The moderating effects of traumatic stress on vulnerability to emotional distress during pregnancy

Abstract

Emotional distress during pregnancy is likely influenced by both maternal history of adversity and concurrent prenatal stressors, but prospective longitudinal studies are lacking. Guided by a life span model of pregnancy health and stress sensitization theories, this study investigated the influence of intimate partner violence (IPV) during pregnancy on the association between childhood adversity and prenatal emotional distress. Participants included an urban, community-based sample of 200 pregnant women (aged 18–24) assessed annually from ages 8 to 17 for a range of adversity domains, including traumatic violence, harsh parenting, caregiver loss, and compromised parenting. Models tested both linear and nonlinear effects of adversity as well as their interactions with IPV on prenatal anxiety and depression symptoms, controlling for potential confounds such as poverty and childhood anxiety and depression. Results showed that the associations between childhood adversity and pregnancy emotional distress were moderated by prenatal IPV, supporting a life span conceptualization of pregnancy health. Patterns of interactions were nonlinear, consistent with theories conceptualizing stress sensitization through an “adaptive calibration” lens. Furthermore, results diverged based on adversity subdomain and type of prenatal IPV (physical vs. emotional abuse). Findings are discussed in the context of existing stress sensitization theories and highlight important avenues for future research and practice.

Cascades of Risk Linking Intimate Partner Violence and Adverse Childhood Experiences to Less Sensitive Caregiving During Infancy

“…Interestingly, these indirect effects were strongest for mothers who had a history of ACEs. Beyond the singular effects of one type of adversity, our findings add to the small body of literature demonstrating the multiplicative effects of ACEs and IPV on prenatal depressive symptoms (Tung et al, 2019). Results show that mothers exposed to both ACEs and IPV are at the greatest risk for experiencing depressive symptoms during pregnancy, which then increases parenting stress and ultimately less sensitive parenting of their infants.…”

“…This may ultimately manifest in clinically significant depressive symptoms, particularly during pregnancy when reproductive hormones influence the stress response (Brummelte & Galea, 2010) such that women are especially vulnerable to depression and IPV. Extant evidence shows synergistic effects of early adversity and later IPV on prenatal depressive symptoms (Tung et al, 2019). For example, Tung and colleagues (2019) found that associations between childhood adversity and emotional distress in pregnancy were moderated by prenatal IPV in a pattern consistent with stress sensitization, highlighting the importance of their multiplicative contribution to mental health.…”

Understanding links between maternal perinatal posttraumatic stress symptoms and infant socioemotional and physical health

“…Women may be especially at risk for PTSS during the perinatal period (i.e., pregnancy through 1 year postpartum; Garcia & Yim, 2017), as epidemiological data suggest that trauma exposure is heightened during this time, and PTSS are more likely to emerge, reemerge, or worsen when women are pregnant or have recently given birth (C. A. L. Cook et al., 2004; Seng et al., 2009). The onslaught of reproductive hormones during and after pregnancy are thought to make women more susceptible to stress, thereby increasing risk for psychopathology (Tung et al., 2020). This is particularly striking for mothers living in poverty, given that 14% of women facing socioeconomic adversity meet criteria for posttraumatic stress disorder (PTSD) during the perinatal period (perhaps due to greater likelihood of trauma exposure), and many more likely experience PTSS (C. A. L. Cook et al., 2004; Jain et al., 2018; Seng et al., 2009).…”

Acupuntura no estresse percebido em gestantes: um estudo de intervenção

“…O sofrimento emocional no decorrer da gestação sofre influência tanto da história materna de adversidade quanto dos estressores vivenciados no período pré-natal (6) . Dentre os fatores de risco, citam-se o histórico de violência doméstica, depressão, eventos estressantes ao longo da vida e conflitos interpessoais (4) .…”