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1.
《Child abuse & neglect》2014,38(9):1560-1568
History of child abuse is considered one of the important risk factors of suicide attempt in general population. At the same time it has been shown that suicide attempts appear significantly more frequently in alcoholics than in healthy individuals. The objective of this study was to investigate associations between history of childhood sexual abuse and suicide attempts in a sample of Polish alcohol dependent patients. A sample of 364 alcohol-dependent subjects was recruited in alcohol treatment centers in Warsaw, Poland. Information was obtained about demographics, family history of psychiatric problems, history of suicide attempts, sexual and physical abuse during childhood and adulthood and severity of alcohol problems. When analyzed by gender, 7.4% of male and 39.2% of female patients had a lifetime history of sexual abuse; 31.9% of the study group reported at least one suicide attempt during their lifetime. Patients who reported suicide attempts were significantly younger (p = 0.0008), had greater severity of alcohol dependence (p = 0.0002), lower social support (p = 0.003), and worse economic status (p = 0.002). Moreover, there was a significant association between history of suicide attempts and family history of psychiatric problems (p = 0.00025), suicide attempts in the family (p = 0.0073), childhood history of sexual abuse (p = 0.009) as well as childhood history of physical abuse (p = 0.002). When entered into linear regression analysis with other dependent variables history of childhood sexual abuse remained a significant predictor of suicide attempt (OR = 2.52; p = 0.035). Lifetime experience of sexual abuse is a significant and independent risk factor of suicide attempts in alcohol-dependent individuals.  相似文献   

2.
BackgroundIn recent years, research has increasingly focused on examining the relationship between one type of child maltreatment -- emotional violence -- and suicidal behaviors. However, the growing body of empirical evidence supporting these associations has been mostly limited to high-income contexts.ObjectiveThis study examines how exposure to emotional violence is associated with suicide ideation in childhood and adolescence in low- and middle-income countries (LMICs), and whether this association differs by sex.Participants and settingWe employ nationally representative samples of 13–24 year-old males and females from the Violence Against Children Surveys in Tanzania (conducted in 2009), Kenya (2010), and Haiti (2012).MethodsWe use logistic regressions to estimate the odds of ever reporting suicide ideation, separately, for each country; models control for self-reported exposure to emotional violence, physical violence from a caregiver, physical violence by an adult in the community, sexual violence, intimate partner violence, and age. Formal moderation by sex for each form of child maltreatment is tested using interaction terms.ResultsWe find the odds of suicide ideation are consistently and significantly greater for adolescents who report ever exposure to emotional violence. This same consistency is not observed for any other form of maltreatment across countries. The size of the relationship between emotional violence and suicide ideation is statistically significantly larger for males in Kenya only.ConclusionResearch in LMICs should explore the mediating factors linking emotional abuse in childhood and adolescence to suicide ideation in adolescence, paying special attention to whether these pathways might operate differently by sex.  相似文献   

3.

Objectives

Depression is prevalent in mothers receiving home visiting. Little is known about the impact of treatment on associated features of maternal depression in this population. The purpose of this study was to examine the impact of a novel, adapted treatment for depressed mothers in home visiting on psychological distress and social functioning.

Methods

In-Home Cognitive Behavioral Therapy (IH-CBT) was developed to treat depressed mothers in home visiting. A randomized clinical trial design was used in which subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3 months postpartum were randomized into IH-CBT and ongoing home visiting (n = 47) or standard home visiting (SHV; n = 46) in which they received home visitation alone and could obtain treatment in the community. Measures of psychological distress, social support, and social network were measured at pre-treatment, post-treatment, and three-month follow-up. Clinical features of depression and home visiting parameters were examined as potential moderators.

Results

Subjects receiving IH-CBT reported decreased psychological distress at post-treatment (ES = 0.77) and follow-up (ES = 0.73). Examination of types of psychological distress indicated broad improvements at both time points. Those receiving IH-CBT reported increased social support over time relative to those in the SHV condition. Effect sizes were modest at post-treatment (ES = 0.38) but increased at follow-up (ES = 0.65). Improvements were seen in affiliative and belonginess aspects of social support, in contrast to tangible support which was statistically non-significant. Findings were not moderated by clinical features of depression or home visiting parameters. No group differences were found in size of and involvement with social networks.

Conclusions

IH-CBT is effective in reducing psychological distress and improving perceived social support in depressed mothers receiving home visiting. To the extent that mothers are better adjusted and feel socially supported, they are more available to their children and more amenable to home visiting services. IH-CBT is a feasible, readily adopted treatment that is compatible with multiple home visiting models. As a result it is a promising approach to help depressed mothers in home visiting. Additional interventions may be needed to support depressed mothers in building sizable and stable social networks.  相似文献   

4.
Childhood maltreatment is a strong risk factor for subsequent violence, including violent behaviors in young adulthood and offspring maltreatment after becoming a parent. Little is known about the specific circumstances under which supportive relationships may help disrupt this cycle of violence throughout the life course. We conducted two complementary analyses to assess whether maternal social support in early childhood, and also paternal involvement in middle childhood, could prevent the intergenerational transmission of violence, using data from the Avon Longitudinal Study of Parents and Children (n = 11,384). We found that higher levels of maternal social support in the postpartum period reduced the odds of offspring maltreatment at ages 0–8 years (OR = 0.95, 95% CI 0.93–0.96). When classifying mothers according to their abuse history, this protective association of social support was observed among mothers with no history of childhood maltreatment and among those with only childhood maltreatment (and not postpartum intimate partner violence [IPV]), but not among mothers who reported IPV since the child’s birth. We then extended our analysis of these offspring forward in time and found that paternal involvement at ages 9–10 years was associated with a reduced risk of offspring self-reported violent perpetration at ages 18–20 years (OR = 0.85, 95% CI = 0.77–0.94). This protective association was generally apparent among all subgroups of children, including those with a history of childhood maltreatment. Together these results highlight the protective influence of supportive relationships against the intergenerational transmission of violence, depending on abuse history, context, and timing, with important implications for the prevention of childhood maltreatment and mitigation of its negative effects.  相似文献   

5.
ObjectiveTo evaluate the social and emotional adjustment of 219 children in families with varying levels of intimate partner violence (IPV) using a model of risk and protection. To explore factors that differentiate children with poor adjustment from those with resilience.MethodologyMothers who experienced IPV in the past year and their children ages 6–12 were interviewed. Standardized measures assessed family violence, parenting, family functioning, maternal mental health, and children's adjustment and beliefs.ResultsUsing cluster analysis, all cases with valid data on the Child Behavior Checklist, Child Depression Inventory, General Self-Worth and Social Self-Competence measures were described by four profiles of children's adjustment: Severe Adjustment Problems (24%); children who were Struggling (45%); those with Depression Only (11%); and Resilient (20%) with high competence and low adjustment problems. Multinomial logistic regression analyses showed children in the Severe Problems cluster witnessed more family violence and had mothers higher in depression and trauma symptoms than other children. Resilient and Struggling children had mothers with better parenting, more family strengths and no past violent partner. Parents of children with Severe Problems were lacking these attributes. The Depressed profile children witnessed less violence but had greater fears and worries about mother's safety.ConclusionFactors related to the child, to the mother and to the family distinguish different profiles of adjustment for children exposed to IPV who are living in the community. Resilient children have less violence exposure, fewer fears and worries, and mothers with better mental health and parenting skills, suggesting avenues for intervention with this population.Practice implicationsFindings suggest that child adjustment is largely influenced by parent functioning. Thus, services should be targeted at both the child and the parent. Clinical interventions shaped to the unique needs of the child might also be tested with this population.  相似文献   

6.
《Child abuse & neglect》2014,38(12):2033-2043
Although poor parenting is known to be closely linked to self-regulation difficulties in early childhood, comparatively little is understood about the role of other risk factors in the early caregiving environment (such as a parent's own experiences of childhood abuse) in developmental pathways of self-regulation into adolescence. Using a longitudinal design, this study aimed to examine how a mother's history of abuse in childhood relates to her offspring's self-regulation difficulties in preadolescence. Maternal controlling parenting and exposure to intimate partner aggression in the child's first 24–36 months were examined as important early social and environmental influences that may explain the proposed connection between maternal abuse history and preadolescent self-regulation. An ethnically diverse sample of mothers (N = 488) who were identified as at-risk for child maltreatment was recruited at the time of their children's birth. Mothers and their children were assessed annually from the child's birth through 36 months, and at age 9–11 years. Structural equation modeling and bootstrap tests of indirect effects were conducted to address the study aims. Findings indicated that maternal abuse history indirectly predicted their children's self-regulation difficulties in preadolescence mainly through maternal controlling parenting in early childhood, but not through maternal exposure to aggression by an intimate partner. Maternal history of childhood abuse and maternal controlling parenting in her child's early life may have long-term developmental implications for child self-regulation.  相似文献   

7.
BackgroundChildren exposed to intimate partner violence (IPV) are at increased risk of disruptions to their health and development. Few studies have explored mothers’ perceptions of what helps their children cope throughout this experience.ObjectiveThe aim of the study was to explore mothers’ perceptions of their children’s resilience and coping following IPV exposure, and the strategies they have used to support their children and promote resilience.MethodsIn depth semi-structured interviews were conducted with nine women from the Maternal Health Study (MHS), a prospective study of women during pregnancy and following the birth of their first child. All women involved in the qualitative interviews reported experiencing IPV during their involvement in the MHS. Transcribed interviews were analysed using interpretative phenomenological analysis which has a focus on how individuals make meaning of their experience.ResultsWomen discussed parenting strategies such as role modelling, stable and consistent parenting, and talking with their children about healthy relationships to promote their children’s resilience. Mothers also spoke about the ways they tried to reduce their child’s direct exposure to IPV, as well as reflecting on the difficulty of attending to their child emotionally when they were experiencing distress.ConclusionsThis study highlights that there are many strategies used by mothers who experience IPV to promote resilience and wellbeing in their children. Understanding what mothers see as useful for their children is essential in providing appropriate services to families following experiences of family violence.  相似文献   

8.
ObjectiveThis research examined whether additional forms of family violence (partner-child aggression, mother-child aggression, and women's intimate partner violence [IPV]) contribute to children's adjustment problems in families characterized by men's severe violence toward women.MethodsParticipants were 258 children and their mothers recruited from domestic violence shelters. Mothers and children completed measures of men's IPV, women's IPV, partner-child aggression, and mother-child aggression. Mothers provided reports of children's internalizing and externalizing behavior problems; children provided reports of their appraisals of threat in relation to interparent conflict.ResultsAfter controlling for sociodemographics and men's IPV: (1) each of the additional forms of family violence (partner-child aggression, mother-child aggression, and women's IPV) was associated with children's externalizing problems; (2) partner-child aggression was associated with internalizing problems; and (3) partner-child aggression was associated with children's threat appraisals. The relation of mother-child aggression to externalizing problems was stronger for boys than for girls; gender differences were not observed for internalizing problems or threat appraisals.ConclusionsMen's severe IPV seldom occurs in the absence of other forms of family violence, and these other forms appear to contribute to children's adjustment problems. Parent-child aggression, and partner-child aggression in particular, are especially important. Systematic efforts to identify shelter children who are victims of parental violence seem warranted.Practice implicationsMen's severe IPV seldom occurs in the absence of other forms of family violence (partner-child aggression, mother-child aggression, and women's IPV), and these different forms of family violence all contribute to children's adjustment problems. Treatment programs for children who come to domestic violence shelters should address these different forms of family violence, especially parent-child aggression.  相似文献   

9.
Suicide attempts occurred in 11 of 201 (5.4%) families in which sexual abuse was substantiated during a 212-year study period. Thirteen attempts occurred in the eleven families—five in mothers and eight in daughter-victims. No perpetrators in this social agency sample attempted suicide. Three mothers made attempts within the 1st week after the sexual abuse report; these three had borderline personalities, prior suicide attempts, personal histories of incest, and, surprisingly, all returned rapidly to adequate maternal functioning. The two mothers who made attempts later had primary depressions with underlying dependent personalities and never returned to successful mothering of their victimized daughters, both of whom themselves attempted suicide later in the family's treatment course. All eight daughters who attempted suicide were 14 to 16 years old and had been involved in incest with father figures. None of their families remained intact after the disclosure of incest, and their mothers actively blamed and disbelieved these victims. Seven of the eight had behavior problems which may have masked depression.  相似文献   

10.
Grounded in ecocultural theory and utilizing in-depth interview data, this paper explores the experiences of 40 low-income immigrant mothers as they selected and secured early childhood care and education (ECCE) for their young children. Cultural and structural aspects of low-income immigrant families’ lives and their influence in shaping these families’ ECCE decision-making processes were examined. Latina and African mothers’ experiences were considered, as these mothers’ country of origin (COO) experiences were varied as well as their documentation statuses upon arrival in the US, with 15 of the Latinas being undocumented. Mothers discussed reasons for seeking ECCE, with maternal employment being most important. Some mothers looked to ECCE to recreate social experiences for their children similar to those in their COOs. Many mothers indicated looking for ECCE programs in which their children could learn English and interact with children from diverse backgrounds. Mothers tended to utilize social and organizational connections to secure ECCE and documentation of residence shaped the number and severity of obstacles mothers faced in securing ECCE. The findings from this study inform researchers, policymakers, and practitioners as to how both culture and structure shape ECCE decision making among low-income African and Latina/o immigrant families.  相似文献   

11.
ObjectivesTo determine the prevalence of intimate partner violence (defined as any physical violence during the last 12 months or previously) among mothers who maltreat their children, and to examine whether mothers’ experiences of intimate partner violence (IPV) are associated with repeated reports (rereports) of children to Child Protective Services (CPS) during the following 18 months.MethodsData for the analyses were from the National Survey of Child and Adolescent Well-Being (NSCAW), a national probability study of children investigated for child maltreatment. The sample of 5,501 children (ages 0–14) was randomly selected from the families who entered the US child welfare system between October 1999 and December 2000. The analysis sample was restricted to 1,236 families in which caregivers were: (1) the alleged perpetrators of the child maltreatment at baseline (independently of substantiation status) and (2) the biological mothers (n = 1,212 or 98.6%), adoptive mothers (n = 17 or 1%), or stepmothers (n = 7 or 0.3%) of children not placed in out-of-home care.ResultsChildren of mothers physically abused by an intimate partner during the last 12 months or previously at the intake interview (44%) were twice as likely as children of mothers who had not experienced such violence to be rereported to CPS (29% vs. 14%, Odds Ratio = 2.0, 95% Confidence Interval = 1.1–3.4). Rereports occurred almost twice as quickly for children of mothers who experienced IPV compared to children of mothers who had not experienced IPV (Hazard Ratio = 1.9, 95% Confidence Interval = 1.1–3.0).ConclusionsThe higher risk and speedier rereports of child maltreatment associated with intimate partner violence highlights the need for universal assessment and provision of services for IPV among families that are investigated by CPS.  相似文献   

12.
OBJECTIVE: The study had two aims: (1) To investigate whether mothers with a history of contact child sexual abuse were anxious about the intimate aspects of parenting compared with a clinical comparison group. (2) To determine if there was any relationship between the mother's anxieties and the kind of parenting they recalled receiving themselves. METHOD: Two groups of mothers in mental health out-patient care were interviewed; 34 women with a history of contact child sexual abuse and 29 women with no history of sexual abuse. They completed the Intimate Aspects of Parenting Questionnaire, The Parenting Stress Index (Short form) The Parental Bonding Instrument and The General Health Questionnaire-28. The index group also completed a sexual abuse history questionnaire. RESULTS: Mothers with a history of child sexual abuse were significantly more anxious about intimate aspects of parenting than the comparison group. They also reported significantly more overall stress as parents. The index group recalled that their own parents were significantly less caring and that their fathers more controlling than the comparison group. A low score on Father Care was significantly associated with concerns about intimate parenting, but not with total parenting stress. By contrast, a low score on Mother Care was significantly associated with higher stress experienced as a parent, but not as strongly with anxieties about intimate parenting. CONCLUSIONS: Mothers with a history of contact child sexual abuse who attend mental health services are often worried that their normal parenting behaviors may be inappropriate or seen as such by other people. These anxieties seem associated with their history of childhood sexual abuse.  相似文献   

13.
Research Findings: This study simultaneously examined parental depression and parent involvement as predictors of satisfaction with an early childhood intervention program. Parents (N = 203) of Head Start children participated in this short-term longitudinal study. Measures of parent involvement and satisfaction assessed multiple dimensions of these constructs. Nearly 40% of low-income mothers reported being sometimes or chronically depressed over the course of 1 year of the Head Start program. Compared with mothers who were never depressed, those who were sometimes depressed reported less involvement in home- and school-based activities as well as fewer interactions with their child's teacher. Never depressed parents were more likely to be satisfied with their child's teacher compared with either group of depressed mothers. Higher levels of parent involvement and parent–teacher interaction predicted optimal satisfaction with Head Start services. Practice or Policy: Implications of results for practice are considered in terms of teacher training to recognize unique needs involved in working to establish a home–school connection with mothers experiencing depression. Strategies for building community partnerships to assist with mental health needs are discussed.  相似文献   

14.
ObjectiveThe expansion of Home Visitation Programs for at-risk, first-time mothers and their young children has drawn attention to the potential impact of depression on program outcomes, yet little research has examined depression in the context of home visitation. The purpose of this study was to determine the prevalence of and changes in depressive symptoms in mothers enrolled in home visitation and identify predictors of change in symptoms over the first 9 months of service.MethodsSubjects consisted of 806 at-risk, first-time mothers enrolled in a Home Visitation Program. Self-reported depression was measured at enrollment and again 9 months later. Established clinical cutoffs were used to identify clinically elevated levels of depression. Additional measures were taken of interpersonal trauma history, concurrent intimate partner violence, and social support.ResultsResults indicated that: (1) 45.3% of mothers had clinically elevated symptoms of depression at some point during the first 9 months of service, (2) 25.9% of mothers had elevated symptoms at both time points or at the 9-month assessment, and (3) 74.1% experienced an interpersonal trauma prior to enrollment. Lack of improvement or worsening of depressive symptoms from enrollment to 9 months was best predicted by pre-enrollment interpersonal trauma history, young maternal age, being African American, and symptoms severe enough to have led to mental health treatment.ConclusionsFindings suggest that maternal depressive symptoms are a significant problem in home visitation. The role of interpersonal trauma in depressive symptoms, and how to best address these clinical issues in home visitation, warrants further examination.Practice implicationsMaternal depression is prevalent in Home Visitation Programs, and many mothers exhibit elevated symptoms at multiple time points over the first year of service. Interpersonal trauma history is also prevalent, and is predictive of increased depressive symptoms over time. Home Visitation Programs should note that mothers with interpersonal trauma history, young maternal age, and being African American have an increased likelihood of persistent depressive symptoms, which may in turn pose significant challenges to providing services.  相似文献   

15.
OBJECTIVE: Studies show that childhood sexual and physical abuse predict repeated suicide attempts and self-mutilation. Little is known about the importance of sexual and physical abuse when compared to other severe childhood adversities with respect to chronic suicidal behavior. METHOD: Seventy-four subjects, 65% of whom were women, consecutively admitted to a general hospital after having made a suicide attempt, were interviewed as part of the intake interview about prior suicide attempts and self-mutilation and received DSM-IV diagnoses. Sexual abuse, physical abuse, neglect, antipathy from parents, loss of parents, and severe discord in the family before the age of 18, were covered by the Childhood Experience of Care and Abuse (CECA) interview schedule. RESULTS: The prevalence of severe sexual abuse was 35%, severe physical abuse 18%, neglect 27%, antipathy 34%, loss of caregiver 37% and exposure to family violence 31%. Physical and sexual abuse were independently associated with repeated suicide attempts when controlling for the effects of the other childhood adverse factors. No other childhood adversity was related to chronic suicidal behavior. The odds ratio of exposure to sexual or physical abuse was highest among those who both repeated suicide attempts and self-mutilated. CONCLUSION: Physical and sexual abuse are significantly and independently associated with repeated suicidal behavior.  相似文献   

16.
BackgroundSexual dating violence is highly prevalent within the context of intimate relationships but this form of violence remains understudied among teenagers and emerging adults.ObjectivesTo identify the specific needs of adolescents and emerging adults who reported sexual dating violence, this study aimed to document the: 1) prevalence of sexual DV; 2) perceived social support and help-seeking strategies; 3) facilitating factors and barriers.Participants and settingA total 396 heterosexual youths and emerging adults (aged 14–25) participated in this study focussing on issues associated with romantic and sexual relationships, including experiences of victimization and help-seeking strategies.MethodsThis analysis relied on a mixed methods design. Sexual dating violence in the last 12 months was assessed using an adapted version of the Sexual Experiences Survey (Koss et al., 2007). Semi-structured interviews were conducted with a subsample of 100 youths and emerging adults.ResultsClose to 30% of participants reported having experienced at least one episode of sexual dating violence in the past year. Participants could count on a friend and/or a parent but girls were more likely to seek help compared to boys. Effect sizes were moderate to small. Several barriers were identified, including, having to disclose intimate aspects of their personal life to a stranger.ConclusionGiven ambiguities regarding sexual consent and sexual violence within the context of an intimate relationship, victims expressed reluctance to get formal support. These findings support the relevance of exploring barriers and facilitators to help-seeking to improve access to services for adolescents and emerging adults who report sexual DV.  相似文献   

17.
SYNOPSIS

Objective . Few studies have explored associations between strength-based factors and positive parenting among mothers experiencing adversity. Adopting a person-centered statistical approach, we examined how patterns of maternal strengths relate to positive parenting practices. Design . Participants were 188 female primary caregivers (71% African American) who experienced intimate partner violence and/or were living with HIV. Women were recruited from community organizations in the Mid-Southern United States and completed measures of adaptability, spirituality, ethnic identity, social support, parent-child communication, community cohesion, and parenting practices. Latent profile analysis was used to generate classes of individual (adaptability, spirituality, education), relational (family support, friend support, parent-child communication about Substance Abuse, Violence, and AIDS/HIV), and contextual (ethnic identity, community cohesion) factors, in line with the social-ecological model of resilience. Associations between the classes and positive parenting practices were examined. Results . Three classes emerged: (1) Low Individual, Relational, & Contextual (LIRC; n = 18); (2) Low SAVA Communication (LSC; n = 30); and (3) High Individual, Relational, & Contextual (HIRC; n = 140). Mothers in the LIRC class reported lower parental involvement and less positive parenting practices than those in the HIRC class. Conclusions . Mothers who endorse increased individual, relational, and contextual factors utilize more positive parenting practices. Optimal clinical approaches to enhance parenting should target supports at multiple levels.  相似文献   

18.
ObjectiveFamilies where parents had childhood history of victimization may likely to abuse their children; hence contributing as an important predictor of child emotional maltreatment (CEM). This study aimed to determine the relationship of intergenerational abuse with CEM among 11–17 years old children residing in peri-urban and urban communities of Karachi, Pakistan.MethodStructured interviews were conducted with 800 children and parents-pair using validated questionnaire “International Child Abuse Screening Tool for Child (ICAST-C)” comprised of 4 domains. Domain of child emotional maltreatment was considered as outcome (CEM-score). The relationship between Parental history of childhood victimization and CEM-Score was measured using linear regression.ResultsThe average CEM-score was came to be 19+5.2 among children whom parental history of childhood victimization was present (P < 0.001). The estimated mean CEM-score increased by 5.59 units (95% CI= {2.61, 8.51}) among children whom parents had a history of childhood victimization (Intergenerational abuse) with severe physical familial abuse.ConclusionThe current study provided evidence on intergenerational transmission of maltreatment suggesting early prevention to break the cycle of child maltreatment through generations. Preventive measures can be taken, once a parental history of childhood victimization has been identified, by providing appropriate services to those families who belong to lower socioeconomic status, where mothers are young, presence of siblings’ rivalry/ bullying and/or violence among family members. However, these factors do not explain a complete causality of the intergenerational transmission therefore additional factors, for instance parenting styles must be taken into consideration.  相似文献   

19.
BackgroundExposure to intimate partner violence (IPV) is an important adverse childhood experience, but there are few longitudinal studies in low and middle-income countries.ObjectiveTo investigate the consequences of exposure to IPV for a child’s mental health.Participants and setting614 mother-child pairs were evaluated in a poor urban district in Recife, northeastern Brazil.MethodsWomen were interviewed in pregnancy, postpartum and six to nine years after delivery, and asked about their experience of IPV, and the exposure of their child to violence. The Strengths and Difficulties Questionnaire (SDQ) was completed by child’s mother and teacher. Ten types of child experience of IPV and the age of onset of exposure were compared with the child’s behavioral profile at school age.ResultsThe mothers reported that 372/614 (60.6%) children had been exposed to IPV. The commonest types of child exposure to IPV were “prenatally”, “overheard”, “eyewitnessed”, and 10.0% of children were physically or verbally involved in the IPV. Mothers reported high SDQ Total Difficulties scores in 71.7% of all children exposed to IPV and teachers in 59.8%. Multivariate logistic regression analysis demonstrated the strongest association with behavioral difficulties was with exposure to IPV in the age group 1–2 years (OR 2.5 [95% CI: 1.3–4.8]).ConclusionYoung children are sensitive to the age of first exposure to IPV and to the type of IPV. Interventions to reduce IPV should be targeted on vulnerable women from poor urban communities during their pregnancies and in the first two years of their child’s life.  相似文献   

20.
ObjectiveThis study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity).MethodsA retrospective record review was completed at an urban academic medical center. Subjects were women who presented at delivery or immediately postpartum with no history of prenatal care (N = 211), and their infants.ResultsInfants of mothers with substance use problems had the highest rates of referral to child protective services and out-of-home placement at discharge, though mothers with other reasons for no prenatal care also experienced both referral and placement. Infants born to mothers using substances experienced the highest rates of neonatal intensive care unit admission, and the lowest mean birth weight.ConclusionsThough those without prenatal care experienced a variety of adverse outcomes, substance use problems were most frequently correlated with adverse infant outcomes. Mothers who either had lost custody of other children or with substance use problems were at highest risk of losing custody of their infants. Those who denied or concealed their pregnancy still frequently retained custody.Practice implicationsAmong mothers without prenatal care, those with substance use problems were least likely to retain custody of their infant at hospital discharge. Custody status of the mother's other children was also independently associated with infant custody. Mothers who denied or concealed their pregnancy still often retained custody. Referrals of mothers with no prenatal care for psychiatric evaluation were rare, though referrals to social work were frequent. Child protective services occasionally did not investigate referrals in the denial and concealment groups. Healthcare providers should be aware of the medical and psychological needs of this vulnerable population of infants and mothers.  相似文献   

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