Peripartum dissociation, sense of control, postpartum posttraumatic stress disorder and emotional adjustment to motherhood in adult survivors of childhood maltreatment.

Adjustment to Motherhood Adverse childhood experiences Dissociation Peritraumatic reactions Postpartum PTSD

Journal

Archives of women's mental health
ISSN: 1435-1102
Titre abrégé: Arch Womens Ment Health
Pays: Austria
ID NLM: 9815663

Informations de publication

Date de publication:
18 Oct 2023
Historique:
received: 25 06 2023
accepted: 07 10 2023
medline: 18 10 2023
pubmed: 18 10 2023
entrez: 18 10 2023
Statut: aheadofprint

Résumé

Survivors of childhood maltreatment (CM) may experience difficulties in the peripartum period and in adjustment to motherhood. In this study we examined a model wherein CM is associated with maternal self-efficacy and maternal bonding three months postpartum, through mediation of peripartum dissociation and reduced sense of control during childbirth and postpartum-posttraumatic-stress disorder (P-PTSD). Women were recruited in a maternity ward within 48 h of childbirth (T1, N = 440), and contacted three-months postpartum (T2, N = 295). Participants completed self-report questionnaires: peripartum dissociation, sense of control (T1), and CM, P-PTSD, postpartum-depression, maternal self-efficacy and bonding (T2). Obstetrical data were collected from medical files. Structural equation modeling was conducted to test the hypothesized model, controlling for mode of delivery and postpartum-depression. Reported CM included child emotional neglect (CEN; 23.5%), child emotional abuse (CEA; 16.3%), child sexual abuse (CSA; 12.9%) and child physical abuse (CPA; 7.1%). CM was positively associated with peripartum dissociation and P-PTSD (p < .001). Peripartum dissociation was positively associated with P-PTSD (p < .001). P-PTSD was negatively associated with maternal self-efficacy (p < .001) and maternal bonding (p < .001). Association between CM and maternal self-efficacy and bonding was serially mediated by peripartum dissociation and P-PTSD, but not by sense of control. Findings remained significant after controlling for mode of delivery and postpartum-depression. CM is a risk factor for adjustment to motherhood, owing to its effects on peripartum dissociation and P-PTSD. Implementation of a trauma-informed approach in obstetric care and recognition of peripartum dissociative reactions are warranted.

Identifiants

pubmed: 37851078
doi: 10.1007/s00737-023-01379-0
pii: 10.1007/s00737-023-01379-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.

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Auteurs

Inbal Brenner (I)

Lev-Hasharon Mental Health Center, Tzur-Moshe, Israel. inbalbrenner@gmail.com.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. inbalbrenner@gmail.com.

Karni Ginzburg (K)

Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.

Ayelet Golan (A)

Department of Obstetrics and Gynecology, Shamir-Assaf Harofeh Medical Center, Tsrifin, Israel.

May Shir Igawa (MS)

Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ido Lurie (I)

Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Shalvata Mental Health Center, Hod Hasharon, Israel.

Yael Reicher (Y)

Department of Obstetrics and Gynecology, Soroka Medical Center, Beersheba, Israel.
Ben Gurion University of the Negev, Beersheba, Israel.

Anat Talmon (A)

Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel.
Department of Psychology, Stanford University, Stanford, CA, USA.

Roni Tomashev (R)

Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Obstetrics and Gynecology, Shamir-Assaf Harofeh Medical Center, Tsrifin, Israel.

Anna Padoa (A)

Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Obstetrics and Gynecology, Shamir-Assaf Harofeh Medical Center, Tsrifin, Israel.

Classifications MeSH