Adverse Childhood Experiences and Mental Health among Women Experiencing Intimate Partner Violence.
Yang Li, Kayla Herbell, Tina Bloom and 2 others
PMID 32401637WHAT IT FOUND
Pregnant women experiencing partner violence frequently reported childhood abuse and household trauma.
Childhood sexual assault and physical abuse were associated with more severe trauma symptoms, while some other childhood experiences were unexpectedly associated with lower symptoms.
Key findings
01In the 87 women analyzed, more than 70% reported parental separation or divorce, over 40% reported childhood sexual assault, 40% said their mothers were treated violently, and over half had three or more ACE types.
02Childhood sexual assault was associated with higher depression scores, but not after current intimate partner violence severity was added; childhood physical abuse and sexual assault were associated with higher PTSD scores.
03Childhood emotional neglect and parental separation or divorce were associated with lower depression scores, and emotional neglect and an incarcerated household member were associated with lower PTSD scores.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a secondary analysis of baseline data from a randomized trial, not a new trial testing an intervention. ACEs were not measured with a standard checklist at baseline; they were identified from open-ended interview statements and field notes, so some ACEs may have been missed. The analysis included 87 of the 239 DOVE participants, and ACE data came only from women who completed both the baseline survey and interview. The associations are cross-sectional, so they do not show that childhood trauma caused current depression or PTSD symptoms. Several unexpected negative associations were found, and the authors suggest they may reflect underreporting, differing perceptions of trauma, or the fact that most participants had multiple severe ACEs. The sample was limited to English-speaking pregnant women in a perinatal home-visiting program who had recent IPV, so findings may not apply to other settings or populations.
Declared interests
The DOVE study was funded by NIH/NR009093; the article text provided does not state author conflicts of interest.
The easy way to misread this
Do not conclude that routine ACE screening or trauma-focused discussion will improve mental health outcomes in pregnant women with IPV. This paper reports associations from a secondary analysis, ACEs were not measured with a standard checklist, and no intervention effect was tested.