Can an evolutionary perspective shed light on maternal abuse of children?

Although the theory of evolution lies at the heart of contemporary biology, its influence on the study of child psychology and psychiatry has been limited. In earlier work we have argued that evolutionary thinking has much of value for clinicians. Here, we explore the possible significance of evolutionary theory for understanding child abuse by mothers, particularly neglect, emotional abuse and physical abuse. We draw on the research of anthropologists, primatologists and evolutionary theorists to make predictions about the environmental circumstances under which one would expect such abuse to be more prevalent. We discuss how in modern, Western cultures there is less understanding of the circumstances that may influence, even predispose, a mother to limit her emotional and material commitment to an infant or child. We use four short vignettes of clinical cases and one longer case description to illustrate the insights offered to clinicians by an evolutionary approach. We see our work both as contributing to greater understanding of these matters and as facilitating more compassionate models of care and intervention for women in such circumstances.

CHILD ABUSE AND ADULT MENTAL HEALTH: DOES GENDER MATTER?

Numerous studies have demonstrated that child abuse is associated with poor adult mental health, but few have investigated the extent to which the frequency of different types of abuse increase mental health conditions, especially at the nexus of gender. The present study examines whether parental abuse frequency and abuse perpetrator have distinct effects for men and women on three mental health outcomes—depressive symptoms, generalized anxiety, and global self-reported mental health. Data came from three waves of the National Survey of Midlife Development in the United States (MIDUS), comprising a baseline sample of 3,032 adults aged 25-74. Estimating a series of mixed effects models revealed that maternal abuse and frequent abuse during childhood were associated with poorer adult mental health during our 20-year observation period, net of childhood and adult risk factors. Specifically, maternal emotional abuse raised the risk of depression, anxiety, and lower self-rated mental health, and was more strongly associated with depression and anxiety for women than men. Compared to adults who did not experience parental abuse during childhood, adults who experienced frequent emotional and physical abuse by either parent were more likely to experience depression and anxiety and report lower ratings of mental health in adulthood. Frequent child abuse was more strongly associated with anxiety for women than men. These results demonstrate that gender differences in adult mental health have early-life antecedents. Future research investigating the long-term mental health consequences of child abuse should consider the type and magnitude of abuse as well as the perpetrator.

CHILD ABUSE AND ADULT MENTAL HEALTH: DOES GENDER MATTER?

Numerous studies have demonstrated that child abuse is associated with poor adult mental health, but few have investigated the extent to which the frequency of different types of abuse increase mental health conditions, especially at the nexus of gender. The present study examines whether parental abuse frequency and abuse perpetrator have distinct effects for men and women on three mental health outcomes—depressive symptoms, generalized anxiety, and global self-reported mental health. Data came from three waves of the National Survey of Midlife Development in the United States (MIDUS), comprising a baseline sample of 3,032 adults aged 25-74. Estimating a series of mixed effects models revealed that maternal abuse and frequent abuse during childhood were associated with poorer adult mental health during our 20-year observation period, net of childhood and adult risk factors. Specifically, maternal emotional abuse raised the risk of depression, anxiety, and lower self-rated mental health, and was more strongly associated with depression and anxiety for women than men. Compared to adults who did not experience parental abuse during childhood, adults who experienced frequent emotional and physical abuse by either parent were more likely to experience depression and anxiety and report lower ratings of mental health in adulthood. Frequent child abuse was more strongly associated with anxiety for women than men. These results demonstrate that gender differences in adult mental health have early-life antecedents. Future research investigating the long-term mental health consequences of child abuse should consider the type and magnitude of abuse as well as the perpetrator.

Postoperative catecholamine resistance following fetal methamphetamine exposure

Methamphetamine and its related compounds are among the most widely abused recreational drugs worldwide. While a myriad of clinical complications of methamphetamine use have been described, there is a paucity of literature regarding the effects of maternal abuse during pregnancy on neonatal hearts. In this report, we describe a neonate who underwent Norwood-type palliation and subsequently developed catecholamine-resistant cardiogenic shock, likely related to methamphetamine exposure, which recovered after a period of venoarterial extracorporeal membrane oxygenation support.

Possessiveness

The opposite of detachment is possessiveness, which generally reflects a personality profile characterized by anxious attachment. This chapter describes the psychological and behavioral traits that characterize people with anxious attachment and discusses two clinical conditions related to abnormal levels of possessiveness: child abuse and pathological jealousy. The discussion of these two conditions is based on very different databases. Whereas descriptions and explanations of pathological jealousy are based on psychiatric literature, the analysis of child abuse consists of a synopsis of studies of spontaneous cases of maternal abuse of offspring in monkeys, including the successful pharmacological treatment of abusive mothers. Also recounted is the author’s correspondence with John Bowlby regarding interpretation of the observations in monkeys. The chapter closes with a brief discussion of the psychological mechanisms that motivate normal jealousy in intimate relationships and of gender differences in jealousy, along with evolutionary explanations for such differences.

Maternal abuse history and reduced fetal heart rate variability: Abuse-related sleep disturbance is a mediator

The consequences of childhood maltreatment are profound and long lasting. Not only does the victim of abuse suffer as a child, but there is mounting evidence that a history of maltreatment places the next generation at risk for significant psychopathology. Research identifies postnatal factors as affecting this intergenerational transmission of trauma. However, emerging evidence suggests that part of this risk may be transmitted before birth, passed on via abuse-related alterations in the in utero environment that are as yet largely unidentified. To date, no study has directly assessed the influence of pregnant women's abuse history on fetal neurobehavioral development, nor considered trauma-associated poor sleep quality as a mediator reflecting established physiological dysregulation. Using data from 262 pregnant adolescents (ages 14–19), a population at elevated risk for childhood maltreatment, the current study examined maternal emotional abuse history and sleep quality in relation to third-trimester fetal resting heart rate variability, an index of parasympathetic nervous system functioning. The results indicate that maternal emotional abuse history is indirectly associated with lower fetal heart rate variability via abuse-related sleep disturbances. These data demonstrate an association between maternal abuse histories and fetal development, showing that at least part of the intergenerational transmission of risk occurs during pregnancy.