title: The roles of resilience and childhood trauma history: main and moderating effects on postpartum maternal mental health and functioning.
abstract: OBJECTIVE
  Recently postpartum women participated to investigate main and moderating influences of resilience and childhood history of maltreatment on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), parental sense of mastery, and family functioning.
  
  
  METHODS
  At 4-months postpartum, 214 mothers (145 with a history of childhood abuse or neglect) completed interviews assessing mental health symptoms, positive functioning, resilience and trauma history. Multiple and moderated linear regression with the Connor-Davidson Resilience Scale (CD-RISC) and Childhood Trauma Questionnaires (CTQ) were conducted to assess for main and moderating effects.
  
  
  RESULTS
  Resilience, childhood trauma severity, and their interaction predicted postpartum PTSD and MDD. In mothers without childhood maltreatment, PTSD was absent irrespective of CD-RISC scores. However, for those with the highest quartile of CTQ severity, 8% of those with highest resilience in contrast with 58% of those with lowest CD-RISC scores met PTSD diagnostic criteria. Similar, in those with highest resilience, no mothers met criteria for postpartum MDD, irrespective of childhood trauma, while for those with lowest quartile of resilience, 25% with lowest CTQ severity and 68% of those with highest CTQ severity were depressed. The CD-RISC, but not the CTQ, was predictive of postpartum sense of competence. The CD-RISC and the CTQ were predictive of postpartum family functioning, though no moderating influence of resilience on childhood trauma was found.
  
  
  CONCLUSIONS
  Resilience is associated with reduced psychopathology and improved wellbeing in all mothers. It further serves as a buffer against psychiatric symptoms following childhood trauma. Such findings may assist in identification of those at greatest risk of adverse functioning postpartum, utilization of resilience-enhancing intervention may benefit perinatal wellness, and reduce intergenerational transmission of risk.
authors.affiliation: Mental Health Service, Ann Arbor Veterans Healthcare Administration, USA; Department of Psychiatry, University of Michigan, USA.
authors.forename: Minden B
authors.initials: MB
authors.lastname: Sexton
authors.affiliation: Department of Psychiatry, University of Michigan, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Hamilton
authors.affiliation: Department of Psychiatry, University of Michigan, USA.
authors.forename: Ellen W
authors.initials: EW
authors.lastname: McGinnis
authors.affiliation: Department of Psychiatry, University of Michigan, USA; Center for Human Growth and Development, University of Michigan, USA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Rosenblum
authors.affiliation: Department of Psychiatry, University of Michigan, USA; Center for Human Growth and Development, University of Michigan, USA. Electronic address: muzik@med.umich.edu.
authors.forename: Maria
authors.initials: M
authors.lastname: Muzik
mesh_terms: D000293:Adolescent; D000328:Adult; D002649:Child Abuse / Q000523:psychology*; D019052:Depression, Postpartum / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D003865:Major Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005192:Family Health; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D055500:Resilience, Psychological; D012649:Self Concept; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D055815:Young Adult
keywords: Childhood; Depression; Posttraumatic stress disorder; Resilience; Trauma