Abstract: Predicting Perinatal Depression in Low-Income Adolescent Mothers: The Role of Interpersonal Trauma and Polytraumatization (Society for Social Work and Research 20th Annual Conference - Grand Challenges for Social Work: Setting a Research Agenda for the Future)

Schedule:

Saturday, January 16, 2016: 8:00 AM

Meeting Room Level-Franklin Square (Renaissance Washington, DC Downtown Hotel)

* noted as presenting author

Candace Killian-Farrell, LCSW, MSSW, Doctoral Candidate, University of North Carolina at Chapel Hill, Chapel Hill, NC

Cynthia Fraga Rizo, PhD, Assistant Professor, University of North Carolina at Chapel Hill, Chapel Hill, NC

Brianna M. Lombardi, MSW, Doctoral Student, University of North Carolina at Chapel Hill, Chapel Hill, NC

Sarah E. Bledsoe, PhD, MSW, MPhil, Associate Professor, University of North Carolina at Chapel Hill, Chapel Hill, NC

Samantha Meltzer-Brody, MD, MPH, Associate Professor, University of North Carolina at Chapel Hill, Chapel Hill, NC

Background:

Childhood interpersonal trauma, intimate partner violence (IPV), and perinatal depression (PND) have been linked to negative proximal and distal outcomes for both the mother and child including low infant birth weight, impaired maternal bonding, and adverse infant neurodevelopmental outcomes. Considerable research supports relationships between childhood maltreatment, IPV, and PND in adolescent and adult women. However, considerably less is known about the specific domains of IPV, childhood trauma subtypes, and childhood loss. The impact of experiencing multiple domains of childhood interpersonal trauma (polytraumatization) on the development of PND has been practically ignored despite recent findings that over 64% of adolescent mothers endorse multiple domains of childhood interpersonal trauma. This prospective longitudinal study addresses this gap by deconstructing IPV, childhood maltreatment, and early interpersonal trauma experiences, and by examining the impact of polytraumatization to test specific relationships between these risk factors and PND in adolescent mothers.

Methods:

A sample of 224 adolescents aged 14-20 years was recruited from a public health prenatal clinic. Depression, childhood trauma history, and IPV were measured prenatally and postpartum. Analyses examined the prevalence of PND, childhood maltreatment, IPV, childhood loss, and polytraumatization. Relationships between maltreatment subtypes, childhood loss, IPV subtypes, polytraumatization and PND were also examined using logistic regression and multiple logistic regression.

Results:

Our sample included a diverse group of adolescent mothers (55.3% Latina, 28.7% Black,16% White). Nearly 82% of subjects reported one domain of interpersonal childhood trauma. Over 75% reported IPV, 12.4% reported sexual IPV, 49.3% reported physical IPV, and 72.7% reported psychological IPV. Nearly 30% of the subjects reported caregiver loss and 28.4% reported child maltreatment. Emotional neglect was the most common form of child maltreatment (16.9%), followed by sexual abuse (10.7%), and physical abuse (8.42%). Over 64% of our sample reported experiencing multiple domains of childhood interpersonal trauma. Our final model (χ² (3)=3.972, p=0.265) indicated childhood sexual abuse (0.204, p<0.01), childhood loss (0.199, p<0.01), and sexual IPV (0.139, p=0.060) were all significantly related (or approaching significance) to PND. Polytraumatization significantly increased the risk for PND (χ² (1)=8.70, p=0.003). With every one-unit increase in the number of polytraumatization domains there is a 37% increase in the odds of experiencing PND.

Conclusions/Implications:

Results suggest childhood interpersonal trauma, and sexual trauma in particular, may be the most substantial risk factor for PND in adolescents. Experiencing more than one domain of childhood interpersonal trauma significantly increases the risk of PND. When IPV was parsed into subtypes, only the sexual subtype held a significant relationship to PND. Future research should focus on examining childhood loss and traumatic grief, as well as more specifically defining IPV and polytraumatization as risk factors. Professionals addressing the needs of this population could consider childhood loss, sexual trauma, and polytraumatization as potential targets for practice and policy change. Overall, the high prevalence of trauma exposure in this population suggests that all adolescent mothers should be screened for interpersonal trauma history and any intervention targeting this population should include a trauma component to enhance outcomes for adolescent mothers and their offspring.