Psychosocial And Behavioral Factors Related To The Post Partum97
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Psychosocial And Behavioral Factors Related To The Post Partum97

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Psychosocial And Behavioral Factors Related To The Post Partum97 Psychosocial And Behavioral Factors Related To The Post Partum97 Presentation Transcript

  • Psychosocial and behavioral factors related to the post-partum placements of infants born to cocaine-using women Reviewed by: Brittany Warrington Lisa Kline Matthew Chang October 14, 2008 PSYC308-UMBC Sonia Minnes, Lynn T. Singer, Rashida Humphrey-Wall, Sudtida Satayathum
  • Introduction
    • Hypothesis: That cocaine-using women who lost custody of their infants at birth would report higher levels of psychological distress symptoms , and have more violent partner relationships , negative coping skills, lower social support, and higher prevalence of childhood trauma than similar women who did not lose custody of their infants.
  • Quote from researchers
    • “ We further hypothesized that higher levels of cocaine use prenatally and severity of psychological distress symptoms would increase the likelihood of child placement .”
    http://www.eurad.net/images/sick-baby.jpg
  • What was known beforehand?
    • Previous studies have shown infant removal occurs more frequently if:
      • The mother used cocaine prenatally
      • Poor prenatal care
      • Positive toxicology screen
      • African American
    • Specific areas of maternal history and psychological functioning are recognized as posing threats to effective parenting
      • Found to be more prevalent among cocaine-using women
    http://www.mayoclinicproceedings.com/images/8005/8005a2-fig2.jpg
  • What was this research designed to answer?
    • If cocaine-using who did not maintain infant custody would report more of the following than those who maintained custody:
    • more psychological distress
    • domestic violence
    • negative coping skills
    • lower social support
    • more childhood trauma
  • Why is this research important?
    • Substantial postnatal risk factor for infant neglect and abuse
    • Use of illegal drugs often results in removal of the child
    • One of the leading causes of infant placement
      • Over 60% in some urban areas
  • Correlations with child maltreatment
    • Half of all parents who self-reported abuse/neglect
      • Lifetime substance abuse disorder
      • Threefold increase
    • Protective service records indicate:
      • Maternal use of substances and child maltreatment
      • 43-79% of affected children
        • At least 1 parent
  • Methods
  • Methods
  • Results Table 1: Maternal characteristics at birth by custody status WAIS-R Block Design-Wechsler Adult Intelligence Scale-Revised, Picture Completion and Block Design subscales PPVT-R-Peabody Picture Vocabulary Test-Revised Maternal Characteristics Mean (MC=142) SD (MC=142) Mean (NMC=63) SD (NMC=63) P-value Years of education 11.70 1.6 11.29 1.7 .09 Age (years) 29.18 4.9 30.40 5.2 .13 Number of prenatal visits 6.09 4.8 3.20 3.4 <.00001 WAIS-R Block Design 7.04 2.0 6.44 2.4 .07 PPVT-R Standard Score 74.38 14.3 71.40 13.5 .18
  • Results Table 1: Maternal characteristics at birth by custody status Maternal Characteristics MC=142 NMC=63 p-value Race (African American) 80.3 81.0 .91 No prenatal care 13.4 30.2 .004 Maternal employment 6.3 3.2 .37 Married 8.5 4.8 .35 Low socioeconomic status 98.0 98.4 .81
  • Results Table 2: Maternal drug use characteristics by custody status Maternal drug use Mean (MC=142) SD (MC=142) Mean (NMC=63) SD (NMC=63) p-value Avg. cigarettes per day 10.7 9.1 13.8 13.8 .49 Avg. drinks per week 9.0 16.4 10.9 21.3 .82 Avg. joints per week 1.4 3.4 1.2 3.9 .13 Avg. cocaine units per week 16.2 25.8 41.2 68.6 .001 Maternal drug use MC=142 NMC=63 p-value Tobacco use 88.7 88.9 .98 Alcohol use 88.7 79.4 .08 Marijuana use 50.7 47.6 .68 Heavy cocaine use 44.4 69.8 .001
  • Discussion
    • 3 maternal characteristics:
      • Few prenatal care visits
      • Heavier cocaine use
      • Clinically elevated psychological distress
  • Discussion
    • Other similarities between NMC
      • Greater use of maladaptive coping skills
      • Less use of positive coping skills
      • Relationship violence
      • Childhood abuse
    http://www.wmin.ac.uk/sabe/images/Girl%20-%20Domestic%20Violence.jpg
  • Discussion
    • Three weaknesses of the study:
    • 1 . Reflect a specific, urban, human service agency from 1994-1996
        • CPS practices vary from city to city, year to year
    • 2 . A potential bias exists
        • Not all women at the hospital were screened
          • Only those posing specific identifiable risks
    • 3. A reduced number of women received the CTQ, reliance on past memory, and differential timing of initial data collection
        • Retrospective data are subject to errors
  • Discussion
    • Ways to improve/expand the experiment:
      • Longitudinal study
        • Multiple cities
      • Screen all women, not just those displaying risks
    <http://www.destination360.com/north-america/us/new-york/images/s/new-york-city.jpg>. http://bergoiata.org/fe/californie-paysages/Moon%20over%20San%20Francisco.jpg
  • References
    • &quot;Domestic Violence and Housing.&quot; (Photograph) University of Westminster: School of Architecture and the Built Environment . University of Westminster. <http://www.wmin.ac.uk/sabe/images/girl%20-%20domestic%20violence.jpg>.
    • Minnes, Sonia, Lynn T. Singer, Rashida Humphrey-Wall, and Sudtida Satayathum. &quot;Psychosocial and behavioral factors related to the post-partum placements of infants born to cocaine-using women.&quot; Child Abuse and Neglect 32 (2008): 353-66.
    • &quot;New York City (Photograph).&quot; Destination 360 . 12 Oct. 2008 <http://www.destination360.com/north-america/us/new-york/images/s/new-york-city.jpg>.
    • &quot;San Francisco: 36th Annual San Francisco Blues Festival.&quot; (Photograph) Downtown Hotels and Events . 12 Oct. 2008 <http://bergoiata.org/fe/californie-paysages/moon%20over%20san%20francisco.jpg>.
    • &quot;Sick Baby.“(Photograph) EURAD: Europe Against Drugs . Europe Against Drugs. 24 Sept. 2008 <http://www.eurad.net/images/sick-baby.jpg>.
    • &quot;Toxicology Screening.“(Photograph) Mayo Clinic Proceedings . Mayo Clinic. 24 Sept. 2008 <http://www.mayoclinicproceedings.com/images/8005/8005a2-fig2.jpg>.