THE CAREGIVING HELPLESSNESS QUESTIONNAIRE: EVIDENCE FOR VALIDITY AND UTILITY WITH MOTHERS OF INFANTS.

Severe disruptions in the caregiving system can lead to disorganized caregiving characterized by maternal helplessness and fear. Such caregivers abdicate their caregiving role and fail to provide protection to the child. The measurement of disorganized caregiving has historically been limited to lengthy, labor-intensive interviews, indicating a need for other feasible tools to assess this important construct. Furthermore, few studies have investigated correlates of disorganized caregiving. Participants included 120 diverse, primarily economically disadvantaged women who were part of a longitudinal study examining psychosocial risk factors before and after the birth of a child. Participants completed the Caregiving Helplessness Questionnaire (CHQ; C. George & J. Solomon, 2011) along with measures assessing maternal mental health, trauma exposure, parenting stress, and infant socioemotional adjustment. Results indicated that caregiver helplessness and fear, based on the CHQ, were positively associated with maternal depression, parenting stress, and perceptions of infant socioemotional problems. Importantly, results also revealed significant associations between current maternal trauma experiences and mothers' reports of helplessness and fear. Findings from the present study indicate that the CHQ may be a valid screening tool for disorganized caregiving among mothers of infants. In addition, a number of maternal experiences may be related to disorganized caregiving following the birth of a child.

Comprehensive Screening for Suicide Risk in Primary Care.

INTRODUCTION: Suicide is a major public health problem and a complex clinical challenge. Assessment and early identification could be enhanced with screening tools that look beyond depression. The purpose of this study was to identify profiles of risk behaviors and social stress associated with suicidal ideation and behavior using the Behavioral Health Screen. METHODS: The study used screening data from 2,513 primary care patients (aged 14-24 years). Data were collected between 2008 and 2012, and were analyzed in 2016. RESULTS: Latent class analysis identified a high and low risk profile. Domains of primary influence included substance use, sexual assault, same-sex behavior, and unsafe sex. The high-risk group was 11 times more likely to have made a suicide attempt, five times more likely to report a history of suicidal ideation and behavior, and three times more likely to report recent suicidal ideation and behavior. CONCLUSIONS: Risk behaviors and social stress contribute to the risk for suicide above and beyond depression and should be assessed during routine primary care visits with adolescents. The Behavioral Health Screen can screen all these domains and thus assist primary care providers in assessing for both psychiatric and social stress factors associated with youth suicide.

Relational trauma and posttraumatic stress symptoms among pregnant women.

Women experience remarkably high rates of relational trauma including childhood abuse and neglect and intimate partner violence (IPV) during adulthood, and the childbearing years are no exception. The meaning of past and current relational trauma perpetrated by primary caregivers and significant others may be unique during pregnancy, in particular, because pregnancy is a salient time when mothers' important relationships are reworked and reorganized to "make room" for the relationship with the baby. The present study examined associations between different forms of relational trauma and posttraumatic stress symptoms in 120 women during the last trimester of pregnancy. Women were between the ages of 18 and 42 years and came from diverse economic and ethnic backgrounds. Results indicated that severity of childhood maltreatment was significantly related to severity of IPV during pregnancy, and both types of trauma made unique, significant contributions to posttraumatic stress symptoms. Furthermore, emotional/psychological violence had the largest associations with posttraumatic stress symptoms compared to other forms of violence. Findings indicate that it is critically important for clinicians working with pregnant women to conduct a thorough assessment of current and past relational trauma, including emotional/psychological trauma, in order to improve the well-being of the mother, the infant, and the mother-infant relationship.