Oliveira Aline Gaudard E Silva de, Reichenheim Michael Eduardo, Moraes Claudia Leite, Howard Louise Michele, Lobato Gustavo
Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier 524 7° andar, Rio de Janeiro, RJ, 20559-900, Brazil.
Medical School, Estácio de Sá University, Rua Riachuelo 27, Rio de Janeiro, RJ, 20230-010, Brazil.
Arch Womens Ment Health. 2017 Apr;20(2):297-309. doi: 10.1007/s00737-016-0705-6. Epub 2016 Dec 28.
The aim of the study was to explore the pathways by which childhood sexual abuse (CSA), psychological and physical intimate partner violence (IPV) during pregnancy, and other covariates relate to each other and to posttraumatic stress disorder (PTSD) symptoms in the postpartum period. The sample comprised 456 women who gave birth at a maternity service for high-risk pregnancies in Rio de Janeiro, Brazil, interviewed at 6-8 weeks after birth. A path analysis was carried out to explore the postulated pathways between exposures and outcome. Trauma History Questionnaire, Conflict Tactics Scales and Posttraumatic Stress Disorder Checklist were used to assess information about exposures of main interest and outcome. The link between CSA and PTSD symptoms was mediated by history of trauma, psychiatric history, psychological IPV, and fear of childbirth during pregnancy. Physical IPV was directly associated with postnatal PTSD symptoms, whereas psychological IPV connection seemed to be partially mediated by physical abuse and fear of childbirth during pregnancy. The role of CSA, IPV, and other psychosocial characteristics on the occurrence of PTSD symptoms following childbirth as well as the intricate network of these events should be acknowledged in clinic and intervention approaches.
该研究的目的是探讨童年期性虐待（CSA）、孕期心理和身体亲密伴侣暴力（IPV）以及其他协变量之间的相互关系，以及它们与产后创伤后应激障碍（PTSD）症状之间的关系。样本包括456名在巴西里约热内卢一家高危妊娠产科服务机构分娩的女性，在产后6至8周接受访谈。进行了路径分析，以探索假设的暴露因素与结果之间的途径。使用创伤史问卷、冲突策略量表和创伤后应激障碍检查表来评估有关主要关注的暴露因素和结果的信息。CSA与PTSD症状之间的联系由创伤史、精神病史、心理IPV以及孕期对分娩的恐惧介导。身体IPV与产后PTSD症状直接相关，而心理IPV的关联似乎部分由身体虐待和孕期对分娩的恐惧介导。在临床和干预方法中，应认识到CSA、IPV和其他社会心理特征在产后PTSD症状发生中的作用以及这些事件的复杂网络。
