Maternal social support patterns and child maltreatment: comparison of maltreating and nonmaltreating mothers

Maternal Caregiving Practices and Child Abuse Experiences as Developmental Antecedents to Insecure Attachments: Differential Pathways Between Adolescents Who Commit Sexual and Non-Sexual Crimes

Grady, Levenson, and Bolder's etiological framework contextualizes sexual offending behaviors through a trauma and attachment lens to suggest child abuse experiences (CAE) are associated with attachment problems that contribute to sexual offending. To empirically test a portion of this theory, this cross-sectional study employed a structural equation mediated-moderated model on a sample of juvenile justice-involved youth (N = 505) who committed sexual (n = 355) and non-sexual (n = 150) offenses. Results revealed a good model fit and statistically significant direct effects between maternal harsh and indifferent caregiving styles and insecure attachment. However, CEAs did not mediate the relationship between caregiving styles and insecure attachment. Results also revealed a moderation effect whereby youth who commit sexual crimes who report harsher and more indifferent maternal caregiving styles were more likely to have higher CAEs relative to youth who commit non-sexual crimes. Implications are discussed using a public health perspective of prevention.

The association between perceived injunctive norms toward corporal punishment, parenting support, and risk for child physical abuse

The use of corporal punishment (CP) is a strong risk factor for many poor outcomes for children including child maltreatment. The use of CP occurs within social contexts which are important to understand. Although it is known that perceived social norms regarding CP are related to its use, the specific role that a mother's primary support person plays in influencing attitudes toward and use of CP remains unknown. The current study assessed linkages between maternal perceived social support in parenting and perceived injunctive norms of CP from her primary source of support, with maternal attitudes toward and use of CP. Survey data were collected from female primary caregivers (N = 436) of children age 2 to 7 years (mean age = 3.7) enrolled in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinics in Southeastern Louisiana. Most frequently, the biological father of the child (37.9%) and the maternal grandmother of the child (24.2%) were identified as the participant's primary source of social support in parenting. Perceived injunctive norms of this support person toward CP use were significantly and positively associated with attitudes toward, AOR = 5.97, 95% CI = [4.04, 8.82], and use of CP, AOR = 3.77, 95% CI = [2.55, 5.59]. However, perceived social support was not associated with these outcomes and also did not moderate these associations. Findings suggest that efforts to reduce maternal risk for child physical abuse and use of CP must include the mother's primary source of social support if they are to be successful.

A Randomized Trial of Home Visitation for CPS-Involved Families: The Moderating Impact of Maternal Depression and CPS History

Home visitation (HV) interventions may hold promise to improve parenting and prevent child maltreatment recidivism in families reported to child protective services (CPS) with young children, but this has rarely been studied. Findings are presented from an 18-month randomized controlled trial in which intact families ( N = 122) with at least one CPS report were provided with a facilitated connection to a paraprofessional evidence-based HV program or usual care services from child protection. Results are reported for changes in maternal stress, depression, and social support outcomes and repeat reports to CPS. No significant changes were found in maternal outcomes by group. Among nondepressed mothers or families without multiple CPS reports prior to study enrollment, HV was associated with a significantly lower likelihood of CPS report recidivism. These results indicate potential for HV to prevent maltreatment recidivism but suggest that higher intensity intervention is warranted for mothers exhibiting significant depressive symptoms or families with extensive CPS histories.

Individual and contextual factors for the child abuse potential of Croatian mothers: The role of social support in times of economic hardship

The study assessed mothers' risk for abusing their children in middle adolescence in relation to individual and contextual factors during the economic crisis in Croatia. Socioeconomic status of mothers, family economic pressure, and mothers' exposure to stress were measured. Special attention was given to the perceived availability of social support as one of protective factors potentially buffering the negative impact of risks of child abuse. The community sample included 746 mothers (Mage = 42.85; SDage = 5.319). The results showed that the risk of child abuse is higher for mothers with lower education, those who perceive themselves as suffering greater family economic hardship, those who have experienced a higher number of stressful events, and those with lower social support. When the mothers perceive a lower availability of social support, the effects of exposure to cumulative risk, namely the combination of socioeconomic status, economic pressure, and exposure to stress, are stronger. Since social support proved to be one of the key protective factors in the relationship between adverse life circumstances and parenting, the development of effective and non-stigmatized interventions aiming to increase social support, positive social relationships, and adequate parenting practices for parents facing economic hardship is an important direction for future family policy measures.

Intergenerational pathways leading to foster care placement of foster care alumni's children

This study examined a path model that postulated intergenerational relationships between biological parent psychosocial functioning and foster care alumni mental health, economic status, and social support; and from these to the likelihood of children of foster care alumni being placed in foster care. The sample included 742 adults who spent time in foster care as children with a private foster care agency and who reported having at least one biological child. A full pathway was found between poorer father's functioning to greater alumni depression, which was in turn associated with negative social support, and then a greater likelihood of child out of home placement. Other parent to alumni paths were that poorer father functioning was associated with alumni anxiety and PTSD, and poorer mother's mental health was associated with PTSD; however, anxiety and PTSD were not implicated as precursors of foster care placement of the child. Findings support the need for increased practice and policy support to address the mental health needs of parents of children in or at risk of foster care, as well as the children themselves, as family history may have a lasting influence on quality of life, even when children are raised apart from biological parents.

Resilience in families raising children with disabilities and behavior problems

The purpose of this study was to investigate the resilience displayed by families raising children with disabilities and behavior problems. The question is why do some families do well when others, exposed to similar stressors, struggle to keep their family life running? A stratified (by child age group) random sample of 538 families raising children with disabilities in Alberta, Canada took part. Participants completed the Family Life Survey, which incorporated measures of child behavior problems, social-ecological resources and family-level 'outcomes'. Families raising children with disabilities and behavior problems 'do well' under conditions of high social support and low financial hardship. In contrast, families with low levels of social support and high levels of financial hardship typically struggle, even when the number or intensity of child behavior problems is low. The study findings are consistent with the view that 'resilience' has more to do with the availability and accessibility of culturally relevant resources than with intrinsic, individual or family factors. With respect to family-level outcomes, strengthening social relationships and ameliorating financial hardship may be more important than behavior modification.

Mothers' experiences in the Nurse-Family Partnership program: a qualitative case study

Background

Few studies have explored the experiences of low income mothers participating in nurse home visiting programs. Our study explores and describes mothers' experiences participating in the Nurse-Family Partnership (NFP) Program, an intensive home visiting program with demonstrated effectiveness, from the time of program entry before 29 weeks gestation until their infant's first birthday.

Methods

A qualitative case study approach was implemented. A purposeful sample of 18 low income, young first time mothers participating in a pilot study of the NFP program in Hamilton, Ontario, Canada partook in one to two face to face in-depth interviews exploring their experiences in the program. All interviews were digitally recorded and transcribed verbatim. Conventional content analysis procedures were used to analyze all interviews. Data collection and initial analysis were implemented concurrently.

Results

The mothers participating in the NFP program were very positive about their experiences in the program. Three overarching themes emerged from the data: 1. Getting into the NFP program; 2. The NFP nurse is an expert, but also like a friend providing support; and 3. Participating in the NFP program is making me a better parent.

Conclusions

Our findings provide vital information to home visiting nurses and to planners of home visiting programs about mothers' perspectives on what is important to them in their relationships with their nurses, how nurses and women are able to develop positive therapeutic relationships, and how nurses respond to mothers' unique life situations while home visiting within the NFP Program. In addition our findings offer insights into why and under what circumstances low income mothers will engage in nurse home visiting and how they expect to benefit from their participation.

Prenatal representations of coparenting among unmarried first-time African American mothers

Results of semistructured interviews with 45 pregnant unmarried first-time African American mothers indicated a wide range of expectancies concerning the coparenting relationship they would develop with others once their baby arrived. Most common coparenting systems projected by respondents involved maternal grandmothers and/or the babies' fathers, though other caregivers were explicitly anticipated in a smaller number of cases. Multiperson coparenting systems were the norm, and only 2 of 45 respondents anticipated that they would be entirely on their own with no coparental system whatsoever. Qualitative analyses of mothers' narratives about postbaby coparenting systems revealed five main constructions: having thought about and anticipating coparenting, positive in outlook; having thought about and anticipating coparenting, but with mild concerns (conflict, unreliability); having thought about coparenting and anticipating limited or no support; having thought about coparenting and anticipating significant conflict and nonsupport; and having not thought much about coparenting, being neither focused on nor worried about this issue. Illustrations of each of these types are provided, and directions for family science and practice are discussed.

The Mediated and Moderated Effects of Family Support on Child Maltreatment

Previous research has linked parents' social support to decreased child maltreatment but questions remain surrounding the mechanisms explaining this association. Further, it is unclear whether this association applies to support provided by family alone (and not friends), and whether it is moderated by the presence of neighborhood violence. Based on a sample of parents of children aged 3-15 in Chicago, we find that parents' family support is associated with a lower risk of child maltreatment. This association is partly mediated by reduced parental depression, but only in neighborhoods with average or high levels of violence. In neighborhoods with low levels of violence, the inverse association between family support and maltreatment is equally strong, but it is not mediated by reduced depression.

Do social networks push families toward or away from youth mental health services?: A national study of families in child welfare

Social support networks may encourage or dissuade help-seeking for youth behavior problems in ways that contribute to racial/ethnic disparities in mental health services. We examined how parental social network characteristics were related to the use of mental health services in a diverse sample of families in contact with Child Welfare. Data from 1519 families of White (n=812), African American (n=418), and Latino (n=289) origin were drawn from the National Survey of Child and Adolescent Well-Being. Data were collected prospectively after the initiation of a Child Welfare investigation for alleged maltreatment. Results revealed that parental perceptions of support were negatively associated with service use across racial/ethnic groups, and this association was explained by better subsequent mental health status enjoyed by children of parents with stronger social support. Moderator analyses suggested that larger social networks were associated with a decreased use of services among Whites and more highly educated families.

From financial hardship to child difficulties: main and moderating effects of perceived social support

BACKGROUND

There is an unequivocal relationship between socio-economic status and child well-being. The Family Stress Model of economic hardship proposes that this relationship is mediated by financial hardship, parenting stress and parenting behaviours. In this study, the Family Stress Model is tested and analysis is extended to examine main and moderating effects of social support.

METHODS

A survey incorporating well-validated measures of financial hardship, parenting stress, parenting behaviours and child difficulties was sent to 1296 parents who had utilized universal family support services in Alberta, Canada. A total of 923 parents (71%) responded. Hierarchical linear regression was employed to investigate the mediating roles of financial hardship, parenting stress and parenting behaviours, and to investigate main and moderating influences of parental social support.

RESULTS

The study findings generally support the Family Stress Model. The relationship between socio-economic status and child difficulties was mediated by financial hardship and parenting stress. Higher levels of parental social support were associated with lower levels of parenting stress, ineffective parenting and child difficulties. Parental social support was important irrespective of parenting stress levels.

CONCLUSIONS

The study findings add to the now critical mass of data showing that parent-child health and well-being is inextricably linked with parental social support. While there is a burgeoning literature on parent training, far less research attention has been given to the development and evaluation of strategies to strengthen parents' social relationships. This is an important direction for future research.

Trajectories of maternal harsh parenting in the first 3 years of life

OBJECTIVE

Despite the high prevalence rates of harsh parenting, the nature of developmental change in this domain early in life and the factors that contribute to changes in harsh parenting over time are not well understood. The present study examined developmental patterns in maternal harsh parenting behavior from birth to age 3 years and their related longitudinal risk factors (contextual and intrapersonal). Partner aggression was also tested as a time-varying predictor to examine its time-specific influence on maternal harsh parenting.

METHODS

Longitudinal data from 4 assessments of a community sample of 488 at-risk mothers were analyzed using latent growth curve modeling. Maternal risk factors and harsh parenting behaviors were assessed at birth and at ages 1, 2, and 3 years.

RESULTS

There was a significant increase in maternal harsh parenting from birth to age 3, particularly between ages 1 and 2. There was a significant direct effect of maternal alcohol use and abuse history on maternal harsh parenting at age 3, and maternal age was positively associated with change in maternal harsh parenting over time. In addition, partner aggression was significantly and positively associated with maternal harsh parenting at each time point.

CONCLUSIONS

The findings suggest possible developmental trends in the emergence of maternal harsh parenting during infancy and toddlerhood. Further investigation is needed to elucidate individual differences in the developmental patterns and to differentiate predictive factors that persist across time and factors that are unique to specific developmental stages.

PRACTICE IMPLICATIONS

The overall high prevalence rates of harsh parenting behavior and growth of such behavior in infancy and toddlerhood support the need for developmentally sensitive early intervention programs.

Parent--child relationship and mother's sexual assault history

Although there is clinical conjecture regarding the effects of maternal trauma on parent- child relationships, research is scarce and this area remains to be explored. In a domestic violence sample, there was significant reduction in quality of parent-child relationships when the mother had experienced sexual assault or rape during adulthood. There was no correlation between the mother's history of childhood sexual assault or rape and parent-child relationship. Survivors of sexual assault may be best served through interventions that utilize relational models. Family-based interventions may be particularly effective in addressing problems in parent-child relationships stemming from the mother's trauma history.

Complications during pregnancy, peri- and postnatal period in a sample of women with a history of child abuse

BACKGROUND

As a proposed risk factor for infant and child development, maternal history of abuse has been a frequent target of investigation. However, there have been no controlled studies about the impact of maternal history of abuse on the medical course of pregnancy, the peri- and postnatal period.

METHOD

All women with a newborn child were contacted by mail and presented with the Childhood Trauma Questionnaire (CTQ). The index group (n = 58) was formed by women who scored above the cutoff for moderate or severe abuse and compared to a control group (n = 60) with regard to pre,- peri-, and postnatal complications as documented in the patient charts.

RESULTS

The results show that women with a history of abuse have significantly more prenatal medical complications and infant medical complications in the post- but not perinatal period.

CONCLUSIONS

Maternal history of abuse significantly impacts the medical course of delivery and the puerperium. Given the prevalence of abusive experiences, this finding is highly relevant from a preventive point of view.

Social support and resilience to stress across the life span: a neurobiologic framework

This review discusses selected neurobiologic and genetic factors-including noradrenergic and hypothalamic-pituitary-adrenal axis markers, oxytocin pathways, and serotonin transporter and brain-derived neurotrophic factor gene polymorphisms-in the context of resilience to stress, with an emphasis on social support. Social support's impact on medical and psychiatric health outcomes is reviewed, and putative mediators are discussed. The reviewed literature indicates that social support is exceptionally important to maintaining good physical and psychological health in the presence of genetic, developmental, and other environmental risks. Future studies should continue to explore the neurobiologic factors associated with social support's contribution to stress resilience.

Psychosocial and behavioral factors related to the post-partum placements of infants born to cocaine-using women

OBJECTIVE

One objective was to determine if cocaine-using women who did not maintain infant custody (NMC) would report more psychological distress, domestic violence, negative coping skills, lower social support and more childhood trauma than cocaine-using women who maintained custody (MC) of their infant. A second objective was to evaluate the relative contribution of psychosocial factors to infant placement.

METHODS

Psychosocial profiles of MC women (n=144) were compared with NMC (n=66) cocaine-using women. Subjects were low income, urban, African-American women who delivered an infant at a county teaching hospital. The Brief Symptom Inventory (BSI), an assessment of coping strategies (COPE), Multidimensional Scale of Perceived Social Support (MSPSS), Conflict Tactics Scale (CTS) and Childhood Trauma Questionnaire (CTQ) were administered. The associations of infant placement status to demographic factors, drug use and psychosocial measures were evaluated.

RESULTS

The NMC group reported greater overall psychological distress, psychoticism, somatization, anxiety and hostility than the MC group. The NMC group had more childhood neglect and physical abuse and used more negative coping strategies than the MC group. Lack of prenatal care [OR=.83, CI (.75-.91), p<.0001], heavier prenatal cocaine use [OR=2.55, CI (1.13-4.34), p<.007], greater psychological distress [OR=2.21, CI (1.13-4.34), p<.02] and a childhood history of emotional neglect [OR=1.10, CI (1.02-1.19), p<.02] were associated with increased likelihood of loss of infant custody after control for other substance use and demographic variables.

CONCLUSIONS

NMC women have more negative psychological and behavioral functioning post-partum than MC women. Less prenatal care and greater cocaine use, psychological distress and maternal childhood emotional neglect are associated with the post-partum placement of infants born to cocaine-using women.

PRACTICE IMPLICATIONS

Results of this study indicate that poor, urban women who use cocaine prenatally display several measurable differences on psychosocial and behavioral risk factors based on child placement status. Among these risk factors heavier cocaine use, lack of prenatal care, more severe psychological symptoms and early childhood experiences of emotional neglect increase the likelihood of loss of infant custody. Routine, objective assessments of psychosocial and behavioral characteristics of women who use cocaine during pregnancy can aid Child Protective Service workers and clinicians by providing baseline data from which to tailor interventions and set improvement criteria for mother-child reunification.

Collaboration between child welfare and substance-abuse fields: combined treatment programs for mothers

OBJECTIVE

To review collaboration between child welfare and drug-abuse fields in providing treatment to mothers who abuse drugs and maltreat their children.

METHODS

Literature review of studies examining effects of maternal drug abuse on parenting skills and outcomes of interventions for both maternal drug abuse and parenting skills.

RESULTS

Parenting skills differ between mothers who do and do not abuse drugs, but these studies are primarily limited to mothers of infants and preschoolers. The evidence base for interventions to address both substance use and parenting in these mothers is growing, but more well-controlled studies are needed. Opportunities for improved collaboration between fields are presented.

CONCLUSION

Progress has been made toward collaboration to address drug abuse and parenting skills of mothers who abuse drugs, but more integrated strategies are needed, especially for mothers who use drugs and maltreat their children.

Genetic and Environmental Processes in Young Children's Resilience and Vulnerability to Socioeconomic Deprivation

Some children exposed to socioeconomic (SES) deprivation are resilient and function better than expected, given the level of deprivation they have experienced. The present study tested genetic and environmental contributions to young children's resilience and vulnerability to SES deprivation. Children's resilience was assessed by the difference between their actual score and the score predicted by their level of SES deprivation in the E-Risk Study, an epidemiological cohort of 1,116 five-year-old twin pairs. Consistent with previous research, results showed that maternal warmth, stimulating activities, and children's outgoing temperament appeared to promote positive adjustment in children exposed to SES deprivation. Findings add new information by demonstrating that resilience is partly heritable and that protective processes operate through both genetic and environmental effects.

Child abuse victims' involvement in community agency treatment: service correlates, short-term outcomes, and relationship to reabuse

This study examines the correlates and impacts of child treatment in 68 cases referred to community agency providers after reports of child physical or sexual abuse. Standardized clinical assessments were conducted with child victims and their caregivers at intake and short-term follow-up (FUP-1), supplemented by official record reviews at a long-term follow-up (FUP-2). Child treatment was received by 19% and 50% of the children at FUP-1 and FUP-2, respectively. There were few correlates of initial child treatment involvement (sexual abuse or parent and family services received concurrently). Initial child treatment was not associated with significant gains in child outcomes. Child improvement in abuse-related outcomes was associated with post-traumatic stress disorder and lower adjustment at intake. Initial child treatment was unrelated to reabuse or out-of-home placement by FUP-2. Additional studies are needed to more fully evaluate the process and outcome of referral of child abuse victims to community-based services.

Social and Professional Support for Pregnant and Parenting Women

PURPOSE

A literature review to contrast the role of social and professional support in improving maternal and infant outcomes in pregnant and parenting women. In addition, recommendations are made for future research and policy and program development concerning support needed by pregnant and parenting women.

DATA SOURCES

Data were limited to published studies. Searches of computerized databases, hand searches of journals, and backward searches from reference lists of studies were conducted. Nursing, medicine, psychology, public health, sociology, and social work literatures were searched (CINAHL, Medline, PsychLit, Social Sciences Abstracts, Social Sciences Citation, and Social Work Abstracts).

STUDY SELECTION

The studies focused on outcomes of social support and professional support to pregnant and parenting women. The samples of the studies included pregnant women and parenting women up to 2 years postpartum. Studies reviewed were conducted in the United States or Canada and included maternal and/or infant outcomes. All ages and races of pregnant and parenting women were considered.

DATA EXTRACTION

Data were extracted from each study concerning the theoretical framework, variables, sample, design, measuring instruments, interventions, and outcomes.

DATA SYNTHESIS

Social support outcomes were summarized in paragraphs while a table was used to summarize professional support intervention outcomes.

CONCLUSIONS

Outcomes associated with specific support interventions should be clearly identified, informed by theory, and include assisting the pregnant and parenting woman to improve her social support.

A comparison of abusive and nonabusive mothers of abused children

A majority of the approximately 240,000 children in this country who were physically maltreated in 1997 live with their mothers, regardless of whether their mothers committed the abuse. This study compared service use and functioning at intake for families of physically abused children as a function of the mother's offender status. Analyses found few differences in the initial functioning and subsequent services received by abusive and nonabusive mothers and their children. Abusive mothers did receive fewer services overall and were significantly less likely to receive individual parent services as compared to nonabusive mothers. This was true, despite abusive mothers receiving less positive parent ratings by their children at intake as compared to nonabusive mothers. Results from this study highlight the similarities among abusive families, whether or not the mother perpetrated the abuse. Future research should include abusive families in the control group to have the greatest impact on developing effective identification and prevention programs. These results also emphasize the importance of collecting data from multiple informants. The only significant difference in maternal functioning was found on a child-completed rating. Mothers involved in child protective services may be less likely to reveal negative information about their own functioning.

Parent stress and coping in relation to child ADHD severity and associated child disruptive behavior problems

Examined parent role distress and coping in relation to childhood attention deficit hyperactivity disorder (ADHD) in mothers and fathers of 66 children age 7 to 11 (42 boys, 24 girls; mean age = 10.2). Parents of children with ADHD combined and inattentive subtypes expressed more role dissatisfaction than parents of control children. Parents of ADHD combined and inattentive type children did not differ significantly in levels of distress. For mothers, child inattention and oppositional-conduct problems but not hyperactivity contributed uniquely to role distress (dissatisfaction related to parenting or parenting performance). For fathers, parenting role distress was associated uniquely with child oppositional or aggressive behaviors but not with ADHD symptom severity. Parent coping by more use of positive reframing (thinking about problems as challenges that might be overcome) was associated with higher role satisfaction for both mothers and fathers. Community supports were associated with higher distress for mothers only.

The relationship between familism and child maltreatment in Latino and Anglo families

Familism, or familismo, refers to attitudes, behaviors, and family structures operating within an extended family system and is believed to be the most important factor influencing the lives of Latinos. Because of the complexity of the construct, this article begins by separating out and defining each dimension of familism, and then clarifies its relationship to the broader literature on social networks, social support, and child maltreatment. The analysis tests whether each dimension of familism is related to child maltreatment within and between 35 abusive Latino, 35 nonabusive Latino, 51 abusive Anglo, and 51 nonabusive Anglo families. Nonabusing Latinas appear to have a higher level of familism than the other three groups of mothers. However; when intraethnic comparisons were made, nonabusive Anglos, compared with abusive Anglos, had higher levels of familism on several variables. Hence, familism seems to characterize families--Latino and Anglo--who do not maltreat their children.

Children in foster care: a nursing perspective on research, policy, and child health issues

ISSUES AND PURPOSE

To examine the roles of public policy and poverty on the rising number of children in family foster care, and to examine the impact of different types of family foster care on children's well-being.

CONCLUSIONS

Recent changes in welfare legislation increase the likelihood of family poverty, with a subsequent increase in the number of children in out-of-home care. Greater emphasis needs to be placed on preventing entry into out-of-home care, improving the quality of foster care, and giving children a voice in care decisions.

PRACTICE IMPLICATIONS

Nurses have important roles to play in the prevention of family dissolution, the design of healthcare delivery systems for children in foster care, in evaluating and educating all types of foster families, and as advocates in legal and legislative proceedings.