Pregnancy complications and intimate partner violence: The moderating role of prenatal posttraumatic stress symptoms.

Intimate partner violence (IPV) and posttraumatic stress disorder increase the risk of poor pregnancy outcomes, but associations among IPV exposure, mental health, and pregnancy complications remain underexplored. This study assessed the interaction between three types of IPV exposure (i.e., physical, sexual, psychological) and posttraumatic stress symptoms (PTSS) on prenatal complications (e.g., preeclampsia, gestational diabetes) among pregnant women exposed to IPV. Participants included 137 IPV-exposed pregnant women (Mage = 27.29, SD = 6.00; 66.9% African American/Black). Three regression models were run to test the main effect of each type of IPV and PTSS on pregnancy complications, and the moderating effect of PTSS on the association between IPV and pregnancy complications, controlling for socioeconomic status, gestational age, and childhood trauma. Main effects were observed for sexual coercion, ß = .32, p = .010, R2 part = .050, and PTSS, ß = 0.19, p = .039, R2 part = .026, with more frequent sexual IPV and higher levels of PTSS associated with more pregnancy complications. Moderating effects were also evident, with the IPV x PTSS interaction significant for all three IPV domains: psychological aggression, f2 = .046; sexual coercion, f2 = .079; and physical assault, f2 = .048. PTSS strengthened the positive association between psychological and sexual IPV and pregnancy complications. Physical IPV and pregnancy complications were inversely related for participants with low-level PTSS. Results provide novel information on how IPV types and PTSS function together during pregnancy. Findings highlight the need for evidence-based prenatal interventions that successfully address both IPV exposure and PTSS severity.

Parenting practices and intergenerational cycle of victimization in Peru.

Existing research has suggested children of caregivers with histories of exposure to trauma are at heightened risk for victimization, but few studies have explored potential mechanisms that explain this intergenerational transmission of risk. With data from peri-urban households in Lima, Peru (N = 402), this study analyzes parenting behaviors in the relation between caregivers' trauma history and child victimization for children aged 4-17. Results indicated caregivers' trauma history and negative parenting behaviors related to child victimization, and negative parenting behaviors mediated this relation. Positive parenting behaviors did not have significant direct effects and were not mediators of risk transmission. Parenting behaviors did not moderate the relation between caregiver and child victimization, suggesting parenting behaviors may not buffer or exacerbate intergenerational transmission. Post-hoc analyses revealed family type (e.g., single, cohabitating/married) exerted significant direct and moderating effects on child risk, interacting with positive parenting. Families with married/cohabitating caregivers reported overall lower levels of child victimization; however, the relation between positive parenting and victimization was slightly stronger for children in single-parent families. Results highlight potential pathways of the intergenerational cycle of victimization and suggest high-risk families in Peru may benefit from parenting supports, especially pertaining to remediation of negative parenting behaviors.

Effects of Intimate Partner Violence, Mental Health, and Relational Resilience on Perinatal Health.

Intimate partner violence (IPV) during and prior to pregnancy has been linked to higher rates of pregnancy complications and early labor and delivery. However, to our knowledge, no studies have examined prenatal mental health problems and relational resilience as parallel mechanisms by which past-year IPV exposure impacts pregnancy and labor. The current study aimed to (a) examine the contribution of IPV exposure to pregnancy complications and early labor and delivery, controlling for childhood adversity, and (b) assess prenatal mental health and relational resilience as mediators of the effect of IPV exposure on pregnancy complications and early labor and delivery. We hypothesized that IPV would predict higher levels of mental health problems and lower levels of relational resilience, each of which would contribute to women's risk of labor complications such that fewer mental health problems and higher levels of relational resilience would each be associated with fewer pregnancy complications and early labor and delivery. Participants were (n = 76) interviewed during pregnancy and 6 weeks postdelivery. No direct effect of IPV exposure on either pregnancy complications or labor complications was found. Parallel indirect effects of IPV on labor via prenatal mental health, indirect effect size = -.09; 95% CI [-.224, -.011]; and relational resilience, indirect effect size = .13, 95% CI [.036, .329] were found. Brief, empirically tested IPV screens at prenatal clinics may help healthcare providers better identify IPV-exposed patients. Clinical interventions targeting prenatal mental health and relational resilience may help improve labor outcomes for IPV-exposed mothers.

Trajectories of Children's Attitudes and Beliefs About Violence in Families Exposed to Intimate Partner Violence.

Intimate partner violence (IPV) poses serious risks to the health of women. Numerous studies link children's IPV exposure to various forms of developmental psychopathology. One possible explanatory factor appears to be children's beliefs and attitudes about the violence they have witnessed. Little research has investigated how these beliefs may change over time. The sample consisted of 109 mother-child pairs where the mother experienced IPV in the past 2 years. Multilevel modeling was used to examine change in children's attitudes and beliefs over time. Maternal depression and corporal punishment were associated with higher initial levels of maladaptive beliefs about family violence. Children's beliefs about violence improved over time. Findings indicate that while cognitive treatments may offer some utility for intervening with children, providing intervention support for the broader family system (i.e., around maternal depression and use of corporal punishment) may also be important pathways to supporting families exposed to IPV.

Profiles of Adaptation Among Child Victims of Suspected Maltreatment.

This research seeks to identify profiles of adaptation among child victims of suspected maltreatment using a social-ecological framework. Data were drawn from the LONGSCAN multisite longitudinal study. Participants were 597 12-year-old children of diverse backgrounds (57% girls) with at least one Child Protective Services report of suspected maltreatment (M = 3.4 reports). Self-, caregiver-, and teacher-reports were collected to assess child competence, psychological and behavioral problems, and family and neighborhood characteristics. Latent Profile Analysis was used to classify individuals into empirically derived groups. The best-fitting model yielded five distinct profiles: consistent resilience; consistent maladaptation; posttraumatic stress problems; school maladaptation, family protection; and low socialization skills. Findings underscore the heterogeneity of child adaptation and reveal unique profiles of adaptation and contextual protection. Within-person variation in functioning suggests the need for comprehensive assessment across domains and contexts to address the clinical needs of maltreated youth.

Direct and Indirect Effects of Maltreatment and Social Support on Children's Social Competence Across Reporters.

Children's social competence is a key characteristic of resilience, yet little research has assessed contributing factors to this construct. The objectives of this study were to examine direct and indirect effects of maltreatment on children's social competence, the promotive role of child and caregiver social support, and factors contributing to reports of child social competence across informants. Structural equation modeling evaluated the influence of CPS report history, child adjustment, and child and caregiver social support on child social competence in n = 783 caregiver-child dyads. CPS report history (age 0-8) was indirectly related to low social competence through child adjustment problems. Social support was a significant promotive factor of child social competence, with caregiver social supports predicting higher levels of parent-reported child social competence. Child social support predicted self-reported child social competence. Findings reinforce the assertion that both caregiver and child social support networks are critical to promoting child well-being after adversity.

Adults' Explanations for Intimate Partner Violence During Childhood and Associated Effects.

OBJECTIVES: Exposure to intimate partner violence (IPV) is known to challenge children's optimal development. This study sought to associate participants' beliefs about IPV held during childhood with their adjustment as adults, and to compare their beliefs from childhood to their beliefs in early adulthood. METHOD: A nationally representative sample of 703 Swedish young adults reported on their past and present beliefs about the causes of their parents' IPV. Standardized measures assessed their mental health (anxiety, depression, and traumatic stress symptoms) and the quality of their relationships as adults. RESULTS: The most common explanations for IPV were that the perpetrator suffered from physical or mental illness, had relationship problems, or was distressed. Participants were less likely to blame themselves for IPV or to believe that the perpetrator was cruel when they were adults, compared to their reports of themselves as children. Women were more likely to attribute mental or physical illness as the cause of the perpetrator's IPV. Childhood beliefs that the perpetrator was debilitated (from mental illness or substance abuse) and cruel (took pleasure in violence and/or despised the child) were associated with greater mental health problems and poorer relationship quality in adulthood. CONCLUSION: Evaluation of children's harmful beliefs about IPV could be useful in adapting intervention services aimed at ameliorating negative personal causal attributions.

Coercive Control and the Stay-Leave Decision: The Role of Latent Tactics Among a Sample of Abused Pregnant Women.

Prior research on intimate partner violence (IPV) and a survivor's decision whether to remain in or leave a violent relationship has often been framed by the question "why do they stay?" This study looks reframe the discussion and examine one facet of this stay-leave decision: abusers' use of coercive control tactics. Using a qualitative approach with a sample of pregnant women exposed to IPV, we sought to expand on the current knowledge by looking at coercive control more broadly via an open-ended assessment. Interview responses show that (a) coercive control was experienced by most of the women in this sample and (b) coercion most often took the form of "latent" or hidden control, including such tactics as providing incentives, showing remorse, and making promises. However, such latent coercive tactics are rarely assessed in IPV survivors and represent an important factor deserving of further research and recognition.

The relationship between types of childhood victimisation and young adulthood criminality.

BACKGROUND: Previous research suggests that some types of childhood abuse and neglect are related to an increased likelihood of perpetrating criminal behaviour in adulthood. Little research, however, has examined associations between multiple different types of childhood victimisation and adult criminal behaviour. AIMS: We sought to examine the contribution of multiple and diverse childhood victimisations on adult criminal behaviour. Our central hypothesis was that, after controlling for gender, substance use and psychopathy, each type of childhood victimisation - specifically experience of property offences, physical violence, verbal abuse, sexual abuse, neglect and witnessed violence - would be positively and independently related to criminal behaviour in young adults. METHODS: We examined data from a large, nationally representative sample of 2244 young Swedish adults who reported at least one form of victimisation, using hierarchical regression analysis to also account for gender, substance use and psychopathy. RESULTS: Experiences of physical assaults, neglect and witnessing violence as a child were significantly associated with adult criminal behaviour, but not experiences of property, verbal or sexual victimizations. CONCLUSIONS: Our findings help to identify those forms of harm to children that are most likely to be associated with later criminality. Even after accounting for gender, substance misuse and psychopathology, childhood experience of violence - directly or as a witness - carries risk for adulthood criminal behaviour, so such children need targeted support and treatment. Copyright © 2016 John Wiley & Sons, Ltd.

Interventions for Posttraumatic Stress With Children Exposed to Violence: Factors Associated With Treatment Success.

BACKGROUND: In the past 15 years, there have been a substantial number of rigorous studies examining the effectiveness of various treatments for child trauma and posttraumatic stress disorder (PTSD). Although a number of review articles exist, many have focused on randomized controlled trials or specific treatment methodologies, both of which limit the ability to draw conclusions across studies and the statistical power to test the effect of particular treatment characteristics on treatment outcomes. The current study is a review and meta-analysis of 74 studies examining treatments for children exposed to violence. METHODS: After reviewing the literature, we examined the relationship of a variety of treatment characteristics (e.g., group or individual treatments) and sample characteristics (e.g., average age) on treatment effect sizes. RESULTS: Results indicated that individual therapies and those with exposure paradigms within a cognitive-behavioral therapy or skills-building framework show the most promise, but treatment is somewhat less effective for those with more severe symptomology and for younger children. CONCLUSIONS: Future treatments should consider the developmental and social contexts that may impede treatment progress for young children and consider how best to develop the effectiveness of group interventions that can be readily delivered in settings of mass trauma.

Posttraumatic stress symptom trajectories among children exposed to violence.

Little research has examined the developmental course of posttraumatic stress symptoms (PTSS) in children. The current study aimed to identify developmental trajectories of PTSS in childhood and to examine predictors of symptom presentation in 1,178 children from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) studies, a consortium of studies focusing on the causes and effects of child maltreatment. Most children had a history of documented reports with Child Protective Services (CPS) and all were identified as living in high-risk environments. Using group-based trajectory modeling, 3 unique developmental trajectories were identified: Resilient, Clinical-Improving (PTSS in the clinical range at baseline then declining over time), and Borderline-Stable (chronically subclinical PTSS). Children in the Clinical-Improving group were more likely than children in the Resilient group to have reports of physical abuse (RRR = 1.76), emotional abuse (RRR = 2.55), neglect (RRR = 1.57), and exposure to violence at home and in the community (RRR = 1.04). Children in the Borderline-Stable group were more likely than children in the Resilient group to have a CPS history of neglect (RRR = 2.44) and exposure to violence at home and in the community (RRR = 1.04). Many children living in high-risk environments exhibit resilience to PTSS, but exposure to witnessed violence and neglect appear to put children at chronic risk for poor adjustment. These children may require more intensive, integrated clinical services that attend to multiple adverse experiences.

An Efficacy Trial of an Intervention Program for Children Exposed to Intimate Partner Violence.

Children exposed to intimate partner violence (IPV) are at high risk for adjustment problems, especially internalizing disorders. Few evidence-based interventions are available to address internalizing behavior problems in this population. An efficacy trial compared outcomes for 4-6 year old children randomly assigned to a program designed to address the effects of exposure to IPV with those allocated to a waitlist comparison condition. Mothers (N = 120) and children from the United States and Canada were assessed at baseline, 5 weeks later (post-intervention) and at 8-month follow-up. The evaluation compared rates of change over time for child internalizing problems. Results were analyzed using both intent-to-treat (ITT) and per-protocol (PP) approaches. ITT analyses indicated the program reduced internalizing problems for girls at follow-up. PP analyses indicated the program reduced internalizing problems for both boys and girls at post-intervention. In this study, child internalizing problems were significantly reduced through an intervention for the mother and the child.

What words can tell us about social determinants of mental health: A multi-method analysis of sentiment towards migration experiences and community life in Lima, Perú.

To support resilience in contexts of migration, a deeper understanding of the experiences of both receiving communities and migrants is required. Research on the impacts of migration on community life is limited in contexts with high internal migration (i.e., migrating within one's country of origin). Evidence suggests that cultural similarity, community relationships, and access to resources may be protective factors that could be leveraged to support the mental health of internal migrants. The current study uses data drawn from a sample of pregnant Peruvian women (N = 251), 87 of whom reported being internal migrants and 164 of whom reported being from the locale of the study (Lima, Perú). The aim was to better understand the social experience of internal migration for both local and migrant women. Inductive thematic analysis was used to examine migration experience and perceived impact of migration on community life. Internal migrants discussed three themes relative to their experiences: motivations, adjustment, and challenges. Experiences of women in receiving communities consisted of four themes related to migration: positive, negative, neutral, and mixed perceptions. Linguistic Inquiry and Word Count (LIWC-22) software was also used to assess sentiment towards migration. Across both analytic methods, migration motivations and perceptions were multifaceted and migrants reported a wide range of challenges before, during, and after migration. Findings indicated that attitudes toward migration are broadly positive, and that there is a more positive appraisal of migration's impact on the community life for internal as opposed to international migration.

Evaluating the effects of prenatal intervention on parenting in women exposed to intimate partner violence.

The Pregnant Moms' Empowerment Program (PMEP) is a brief, group intervention for pregnant women who have experienced intimate partner violence (IPV). This study was a quasirandomized trial of the effects of PMEP on parenting. Participants were 137 pregnant women exposed to IPV in the past year; 82 received PMEP and 55 were in a no-treatment control condition. Participants completed four assessments (pretest [T1], posttest [T2], 3-month postpartum[T3], and 12-month postpartum [T4]). At T1-T4, women self-reported on their parenting attitudes (i.e., expectations of children, parental empathy, corporal punishment, parent-child family roles) and parenting confidence. At the postpartum assessments, mother-infant dyads participated in a videorecorded free play session that was coded for warm-sensitive parenting. Results showed that women who received PMEP had more appropriate expectations of children (ß = 0.51, 95% CI [0.03, 0.99], dr = 0.53, 95% CI [0.31, 1.02]) and higher empathy toward children (ß = 0.64, 95% CI [0.05, 1.23], dr = 0.53, 95% CI [0.04, 1.02]) at T2, as compared to women in the control group. Women who received PMEP also showed more warm-sensitive parenting at T4 (Wald χ² = 4.01, p = .045; R² = 5.58%, d = 0.41, 95% CI [0.07, 0.88]) as compared to women in the control group. No differences emerged on corporal punishment, parent-child family roles, postpartum empathy and expectations of children, parenting confidence, or 3-month postpartum parenting behaviors. Thus, results were mixed, with some short-term positive effects and other benefits emerging only at 1-year postpartum. Findings highlight the potential clinical utility of brief interventions for pregnant, IPV-exposed women. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

"My Cross to Bear": Mothering in the Context of Intimate Partner Violence Among Pregnant Women in Mexico.

Intimate partner violence (IPV) during pregnancy negatively affects both maternal and infant health, yet gaps remain in understanding factors that maintain violence and/or promote resilience within the context of mothering. Nine focus groups were conducted with pregnant and/or IPV-exposed women (n = 17) and service providers (n = 26) working with these women in Nuevo León, Mexico. Thematic analysis of the focus group data revealed the detrimental impact of cultural norms that prioritize the relationship with women's partners, marriage, and family above women's dignity. Participants also identified ways that values regarding motherhood function as motivation for women to pursue a life without violence.

A Developmental Psychopathology Perspective on Political Violence and Youth Adjustment.

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Associations between childhood polyvictimization, intimate partner violence victimization and substance use among college students.

Objectives: Intimate partner violence (IPV) is associated with an elevated risk of substance use, but few studies have simultaneously examined other aspects of victimization history that may contribute to substance use. The current study examined the direct and moderating effects of childhood polyvictimization (i.e., multiple experiences of violence victimization before age 18) on the association between IPV subtypes (physical, sexual, psychological, and injury) and alcohol/drug use. Methods: A sample of 256 college students ages 18-25 (72% female, 68% white) completed a survey assessing past-year IPV, childhood polyvictimization, and past three-month substance use. Results: There were no direct or joint associations between IPV, childhood polyvictimization, and alcohol use. There were direct associations between psychological IPV, childhood polyvictimization, and drug use. No other forms of IPV were significantly associated with drug use. Conclusions: Results highlight unique direct associations between violence victimization and drug use risk compared to alcohol use risk in this context.

Patterns and predictors of perinatal posttraumatic stress symptoms: A latent transition analysis.

BACKGROUND: Pregnancy is a time of increased risk for intimate partner violence (IPV), yet there is a dearth of prospective research examining the relationship between IPV and posttraumatic stress symptoms (PTSS) in the perinatal period. Further, relationships among different types of IPV and perinatal PTSS remain understudied. METHODS: Latent class and transition analyses were used to examine classes of PTSS in pregnancy and postpartum, the longitudinal patterns of transitions across these classes, and the role of IPV types, childhood adversity, and depressive symptoms in PTSS presentation. Participants (N = 238) were drawn from two longitudinal studies of high-risk perinatal women. RESULTS: Four latent PTSS classes emerged: High, Avoidant, Hypervigilant, and Low. Childhood adversity (χ2(3) = 13.09, p = .004), prenatal depression (χ2(3) = 17.58, p = .001), and psychological IPV (χ2(3) = 10.51, p = .01) were associated with membership in High, Avoidant, and Hypervigilant classes. Women with low prenatal PTSS continued to have low levels at postpartum. Women in higher severity classes during pregnancy tended to transition into classes with adjacent, and often lower, levels of symptom severity postpartum. Women in the High PTSS class in pregnancy with elevated levels of depression were significantly more likely to remain in the High PTSS class or transition into the Avoidant class at postpartum, compared to the Low PTSS class, χ2(3) = 11.84, p = .008. LIMITATIONS: Relatively modest sample size precluded examination of a broader range of symptoms consistent with PTSD. CONCLUSIONS: Findings highlight the importance of individualized approaches to assessing, monitoring, and treating perinatal PTSS.

Elucidating the relations between adverse childhood experiences, age of exposure to adversity, and adult posttraumatic stress symptom severity in pregnant women.

BACKGROUND: Adverse childhood experiences (ACEs) are typically assessed within two subscales: child maltreatment (CM) and household dysfunction (HD). More research is needed about how the CM and HD subscales differentially contribute to adult posttraumatic stress symptoms (PTSS), accounting for additional adversities. OBJECTIVE, PARTICIPANTS, AND SETTING: In a sample of 137 pregnant women exposed to recent intimate partner violence (IPV) in the United States, this study aimed to (1) explore the contributions of ACEs subscales to pregnant women's PTSS severity, (2) examine the inclusion of the witnessing IPV ACE in the CM subscale, and (3) contextualize the contributions of the ACEs subscales to women's PTSS by examining the moderating effect of age of first ACE exposure. METHODS: The study used linear, multiple, and hierarchical regression analyses and the Hotelling-Williams test. RESULTS: The CM subscale predicted pregnant women's PTSS significantly better than the HD subscale, controlling for past-year IPV (t(134) = 2.69, p = .008). Adding the witnessing IPV ACE to the CM subscale did not significantly improve the subscale's prediction of PTSS (ΔR2 = 0.07, p = .290). Age of first exposure did not significantly moderate the effects of the CM (ß = 0.12, p = .140) or HD (ß = -0.10, p = .238) ACEs subscales on PTSS. CONCLUSIONS: Results suggest that for pregnant women exposed to high levels of trauma, polyvictimization and particularly experiencing multiple types of CM have stronger predictive validity for PTSS than HD. Cumulative victimization may be more influential than age of exposure to adversity.

The Multidimensional Taxonomy of Individual Resilience.

Theoretical work in resilience has continuously evolved to inform and respond to advances in empirical work. In order to further scientific inquiry, it must continue to do so. This narrative overview of the field of resilience science focuses on contemporary challenges confronted by theoretical models of individual resilience and proposes a taxonomic structure for resilience-the multidimensional taxonomy of individual resilience (MTIR). The goal of the MTIR is to articulate a systematic framework within which extant theoretical and empirical work can be nested. Consistent with existing work, the MTIR organizes resilience into two primary branches-manifested resilience and generative resilience. These two components are then organized into subdomains that demonstrate evidence of conceptual distinctiveness. The specification of the subdomains in the MTIR draws support from a diverse body of work on resilience across disciplines and in multiple global contexts. The MTIR makes several critical advances, including expanding and refining the definitions and components of resilience in psychology, providing a clearer framework for conceptualizing mixed profiles of resilience, and tempering assumptions regarding the relational dependencies across domains of resilience. Finally, the utility of the MTIR in organizing research in resilience and advancing theory-testing and development is discussed.