Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia.
Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
PLoS One. 2019 Mar 13;14(3):e0213460. doi: 10.1371/journal.pone.0213460. eCollection 2019.
Child maltreatment is a global health priority affecting up to half of all children worldwide, with profound and ongoing impacts on physical, social and emotional wellbeing. The perinatal period (pregnancy to two years postpartum) is critical for parents with a history of childhood maltreatment. Parents may experience 'triggering' of trauma responses during perinatal care or caring for their distressed infant. The long-lasting relational effects may impede the capacity of parents to nurture their children and lead to intergenerational cycles of trauma. Conversely, the perinatal period offers a unique life-course opportunity for parental healing and prevention of child maltreatment. This scoping review aims to map perinatal evidence regarding theories, intergenerational pathways, parents' views, interventions and measurement tools involving parents with a history of maltreatment in their own childhoods.
We searched Medline, Psychinfo, Cinahl and Embase to 30/11/2016. We screened 6701 articles and included 55 studies (74 articles) involving more than 20,000 parents. Most studies were conducted in the United States (42/55) and involved mothers only (43/55). Theoretical constructs include: attachment, social learning, relational-developmental systems, family-systems and anger theories; 'hidden trauma', resilience, post-traumatic growth; and 'Child Sexual Assault Healing' and socioecological models. Observational studies illustrate sociodemographic and mental health protective and risk factors that mediate/moderate intergenerational pathways to parental and child wellbeing. Qualitative studies provide rich descriptions of parental experiences and views about healing strategies and support. We found no specific perinatal interventions for parents with childhood maltreatment histories. However, several parenting interventions included elements which address parental history, and these reported positive effects on parent wellbeing. We found twenty-two assessment tools for identifying parental childhood maltreatment history or impact.
Perinatal evidence is available to inform development of strategies to support parents with a history of child maltreatment. However, there is a paucity of applied evidence and evidence involving fathers and Indigenous parents.
儿童虐待是一个全球性的健康重点问题，影响到全球多达一半的儿童，对其身心健康和社会情感健康都有着深远且持续的影响。围产期（怀孕至产后两年）对于有儿童虐待史的父母来说至关重要。在围产期护理或照顾他们焦虑的婴儿期间，父母可能会经历创伤反应的“触发”。持久的关系影响可能会阻碍父母养育孩子的能力，并导致代际创伤循环。相反，围产期为父母的疗愈和预防儿童虐待提供了独特的人生历程机会。本范围综述旨在绘制围产期相关证据，包括涉及有儿童期虐待史的父母的理论、代际途径、父母观点、干预措施和测量工具。
我们于 2016 年 11 月 30 日检索了 Medline、Psychinfo、Cinahl 和 Embase。我们筛选了 6701 篇文章，纳入了 55 项研究（74 篇文章），涉及 20000 多名父母。大多数研究在美国进行（42/55），仅涉及母亲（43/55）。理论构念包括：依恋、社会学习、关系发展系统、家庭系统和愤怒理论；“隐藏的创伤”、韧性、创伤后成长；以及“儿童性侵犯疗愈”和社会生态模型。观察性研究说明了影响父母和儿童福祉的代际途径的社会人口统计学和心理健康保护和风险因素。定性研究提供了关于疗愈策略和支持的父母经验和观点的丰富描述。我们没有发现针对有儿童虐待史的父母的特定围产期干预措施。然而，一些育儿干预措施包括解决父母历史问题的内容，这些干预措施报告了对父母健康的积极影响。我们发现了 22 种用于识别父母儿童虐待史或影响的评估工具。
有围产期证据可用于为支持有儿童虐待史的父母制定策略提供信息。然而，应用证据和涉及父亲和土著父母的证据都很缺乏。
