Adverse Childhood Experiences and Current Psychosocial Stressors: Exploring Effects on Mental Health and Parenting
Nora L Erickson1, Jessica M Flynn1, Helen G Kim2,3
1Mother‑Baby Program, Department of Psychiatry, and Redleaf Center for Family Healing, Hennepin Healthcare, Minneapolis, MN, USA.
Insights
Adverse childhood experiences (ACEs) and current stressors did not significantly impair perinatal mental health outcomes. Trauma-informed care effectively improved maternal functioning and reduced symptoms.
Area of Science:
- Perinatal mental health
- Trauma-informed care
- Maternal psychology
Background:
- Adverse childhood experiences (ACEs) and psychosocial stressors negatively affect perinatal mental health, birth outcomes, and parenting.
- Effective perinatal mental health programs are crucial for individuals facing adversity and severe symptoms.
Purpose of the Study:
- To evaluate the impact of a trauma-informed, multi-generation treatment program on perinatal mental health.
- To examine the relationship between ACEs, psychosocial stressors, and treatment outcomes.
Main Methods:
- The Mother-Baby Day Hospital provided trauma-informed treatment to perinatal women.
- Data included pre- and post-treatment assessments of depression, anxiety, maternal functioning, ACEs, and psychosocial stressors.
- Bivariate tests and regression models analyzed the predictors of post-treatment symptoms.
Main Results:
- A high prevalence of ACEs and psychosocial stressors was observed among patients.
- Pre-treatment symptoms were the strongest predictors of post-treatment outcomes.
- ACEs and food insecurity showed a marginal effect on post-treatment depression and maternal functioning, respectively.
Conclusions:
- Current psychosocial stressors and ACEs did not substantially limit improvements in depression, anxiety, and maternal functioning.
- The high prevalence of adversity underscores the need for trauma-informed, multi-generation treatments.
- Such programs are vital for enhancing maternal mental health and parenting capacity.
Objectives:
Adverse childhood experiences (ACEs) can detrimentally impact perinatal mental health, birth outcomes, and parenting behaviors. Proximal psychosocial stressors also increase risks to perinatal health and wellbeing. Additional research on effective perinatal mental health programs is needed, especially for individuals and families with historical and concurrent adversity, and those with moderate to severe symptoms.
Methods:
The Mother-Baby Day Hospital at Hennepin County Medical Center provides trauma-informed, multi-generation treatment for perinatal women. Data were collected from patients between January 2016 and September 2019. Self-reported depression, anxiety, and maternal functioning assessments were administered pre- and post-treatment. Patients completed the ACE questionnaire and indicators of current psychosocial stressors (i.e., food insecurity, housing insecurity, and social support) at intake. A series of bivariate tests and hierarchical regression models examined relationships among variables, including whether distal and proximal adversity predicted post-treatment symptoms.
Results:
159 Perinatal patients consented to research and completed the ACEs questionnaire at first admission. High proportions of patients reported 4+ ACEs and current psychosocial stressors. Effect sizes for associations between ACEs, psychosocial stressors, and self-report symptoms were small to moderate. Individuals with food or housing insecurity entered treatment with higher anxiety. In regression models, the most robust predictors of post-treatment symptoms were pre-treatment symptoms. Effects of ACEs on post-treatment depression and food insecurity on post-treatment maternal functioning approached the adjusted significance cut-off (p < .01). CONCLUSIONS FOR PRACTICE: Current psychosocial stressors and ACEs did not substantially limit post-treatment depression, anxiety, and maternal functioning outcomes. High prevalence of ACEs and psychosocial stressors highlight the need for trauma-informed, multi-generation treatments to improve maternal mental health and parenting capacity.
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