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      Parenting after a history of childhood maltreatment: A scoping review and map of evidence in the perinatal period

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          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.

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          Most cited references134

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          Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health.

          To assess the utility of an acronym, place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital ("PROGRESS"), in identifying factors that stratify health opportunities and outcomes. We explored the value of PROGRESS as an equity lens to assess effects of interventions on health equity.
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            Childhood Experience of Care and Abuse (CECA): a retrospective interview measure.

            The development of a retrospective, investigator-based interview measure of Childhood Experience of Care and Abuse (CECA) used with two community samples of adults in London is described. The component ratings are shown to have satisfactory inter-rater reliability and also validity as determined by agreement between sisters' independent accounts. The association between the different childhood scales is explored as well as the relationship of childhood experiences to adult depression. Methodological issues concerning investigator-based versus respondent-based measures of childhood are discussed and a case made for use of the former. Advantages of using the CECA, a retrospective, time-based measure of childhood, are outlined.
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              National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England

              Background Epidemiological and biomedical evidence link adverse childhood experiences (ACEs) with health-harming behaviors and the development of non-communicable disease in adults. Investment in interventions to improve early life experiences requires empirical evidence on levels of childhood adversity and the proportion of HHBs potentially avoided should such adversity be addressed. Methods A nationally representative survey of English residents aged 18 to 69 (n = 3,885) was undertaken during the period April to July 2013. Individuals were categorized according to the number of ACEs experienced. Modeling identified the proportions of HHBs (early sexual initiation, unintended teenage pregnancy, smoking, binge drinking, drug use, violence victimization, violence perpetration, incarceration, poor diet, low levels of physical exercise) independently associated with ACEs at national population levels. Results Almost half (47%) of individuals experienced at least one of the nine ACEs. Prevalence of childhood sexual, physical, and verbal abuse was 6.3%, 14.8%, and 18.2% respectively (population-adjusted). After correcting for sociodemographics, ACE counts predicted all HHBs, e.g. (0 versus 4+ ACEs, adjusted odds ratios (95% confidence intervals)): smoking 3.29 (2.54 to 4.27); violence perpetration 7.71 (4.90 to 12.14); unintended teenage pregnancy 5.86 (3.93 to 8.74). Modeling suggested that 11.9% of binge drinking, 13.6% of poor diet, 22.7% of smoking, 52.0% of violence perpetration, 58.7% of heroin/crack cocaine use, and 37.6% of unintended teenage pregnancy prevalence nationally could be attributed to ACEs. Conclusions Stable and protective childhoods are critical factors in the development of resilience to health-harming behaviors in England. Interventions to reduce ACEs are available and sustainable, with nurturing childhoods supporting the adoption of health-benefiting behaviors and ultimately the provision of positive childhood environments for future generations.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: MethodologyRole: Writing – review & editing
                Role: Data curation
                Role: MethodologyRole: Writing – review & editing
                Role: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                13 March 2019
                2019
                : 14
                : 3
                : e0213460
                Affiliations
                [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 Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
                [11 ] School of Psychology, University of Adelaide, Hughes, Adelaide, South Australia, Australia
                [12 ] South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
                [13 ] Royal Children’s Hospital, Melbourne, Victoria, Australia
                [14 ] Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
                [15 ] Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
                [16 ] Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
                [17 ] Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
                [18 ] Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
                Università degli Studi di Perugia, ITALY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                [¤]

                Current address: Centre for Rural and Remote Health, James Cook University, Mount Isa Hospital Campus, Mount Isa, Queensland, Australia

                ¶ Complete membership for the ‘Healing the Past by Nurturing the Future’ group can be found in the Acknowledgments

                Author information
                http://orcid.org/0000-0003-3446-0227
                http://orcid.org/0000-0002-6283-2350
                Article
                PONE-D-18-29592
                10.1371/journal.pone.0213460
                6415835
                30865679
                e74bca1f-5ab7-4c22-965e-ed351cc739e2
                © 2019 Chamberlain et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 12 October 2018
                : 21 February 2019
                Page count
                Figures: 2, Tables: 5, Pages: 41
                Funding
                Funded by: Australian Government (AU), Cooperative research Centre Programme
                Award ID: Lowitja Institute CRC
                Award Recipient : Catherine R Chamberlain
                Funded by: National Health and Medical Research Council
                Award ID: 1088813
                Award Recipient : Catherine R Chamberlain
                Funded by: Department of Education and Training, Australian Government
                Award ID: Endeavour Award (2017)
                Award Recipient : Catherine R Chamberlain
                Funded by: Australian National Health and Medical Research Council
                Award ID: 1111160
                Award Recipient :
                Funded by: Australian National Health and Medical Research Council
                Award ID: 1103976
                Award Recipient :
                Funded by: Australian National Health and Medical Research Council
                Award ID: 1080820
                Award Recipient :
                Funded by: Victorian Government’s Operational Infrastructure Support Program
                Work on this review was supported by a grant from the Lowitja Institute Aboriginal and Torres Strait Islander Health Cooperative Research Centre (CRC). CC was supported by a National Health and Medical Research Council (NHMRC) Early Career Fellowship (1088813), and Australian Endeavour Award (2017). FM was supported by NHMRC Career Development Fellowship (1111160). SB was supported by an NHMRC Research Fellowship (1103976). HH was supported by an Australian NHMRC Practitioner Fellowship (1080820). Research at MCRI is supported by the Victorian Government’s Operational Infrastructure Support Program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
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                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                Traumatic Injury Risk Factors
                Child Abuse
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                Public and Occupational Health
                Traumatic Injury Risk Factors
                Child Abuse
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