Catherine Chamberlain1,2,3, Graham Gee4, Stephen Harfield5,6,7, Sandra Campbell8,9, Sue Brennan3, Yvonne Clark1,10,11, Fiona Mensah2,12,13, Kerry Arabena14, Helen Herrman15,16, Stephanie Brown2,11,13,17. 1. Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia. 2. Murdoch Children's Research Institute, Melbourne, Victoria, Australia. 3. School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 4. Victorian Aboriginal Health Service, Melbourne, Victoria, Australia. 5. Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. 6. School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia. 7. Sansom Institute for Health Research, The University of South Australia, Adelaide, South Australia, Australia. 8. Centre for Chronic Disease Prevention, James Cook University, Cairns, Queensland, Australia. 9. Centre for Indigenous Health Equity Research, Central Queensland University, Cairns, Queensland, Australia. 10. School of Psychology, University of Adelaide, Hughes, Adelaide, South Australia, Australia. 11. South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. 12. Royal Children's Hospital, Melbourne, Victoria, Australia. 13. Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia. 14. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. 15. Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia. 16. Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. 17. Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia.
Abstract
BACKGROUND AND AIMS: Child maltreatment is a global health priority affecting up to half of all children worldwide, with profound and ongoing impacts on physical, social and emotional wellbeing. The perinatal period (pregnancy to two years postpartum) is critical for parents with a history of childhood maltreatment. Parents may experience 'triggering' of trauma responses during perinatal care or caring for their distressed infant. The long-lasting relational effects may impede the capacity of parents to nurture their children and lead to intergenerational cycles of trauma. Conversely, the perinatal period offers a unique life-course opportunity for parental healing and prevention of child maltreatment. This scoping review aims to map perinatal evidence regarding theories, intergenerational pathways, parents' views, interventions and measurement tools involving parents with a history of maltreatment in their own childhoods. METHODS AND RESULTS: We searched Medline, Psychinfo, Cinahl and Embase to 30/11/2016. We screened 6701 articles and included 55 studies (74 articles) involving more than 20,000 parents. Most studies were conducted in the United States (42/55) and involved mothers only (43/55). Theoretical constructs include: attachment, social learning, relational-developmental systems, family-systems and anger theories; 'hidden trauma', resilience, post-traumatic growth; and 'Child Sexual Assault Healing' and socioecological models. Observational studies illustrate sociodemographic and mental health protective and risk factors that mediate/moderate intergenerational pathways to parental and child wellbeing. Qualitative studies provide rich descriptions of parental experiences and views about healing strategies and support. We found no specific perinatal interventions for parents with childhood maltreatment histories. However, several parenting interventions included elements which address parental history, and these reported positive effects on parent wellbeing. We found twenty-two assessment tools for identifying parental childhood maltreatment history or impact. CONCLUSIONS: Perinatal evidence is available to inform development of strategies to support parents with a history of child maltreatment. However, there is a paucity of applied evidence and evidence involving fathers and Indigenous parents.
BACKGROUND AND AIMS: Child maltreatment is a global health priority affecting up to half of all children worldwide, with profound and ongoing impacts on physical, social and emotional wellbeing. The perinatal period (pregnancy to two years postpartum) is critical for parents with a history of childhood maltreatment. Parents may experience 'triggering' of trauma responses during perinatal care or caring for their distressed infant. The long-lasting relational effects may impede the capacity of parents to nurture their children and lead to intergenerational cycles of trauma. Conversely, the perinatal period offers a unique life-course opportunity for parental healing and prevention of child maltreatment. This scoping review aims to map perinatal evidence regarding theories, intergenerational pathways, parents' views, interventions and measurement tools involving parents with a history of maltreatment in their own childhoods. METHODS AND RESULTS: We searched Medline, Psychinfo, Cinahl and Embase to 30/11/2016. We screened 6701 articles and included 55 studies (74 articles) involving more than 20,000 parents. Most studies were conducted in the United States (42/55) and involved mothers only (43/55). Theoretical constructs include: attachment, social learning, relational-developmental systems, family-systems and anger theories; 'hidden trauma', resilience, post-traumatic growth; and 'Child Sexual Assault Healing' and socioecological models. Observational studies illustrate sociodemographic and mental health protective and risk factors that mediate/moderate intergenerational pathways to parental and child wellbeing. Qualitative studies provide rich descriptions of parental experiences and views about healing strategies and support. We found no specific perinatal interventions for parents with childhood maltreatment histories. However, several parenting interventions included elements which address parental history, and these reported positive effects on parent wellbeing. We found twenty-two assessment tools for identifying parental childhood maltreatment history or impact. CONCLUSIONS: Perinatal evidence is available to inform development of strategies to support parents with a history of child maltreatment. However, there is a paucity of applied evidence and evidence involving fathers and Indigenous parents.
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