Abstract
Objective: To foster resilience through reducing posttraumatic stress disorder (PTSD) symptoms in pregnant mothers with child maltreatment (CM) histories, it is important to understand factors impacting their well-being. This study explored whether CM predicted the severity of PTSD symptoms and symptom clusters during pregnancy and change in symptoms from pregnancy (Time 1; T1) to 3 months postpartum (Time 2; T2).
Methods: 88 pregnant women (aged 18 to 29) completed surveys on CM exposure, adult interpersonal trauma experiences, and PTSD symptoms at T1; 58 participated at T2.
Results: Stepwise regressions were conducted with the covariates age, family status, and adult interpersonal traumas. When accounting for all CM types, only neglect remained associated with overall PTSD symptoms (Ft1(4, 71) = 19.08, p < .001) and for each of the PTSD symptom clusters (ps < .01). Physical abuse remained associated with the alterations in cognition and mood cluster. No CM types were associated with changes in PTSD symptoms from T1 to T2.
Implications: In future research, the implications of neglect for pregnant mothers should be explored in depth. Perinatal care should be trauma-informed, including assessing for CM histories, to foster greater resilience by reducing perinatal PTSD symptoms.
References
Adam, E. K., Collier Villaume, S., Thomas, S., Doane, L. D., & Grant, K. E. (2023). Stress and hypothalamic-pituitary-adrenal axis activity in adolescence and early adulthood. In L. J. Crockett, G. Carlo, & J. E. Schulenberg (Eds.), APA handbook of adolescent and young adult development (pp. 55-72). American Psychological Association. http://doi.org/10.1037/0000298-004
Afifi, T. O., MacMillan, H. L., Boyle, M., Taillieu, T., Cheung, K., & Sareen, J. (2014). Child abuse and mental disorders in Canada. Canadian Medical Association Journal, 186(9), E324-E332. https://doi.org/10.1503/cmaj.131792
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Atzl, V. M., Narayan, A. J., Rivera, L. M., & Lieberman, A. F. (2019). Adverse childhood experiences and prenatal mental health: Type of ACEs and age of maltreatment onset. Journal of Family Psychology, 33(3), 304-314. https://doi.org/10.1037/fam0000510
Bremner, J. D., Bolus, R., & Mayer, E. A. (2007). Psychometric properties of the Early Trauma Inventory-Self Report. Journal of Nervous & Mental Disease, 195(3), 211-218. https://doi.org/10.1097/01.nmd.0000243824.84651.6c
Brunton, R., & Dryer, R. (2021). Child sexual abuse and pregnancy: A systematic review of the literature. Child Abuse & Neglect, 111, Article 104802. https://doi.org/10.1016/j.chiabu.2020.104802
Chauhan, M., Kaur, A., Singh, N., Singh, R., Kumar, S., & Kour, P. (2021). Child abuse and neglect: An overview. Journal of Current Medical Research and Opinion, 4(05), 928-936. https://doi.org/10.15520/jcmro.v4i05.420
Choi, K. W., & Sikkema, K. J. (2016). Childhood maltreatment and perinatal mood and anxiety disorders: A systematic review. Trauma, Violence, & Abuse, 17(5), 427-453. https://doi.org/10.1177/1524838015584369
Dunne, M. P., Zolotor, A. J., Runyan, D. K., Andreva-Miller, I., Choo, W. Y., Dunne, S. K., Gerbaka, B., Isaeva, O., Jain, D., Kasim, M. S., Macfarlane, B., Mamyrova, N., Ramirez, C., Volkova, E., & Youssef, R. (2009). ISPCAN Child Abuse Screening Tools Retrospective version (ICAST-R): Delphi study and field testing in seven countries. Child Abuse & Neglect, 33(11), 815-825. https://doi.org/10.1016/j.chiabu.2009.09.005
Dye, H. (2018). The impact and long-term effects of childhood trauma. Journal of Human Behavior in the Social Environment, 28(3), 381-392. https://doi.org/10.1080/10911359.2018.1435328
Frederickson, A., Kern, A., & Langevin, R. (2023). Perinatal (re)experiencing of post-traumatic stress disorder symptoms for survivors of childhood sexual abuse: An integrative review. Journal of Women’s Health, 32(1), 78-93. https://doi.org/10.1089/jwh.2022.0183
Gama, C. M. F., Portugal, L. C. L., Gonçalves, R. M., de Souza Junior, S., Vilete, L. M. P., Mendlowicz, M. V., Figueira, I., Volchan, E., David, I. A., de Oliveira, L., & Pereira, M. G. (2021). The invisible scars of emotional abuse: A common and highly harmful form of childhood maltreatment. BMC Psychiatry, 21(156). https://doi.org/10.1186/s12888-021-03134-0
Guyon-Harris, K. L., Ahlfs-Dunn, S., & Huth-Bocks, A. (2017). PTSD symptom trajectories among mothers reporting interpersonal trauma: Protective factors and parenting outcomes. Journal of Family Violence, 32(7), 657-667. https://doi.org/10.1007/s10896-017-9934-3
Henderson, D. A., & Denison, D. R. (1989). Stepwise regression in social and psychological research. Psychological Reports, 64(1), 251-257. https://doi.org/10.2466/pr0.1989.64.1.251
Herrenkohl, T. I., Hong, S., Klika, J. B., Herrenkohl, R. C., & Russo, M. J. (2013). Developmental impacts of child abuse and neglect related to adult mental health, substance use, and physical health. Journal of Family Violence, 28(2), 191-199. https://doi.org/10.1007/s10896-012-9474-9
Huth-Bocks, A. C., Krause, K., Ahlfs-Dunn, S., Gallagher, E., & Scott, S. (2013). Relational trauma and posttraumatic stress symptoms among pregnant women. Psychodynamic Psychiatry, 41(2), 277-301. https://doi.org/10.1521/pdps.2013.41.2.277
Juruena, M. F., Eror, F., Cleare, A. J., Young, A. H. (2020). the role of early life stress in HPA axis and anxiety. In Y. K. Kim (eds.) Anxiety disorders. Advances in experimental medicine and biology, vol 1191. Springer. https://doi.org/10.1007/978-981-32-9705-0_9
Kisely, S., Strathearn, L., & Najman, J. M. (2020). Child maltreatment and mental health problems in 30-year-old adults: A birth cohort study. Journal of Psychiatric Research, 129, 111-117. https://doi.org/10.1016/j.jpsychires.2020.06.009
Lev-Wiesel, R., & Daphna-Tekoa, S. (2007). Prenatal posttraumatic stress symptomatology in pregnant survivors of childhood sexual abuse: A brief report. Journal of Loss and Trauma, 12(2), 145-153. https://doi.org/10.1080/15325020600945988
Lev-Wiesel, R., & Daphna-Tekoah, S. (2010). The role of peripartum dissociation as a predictor of posttraumatic stress symptoms following childbirth in Israeli Jewish women. Journal of Trauma & Dissociation, 11(3), 266-283. https://doi.org/10.1080/15299731003780887
McLaughlin, K. A., Sheridan, M. A., & Nelson, C. A. (2017). Neglect as a violation of species-expectant experience: Neurodevelopmental consequences. Biological Psychiatry, 82(7), 462-471. https://doi.org/10.1016/j.biopsych.2017.02.1096
Montgomery, E., Pope, C., & Rogers, J. (2015). The re-enactment of childhood sexual abuse in maternity care: A qualitative study. BMC Pregnancy and Childbirth, 15(194), 1-7. https://doi.org/10.1186/s12884-015-0626-9
Ney, P. G., Moore, C., McPhee, J., & Trought, P. (1986). Child abuse: A study of the child's perspective. Child Abuse & Neglect, 10(4), 511-518. https://doi.org/10.1016/0145-2134(86)90056-6
Noll, J. G. (2021). Child sexual abuse as a unique risk factor for the development of psychopathology: The compounded convergence of mechanisms. Annual Review of Clinical Psychology, 17, 439-464. https://doi.org/10.1146/annurev-clinpsy-081219-112621
Sanchez, S. E., Pineda, O., Chaves, D. Z., Zhong, Q.-Y., Gelaye, B., Simon, G. E., Rondon, M. B., & Williams, M. A. (2017). Childhood physical and sexual abuse experiences associated with post-traumatic stress disorder among pregnant women. Annals of Epidemiology, 27(11), 716-723. https://doi.org/10.1016/j.annepidem.2017.09.012
Slade, A., Cohen, L. J., Sadler, L. S., & Miller, M. (2009). The psychology and psychopathology of pregnancy: Reorganization and transformation. In C. H. Zeanah, Jr. (Ed.), Handbook of infant mental health (pp. 22-39). The Guilford Press.
Walker, H. E., Freud, J. S., Ellis, R. A., Fraine, S. M., & Wilson, L. C. (2019). The prevalence of sexual revictimization: A meta-analytic review. Trauma, Violence, & Abuse, 20(1), 67-80. https://doi.org/10.1177/1524838017692364
Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2013a). The Life Events Checklist for DSM-5 (LEC-5). National Center for PTSD, www.ptsd.va.gov
Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013b). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD, www.ptsd.va.gov
Widom, C. S., Czaja, S. J., & Dutton, M. A. (2008). Childhood victimization and lifetime revictimization. Child Abuse & Neglect, 32(8), 785-796. https://doi.org/10.1016/j.chiabu.2007.12.006