Relationships between psychosocial factors and abusive parenting attitudes in low-income single mothers

BACKGROUND: Linkages among family violence, maternal mental health, and parenting attitudes are not clearly understood. OBJECTIVE: To investigate the relationships of abuse (childhood and/or partner), everyday stressors, self-esteem, depressive symptoms, and anger with abusive parenting attitudes. METHOD: Cross-sectional analysis of data collected in interviews with 53 low-income, single mothers from wave two of a 3-wave study. A conceptual framework and bivariate correlations guided a series of multiple regressions to identify the best predictors for each variable. RESULTS: A high prevalence of abuse, depressive symptoms, and abusive parenting attitudes was found. Few women had ever received mental health treatment. Abuse (partner and childhood physical) predicted higher everyday stressors which in turn predicted lower self-esteem. Childhood abuse and lower self-esteem predicted more depressive symptoms. More depressive symptoms were related to higher levels of state anger. More everyday stressors and more depressive symptoms predicted higher levels of trait anger. Higher levels of anger expression were associated with higher everyday stressors and lower self-esteem. The presence of partner abuse best predicted higher levels of overall abusive parenting attitudes and more parent-child role reversal. Less parental empathy was associated with higher levels of state anger. CONCLUSIONS: This study partially explains the relationships of maternal abuse history and mental health status with parenting attitudes. Other predictors of parenting attitudes remain to be identified. The findings underscore the need for healthcare providers to consider the mental health status and abuse histories of low-income, single mothers. The potential disturbance in the parenting process of single mothers in abusive relationships warrants further investigation.     

Relationships Among Prenatal Maternal Attachment, Presence of Postnatal Depressive Symptoms, and Maternal Role Attainment

purpose . To examine the relationships among a woman's attachment to her fetus, the presence of postpartum depressive symptoms, and subsequent perceptions of maternal role attainment three months after birth
design . A longitudinal, panel design
setting . Hospital-sponsored childbirth education classes
participants . Primiparous women (N = 136) at 24–40 weeks of pregnancy and 9–14 weeks after the birth
main outcome measures . Perceived Competence Scale, Myself as Mother Scale, and My Baby Scale
results . Prenatal maternal attachment was positively related to maternal role attainment but not to postpartum depressive symptoms. Postpartum depression was negatively related to maternal role attainment.
conclusions . These findings enhance maternal identity theory and provide a means to evaluate the transition to motherhood.     

Depressed adolescent mothers' perceptions of their own maternal role.

Although there is a growing body of research in the area of adolescent pregnancy and parenting, little is known about the more personal experiences of these teens. Ethnographic research methods were used in the present study with the goal of narrowing existing gaps in knowledge about the affective component of adolescent mothers' role attainment. The sample consisted of 15 voluntary informants who reported depressive symptoms during pregnancy or postpartum. The findings suggest that for some adolescent mothers the experience of motherhood may help them improve their previously self-destructive lives. Many adolescent mothers have engaged in impulsive high-risk activities prior to their pregnancies. Through the establishment of a maternal identity and simultaneous development of a strong sense of maternal protectiveness these young women are making realistic, future-oriented decisions that are motivating them to leave gang life, finish high school, go to college, and get vocational training. However, a subset of adolescent mothers who experience chronic depressive mood along with social isolation in the postpartum period may be at increased risk for development of problematic maternal behaviors.     

Developmental Antecedents of Sexual Coercion in Juvenile Sexual Offenders

Previous research has linked adult sex offending behavior to a multiplicity of variables, including juvenile delinquency and the experience of childhood abuse. The purpose of this study was to explore developmental pathways among childhood abuse, juvenile delinquency, and personality dimensions possibly conducive to adolescent sexual coercion. Using a retrospective self-report inventory, we measured the extent to which juvenile sexual offenders experienced childhood trauma, engaged in adolescent delinquency, and exhibited particular dispositions and cognitive biases. The effects of childhood and adolescent antecedents on sexual coerciveness were then analyzed through simultaneous multiple regression path analyses. Results suggest that sexual compulsivity and hypermasculinity, through misogynistic fantasy behavior, significantly discriminate verbally and physically coercive juvenile offenders from those offenders who do not report using force in their offenses. Results also suggest that alcohol abuse may play a more salient role in the expression of coercive juvenile sexual coercion than previously hypothesized.     

Childhood Physical and Sexual Abuse: Their Relationship with Depressive Symptoms in Adulthood

The purposes of this study were to determine the prevalence of childhood physical and sexual abuse among 206 low-income single mothers and to examine the relationship of childhood abuse to current maternal depressive symptoms. Severe physical abuse was reported by 36 percent of the women. The prevalence of sexual abuse was 22 percent; more than one-half of these women were violently abused. High depressive symptoms were reported by 51 percent of the mothers. Both severe physical abuse and sexual abuse in childhood were associated with high depressive symptoms. Women who experienced violent sexual abuse were almost four and one-half times more likely to report high depressive symptoms, compared to the women who were not sexually abused. These findings provide further evidence that childhood abuse may have long-term consequences for women's mental health .     

Maladaptive Mother-Child Relationships: A Pilot Study

The primary purposes of this pilot study were to identify maternal psychosocial correlates of unrealistic expectations of children and of child abuse potential, and to investigate the relationships of these factors with child behavior. A cross-sectional, two-group design was used. One group consisted of 20 low-income mothers whose preschool children were referred to a family care center for suspected abuse or neglect. A comparison group was made up to 20 low-income mothers whose children attended a university-based pediatric clinic and who were not referred for abuse or neglect. Data were collected during structured in-home interviews with the mothers. Measures of parental bonding, maternal depressive symptoms, unrealistic expectations of children, child abuse potential, and child behavior were obtained. Preschool teachers of the children also rated the children's behavior. Mothers with high depressive symptoms reported more unrealistic expectations of children and had greater child abuse potential scores than those with fewer symptoms. The more child behavior problems mothers reported, the greater their unrealistic expectations of the children and the higher their score for child abuse potential. Maternal depressive symptoms were not directly related to child behavior. Teacher reports of child behavior were moderately correlated with maternal reports, but no study variable was associated with teacher reports.     

儿童期虐待史问卷在社区人群中的信度和效度检测

背景:英国伦敦大学精神病学研究所编制的儿童期虐待史问卷在国外社区成年人群和情感障碍的患者测评中,都被证实有较好的信度和效度,但是该问卷在中国使用还需进行各种群体的信度和效度验证。目的:分析儿童期虐待史问卷在社区人群中的信效度。设计:随机选择对象,按量表信度和效度分析的原则进行实施。单位:中南大学精神卫生研究所。对象:于2003-09/2004-02选择来自湖南长沙市和河南新乡市的两个社区的成年人群608人作为社区普通人群组,发放儿童期虐待史问卷608份,剔出无效问卷8份,共计600人完成了这项调查。随机从河南省精神病院住院的抑郁性疾病患者中,抽取60例成人患者组成抑郁性疾病患者组。方法:对社区普通人群组和抑郁性疾病患者组进行了儿童期虐待史问卷测试,主要为回顾性地调查成年人在童年时是否存在躯体、性或精神方面虐待的自评量表。其中精神虐待又包括憎恶和忽视2个因子(各含8个条目)。对条目的回答被量化为5个等级分值。由受试者评定其父母是否存在施虐的情况。分值越高则表明遭受精神虐待的程度越大。社区人群经儿童期虐待史问卷评定为有儿童躯体虐待和性虐待史的40例阳性样本和评定阴性的560例样本中随机抽查40例,再行Bifulco提供的儿童期虐待史晤谈(CECA)的评定。普通人群组中有100名还同时评定了Zung抑郁自评量表,另外有30名受试者于首次测定2周后进行重测儿童期虐待史问卷。主要观察指标:分析儿童期虐待史问卷的内部一致性,重测信度,内容及校标效度。结果:社区人群中剔出无效问卷8份后,余600例进入统计分析。①儿童期虐待史问卷的信度及重测信度:儿童期虐待史问卷的精神虐待部分的Cronbach’sа系数为0.87(其中母亲为0.85,父亲为0.83),其中憎恶因子为0.84(其中母亲为0.80,父亲为0.81),忽视因子为0.85(其中母亲0.84,父亲0.83)。精神虐待的重测信度0.83(其中母亲0.81,父亲082),其中憎恶因子为0.81(其中母亲为0.82,父亲为0.70),忽视因子为0.79(其中母亲0.78,父亲0.75);躯体及性虐待的两次测评的一致性好(Kappa值为0.78)。②儿童期虐待史问卷的校标效度:儿童期虐待史问卷精神虐待及憎恶、忽视因子与Zung抑郁自评量表的相关系数依次为0.58、0.55、0.60(P值均<0.01)。儿童期虐待史问卷与儿童期虐待史晤谈评定提纲(CECA)评定躯体及性虐待史的一致性好,抑郁性患者的精神虐待分值高于社区人群的精神虐待分值(P<0.05)。结论:儿童期虐待史问卷在社区人群中也具有较好的信、效度,在中国可作为社区人群的回顾性儿童期虐待史筛选调查的自评工具。     

"My nurse taught me how to have a healthy baby and be a good mother:" nurse home visiting with pregnant women 1888 to 2005

Nurse home visiting with pregnant women and new mothers in the early decades of the twentieth century was designed to improve birth and newborn outcomes, hasten Americanization of immigrant mothers, and improve their parenting skills. Today the Nurse Family Partnership home visitation program improves newborn and child outcomes by positively influencing maternal role attainment and significantly decreasing maternal smoking and other substance abuse, child abuse and neglect, and children's emergency room visits. It also improves life possibilities for vulnerable young women by decreasing the interval and frequency of subsequent pregnancies and reduces dependence on welfare by increasing workforce participation. This article reviews the history of home visits by nurses to pregnant women and demonstrates the benefits achieved by these programs today.     

Childhood abuse history and risk behaviors among teen parents in a culturally rooted, couple-focused HIV prevention program.

Pregnant and parenting adolescents living in inner cities are at risk for acquiring HIV through unprotected sexual activity. In addition to individual risk behaviors, a lack of socioeconomic and other environmental resources create risk environments that make certain communities vulnerable to both adolescent pregnancy and HIV/AIDS. Research indicates that adolescent parents, many who have histories of childhood trauma, may use their experience of young parenthood and the concomitant feelings of parental protectiveness as a source of renewed hope for their future. The purpose of this report is to explore the relationship between history of childhood abuse and high risk behaviors in adolescent Latino mothers and fathers enrolled in a randomized clinical trial of a culturally rooted, couple-focused HIV prevention program. In addition, this report describes the HIV prevention program that was designed specifically for young Latino parents wherein maternal and paternal protectiveness are viewed as intrinsic and developing critical factors that promote resiliency and motivate behavioral change.     

The Impact of Maternal Childhood Abuse on Parenting and Infant Temperament

The impact of maternal history of maltreatment and psychopathology on mother–child relationship, parenting, and infant temperament was evaluated. Women completed self-report measures addressing childhood trauma, psychopathology, infant–parent relationship, parenting, and infant temperament. Maternal physical abuse was associated with poorer mother–child interactions, increased vigilance, and difficulty recovering from distress among infants, whereas a history of emotional abuse was linked with less interactional dysfunction, lower levels of infant frustration, and more pleasure. Maternal depression was associated with infant temperament and attitudes about parenting. These findings suggest that maternal history of childhood abuse and psychopathology are important determinants of parenting and infant temperament.     

Context of sexual risk behaviour among abused ethnic minority adolescent women

CHAMPION J.D. (2011) Context of sexual risk behaviour among abused ethnic minority adolescent women. International Nursing Review 58 , 61–67 Background: Evidence suggests that multiple influences on sexual behaviour of adolescents exist, ranging from relationships with significant others including sexual or physical abuse and childhood molestation to substances used prior to sex and environmental circumstances such as sex work. Purpose: This study aims to describe associations between childhood molestation and sexual risk behaviour. Method: African American and Mexican American adolescent women aged 14–18 years (n = 562) with sexually transmitted infection (STI) or abuse histories and enrolled in a randomized controlled trial of behavioural interventions were interviewed via self‐report concerning sexual risk behaviour, abuse and childhood molestation at study entry. Results: Sexual (59%), physical (77%) and psychological (82%) abuse and childhood molestation (25%) were self‐reported without differences by ethnicity. Adolescents reporting childhood molestation experienced more forms of sexual, physical and psychological abuse than others and higher incidences of STI. Fewer attended school; however, more had arrests, convictions, incarcerations and probations. Stressors including depression, running away, thoughts of death and suicide were highest for those reporting childhood molestation. Those reporting childhood molestation engaged in higher sexual risk behaviours than adolescents experiencing other forms of sexual or physical abuse (lifetime partners, bisexual relationships, anal and group sex, sex with friends with benefits, sex for money, concurrent partners, drug use including multiple substances, alcohol use and alcohol problems). These adolescents reported ‘getting high’ and having sex when out of control as reasons for sex with multiple partners. Conclusion: Interventions for abused adolescent women necessitate a focus on associations between childhood molestation and a multiplicity of sexual risk behaviours for prevention of abuse, substance use and sex work, STI/human immunodeficiency virus (HIV) and sequelae.     

Distress and growth outcomes in mothers of medically fragile infants.

BACKGROUND: With recent advances in medical and nursing care, many high-risk infants are surviving the neonatal period with severe, life-threatening chronic illnesses, resulting in extended hospitalizations and/or frequent rehospitalizations and long periods of dependence on technology for survival. OBJECTIVE: To describe the factors predicting maternal adjustment in mothers caring for medically fragile infants. METHOD: Subjects were mothers (n = 67) whose infants had a serious life-threatening illness requiring hospitalization and technology for survival. Data for this longitudinal study were collected at enrollment and hospital discharge, and at 6, 12, and 16 months after birth. Distress was measured as depressive symptoms using the Center for Epidemiologic Studies Depression Scale, and growth was assessed using a personal developmental impact rating scale. Data about personal characteristics, parental role attainment, infant-illness characteristics, and maternal illness distress were collected. RESULTS: Mothers of medically fragile infants experience distress and growth as a result of their child's illness. Mean scores on the depression scale at both time points were moderately high and a high percentage of mothers scored at risk for depressive symptoms. Maternal developmental impact ratings at 6 months were neutral to slightly negative and at 16 months were between neutral and positive. While the mean depressive symptom scores and maternal developmental ratings were lower at the later time points, these differences were not significant. Maternal depressive symptoms and developmental impact ratings were moderately but negatively correlated at 6 and 16 months, indicating that higher depressive symptoms were related to more negative developmental impact ratings. Distress was influenced by maternal characteristics, hospital environmental stress, and worry about the child's health. Growth was influenced by characteristics of the child's illness, hospital environmental stress, concern about the child's health, and level of maternal role attainment. CONCLUSIONS: Nurses should consider personal characteristics and level of parental role attainment as well as characteristics of the child and illness-related distress in their approaches to intervention with mothers of critically ill infants.     

Adverse Childhood Experiences (ACEs) and Internalizing Mental Health,Pain, and Quality of Life in Youth With Chronic Pain: A Longitudinal Examination

The aims of this longitudinal study were to 1) identify categories of adverse childhood experiences (ACEs) (ie, neglect, abuse, household dysfunction in childhood) that increase risk for internalizing mental health problems, pain-related impairment, and poorer quality of life and 2) examine the moderating role of posttraumatic stress symptoms (PTSS) in these associations, in a clinical sample of youth with chronic pain. At 2 timepoints, youth (N = 155; aged 10–18 years) completed measures of exposure to ACEs, PTSS, depressive and anxiety symptoms, pain intensity, pain interference, and quality of life. Multivariate analyses of variance, linear mixed modeling, and moderation analyses were conducted. Results from cross-sectional and longitudinal analyses were similar; youth with a history of 3+ ACEs reported significantly higher PTSS, depressive and anxiety symptoms, and poorer quality of life than youth with no ACE history. Results also revealed differences in functioning between youth exposed to different types of ACEs (ie, maltreatment only, household dysfunction only, both, none). Finally, PTSS was found to moderate the association between ACEs and anxiety and depressive symptoms. Findings underscore the influence that ACEs can have on the long-term functioning of youth with chronic pain as well as the important role of current PTSS in this association.PerspectiveThis study found that the risk of poorer outcomes imposed by ACEs at baseline remains longitudinally and that posttraumatic stress symptoms (PTSS) moderate the relationship between ACEs and anxiety and depressive symptoms in youth with chronic pain. These results underscore the importance of assessing for ACEs and PTSS alongside chronic pain in youth.     

Childhood abuse and cannabis use among adolescents with mental health needs in Ontario,Canada

Objective: The purpose of this study was to examine the association between childhood abuse (emotional, physical and sexual abuse) and cannabis use among adolescents with mental health needs. Methods: Data on 3681 adolescent in-patients, 12–18 years old, were obtained from the Resident Assessment Instrument for Mental Health (RAI-MH). Using logistic regression, we estimated the odds of using cannabis by adolescents who experienced childhood abuse after controlling for age, gender, Aboriginal origin, problems with addiction, history of criminal justice involvement and symptoms of depression and mania. Results: There were 1844 adolescents, representing 50.1%, who reported using cannabis within the last 12 months. Controlling for demographic and patient characteristics, we found that cannabis use in the past year was strongly associated with childhood sexual and physical abuse. Compared to non-abused females, females who experienced sexual and physical abuse were more likely to have used cannabis. For males, the experience of physical abuse was marginally associated with cannabis use. Conclusion: The current data demonstrate the strong association between childhood sexual and physical abuse and cannabis use with a particularly strong association for females. Efforts aimed at treating cannabis use in adolescents who present with mental health needs should also consider their abuse histories.     

Childhood maltreatment and cluster B personality pathology in female serious offenders

The authors examined early maltreatment among serious female offenders at a maximum-security correctional facility, contrasting the maltreatment histories of inmates with and without Cluster B personality pathology. Women were interviewed regarding the frequency of 13 indicators of psychological or physical abuse perpetrated by maternal or paternal caregivers and the frequency of 10 types of sexual abuse perpetrated by persons at least 5 years older. Reports were based on inmates' recollected worst years of maltreatment before age 16. Women in both diagnostic groups reported substantial early maltreatment. Cluster B inmates reported higher levels and a greater variety of maternal and paternal physical and psychological abuse but were not distinguished from non-Cluster B inmates on levels of childhood sexual abuse. Inmates reported more physical and psychological abuse from maternal than paternal caregivers. The results document the high levels of childhood maltreatment of female prisoners and the relevance of this history to personality pathology.     

Childhood Maltreatment and Psychopathology: Prospective Tests of Attachment,Cognitive Vulnerability,and Stress as Mediating Processes

A childhood history of maltreatment is a distal risk factor for depression, although less research has examined the proximal mechanisms for this relation. To address this question, three theoretically derived mechanisms were tested as mediators: an insecure attachment style, a negative cognitive style, and negative life events. These mediating processes were examined in two prospective studies. In the first, young adults (n = 652) completed a detailed self-report measure assessing a childhood history (before age 14) of physical, sexual, and emotional abuse. In the second, an independent sample of young adults (n = 75) were interviewed with a well-validated, objective, contextual threat interview that assesses a childhood history (before age 14) of physical, sexual, and psychological abuse as well as the surrounding familial context of emotional neglect, antipathy, discipline, and discord. In both studies, participants completed measures of the proposed mediators as well as anxiety and depressive symptoms at 2 time points (10-week interval in Study 1 and 2-year interval in Study 2). Across both studies, a childhood history of emotional maltreatment and adversity specifically predicted prospective elevations of depressive symptoms, whereas no specific form of childhood maltreatment predicted anxiety symptoms after controlling for initial symptoms and overlap among forms of maltreatment. Further, support was found for the proposed mediating processes. An insecure attachment style, a negative cognitive style, and negative events helped to account for the link between childhood maltreatment and later depressive symptoms in young adulthood.     

The Parent-Baby Venture Program: Prevention of Child Abuse

TOPIC The overwhelming obstacles adolescents face to successful achievement of the maternal role.
PURPOSE. To describe an innovative, community-based program to support high risk adolescents during the early postpartum period.
SOURCE. A review of the literature related to programs designed to promote maternal-role attainment and prevent child abuse/neglect.
CONCLUSION. Interviews with participants indicate a positive response to the intervention but regression to maladaptive behavior in some following termination.     

Adverse Childhood Experiences in Mothers With Chronic Pain and Intergenerational Impact on Children

Adverse childhood experiences (ACEs; eg, parental divorce, physical or sexual abuse) are more prevalent in individuals with chronic pain compared with the general population. Both increased maternal ACEs and chronic pain have been associated with poor physical and emotional functioning in offspring. However, the mechanisms driving these associations are poorly understood. Thus, this cross-sectional study evaluated the relation between maternal ACEs, mothers’ current functioning, and children's physical and emotional functioning in a sample of mothers with chronic pain and their 8- to 12-year-old children. Results indicated a higher prevalence of ≥1 ACE in this sample of mothers with chronic pain (84%) compared with normative data from a community sample of women. Higher maternal ACE scores corresponded with lower physical and social functioning, greater anxiety and depressive symptoms, greater fatigue and sleep disturbances, and greater pain intensity and pain interference in mothers. Higher maternal ACE scores significantly correlated with higher child self-reported depressive symptoms, but not somatic symptoms or functional impairment. A path model indicated that maternal depressive symptoms accounted for the relation between higher maternal ACE scores and children's depressive symptoms. Intervening on maternal depression among mothers with chronic pain may reduce the impact of intergenerational ACE transmission.Perspective: This article presents evidence regarding the intergenerational impact of ACEs in a large sample of mothers with chronic pain and their school-aged children. Maternal depressive symptoms accounted for the relation between maternal ACEs and children's depressive symptoms providing evidence regarding targets for preventive interventions.     

Identifying Risk Factors for Maternal Depression in Families of Adolescents With Epilepsy

ISSUES AND PURPOSE. To investigate factors associated with depressive symptoms in mothers of children with chronic seizure disorders.
DESIGN AND METHODS. A cross-sectional correlational design was used with a sample of 115 mother-child dyads in families where the child had chronic epilepsy.
RESULTS. A three-factor model consisting of family income, satisfaction with family relationships, and presence of child behavior problems explained 32% of the variance in maternal depressive symptoms.
PRACTICE IMPLICATIONS. Childhood epilepsy has a negative effect on the mother's mood in many families. Child behavior problems were found to be the strongest predictor of maternal depressive symptoms. Assessing for behavior problems and maternal depression should become a routine part of the family nursing assessment.