Longitudinal course of endocannabinoids and N-acylethanolamines in hair of mothers and their children in the first year postpartum: investigating the relevance of maternal childhood maltreatment experiences.

BACKGROUND: Childhood maltreatment (CM) exerts long-lasting psychological and biological alterations in affected individuals and might also affect the endocannabinoid (eCB) system which modulates inflammation and the endocrine stress response. Here, we investigated the eCB system of women with and without CM and their infants using hair samples representing eCB levels accumulated during the last trimester of pregnancy and 10-12 months postpartum. METHODS: CM exposure was assessed with the Childhood Trauma Questionnaire. At both timepoints, 3 cm hair strands were collected from mothers and children (N = 170 resp. 150) to measure anandamide (AEA), 2/1-arachidonoylglycerol (2-AG/1-AG), stearoylethanolamide (SEA), oleoylethanolamide (OEA), and palmitoylethanolamide (PEA). RESULTS: Maternal hair levels of 2-AG/1-AG increased and SEA levels decreased from late pregnancy to one year postpartum. Maternal CM was associated with lower SEA levels in late pregnancy, but not one year later. In the children's hair, levels of 2-AG/1-AG increased while levels of SEA, OEA, and PEA decreased from late pregnancy to one year later. Maternal CM was not consistently associated with the eCB levels measured in children's hair. CONCLUSIONS: We provide first evidence for longitudinal change in the eCB system of mothers and infants from pregnancy to one year later. While maternal CM influenced the maternal eCB system, we found no consistent intergenerational effects on early regulation of the eCB system in children. Longitudinal research on the importance of the eCB system for the course and immunoregulation of pregnancy as well as for the children's development.

Sources of social support for postpartum women with a history of childhood maltreatment: Consequences for perceived stress and general mental health in the first year after birth.

BACKGROUND: Women with a history of childhood maltreatment (CM) experience the postpartum period as particularly stressful and may benefit less from social support, implicating a higher risk for mental health problems and higher stress levels in mothers with CM. OBJECTIVE: Thus, we investigated the complex relationship of CM and social support provided by different sources (intimate partner, parents, parents-in-law, friends) in predicting stress perception and mental health over the course of the first year postpartum. PARTICIPANTS: In N = 295 postpartum women we assessed CM experiences, stress perception, perceived social support and general mental health 3 and 12 months postpartum. METHOD: Linear mixed effect models were used to examine the course of social support over the first year postpartum and path analyses were used to investigate mediation and moderation effects. RESULTS: We found that CM was linked to lower levels of perceived social support, accounted for more mental health problems, and amplified the negative association between perceived stress and maternal mental health. Most importantly, we showed that only partner support was beneficial for maternal mental health, and this association was mediated by reductions in perceived stress. CONCLUSION: CM as a major risk factor for mental health impairs the stress resilience of affected postpartum women. Extending previous research, our results reveal that the source of postpartum social support determines its benefits for maternal health. Our findings emphasize the need of at-risk mothers to be provided with additional sources of support to cope with daily practical, organizational and emotional challenges.

Long-Term Consequences of Childhood Maltreatment Among Postpartum Women-Prevalence of Psychosocial Risk Factors for Child Welfare: An Independent Replication Study.

Introduction: As an especially burdensome experience, childhood maltreatment (CM) can have lifelong consequences on the mental health and wellbeing of an individual well into adulthood. We have previously reported that CM constitutes a central risk factor not only for the development of mental problems, but also for facing additional psychosocial risks, endangering healthy development of mother and offspring throughout life (e.g., financial problems, intimate partner violence, substance use). This study was designed to replicate these findings in a larger, independent study cohort. Method: In this cross-sectional replication study an independent cohort of 533 healthy postpartum women was interviewed within seven days after parturition. CM experiences were assessed retrospectively using the German version of the Childhood Trauma Questionnaire (CTQ) and current psychosocial risk factors for child welfare were assessed using the Konstanzer Index (KINDEX). Results: Of all women, 16.1% experienced emotional and 10.1% physical abuse, 28.5% emotional neglect, 9.4% physical neglect and 10.3% experienced sexual abuse. Most importantly, the higher the CM load the more psychosocial stressors existed in women's life. In Particular, women with higher CM load had a higher risk for mental health problems, intimate partner violence, financial problems, and a higher postnatal stress load. Conclusions: In an independent sample, this study replicated the previous findings that CM and psychosocial risk factors for child welfare were strongly associated in a dose-response manner. Our results emphasize the higher vulnerability of women with a CM history in the postpartum period. To avoid negative consequences for mother and child, a regular and evidence-based screening for CM and psychosocial risk factors during pregnancy and puerperium is needed to identify at-risk mothers early during pregnancy and to provide appropriate support. Hence, our findings highlight the mandatory requirement for an interdisciplinary collaboration of gynecological practices, hospitals and midwifes, along with psychologists and psychotherapists and child and youth welfare services.

Atypical maternal interaction is associated with elevated levels of hair cortisol in children.

The quality of maternal caregiving is an important factor in the healthy development of a child. One consequence of prolonged insensitive and atypical maternal interaction behavior (e.g., withdrawing from interactions with the child and role-reversal, i.e., the takeover of the parental role or parts of it by the child) in mother-child-dyads can cause alteration of the child's stress response system. Higher salivary cortisol concentrations were reported in infants and toddlers directly after negative interactions with their parents. However, no study to date has examined the association between atypical maternal interaction behavior and hair cortisol concentrations (HCC) in infants. Here, we studied the association of maternal interaction behavior with HCC of the child. Mother-child dyads (N = 112) participated in the longitudinal study My Childhood-Your Childhood. The AMBIANCE scale and its subscales were used to assess atypical maternal interaction behavior during the Strange Situation Procedure. Chronic stress levels in the child were assessed by HCC of 3 cm hair strands at the age of 12 months. Maternal educational level (operationalized in highest education level) served as a control variable. Robust multiple linear regression analyses revealed that role/boundary confusion was associated with HCC, i.e., the higher atypical interaction behavior of the mother the higher the HCC in the children. By measuring hair cortisol in this study, it is possible to determine the average long-term activity of the child's stress response system.Thus, atypical maternal interaction behavior could be a risk factor for persistent stress in children, contributing to a higher risk for negative health outcomes in later life. The results of this study highlight the importance of early intervention programs that focus on the relationship between mother and child.

Deconstructing Traumatic Mission Experiences: Identifying Critical Incidents and Their Relevance for the Mental and Physical Health Among Emergency Medical Service Personnel.

Emergency medical service (EMS) personnel frequently encounter emotionally stressful or even traumatic incidents in their line of duty. In this study, a checklist of emotionally stressful events for the German EMS was introduced. A mixed-method approach was used to identify mission events that were critical for the development of mental and physical stress symptoms. Data were collected in a cross-sectional sample of 102 EMS employees. A quantitative content analysis of the participants' worst experiences on duty indicated, traumatic missions to be a concatenation of two to five emotionally stressful events. Rescue missions were experienced as traumatic if (i) EMS personnel became victims of attacks or threats; (ii) certain circumstances caused them to give up their professional detachment from patients; (iii) EMS personnel perceived the overall mission as exceptionally tragic. In subsequent correlation analyses, the corresponding checklist items showed consistent positive associations with the post-traumatic, depressive and physical stress symptoms among the study cohort. Within the exploratory regressions, the sum score of critical on-duty exposures contributed incrementally to the prediction of mental and physical stress symptoms when non-work-related trauma exposure and perceived social support were also considered. Findings point toward the importance of considering the cumulative burden of critical incidents for the long-term health of EMS personnel. Future research is needed to investigate, how on-duty trauma affects the social support EMS personnel received from their work and personal relationships.