did not experience parental abuse during childhood, adults who experienced frequent emotional and physical abuse by either parent were more likely to experience depression and anxiety and report lower ratings of mental health in adulthood. Frequent child abuse was more strongly associated with anxiety for women than men. These results demonstrate that gender differences in adult mental health have early-life antecedents. Future research investigating the long-term mental health consequences of child abuse should consider the type and magnitude of abuse as well as the perpetrator.

CHILD ABUSE AND ADULT MENTAL HEALTH: DOES GENDER MATTER?

Numerous studies have demonstrated that child abuse is associated with poor adult mental health, but few have investigated the extent to which the frequency of different types of abuse increase mental health conditions, especially at the nexus of gender. The present study examines whether parental abuse frequency and abuse perpetrator have distinct effects for men and women on three mental health outcomes—depressive symptoms, generalized anxiety, and global self-reported mental health. Data came from three waves of the National Survey of Midlife Development in the United States (MIDUS), comprising a baseline sample of 3,032 adults aged 25-74. Estimating a series of mixed effects models revealed that maternal abuse and frequent abuse during childhood were associated with poorer adult mental health during our 20-year observation period, net of childhood and adult risk factors. Specifically, maternal emotional abuse raised the risk of depression, anxiety, and lower self-rated mental health, and was more strongly associated with depression and anxiety for women than men. Compared to adults who did not experience parental abuse during childhood, adults who experienced frequent emotional and physical abuse by either parent were more likely to experience depression and anxiety and report lower ratings of mental health in adulthood. Frequent child abuse was more strongly associated with anxiety for women than men. These results demonstrate that gender differences in adult mental health have early-life antecedents. Future research investigating the long-term mental health consequences of child abuse should consider the type and magnitude of abuse as well as the perpetrator.

Invalidating Caregiving Environments, Specific Emotion Regulation Deficits, and Non-suicidal Self-injury.

This study examined the indirect effects of distinct aspects of invalidating caregiving environments (i.e., paternal maltreatment, maternal maltreatment, and perceived alienation) on non-suicidal self-injury (NSSI) via six specific emotion regulation difficulties. We hypothesized that specific emotion regulation deficits would mediate associations between invalidating environments and NSSI. Participants included 114 young adults (57 self-injurers; 57 age- and sex-matched comparison participants) aged 17-25years. Three parallel mediation models tested hypotheses. Results showed that maternal maltreatment, paternal maltreatment, and perceived alienation indirectly predicted NSSI through poor emotional clarity. Maternal maltreatment uniquely predicted NSSI through limited access to regulation strategies. Lastly, maternal maltreatment and perceived alienation were both linked to greater difficulties engaging in goal-directed behavior during emotional upsets; however, contrary to hypotheses, this particular deficit was associated with decreased odds of engaging in NSSI. Findings illustrate how different aspects of invalidating environments and specific emotion regulation deficits may be implicated in NSSI engagement.

Disentangling the Effects of Exposure to Maternal Substance Misuse and Physical Abuse and Neglect on Child Behavioral Problems.

There is inconsistent evidence on the association between prenatal substance exposure and child behavioral problems. Children affected by maternal substance misuse are vulnerable to physical abuse and neglect. Few studies have examined factors contributing to internalizing and externalizing problems in these children. This study, with a focus on children with prenatal substance exposure, investigated whether family characteristics (the duration of maternal substance misuse postpartum or the existence of a sibling) moderated the association between adverse exposure (physical abuse or neglect) and behavior (internalizing or externalizing problems). We recruited 54 Hong Kong Chinese mothers with registered records of substance misuse during pregnancy and their children (2-9 years). Mothers completed questionnaires on drug use patterns during pregnancy and postpartum, abusive and neglectful parenting behaviors in the preceding year, and children's current behavioral problems. Moderated regression analyses tested whether abusive and neglectful parenting behavior interacted with family characteristics to affect child behavioral problems. The existence of a sibling moderated the relationship between neglect experience and internalizing problems, with a positive relationship observed only among single children (adjusted B [95% confidence interval] = 3.70 [0.98, 6.41], p = .012). The duration of maternal substance misuse postpartum moderated the relationship between physical abuse experience and externalizing problems, with a positive relationship observed only among children of mothers abusing substances beyond the child's infancy period (adjusted B [95% confidence interval] = 6.86 [2.34, 11.38], p = .008). The results show that the impact of physical abuse and neglect experiences depend on the type of behavior assessed and family and child characteristics. Positive sibling relationship and early detoxification in the mother can foster healthy behavioral development for children exposed prenatally to maternal substance misuse.

Verbal abuse during pregnancy increases frequency of newborn hearing screening referral: The Japan Environment and Children's Study.

Verbal abuse during pregnancy has a greater impact than physical and sexual violence on the incidence of postnatal depression and maternal abuse behavior towards their children. In addition, exposure of children (aged 12 months to adolescence) to verbal abuse from their parents exerts an adverse impact to the children's auditory function. However, the effect of verbal abuse during pregnancy on fetal auditory function has not yet been thoroughly investigated. The objective of the study was to examine the relationship between intimate partner verbal abuse during pregnancy and newborn hearing screening (NHS) referral, which indicates immature or impaired auditory function. The Japan Environment and Children's Study is an ongoing nationwide population-based birth-cohort study designed to determine environmental factors during and after pregnancy that affect the development, health, or wellbeing of children. Pregnant women living in 15 areas of Japan were recruited between January 2011 and March 2014. Multiple imputation for missing data was performed, followed by multiple logistic regression using 16 confounding variables. Of 104,102 records in the dataset, 79,985 mother-infant pairs submitted complete data for questions related to verbal and physical abuse and the results of NHS. Of 79,985 pregnant women, 10,786 (13.5%) experienced verbal abuse and 978 (1.2%) experienced physical abuse. Of 79,985 newborns, 787 (0.98%) received a NHS referral. Verbal abuse was significantly associated with NHS referral (adjusted odds ratio: 1.44; 95% confidence interval: 1.05-1.98). Verbal abuse should be avoided during pregnancy to preserve the newborn's auditory function.