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).

Strengths-Based Factors Related to Post-Traumatic Stress Problems in Black Youth with High Body Weights.

OBJECTIVE: Black youth with high body weights [BYHW; Body Mass Index (BMI)≥95th percentile] endure unique stressors (e.g., exposure to discrimination due to race and size) that may contribute to psychopathology. Factors that decrease mental health problems associated with these stressors have been underexamined in BYHW. The current study assessed how multisystemic resilience, weight-related quality of life (QOL), and discrimination were associated with post-traumatic stress problems in BYHW from the perspective of youth and their caregivers. METHODS: A total of 93 BYHW and one of their primary caregivers were recruited from a Midsouth children's hospital. Youth ranged in age from 11 to 17 years (Mage=13.94, SD = 1.89), were mostly girls (61.3%), and had CDC-defined BMI scores above the 95th percentile. Nearly all caregivers were mothers (91.4%; Mage=41.73 years, SD = 8.08). Youth and their caregivers completed measures of resilience, discrimination, weight-related QOL, and post-traumatic stress problems. RESULTS: Utilizing linear regression modeling, the youth model was significant [F(3, 89)=31.63, p<.001, Adj. R2=.50], with higher resilience (ß=-.23; p=.01) and lower discrimination (ß=.52; p<.001) associated with fewer post-traumatic stress problems. The caregiver regression model was also significant [F(2, 90)=10.45, p<.001, Adj. R2=.17], with higher weight-related QOL associated with lower post-traumatic stress problems (ß=-.37; p<.001). CONCLUSIONS: Findings illustrate differences in youth and caregiver perceptions of factors related to post-traumatic stress problems in BYHW. Youth emphasized both internal and external contributors to stress, while caregivers focused on internal variables. Such knowledge could be harnessed to develop strengths-based interventions that address health and well-being among BYHW.

Demographic factors, personal life experiences, and types of intimate partner violence.

OBJECTIVE: This study examines how demographic factors (i.e., age, employment, or income) and personal life experiences (i.e., witnessing intimate partner violence [IPV] in childhood, number of violent partners, violence perpetration, or stressful life events) are related to IPV frequency across types of IPV (i.e., physical assault, psychological aggression, or sexual coercion) in a racially diverse sample. METHOD: Participants included 126 women recruited from community organizations in the Mid-South, United States who experienced IPV in the past 6 months (Mage = 32.90, SD = 6.82). The majority of the sample self-identified as Black or African American (66%) and reported an annual income below $20,000 (73%). Three linear regressions were run to assess relations between age, employment status, annual income, witnessing IPV in childhood, number of violent partners, violence perpetration, and stressful life events for each type of IPV; all three models also accounted for the other forms of IPV. RESULTS: Psychological aggression was significantly associated with a higher income as well as more frequent physical assault and sexual coercion. Physical assault was linked with younger age, lower income, not witnessing IPV in childhood, IPV perpetration, more psychological aggression, and more sexual coercion. Sexual coercion was associated with more stressful life events, having multiple violent partners, higher psychological aggression, and higher physical assault. CONCLUSIONS: Results suggest that interventions should target mutable demographic factors and screen for personal life events to reduce IPV frequency and revictimization across types of IPV. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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 Function of Connection: Examining Social Supports in the Lives of Parentally Bereaved Youth.

Through reflexive thematic analysis, this study explored three forms of social support in the lives of parentally bereaved youth: support derived from one's spirituality, caregiver support via parent-child communication, and therapist support from grief counseling (N = 30 youth, Mage = 12.5 years, SD = 2.8 years). Results showed that these sources of support serve varied and vital functions in the lives of parentally bereaved youth. Namely, the benefits of grief counseling and spirituality were consistently identified by youth as critical in facilitating their coping with the loss of a parent; while parent-child communication regarding the deceased varied widely, highlighting the need for additional supports beyond their surviving caregiver. Findings also revealed differences among these supports across youth gender, race, ethnicity, and age. Adolescents were more likely to disengage from counseling services and reported less parental and spiritual support. Males and minoritized youth experienced more benefits from spiritual and therapist supports.

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.

Differentiating the effects of anxious and avoidant attachment on depression and resilience following trauma.

Objective Few studies have explored the impact of insecure attachment on college student mental health. The present study examined how anxious and avoidant attachment to a mother, father, and best friend were related to depression and resilience in emerging adults exposed to trauma. Participants: Participants included 372 trauma-exposed emerging adults, aged 18-24 (Mage=19.64, SD = 1.62), from a university in the Midsouth, United States. Method: Participants completed an assessment battery of self-report measures to determine how maternal, paternal, and best friend insecure attachment each uniquely contribute to the variance in depression and resilience. Results: Hierarchical linear regression analyses revealed that anxious and avoidant attachment to a best friend were associated with lower resilience, but only anxious attachment to a best friend was associated with more depressive symptoms. Discussion: Findings highlight the importance of cultivating healthy relationships in a university setting to foster secure peer attachments for emerging adults exposed to adversity.

Charting a Course towards Resilience Following Adverse Childhood Experiences: Addressing Intergenerational Trauma via Strengths-Based Intervention.

Early research on adverse childhood experiences (ACEs) provided staggering evidence of the significant ramifications of ACEs on physical health and functioning. It brought to the forefront the importance of addressing trauma and family dysfunction to enhance public health. Over the past several decades, the study of childhood adversity has blossomed, with expanded conceptualizations and assessments of ACEs. This review brings together various biological, psychological, and sociological principles that inform our understanding of ACEs and our approach to treatment. Specifically, we document the evolution of ACEs research, focusing on the intergenerational impact of ACEs, the importance of incorporating a resilience framework when examining ACEs, and implementing interventions that address adversity across generations and at multiple levels of the social ecology. Evidence is provided to support the evolving perspective that ACEs have long-lasting effects beyond the ACE(s)-exposed individual, with significant attention to the impact of parental ACEs on child development. An intergenerational and multilevel approach to understanding and addressing ACEs offers specific areas to target in interventions and in public policy.

The Road to Resilience: Strength and Coping Among Pregnant Women Exposed to Intimate Partner Violence.

Pregnancy is a period of heightened risk for exposure to intimate partner violence (IPV), which is characterized by actual or threatened emotional, physical, or sexual violence committed by a past or current intimate partner. Pregnancy also represents a unique period in which women may be highly motivated to address IPV, to improve not only her health and well-being but also that of her child. Accordingly, the prenatal period affords an important opportunity for intervention among women experiencing IPV. Focus groups were conducted to evaluate coping strategies utilized by women exposed to IPV during pregnancy in addition to the strengths these women exhibit. Via thematic analysis, focus group data were evaluated from 10 women exposed to IPV proximal to their pregnancy and 46 service providers (e.g., medical personnel, family resource coordinators and case managers) who work directly with pregnant women experiencing IPV. When participants were queried about the personal strengths of IPV-exposed women, two domains emerged: (a) understanding and ending the cycle of IPV and (b) strengths achieved as a result of leaving the violent relationship (i.e., personal growth, enhanced self-esteem, improved attentiveness as a parent and resilience). With respect to coping, three central domains emerged: (a) the necessity of ensuring physical safety as a precondition for coping, (b) maladaptive coping strategies (e.g., substance use, avoidance), and (c) adaptive coping strategies (e.g., seeking support from others via both formal and informal relationships). These findings reinforce the importance of engaging with women before, during, and after they leave a violent relationship to provide support, affirmation and hope.