Karmel W Choi1,2,3, Christy A Denckla4, Nadia Hoffman5, Shrish Budree6,7, Liz Goddard6,7, Heather J Zar6,7, Micky Stern5, Dan J Stein8,9. 1. Department of Psychiatry, Massachusetts General Hospital, Boston, USA. kwchoi@mgh.harvard.edu. 2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA. kwchoi@mgh.harvard.edu. 3. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA. kwchoi@mgh.harvard.edu. 4. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA. 5. Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital J2, Anzio Road, Observatory, Cape Town, 7925, South Africa. 6. Unit on Child and Adolescent Health, South African Medical Research Council, Cape Town, South Africa. 7. Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa. 8. Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital J2, Anzio Road, Observatory, Cape Town, 7925, South Africa. dan.stein@uct.ac.za. 9. Research Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council, Cape Town, South Africa. dan.stein@uct.ac.za.
Abstract
INTRODUCTION: Mothers who have experienced childhood trauma may be at increased risk for disruptions in caregiving behavior, with potential consequences for early child development. However, assessments of caregiving behavior tend to be self-reported, which may bias results, and have been limited in lower-resource settings. METHODS: In an overall sample of 256 South African mothers followed across the perinatal period, this longitudinal study used structural equation modeling to test pathways of association between maternal childhood trauma and depressive symptoms on observed mother-infant interactions at 3.5 months and subsequent child growth outcomes at 1 year. RESULTS: On average, mothers with childhood trauma histories tended to show lower rated overall interactions with their infants (B = - 0.16, p = .013), which in turn was associated with reduced child growth at 1 year (B = 0.17, p = .046). When this model was adjusted for maternal age and relative socioeconomic status (SES), maternal SES strongly explained child growth (B = 0.31, p < .001) such that the direct effect of mother-infant interactions was no longer significant. DISCUSSION: For child growth in a lower-resource setting, quality of mother-infant interactions could be a relevant predictor but more strongly explained by maternal SES factors, suggesting a need for broader approaches that not only improve dyadic relationships but also address maternal ecological resources.
INTRODUCTION: Mothers who have experienced childhood trauma may be at increased risk for disruptions in caregiving behavior, with potential consequences for early child development. However, assessments of caregiving behavior tend to be self-reported, which may bias results, and have been limited in lower-resource settings. METHODS: In an overall sample of 256 South African mothers followed across the perinatal period, this longitudinal study used structural equation modeling to test pathways of association between maternal childhood trauma and depressive symptoms on observed mother-infant interactions at 3.5 months and subsequent child growth outcomes at 1 year. RESULTS: On average, mothers with childhood trauma histories tended to show lower rated overall interactions with their infants (B = - 0.16, p = .013), which in turn was associated with reduced child growth at 1 year (B = 0.17, p = .046). When this model was adjusted for maternal age and relative socioeconomic status (SES), maternal SES strongly explained child growth (B = 0.31, p < .001) such that the direct effect of mother-infant interactions was no longer significant. DISCUSSION: For child growth in a lower-resource setting, quality of mother-infant interactions could be a relevant predictor but more strongly explained by maternal SES factors, suggesting a need for broader approaches that not only improve dyadic relationships but also address maternal ecological resources.
Authors: Nancy K Grote; Jeffrey A Bridge; Amelia R Gavin; Jennifer L Melville; Satish Iyengar; Wayne J Katon Journal: Arch Gen Psychiatry Date: 2010-10
Authors: Kirsten A Donald; Michelle Hoogenhout; Christopher P du Plooy; Catherine J Wedderburn; Raymond T Nhapi; Whitney Barnett; Nadia Hoffman; Susan Malcolm-Smith; Heather J Zar; Dan J Stein Journal: BMJ Paediatr Open Date: 2018-06-13