Maternal sensitivity, posttraumatic stress, and acculturation in Vietnamese and Hmong mothers

To determine the extent of posttraumatic stress and acculturation in Vietnamese and Hmong mothers and identify their relationship to maternal sensitivity.

Descriptive correlational research design.

A sample of 30 mothers was evenly divided between Hmong and Vietnamese who had lived in the United States 2 to 21 years, had healthy children under 30 months, and had varied education and literacy levels. Data were collected in the home using a script. The mother's sensitivity to her infant was measured by Ainsworth's Sensitivity vs. Insensitivity to the Baby's Communication, degree of acculturation by the Suinn-Lew Self-identity Acculturation Scale (SL-ASIA), and posttraumatic stress by the Hopkins Symptom Checklist-25 (HSCL-25).

Depression and anxiety correlated highly with posttraumatic stress (PTS), and thus were substituted for PTS. Almost half (43%) were clinically depressed or anxious, with less acculturated mothers tending to be more anxious and depressed. One third had considered suicide in the previous week. Mothers found it difficult to communicate their distress to primary providers. In spite of high depression and anxiety rates, maternal sensitivity was high, and was not significantly correlated to any variable.

Nurses should incorporate screening for depression and anxiety into routine assessments or discharge planning for foreign-born mothers, then refer stressed mothers to appropriate resources. It is important to not assume diminished sensitivity in depressed or anxious mothers and to consider the coaching role of the grandmother.