Posttraumatic stress disorder and pregnancy complications.

OBJECTIVE: To assess the associations between specific pregnancy complications and posttraumatic stress disorder based on neurobiologic and behavioral characteristics, using Michigan Medicaid claims data from 1994-1996. METHODS: Two thousand, two hundred nineteen female recipients of Michigan Medicaid who were of childbearing age had posttraumatic stress disorder on the basis of International Classification of Diseases, 9th Revision (ICD-9) codes. Twenty percent (n = 455) of those recipients and 30% of randomly selected comparison women with no mental health diagnostic codes (n = 638; P <.001) had ICD-9 diagnostic codes for pregnancy complications. We used multiple logistic regression to investigate associations between specific pregnancy complications and posttraumatic stress disorder, controlling for demographic and psychosocial variables. Obstetric complications were hypothesized based on high-risk behaviors and neurobiologic alterations in stress axis function in posttraumatic stress disorder. RESULTS: After controlling for demographic and psychosocial factors, women with posttraumatic stress disorder had higher odds ratios (ORs) for ectopic pregnancy (OR 1.7, 95% confidence interval [CI] 1.1, 2.8), spontaneous abortion (OR 1.9, 95% CI 1.3, 2.9), hyperemesis (OR 3.9, 95% CI 2.0, 7.4), preterm contractions (OR 1.4, 95% CI 1.1, 1.9), and excessive fetal growth (OR 1.5, 95% CI 1.0, 2.2). Hypothesized labor differences were not confirmed and no differences were found for complications not thought to be related to traumatic stress. CONCLUSIONS: Pregnant women with posttraumatic stress disorder might be at higher risk for certain conditions, and assessment and treatment for undiagnosed posttraumatic stress might be warranted for women with those obstetric complications. Prospective studies are needed to confirm present findings and to determine potential biologic mechanisms. Treatment of traumatic stress symptoms might improve pregnancy morbidity and maternal mental health.

Behavioral observations of parenting in battered women.

The current study assessed observational data of parenting in 95 battered women and their school-aged children's behavioral adjustment and analyzed them within an ecological framework. Results indicated that maternal experience of psychological and physical abuse predicts maternal warmth, but not maternal authority-control, over and above ontogenic and exosystemic factors. In addition, maternal experience of psychological abuse and maternal authority-control predicted children's observed behavior, over and above child characteristics. An ecological framework for understanding the effects of domestic violence on parenting was supported.

Gender, power, and violence: assessing the family stereotypes of the children of batterers.

Two hundred twenty one children, ages 6 to 12 years, in families with varying levels of domestic violence rated how much they agreed with 40 items concerning stereotyped beliefs about power and violence in the family. Varimax analyses yielded 4 factors; Male Power, Female Power, Violence Privilege, and Family Autonomy. Internal reliability and construct validity for the Family Stereotypes Card Sort were evaluated. Significant positive associations were found among physical violence and emotional abuse reported by the mother and family role stereotyping in the child. Family role stereotyping and beliefs in the acceptability of family violence differed by gender and ethnic minority status and varied by age and income but not by the level of adjustment problems in the child.

Surviving poverty: stress and coping in the lives of housed and homeless mothers.

Stress, coping, and depressed mood were examined in a sample of 64 homeless mothers and a comparison group of 59 housed low-income mothers. Homeless mothers reported significantly higher levels of stress and depression, as well as greater use of avoidant and active-cognitive coping strategies, than did the housed mothers. Within-group analyses revealed an association between greater use of avoidant strategies and higher levels of reported depression for both groups. Implications for research and program development are discussed.

Building an empowerment policy paradigm: self-reported strengths of homeless mothers.

Self-reported strengths and goals of a sample of 64 mothers of young children residing in a temporary shelter for homeless families, were documented. The strengths most frequently reported included ability to take action, parental competence, and determination in the face of stress. Program and policy implications of these positive attributes of homeless mothers are discussed.

The assessment of childhood sibling relationships: varying perspectives on cooperation and conflict.

The levels of cooperation and conflict in the relationships of 40 sibling pairs, 11 to 14 years old, were explored from several different perspectives. Ratings of levels of cooperation and conflict in the sibling relationship were obtained from the participants, siblings, and mothers. Amounts of cooperation and conflict were also coded from responses to a projective story test that elicited perceptions of the relationship from each child, and from their conjoint performance on three interactive tasks. Either child's perspective on the sibling relationship evidenced more conflict and less cooperation relative to maternal evaluations. Interactive tasks revealed more cooperation, whereas projective stories revealed more conflict for these siblings. In addition, levels of cooperation varied by sex, birth order, and dyad type, whereas conflict levels differed only by dyad type.

Children in homeless families: risks to mental health and development.

This study examined the psychological adjustment of 159 homeless children in comparison with a sample of 62 low-income children living at home. In each group, ages ranged from 8 to 17 years. As expected, homeless children were found to have greater recent stress exposure than housed poor children, as well as more disrupted schooling and friendships. Child behavior problems were above normative levels for homeless children, particularly for antisocial behavior. Across the 2 samples, however, behavior problems were more related to parental distress, cumulative risk status, and recent adversity than to housing status or income. Results suggest that homeless children share many of the risks and problems of other American children being reared in poverty.

Siblings in dyads: relationships among perceptions and behavior.

The ways in which middle-childhood siblings perceive themselves as similar or different was assessed with a sample of 40 pairs of 9- to 11-year-old (younger) and 12- to 14-year-old (older) siblings. Each child was interviewed and completed a card sort procedure and a measure of self-competence. Sibling pairs participated in three behavioral tasks coded for cooperation and conflict. Self-ratings, self-perceptions, and sibling behavior were analyzed for their association with the perceived similarity construct. Siblings perceived themselves as being more like one another than did their mothers. Forty-one percent of the variance in their perceived similarity was accounted for by paired self-cooperation ratings, social competence, and behavioral task scores.