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).

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.

A Developmental Psychopathology Perspective on Political Violence and Youth Adjustment.

According to the United Nations (2021), [...].

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.

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.

Examining the efficacy of prenatal intervention in reducing IPV revictimization and improving maternal mental health: A quasirandomized controlled trial of the Pregnant Moms' Empowerment Program (PMEP).

OBJECTIVE: The present study was a quasirandomized trial of the Pregnant Moms' Empowerment Program (PMEP) that examined the effects of the program on women's intimate partner violence (IPV) revictimization, depression, posttraumatic stress, and resilience. It was hypothesized that treatment would be associated with improvements across all of the indicated dimensions and that those women completing the module on violence and mental health would have particularly strong improvements. METHOD: Women who were currently pregnant, IPV-exposed, and at least 16 years of age were recruited and assigned to either a treatment or control condition. Participants (N = 137) completed four assessments (pretest [T1], posttest [T2], 3-months postpartum [T3], and 12-months postpartum [T4]). The key outcomes assessed included IPV (Revised Conflict Tactics Scales), depressed mood (Center for Epidemiological Studies Depression Scale), posttraumatic stress (PTSD Checklist for DSM-5), and resilience (Connor-Davidson Resilience Scale). RESULTS: Results of multilevel models examining IPV revictimization indicated that treatment was associated with significantly fewer experiences of physical assault and sexual coercion at all follow-up interviews (T2, T3, and T4) and fewer IPV-related injuries at T3 and T4. In addition, treatment exposure was associated with statistically and clinically significant improvement in depression at T2 and T4. The intervention had limited efficacy in increasing women's self-reported resilience or in reducing symptoms of posttraumatic stress. CONCLUSIONS: Together, these data suggest that PMEP is a promising evidence-based intervention for pregnant, IPV-exposed women, and that the effects-particularly for IPV and depression-are likely to be sustained over time. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Evaluating the Role of Maternal and Paternal Trauma Exposure, Emotional Security, and Mental Health in Predicting Psychological Adjustment among Palestinian Adolescents.

Previous research has established a strong relationship between family system functioning and child adjustment outcomes. However, within the context of Gaza, an evaluation of both maternal and paternal factors associated with adolescent psychological adjustment has not yet been thoroughly evaluated. The current study examines how maternal and paternal trauma exposure, emotional security, and mental health are related to parent-reported scores of adolescent psychological adjustment, while controlling for adolescent trauma exposure and security in the family. The sample included N = 68 family units living in the Gaza Strip, with two parents and one adolescent surveyed within each unit (adolescent Mage = 14.03 years). The regression model examining maternal factors was significant overall (F = 7.44, R2 = 42.70%, p < 0.001), with increased maternal depression associated with greater adolescent adjustment difficulties (ß = 0.31, p = 0.011) and greater maternal emotional security in the family associated with fewer adolescent adjustment difficulties (ß = −0.36, p = 0.004). The regression model examining paternal factors was also significant (F = 4.57, R2 = 31.00%, p < 0.001), with increased paternal trauma exposure associated with greater adolescent adjustment difficulties (ß = 0.32, p = 0.012). Understanding family-level factors associated with adolescent adjustment is an important step in conceptualizing the mental health needs of conflict-affected youth within the context of Gaza and more broadly.

Supporting Youth and Families in Gaza: A Randomized Controlled Trial of a Family-Based Intervention Program.

Background: A total of 450 million children are now living in active conflict zones. The negative consequences for children are significant and long lasting. In response to the urgent need for sustainable interventions for children and families, the current study evaluated a brief (12 hr, 8 session) family-based coping and support program, Promoting Positive Family Futures (PPFF), in Gaza. Methods: Families (n = 68, mother/father/adolescent triads) were randomized into the PPFF intervention or another lengthier (50 hr, 25 session) locally well-established psychosocial support program (treatment as usual; TAU). Results: Improvements were found for both conditions for paternal and maternal depression, emotion regulation using cognitive reappraisal, family-wide emotional security, and adolescent adjustment. Effect sizes were medium to large (d = 0.35-1.27). Fathers in the PPFF condition reported lower depression and higher emotion regulation using cognitive reappraisal at post-test than did fathers in the TAU condition. Mothers in the PPFF condition reported higher levels of emotion regulation using cognitive reappraisal at post-test than did mothers in the TAU condition. PPFF was also indirectly associated with improved depression at post-test for both mothers and fathers via improvements in emotion regulation using cognitive reappraisal and with adolescent adjustment at six months via improvements in maternal emotion regulation using cognitive reappraisal. Conclusions: These findings suggest that the PPFF intervention has many benefits comparable with a longer and locally well-established program. PPFF was also associated with unique positive implications for family-wide adjustment over time. Support was also identified for transdiagnostic processes of improvement associated with the PPPF intervention consistent with the theoretical models informing the approach.

Trauma, resilience, and distress in post-revolution Egypt.

OBJECTIVE: Trauma represents a persistent threat to health and wellbeing. Yet, little research has examined links between trauma, psychopathology, and resilience in the Middle East and North Africa region outside of refugee settings, especially in Egypt. Existing studies in Egypt rarely examine trauma exposure from a polyvictimization lens, assess multiple forms of trauma-related psychopathology, or focus on dimensional symptom assessment. The current study aimed to address these gaps by (a) reporting on the diverse range of trauma exposure types, including direct, witnessed, and indirect exposure in a trauma-exposed sample; and (b) examining the associations between trauma exposure, psychopathology, and resilience. METHOD: Participants (N = 87) were drawn from the baseline survey of a randomized clinical trial for online treatment of posttraumatic stress and reported on demographics, trauma exposure, resilience, and psychopathology. RESULTS: Men reported more direct and witnessed exposure to sociopolitical violence than women, but there were no gender differences in sexual violence or total trauma exposure. Multivariate regression models examining the effect of trauma and resilience on psychopathology, controlling for age and gender, indicated that all models explained significant variance for posttraumatic stress and anxiety (F(87, 7)PTSS = 2.64, p = .022, R² = 16.5%; F(87, 7)Anx = 6.04, p < .001, R² = 31.2%) but not depression. Direct trauma exposure was associated with higher severity levels of posttraumatic stress and anxiety (ßPTSS = 1.11, p = .005; ßAnx = 1.04, p = .001). Resilience was only associated with lower levels of anxiety (ßAnx = -.22, p < .001). CONCLUSIONS: These findings suggest the high need for evidence-based care in Egypt for trauma-related psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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.

A qualitative exploration of families' experiences and resilience factors during the COVID-19 pandemic.

The COVID-19 pandemic has prompted widespread changes and challenges worldwide. In the context of the early months of the pandemic, the current study utilized thematic analysis to assess parents' (N = 13) perspectives of need for resources to foster their family's wellbeing. Five themes emerged: Information Deficits, Need for More Instrumental Supports, Frustration and Worry, Resources Promoting Resilience, and Positive Perspective Shift. Results indicate the importance of information and expanded access to community resources to scaffold resilience in the face of ongoing mass stressors.

"I Did It to Save My Children": Parenting Strengths and Fears of Women Exposed to Intimate Partner Violence.

Intimate partner violence (IPV) is experienced by one in four women in the United States, and a wealth of quantitative research has underscored its detrimental effects on women's mental health and parenting practices. Little research, however, has considered ways in which women exposed to IPV retain and foster parenting strengths and ways in which motherhood serves as a source of resilience for these women. The objective of the current study was to conduct a thematic analysis of IPV-exposed women's parenting strengths and concerns as reported through focus groups conducted with IPV-exposed women (n = 22) and service providers (n = 31) in two urban areas in the Mid-West and Mid-South. Results of the thematic analysis indicated the emergence of three core themes: resilience and challenges of parenting in the context of IPV, leaving the violent partner, and intergenerational processes. Overall, service providers recognized far fewer strengths in parenting on all dimensions than did women, suggesting that service providers may be conceptualizing parenting in the context of IPV from a deficit model that underestimates the resilience demonstrated by these women. This has important consequences for the extent to which women may feel stigmatized or blamed when receiving resources and services critical to their families. Future research on parenting among women experiencing IPV would be enhanced by capturing the dynamic interplay between women's parenting strengths and challenges, and the ways in which these capacities are affected by resource access within and across social ecological contexts.

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.

Types of Childhood Exposure to Violence and Association With Caregiver Trauma in Peru.

This study examined typologies of childhood polyvictimization and the associations of profiles with demographic characteristics at the levels of child, household, and primary caregiver. This study evaluated a sample of children aged 4 to 17 years residing in San Juan de Lurigancho District, an urban setting on the edge of Lima, Peru (n = 384). An in-person interview of the primary caregiver of each child was conducted in June 2018, assessing the victimization of the child, the caregiver's exposure to trauma and abuse, and general socioeconomic and demographic characteristics of the household. Latent class analysis was used to identify typologies of child victimization. Follow-up analysis was conducted to quantify differences between the classes which emerged, in terms of the child, caregiver, and household. Five classes emerged: High Peer victimization, Moderate Community victimization; High Community victimization; Verbal Abuse; High victimization across domains; and Low victimization across domains. Caregiver exposure to trauma was positively associated with membership in the high-exposure classes. This study offers a unique opportunity to more deeply understand childhood exposure to violence in Latin America, specifically in an urban setting in Peru, and to further understand how childhood victimization is associated with various characteristics of the child, caregiver, and household. These findings could inform interventions supporting children and families at risk of exposure to violence in Peru or globally.

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.

I'll catch you when you fall: Social safety nets and housing instability in IPV-exposed pregnant women.

BACKGROUND: Intimate partner violence (IPV) has significant consequences for women's mental health, and it also compromises women's economic security and livelihood, including housing stability. There is a dearth of research, however, on protective factors in the link between housing instability and psychopathology in IPV-exposed women. METHODS: The current study examines the protective role of social support in the association between housing instability and mental health (depression, posttraumatic stress) in a sample of pregnant, IPV-exposed women (N = 137). RESULTS: Overall models for both depression and posttraumatic stress were significant (F = 6.42, p<.001; R2=16.3%; F = 15.09, p<.001; R2=31.0%, respectively). Housing instability was significantly associated with higher levels of depressed mood (ß=0.20, p<.016), but not posttraumatic stress symptoms. Social support was significantly associated with lower levels of depressed mood (ß=-0.17, p<.036) and posttraumatic stress (ß=-0.38, p =0.001). The addition of the interaction term (housing instability*social support) resulted in a significant improvement in variance explained from the main effects model for depression (F = 4.90, p<.028, ∆R2=3.0%) and the interaction term was significant (ß=-0.60, p=.029). An interaction effect of housing instability and social support on posttraumatic stress was not identified. LIMITATIONS: Although the current study is the first to examine protective factors in the relationship between housing instability and psychopathology in IPV-exposed pregnant women, data were cross-sectional and therefore directionality and temporality cannot be inferred. CONCLUSIONS: Results suggest that housing instability may play a greater role in women's depressed mood than in their experience of posttraumatic stress symptoms, and the presence of social support may substantially ameliorate the effect of this adversity.

Lessons learned in adapting an online intervention program for posttraumatic stress for use in Egypt.

Cultural adaptation of evidence-based treatments is a pressing priority for global health, and previous research has informed recommendations for guiding the process of translation and adaptation. As research in the domain of cultural adaptation and evaluation of evidence-based treatments progresses, it is critical that researchers communicate key lessons learned, so that models of adaptation can be continuously refined and reconsidered. The work described in this article aimed to translate and culturally adapt an online intervention to address symptoms of posttraumatic stress-the PTSD Coach Online-for use with young adults in Egypt. The cultural adaptation framework proposed by Bernal and colleagues (1995) was used, and focus groups and interviews with members of the target population, mental health professionals, and service users were conducted. The authors encountered a number of challenges in treatment adaptation that generated important insights for future work. Specifically, this case study highlights the importance of translation teams with diverse backgrounds and experiences, the critical nature of iterative feedback throughout the adaptation process, and the importance of a long time-horizon for optimal adaptation.

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.

Women's Cigarette and Marijuana Use in Pregnancy: Identifying the Role of Past Versus Recent Violence Exposure.

Both cigarette smoking and marijuana use during pregnancy pose serious risks to healthy fetal development, yet little is known about the comparative contribution of recent versus past traumatic experiences to women's smoking behavior. The current study aimed to examine the relative contributions of childhood adversity and past year intimate partner violence (IPV) to women's cigarette and marijuana use during pregnancy in a high-risk, low-income sample. Participants (n = 101) were interviewed to evaluate past year IPV, childhood adversity, and cigarette and marijuana use. Results indicated that approximately one in four pregnant women in the sample reported that they were currently smoking cigarettes. Only a minority of those who reported prepregnancy smoking (22.5%) were able to quit smoking once pregnant. Regarding marijuana use, 6.9% of women reported use during pregnancy, with 68.1% of women using prior to pregnancy ceasing use once pregnant. Results of multinomial regressions controlling for income and education indicated that past year physical abuse by a partner was associated with light cigarette use during pregnancy whereas high rates of childhood adversity were associated with moderate cigarette use during pregnancy. Sexual IPV was associated with marijuana use during pregnancy. Comprehensive assessment of women's history of exposure to violence, including both past and recent exposure, provides insight into which women may have the most difficulty with unassisted cessation in the prenatal period. Providing better intervention and support around cigarette and marijuana cessation for women exposed to violence is a critical need, especially among groups that are at sociodemographic risk for substance use in pregnancy.