title: Childhood sexual abuse, intimate partner violence during pregnancy, and posttraumatic stress symptoms following childbirth: a path analysis.
abstract: The aim of the study was to explore the pathways by which childhood sexual abuse (CSA), psychological and physical intimate partner violence (IPV) during pregnancy, and other covariates relate to each other and to posttraumatic stress disorder (PTSD) symptoms in the postpartum period. The sample comprised 456 women who gave birth at a maternity service for high-risk pregnancies in Rio de Janeiro, Brazil, interviewed at 6-8 weeks after birth. A path analysis was carried out to explore the postulated pathways between exposures and outcome. Trauma History Questionnaire, Conflict Tactics Scales and Posttraumatic Stress Disorder Checklist were used to assess information about exposures of main interest and outcome. The link between CSA and PTSD symptoms was mediated by history of trauma, psychiatric history, psychological IPV, and fear of childbirth during pregnancy. Physical IPV was directly associated with postnatal PTSD symptoms, whereas psychological IPV connection seemed to be partially mediated by physical abuse and fear of childbirth during pregnancy. The role of CSA, IPV, and other psychosocial characteristics on the occurrence of PTSD symptoms following childbirth as well as the intricate network of these events should be acknowledged in clinic and intervention approaches.
authors.affiliation: Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier 524 7° andar, Rio de Janeiro, RJ, 20559-900, Brazil. alinegaudard@yahoo.com.br.
authors.forename: Aline Gaudard E Silva de
authors.initials: AG
authors.lastname: Oliveira
authors.affiliation: Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier 524 7° andar, Rio de Janeiro, RJ, 20559-900, Brazil.
authors.forename: Michael Eduardo
authors.initials: ME
authors.lastname: Reichenheim
authors.affiliation: Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier 524 7° andar, Rio de Janeiro, RJ, 20559-900, Brazil.|Medical School, Estácio de Sá University, Rua Riachuelo 27, Rio de Janeiro, RJ, 20230-010, Brazil.
authors.forename: Claudia Leite
authors.initials: CL
authors.lastname: Moraes
authors.affiliation: Institute of Psychiatry, King's College London, PO31 De Crespigny Park, London, SE5 8AF, UK.
authors.forename: Louise Michele
authors.initials: LM
authors.lastname: Howard
authors.affiliation: Fernandes Figueira Institute, Oswaldo Cruz Foundation, Avenida Rui Barbosa 716, Rio de Janeiro, RJ, 22250-020, Brazil.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Lobato
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D000066511:Intimate Partner Violence / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D049590:Postpartum Period; D011237:Predictive Value of Tests; D011247:Pregnancy; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Childhood sexual abuse; Intimate partner violence; Path analysis; Postpartum; Posttraumatic stress disorder