Posttraumatic stress disorder (PTSD) in mothers appears to be associated with an increased risk for child maltreatment beyond that associated with maternal depression, according to a study published by JAMA Pediatrics.
The psychopathology of a caregiver is understood to be an important risk factor for child maltreatment and maternal depression is associated with an increased use of corporal punishment and physical abuse of children. Until recently, research on maternal depression and maltreatment risk has largely ignored the high rate of comorbidity between depression and PTSD. The National Comorbidity Survey suggests that 24.7 percent of depressed women have PTSD and that 48.4 of women with PTSD have depression, according to the study background.
Claude M. Chemtob, Ph.D., of the NYU School of Medicine, and colleagues examined the association of probable maternal depression, PTSD and comorbid PTSD and depression with the risk for child maltreatment and parenting stress and with the number of traumatic events that preschool children are exposed to.
The study included 97 mothers of children ages 3 to 5 years old. About half of the children were boys.
The children of mothers with PTSD (mean number of events the child was exposed to, 5) or with comorbid PTSD and depression (3.5 events) experienced more traumatic events than those of mothers with depression (1.2 events) or neither disorder (1.4 events). When PTSD symptom severity scores were high, psychological aggression and the number of traumatic events children experienced increased. Depressive symptom severity scores also were associated with the risk for psychological aggression and exposure to traumatic events only when PTSD symptom severity scores were low, according to the study results.
"Mothers in the comorbid group reported the highest levels of physically and psychologically abusive behaviors and overall parenting stress. Although not statistically significant, mothers with depression alone showed a trend toward endorsing more physically abusive and neglectful parenting behaviors," the study concludes. "Given the high comorbidity between PTSD and depression, these findings suggest the importance of measuring PTSD symptoms when considering the relationship between depression and increased risk for child maltreatment."
JAMA Pediatr. Published online August 19, 2013. DOI: 10.1001/jamapediatrics.2013.2218