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).

Attentional Bias to Threat: Examining Associations with Children's Emotional Regulation and Interactions with Intimate Partner Violence.

Intimate partner violence (IPV) in the home-a prevalent environmental risk for children-exemplifies a key factor that may alter the role of attentional bias to threat (ABT) in children's psychological adjustment. The current study aims to (1) examine potential variations in ABT and emotion regulation across animal and face stimuli and (2) test IPV as a potential moderator of the relationship between ABT and child outcomes. Participating children (N = 37) completed computerized tasks assessing ABT. Mothers provided data on IPV in the home, child victimization, and child emotion regulation. Children's ABT toward animal stimuli was not associated with emotion regulation; IPV significantly moderated the link between ABT and emotion regulation (ß = - 0.06, p < .001). At low levels of IPV, children's ABT and emotion regulation were not related, but at high levels of IPV, ABT was negatively associated with emotion regulation skills. The relevance of ABT for understanding functioning may vary by both stimulus selection and by previous experiences of environmental risk.

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.

A randomized prospective cross over study on the effects of medium cut-off membranes on T cellular and serologic immune phenotypes in hemodialysis.

Extended cut-off filtration by medium cut-off membranes (MCO) has been shown to be safe in maintenance hemodialysis (HD). The notion of using them for the control of chronic low-grade inflammation and positively influencing cellular immune aberrations seems tempting. We conducted an open label, multicenter, randomized, 90 day 2-phase cross over clinical trial (MCO- vs. high flux-HD). 46 patients underwent randomization of which 34 completed the study. Dialysate- or pre- and post-dialysis serum inflammatory mediators were assayed for each study visit. Ex vivo T cell activation was assessed from cryopreserved leucocytes by flow cytometry. Linear mixed models were used to compare treatment modalities, with difference in pre-dialysis serum MCP-1 levels after 3 months as the predefined primary endpoint. Filtration/dialysate concentrations of most mediators, including MCP-1 (mean ± SD: 10.5 ± 5.9 vs. 5.1 ± 3.8 pg/ml, P < 0.001) were significantly increased during MCO- versus high flux-HD. However, except for the largest mediator studied, i.e., YKL-40, this did not confer any advantages for single session elimination kinetics (post-HD mean ± SD: 360 ± 334 vs. 564 ± 422 pg/ml, P < 0.001). No sustained reduction of any of the studied mediators was found neither. Still, the long-term reduction of CD69+ (P = 0.01) and PD1+ (P = 0.02) activated CD4+ T cells was striking. Thus, MCO-HD does not induce reduction of a broad range of inflammatory mediators studied here. Long-term reduction over a 3-month period was not possible. Increased single session filtration, as evidenced by increased dialysate concentrations of inflammatory mediators during MCO-HD, might eventually be compensated for by compartment redistribution or increased production during dialysis session. Nevertheless, lasting effects on the T-cell phenotype were seen, which deserves further investigation.

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.

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.

Feelings and feedings: Psychopathology and breastfeeding attitudes in women with a history of intimate partner violence.

Objective: Breastfeeding has myriad benefits for mother-child dyads, but women exposed to intimate partner violence (IPV) are less likely to sustain breastfeeding. Prior studies, however, have not analyzed mothers' breastfeeding attitudes in relation to breastfeeding behavior, IPV, and psychopathology. Further, little research has examined distinctive effects of posttraumatic stress symptoms (PTSS) and depression on breastfeeding behaviors and attitudes in IPV-exposed women. This study examines breastfeeding attitudes, psychopathology, and IPV as predictors of breastfeeding continuation, the prospective role of IPV for psychopathology and breastfeeding attitudes, and reciprocal relations among psychopathology and breastfeeding attitudes. Method: The current study includes a longitudinal sample of women (N = 83) recruited from a low-income clinic. Eligibility criteria included: pregnant and over age 18 at baseline. Data were collected during pregnancy and at 6 weeks and 4 months postpartum. Participants reported on psychopathology, IPV exposure, and breastfeeding behaviors and attitudes through prenatal interviews and postpartum surveys. Hypotheses were tested using cross-lagged models. Results: IPV, psychopathology, and breastfeeding attitudes were not related to breastfeeding continuation at 4 months postpartum. PTSS (ß = .76, p < .001) and breastfeeding attitudes (ß = -.19, p < .05) at 6 weeks postpartum predicted PTSS at 4 months, but not subsequent breastfeeding attitudes. Depression at 6 weeks postpartum predicted depression (ß = .63, p < .001) and breastfeeding attitudes (ß = -.48, p < .001) at 4 months postpartum. IPV was not significant in any model. Conclusions: Although depression severity was not associated with breastfeeding cessation, it was associated with less positive attitudes about breastfeeding, suggesting lactation supports may benefit from content addressing mothers' mental health needs and emotional experiences nursing newborns. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Caregiver and family factors promoting child resilience in at-risk families living in Lima, Peru.

BACKGROUND: Child victimization is one of the most serious, preventable threats to child health and wellbeing around the world. Contemporary research has demonstrated that polyvictimization, or children's experience of multiple types of victimization, is particularly detrimental. OBJECTIVE: The current study aims to evaluate relationships between child victimization and child resilience with a particular focus on caregiver and family promotive factors. PARTICIPANTS AND SETTING: Participants included N = 385 caregiver-child dyads from a high-risk neighborhood in San Juan de Lurigancho district in Lima, Peru. METHODS: Data were collected in the context of a representative survey of houses in the neighborhood; an index child (ages 4-17) was randomly selected for each household and caregivers provided reports on core study constructs. RESULTS: Child victimization (ß = .35, p < .001) and harsh punishment (ß = .17, p < .001) were associated with higher levels of child adjustment problems. Caregiver depression was associated with both higher adjustment problems (ß = .22, p < .001) and higher prosocial skills (ß = .14, p = .003). Caregiver resilience was associated with lower adjustment problems (ß = -.15, p = .01) and higher prosocial skills (ß = .14, p = .04). Positive parenting was associated with lower adjustment problems (ß = -.15, p < .001) and higher prosocial skills (ß = .20, p < .001). Family cohesion (ß = .23, p = .001) was positively associated only with children's prosocial skills. CONCLUSIONS: Findings suggest that caregiver resilience and positive parenting are consistent promotive factors for child resilience across indicators, including both adjustment problems and prosocial skills. These promotive factors may therefore be promising potential targets address in the context of interventions aimed at promoting child resilience.

Breastfeeding continuation at 6 weeks postpartum remediates the negative effects of prenatal intimate partner violence on infant temperament.

Very little work has examined potential moderating effects in the link between prenatal intimate partner violence (IPV) and infant adjustment, especially in the first critical weeks following delivery. The current study evaluated the protective role of breastfeeding in the relationship between prenatal IPV and infant temperament at 4 months. Pregnant women (n = 82) were interviewed during pregnancy and at 6 weeks and 4 months postpartum. It was hypothesized that (a) prenatal IPV would predict infant temperament outcomes at the 4-month postpartum visit, and (b) breastfeeding continuation at 6 weeks acts as a protective factor such that breastfed infants will be less affected by the risk posed by prenatal IPV. Results indicated direct and negative effects of prenatal IPV on positive affectivity/surgency and orienting/regulatory capacity at 4 months. A significant moderating effect of breastfeeding at 6 weeks postpartum was identified. Mothers who were not breastfeeding at 6 weeks postpartum demonstrated the expected negative relationship between prenatal IPV exposure and infant adjustment, but if mothers were breastfeeding at 6 weeks postpartum, the relationship between IPV exposure and infant positive affectivity/surgency and orienting/regulatory capacity was not significantly different from zero. Results indicate a significant protective effect of breastfeeding in the intergenerational transmission of risk for infants born to mothers exposed to IPV.

"Violence is Everywhere": Childhood Polyvictimization, Perceptions of the Prevalence of Victimization, and Posttraumatic Stress Symptoms.

Childhood polyvictimization is related to a heightened risk for mental health and functional problems in young adulthood, including posttraumatic stress symptoms, but little research has examined how perceptions of the prevalence of victimization may contribute to specific symptoms of posttraumatic stress. The primary aims of the current study were to (a) evaluate the accuracy of young adults' beliefs about the prevalence of multiple types of childhood victimization and (b) determine how inaccurate appraisals of victimization prevalence are associated with posttraumatic stress symptoms. College students (n = 369) drawn from two geographic regions of the United States responded to an online survey assessing their experiences of childhood victimization, perceptions about the prevalence of victimization, emotion regulation skills, and mental health. Childhood polyvictimization was significantly and positively related to distorted appraisals of the prevalence of victimization overall (r = .26, p < .001), and emotion regulation was associated with symptoms of posttraumatic stress in all domains. Distorted perceptions of the prevalence of victimization were linked to higher symptoms of hyperarousal, but not to higher symptoms of reexperiencing, avoidance, or negative mood/cognition. Results suggest that emotion regulation skills training is likely to be beneficial for many individuals experiencing posttraumatic stress, and intervention around perceptions of the prevalence of victimization may be useful for addressing symptoms of hyperarousal.