Maternal Neglect Research Articles

Are there differential relationships between different types of childhood maltreatment and different types of adult personality pathology?

While considerable data support the relationship between childhood trauma and adult personality pathology in general, there is little research investigating the specific relationships between different types of childhood maltreatment and adult personality disorders. The present study tested a model incorporating five a priori hypotheses regarding the association between distinct forms of childhood maltreatment and personality pathology in 231 psychiatric patients using multiple self-report measures (Personality Diagnostic Questionnaire-4th Edition, Child Trauma Questionnaire, Conflict in Tactics Scale Parent-Child Child-Adult, and Multidimensional Neglectful Behavior Scale). Step-wise linear regressions supported three out of five hypotheses, suggesting independent relationships between: physical abuse and antisocial personality disorder traits; emotional abuse and Cluster C personality disorder traits; and maternal neglect and Cluster A personality disorder traits after controlling for co-occurring maltreatment types and personality disorder traits. Results did not support an independent relationship between sexual abuse and borderline personality traits nor between emotional abuse and narcissistic personality disorder traits. Additionally, there were three unexpected findings: physical abuse was independently and positively associated with narcissistic and paranoid traits and negatively associated with Cluster C traits. These findings can help refine our understanding of adult personality pathology and support the future development of clinical tools for survivors of childhood maltreatment.

Use of a Projective Test in Psychodynamic Play Therapy with a Latency Age Child to Explore Themes of Attachment and Loss

This article uses the treatment of William, a 7-year-old boy with a history of maternal loss and early neglect, to illustrate the clinical integration of a projective test into a psychodynamically informed play therapy. The ability of this patient to create an imaginary friend through The Fantasy Animal Drawing (Handler & Hilsenroth, 1994) made it possible for him to explore, play with, own, and disown experiences of connection, aggression, loss, and oral hunger. Also, the imaginary friend created through the game made it possible for the patient and therapist to co-create a transitional space (Winnicott, 1971a) from which a narrative of this year-long treatment was derived. The writer will discuss the impact that this case had on her training as a PhD student of clinical psychology in her sixth and final year of predoctoral training. Discussion of the use of supervision and the impact of a predetermined termination of the case at the end of the training year will also be addressed.

Reconceptualizing Motherhood, Reconceptualizing Resistance

Female labour migrants face contradictory expectations. On the one hand, they are expected to be their families' and communities' economic saviours. On the other hand, they are expected to meet their maternal responsibilities even while they are abroad; otherwise, they face charges of maternal neglect. My goal in this article is to highlight how female migrant workers handle these conflicting demands. I discuss how migrant women simultaneously adapt to and challenge imposed family separation through the case study of Filipina live-in caregivers in Canada. They do this in two ways. First, they exhibit transnational hyper-maternalism which allows them to overcome accusations of neglect. They ‘mother across borders’ by providing for their families and by using technology to supervise, monitor and communicate with their children. In doing so, they reify and contest established gender roles. Second, they are active in civil society. In doing so, they highlight the negative consequences migrant women and their families face. Reconceptualized notions of motherhood characterize migrant women's transnational parenting, while the desire to ameliorate the negative consequences of family separation and reunification explain their activism.

Dating Violence Perpetration: The Predictive Roles of Maternally versus Paternally Perpetrated Childhood Abuse and Subsequent Dating Violence Attitudes and Behaviors

This study investigated both young men's and young women's perpetration of physical, sexual, and psychological forms of dating violence, examining predictors of violence including maternally or paternally perpetrated forms of various types of child maltreatment, as well as attitudes toward dating violence and dating violence victimization. Results of hierarchical linear regressions found that childhood experiences of maternal neglect predicted men's physical perpetration, and childhood sexual abuse predicted women's sexual perpetration and men's psychological perpetration. Further, positive attitudes toward dating violence predicted women's physical, psychological, and sexual perpetration, as well as men's sexual perpetration, and experiences of dating violence victimization were the strongest predictors of most forms of dating violence perpetration, particularly among women. Implications for future research and prevention initiatives are discussed.

Maternal neglect with reduced depressive-like behavior and blunted c-fos activation in Brattleboro mothers, the role of central vasopressin

Early mother–infant relationships exert important long-term effects in offspring and are disturbed by factors such as postpartum depression. We aimed to clarify if lack of vasopressin influences maternal behavior paralleled by the development of a depressive-like phenotype. We compared vasopressin-deficient Brattleboro mothers with heterozygous and homozygous normal ones. The following parameters were measured: maternal behavior (undisturbed and separation-induced); anxiety by the elevated plus maze; sucrose and saccharin preference and forced swim behavior. Underlying brain areas were examined by c-fos immunocytochemistry among rest and after swim-stress. In another group of rats, vasopressin 2 receptor agonist was used peripherally to exclude secondary changes due to diabetes insipidus. Results showed that vasopressin-deficient rats spend less time licking–grooming their pups through a centrally driven mechanism. There was no difference between genotypes during the pup retrieval test. Vasopressin-deficient mothers tended to explore more the open arms of the plus maze, showed more preference for sucrose and saccharin and struggled more in the forced swim test, suggesting that they act as less depressive. Under basal conditions, vasopressin-deficient mothers had more c-fos expression in the medial preoptic area, shell of nucleus accumbens, paraventricular nucleus of the hypothalamus and amygdala, but not in other structures. In these areas the swim-stress-induced activation was smaller. In conclusion, vasopressin-deficiency resulted in maternal neglect due to a central effect and was protective against depressive-like behavior probably as a consequence of reduced activation of some stress-related brain structures. The conflicting behavioral data underscores the need for more sex specific studies.

The development of father–child attachment: associations between adult attachment representations, recollections of childhood experiences and caregiving

The association between fathers' adult attachment representations and their recollections of childhood experiences with their caregiving quality with their eight-month-old infants and with father–infant attachment classification was examined in a longitudinal study of 117 fathers and their infants. Sensitive caregiving was related to secure-autonomous classification in the Adult Attachment Interview (AAI), hostile caregiving was related to fathers' dismissing and unresolved attachment, and emotional disengagement and role-reversed caregiving were both related to fathers' unresolved attachment. Childhood experiences of parental pressure to achieve were related to fathers' hostile and role-reversed caregiving and low sensitivity, independent of AAI classification. However, fathers' childhood experiences of maternal neglect were related to high-quality caregiving. It was also found that fathers' secure-autonomous AAI classification was related to secure father–child attachment in the Strange Situation Paradigm, and this relation was mediated by sensitive caregiving.

Childhood Abuse in Chinese Patients with Borderline Personality Disorder

This study examined (1) the relative prevalence of childhood abuse and other pathological childhood experiences in China reported by outpatients with borderline personality disorder (BPD), with other personality disorders, and without personality disorders; and, (2) whether the primary predictors of BPD in North America are associated with the development of BPD in China. The childhood experiences of 203 outpatients with BPD, 109 outpatients with other personality disorders, and 70 outpatients without Axis II diagnoses were assessed with the Chinese version of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q). Patients with BPD reported significantly more physical, emotional, and sexual abuse than either comparison group. Four types of childhood experiences were significant predictors of BPD: maternal neglect, paternal antipathy, sexual abuse, and maternal physical abuse. The findings suggest that maternal physical abuse is as strong a predictor of BPD in China as sexual abuse, a finding not replicated in North America.

Maternal oxytocin response during mother–infant interaction: Associations with adult temperament

Oxytocin is a neuropeptide associated with social affiliation and maternal caregiving. However, its effects appear to be moderated by various contextual factors and stable individual characteristics. The purpose of this study was to investigate the relationship of self-reported state and trait measures (such as temperament, mood and affect) with peripheral oxytocin response in mothers. Fifty-five first-time mothers participated in a semi-structured procedure, during which time repeated peripheral oxytocin levels were measured before, during and after an episode of mother–infant interaction. The maternal oxytocin response was then calculated, based on the difference in oxytocin concentration between initial baseline and interaction phase. Mothers also completed state measures of positive and negative affect and depression, and trait measures of temperament, personality disturbance and depression across time. Regression analyses determined which factors were independently associated with maternal oxytocin response. The trait measure of adult temperament emerged as a significant predictor of oxytocin response. Two out of four Adult Temperament Questionnaire factor scales were independently associated with oxytocin response: Effortful Control was negatively associated, whereas Orienting Sensitivity was positively associated. No state measure significantly predicted oxytocin response. The results indicate that mothers who show an increased oxytocin response when interacting with their infants are more sensitive of moods, emotions and physical sensations; and less compulsive, schedule driven and task oriented. These findings link differences in individual temperament in new mothers with the peripheral oxytocin response, which may have implications in the pharmacologic treatment of disorders such as maternal neglect, post-partum depression and maternal addiction.This article is part of a Special Issue entitled Oxytocin, Vasopressin, and Social Behavior.

Translational Research Models and Methods for Mother-Infant Interactions and Developmental Studies

The disruption of mother-infant interactions can have life-long detrimental consequences for offspring and mothers. Recently, science has begun to emphasize translational research including preclinical and neurobiological research that may have direct implications for clinical populations and issues. This group of papers focuses broadly on translational studies highlighting factors that may affect or alter infant or child development and maternal response capability. Articles, both preclinical and clinical, highlight topics such as drug abuse, maternal neglect, altered reward systems, stress, biological and neural system development, child and infant behavioral development, genetics/epigenetics, intergenerational studies and logistical issues of comparative measurement. Articles include research methods papers, reviews, original research articles, techniques, and opinion articles that address these topics. New methods papers for comparative measures between clinical and preclinical populations are included. Our aims include introducing new translational models and methods for research through a group of outstanding papers focused on these topics.

Maternal Neglect: Oxytocin, Dopamine and the Neurobiology of Attachment

Maternal neglect, including physical and emotional neglect, is a pervasive public health challenge with serious long-term effects on child health and development. I provide an overview of the neurobiological basis of maternal caregiving, aiming to better understand how to prevent and respond to maternal neglect. Drawing from both animal and human studies, key biological systems are identified that contribute to maternal caregiving behaviour, focusing on the oxytocinergic and dopaminergic systems. Mesocorticolimbic and nigrostriatal dopamine pathways contribute to the processing of infant-related sensory cues leading to a behavioural response. Oxytocin may activate the dopaminergic reward pathways in response to social cues. Human neuroimaging studies are summarised that demonstrate parallels between animal and human maternal caregiving responses in the brain. By comparing different patterns of human adult attachment, we gain a clearer understanding of how differences in maternal brain and endocrine responses may contribute to maternal neglect. For example, in insecure/dismissing attachment, which may be associated with emotional neglect, we see reduced activation of the mesocorticolimbic dopamine reward system in response to infant face cues, as well as decreased peripheral oxytocin response to mother-infant contact. We are currently testing whether the administration of intranasal oxytocin, as part of a randomised placebo controlled trial, may reverse some of these neurological differences, and potentially augment psychosocial and behavioural interventions for maternal neglect.

Parental Care in Childhood and Obesity in Adulthood: A Study Among Twins

The purpose of the study was to examine if parental antipathy and neglect during childhood were associated with obesity in adulthood. From the Danish Twin Registry (DTR) 146 adult same-sexed twin pairs discordant for BMI were identified. Criteria for being discordant were that one of the twins should have a BMI between 20 and 25 kg/m(2) (normal weight) and the co-twin a BMI ≥30 kg/m² (obesity). In total 236 out of 289 (81.7%) eligible twin individuals participated in an interview and a physical examination. A part of the Childhood Experience of Care and Abuse, the parental care and neglect questionnaire, by Bifulco et al., was used to assess perceived parental antipathy and neglect. Data were analyzed by means of intrapair comparisons. Our results showed that recalled maternal antipathy (P = 0.04) and maternal neglect (P = 0.01) were both associated with adult obesity. Paternal neglect and antipathy were not related with adult obesity. The study demonstrates that experience in childhood maternal antipathy and neglect may contribute to the development of obesity at age 20 and later in adulthood.

A comparison of path factors influencing depressive symptoms in children of immigrant women and Korean children in South Korea

The aim of this study is to compare Korean children and the children of immigrant women with respect to how depressive symptoms in these two groups are related to potential causes, including paternal neglect, maternal neglect, gender, socioeconomic status, ego resilience, peer relationships, teacher-student relationships, and discrimination. Concurrently analyzing multiple populations, we found that the path model and the path coefficients we used for the study were appropriate for both groups. Peer relationships and discrimination were found to have direct influences on depressive symptoms in both groups. We also found that gender, ego resilience, and teacher-student relationships had indirect effects in causing depressive symptoms in the children of immigrant women. Furthermore, maternal neglect had a more significant indirect effect among the children of immigrant women, whereas paternal neglect had a more significant indirect effect among the Korean children in our study. The results indicate that the same path model could be applied to both groups of children, allowing us to conclude that the same focus and approaches for intervention could be provided to both groups to decrease the levels of depressive symptoms.

Socialization of emotion and offspring internalizing symptoms in mothers with childhood-onset depression

This study examines how mothers with and without a history of childhood-onset depression respond to their 3–9 year-old children's emotions. Mother–child dyads included 55 offspring of mothers with a history of childhood-onset depressive disorders and 57 offspring of never-depressed mothers. Mothers with a history of childhood depression were less likely than control mothers to respond in supportive ways to their children's negative emotions and were more likely to magnify, punish, or neglect their children's negative emotions. Magnification, neglect, and punishment of children's negative emotions were concurrently associated with children's internalizing symptoms, and neglect and punishment were associated with internalizing over a one year follow-up. Maternal neglect of children's negative emotion was positively associated with later internalizing symptoms for children who already had higher internalizing symptoms at the initial assessment. Findings suggest that atypical socialization of emotion may be one mechanism in the development of internalizing disorders.

Effect of childhood psychological abuse on the personality of undergraduates with depression

Objective To investigate the effect of psychological abuse in childhood on the personality of undergraduates with depression as well as its possible mechanism, and thus provide scientific evidence for the intervention of depression in undergraduates. Methods Particinants were 733 undergraduates from a university in Henan Province. They were surveyed with Center for Epidemiological Studies-Depression scale (CES-D), childhood experience of care and abuse questionnaire (CECA. Q) and Eysenck personality theory (EPQ). Results the correlation between maternal antipathy and introversion-extroversion of personality;psychological abuse in childhood had apparently positive correlation with the depression in undergraduates (r = 0. 257, r = 0. 304, r =0. 243, P＜ 0. 01) and that of childhood maternal neglect to psychoticism (β = 0.206, P＜ 0.01) were positive and significant. The standard regression coefficients of paternal neglect to introversion-extroversion (β= -0. 143, P＜0. 01)were negative and significant . The scores of childhood paternal antipathy and maternal antipathy explained that childhood paternal antipathy had indirect effect via adulthood neuroticism on the depression in undergraduates,furthermore, the indirect effect demonstrated 59.8% of the total effect. Conclusion This study suggests that the personality of undergraduates with depression is affected directly by psychological abuse in childhood, and adulthood personality may mediate the relation between childhood psychological abuse and adulthood depression. Key words: Childhood psychological abuse; Personality; Depression

Ethyl t‐butyl ether: review of reproductive and developmental toxicity

Ethyl t-butyl ether (ETBE) is a motor fuel oxygenate used in reformulated gasoline. Knowledge of developmental and reproductive toxicity potential of ETBE is critical for making informed decisions about acceptance and regulations. This review discusses toxicology studies providing information about effects on reproduction and the conceptus. Seven GLP-compliant studies following widely accepted protocols have focused specifically on developmental and reproductive toxicity (DART) in rats and rabbits exposed to ETBE by gavage with doses up to 1,000 mg/kg body weight/day, the limit specified in standardized test guidelines. Other repeat-dose general toxicology studies have administered ETBE to rodents for up to 180 days, and included reproductive organ weights, histology, or other indications of reproductive system structure or function. DART potential of the main ETBE metabolite t-butyl alcohol and class-related MTBE has also been studied. More GLP-compliant studies exist for evaluating ETBE using well-established, currently recommended protocols than are available for many other chemicals used today. The database for determining ETBE DART potential is adequate, although not all study details are currently easily accessible for peer-review. ETBE does not appear to be selectively toxic to reproduction or embryofetal development in the absence of other manifestations of general toxicity. Studies using recommended methods for sample preservation and analysis have shown no targeted effect on the reproductive system. No embryofetal effects were observed in rabbits. Early postnatal rat pup deaths show no clear dose-response and have largely been attributed to total litter losses with accompanying evidence of maternal neglect or frank maternal morbidity.

Severe early life stress hampers spatial learning and neurogenesis, but improves hippocampal synaptic plasticity and emotional learning under high-stress conditions in adulthood.

Early life stress increases the risk for developing stress-related pathologies later in life. Recent studies in rats suggest that mild early life stress, rather than being overall unfavorable, may program the hippocampus such that it is optimally adapted to a stressful context later in life. Here, we tested whether this principle of "adaptive programming" also holds under severely adverse early life conditions, i.e., 24 h of maternal deprivation (MD), a model for maternal neglect. In young adult male rats subjected to MD on postnatal day 3, we observed reduced levels of adult hippocampal neurogenesis as measured by cell proliferation, cell survival, and neuronal differentiation. Also, mature dentate granule cells showed a change in their dendritic morphology that was most noticeable in the proximal part of the dendritic tree. Lasting structural changes due to MD were paralleled by impaired water maze acquisition but did not affect long-term potentiation in the dentate gyrus. Importantly, in the presence of high levels of the stress hormone corticosterone, even long-term potentiation in the dentate gyrus of MD animals was facilitated. In addition to this, contextual learning in a high-stress environment was enhanced in MD rats. These morphological, electrophysiological, and behavioral observations show that even a severely adverse early life environment does not evolve into overall impaired hippocampal functionality later in life. Rather, adversity early in life can prepare the organism to perform optimally under conditions associated with high corticosteroid levels in adulthood.

Adolescent mental health: Challenges with maternal noncompliance

The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal-child dysfunction are well-documented. However, resources to prevent offspring victimization are lacking. Here, we report maternal neglect of a 15-year-old male brought to the psychiatric emergency room for suicidal ideation. An inpatient treatment plan including pharmacotherapy, family therapy and psychological testing was initiated. The patient's mother failed to attend clinic appointments or family therapy sessions. Clinician attempts to engage the mother in the treatment plan was met with verbal assaults, aggression, and threatening behavior. The patient decompensated in relation to the mother's actions. Child Protective Services were contacted and a follow-up assessment with the patient and mother is pending. Psychiatric treatment of the mother may be a necessary intervention and prevention regimen for both the adolescent and the mother. Without consistent Child Protective Services oversight, medical and psychosocial follow-up, the prognosis and quality of life for this adolescent is considered very poor. Stringent mental health law and institutional policies are needed to adequately intercede and protect adolescents with mental illness.

The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder.

Childhood adversity has been associated with onset of psychosis in adulthood but these studies have used only general definitions of this environmental risk indicator. Therefore, we sought to explore the prevalence of more specific adverse childhood experiences amongst those with and without psychotic disorders using detailed assessments in a large epidemiological case-control sample (AESOP). Data were collected on 182 first-presentation psychosis cases and 246 geographically matched controls in two UK centres. Information relating to the timing and frequency of exposure to different types of childhood adversity (neglect, antipathy, physical and sexual abuse, local authority care, disrupted living arrangements and lack of supportive figure) was obtained using the Childhood Experience of Care and Abuse Questionnaire. Psychosis cases were three times more likely to report severe physical abuse from the mother that commenced prior to 12 years of age, even after adjustment for other significant forms of adversity and demographic confounders. A non-significant trend was also evident for greater prevalence of reported severe maternal antipathy amongst those with psychosis. Associations with maternal neglect and childhood sexual abuse disappeared after adjusting for maternal physical abuse and antipathy. Paternal maltreatment and other forms of adversity were not associated with psychosis nor was there evidence of a dose-response effect. These findings suggest that only specific adverse childhood experiences are associated with psychotic disorders and only in a minority of cases. If replicated, this greater precision will ensure that research into the mechanisms underlying the pathway from childhood adversity to psychosis is more fruitful.

Does Breastfeeding Protect Against Substantiated Child Abuse and Neglect? A 15-Year Cohort Study

We explored whether breastfeeding was protective against maternally perpetrated child maltreatment. A total of 7223 Australian mother-infant pairs were monitored prospectively over 15 years. In 6621 (91.7%) cases, the duration of breastfeeding was analyzed with respect to child maltreatment (including neglect, physical abuse, and emotional abuse), on the basis of substantiated child protection agency reports. Multinomial logistic regression was used to compare no maltreatment with nonmaternal and maternally perpetrated maltreatment and to adjust for confounding in 5890 cases with complete data (81.5%). Potential confounders included sociodemographic factors, pregnancy wantedness, substance abuse during pregnancy, postpartum employment, attitudes regarding infant caregiving, and symptoms of anxiety or depression. Of 512 children with substantiated maltreatment reports, >60% experienced > or =1 episode of maternally perpetrated abuse or neglect (4.3% of the cohort). The odds ratio for maternal maltreatment increased as breastfeeding duration decreased, with the odds of maternal maltreatment for nonbreastfed children being 4.8 times the odds for children breastfed for > or =4 months. After adjustment for confounding, the odds for nonbreastfed infants remained 2.6 times higher, with no association seen between breastfeeding and nonmaternal maltreatment. Maternal neglect was the only maltreatment subtype associated independently with breastfeeding duration. Among other factors, breastfeeding may help to protect against maternally perpetrated child maltreatment, particularly child neglect.

Altered Dopamine Signaling in Naturally Occurring Maternal Neglect

BackgroundChild neglect is the most common form of child maltreatment, yet the biological basis of maternal neglect is poorly understood and a rodent model is lacking.Methodology/Principal FindingsThe current study characterizes a population of mice (MaD1) which naturally exhibit maternal neglect (little or no care of offspring) at an average rate of 17% per generation. We identified a set of risk factors that can predict future neglect of offspring, including decreased self-grooming and elevated activity. At the time of neglect, neglectful mothers swam significantly more in a forced swim test relative to nurturing mothers. Cross-fostered offspring raised by neglectful mothers in turn exhibit increased expression of risk factors for maternal neglect and decreased maternal care as adults, suggestive of possible epigenetic contributions to neglect. Unexpectedly, offspring from neglectful mothers elicited maternal neglect from cross-fostered nurturing mothers, suggesting that factors regulating neglect are not solely within the mother. To identify a neurological pathway underlying maternal neglect, we examined brain activity in neglectful and nurturing mice. c-Fos expression was significantly elevated in neglectful relative to nurturing mothers in the CNS, particularly within dopamine associated areas, such as the zona incerta (ZI), ventral tegmental area (VTA), and nucleus accumbens. Phosphorylated tyrosine hydroxylase (a marker for dopamine production) was significantly elevated in ZI and higher in VTA (although not significantly) in neglectful mice. Tyrosine hydroxylase levels were unaltered, suggesting a dysregulation of dopamine activity rather than cell number. Phosphorylation of DARPP-32, a marker for dopamine D1-like receptor activation, was elevated within nucleus accumbens and caudate-putamen in neglectful versus nurturing dams.Conclusions/SignificanceThese findings suggest that atypical dopamine activity within the maternal brain, especially within regions involved in reward, is involved in naturally occurring neglect and that MaD1 mice are a useful model for understanding the basis of naturally occurring neglect.