psychosocial and behavioral factors related to the post partum97
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Psychosocial and behavioral factors Psychosocial and behavioral factors related to the post-partum placements related to the post-partum placements of infants born to cocaine-using womenof infants born to cocaine-using women
Reviewed by:Reviewed by:Brittany WarringtonBrittany Warrington
Lisa KlineLisa KlineMatthew ChangMatthew Chang
October 14, 2008October 14, 2008PSYC308-UMBCPSYC308-UMBC
Sonia Minnes, Lynn T. Singer, Rashida Humphrey-Wall, Sudtida Satayathum
IntroductionIntroduction
Hypothesis: That Hypothesis: That cocaine-using women cocaine-using women who who lost custodylost custody of their infants at birth would of their infants at birth would report higher levels of report higher levels of psychological distress psychological distress symptomssymptoms, and have more , and have more violent partner violent partner relationshipsrelationships, negative coping skills, lower , negative coping skills, lower social support, and social support, and higher prevalence of higher prevalence of childhood traumachildhood trauma than similar women who than similar women who did not lose custody of their infants.did not lose custody of their infants.
Quote from researchersQuote from researchers
““We further hypothesized We further hypothesized that that higher levels of higher levels of cocaine use prenatallycocaine use prenatally and severity of and severity of psychological distress psychological distress symptoms would symptoms would increase the likelihood increase the likelihood of child placementof child placement.”.”
http://www.eurad.net/images/sick-baby.jpg
What was known beforehand?What was known beforehand? Previous studies have shown infant removal occurs Previous studies have shown infant removal occurs
more frequently if:more frequently if:– The mother used cocaine prenatallyThe mother used cocaine prenatally– Poor prenatal carePoor prenatal care– Positive toxicology screenPositive toxicology screen– African AmericanAfrican American
Specific areas of maternal history and psychological Specific areas of maternal history and psychological functioning are recognized as posing threats to functioning are recognized as posing threats to effective parentingeffective parenting Found to be more prevalent among cocaine-using womenFound to be more prevalent among cocaine-using women
http://www.mayoclinicproceedings.com/images/8005/8005a2-fig2.jpg
What was this research designed to What was this research designed to answer?answer?
If cocaine-using who did not maintain infant If cocaine-using who did not maintain infant custody would report more of the following custody would report more of the following than those who maintained custody:than those who maintained custody:
more psychological distressmore psychological distress domestic violencedomestic violence negative coping skillsnegative coping skills lower social supportlower social support more childhood traumamore childhood trauma
Why is this research important?Why is this research important?
Substantial postnatal risk factor for infant Substantial postnatal risk factor for infant neglect and abuseneglect and abuse
Use of illegal drugs often results in removal of Use of illegal drugs often results in removal of the childthe child
One of the leading causes of infant placementOne of the leading causes of infant placement Over 60% in some urban areasOver 60% in some urban areas
Correlations with child maltreatmentCorrelations with child maltreatment
Half of all parents who self-reported Half of all parents who self-reported abuse/neglect abuse/neglect Lifetime substance abuse disorderLifetime substance abuse disorder Threefold increaseThreefold increase
Protective service records indicate:Protective service records indicate: Maternal use of substances and child Maternal use of substances and child
maltreatmentmaltreatment 43-79% of affected children43-79% of affected children
At least 1 parentAt least 1 parent
MethodsMethods
MethodsMethods
ResultsResultsMaternal Characteristics
Mean(MC=142)
SD(MC=142)
Mean (NMC=63)
SD (NMC=63) P-value
Years of education
11.70 1.6 11.29 1.7 .09
Age (years) 29.18 4.9 30.40 5.2 .13
Number of prenatal visits
6.09 4.8 3.20 3.4 <.00001
WAIS-R Block Design
7.04 2.0 6.44 2.4 .07
PPVT-R Standard Score
74.38 14.3 71.40 13.5 .18
Table 1: Maternal characteristics at birth by custody status
WAIS-R Block Design-Wechsler Adult Intelligence Scale-Revised, Picture Completion and Block Design subscalesPPVT-R-Peabody Picture Vocabulary Test-Revised
ResultsResults
Maternal Characteristics
MC=142 NMC=63 p-value
Race (African American)
80.3 81.0 .91
No prenatal care 13.4 30.2 .004
Maternal employment
6.3 3.2 .37
Married 8.5 4.8 .35
Low socioeconomic status
98.0 98.4 .81
Table 1: Maternal characteristics at birth by custody status
ResultsResultsMaternal drug use
Mean (MC=142)
SD(MC=142)
Mean(NMC=63)
SD(NMC=63)
p-value
Avg. cigarettes per day
10.7 9.1 13.8 13.8 .49
Avg. drinks per week
9.0 16.4 10.9 21.3 .82
Avg. joints per week
1.4 3.4 1.2 3.9 .13
Avg. cocaine units per week
16.2 25.8 41.2 68.6 .001
Table 2: Maternal drug use characteristics by custody status
Maternal drug use MC=142 NMC=63 p-value
Tobacco use 88.7 88.9 .98
Alcohol use 88.7 79.4 .08
Marijuana use 50.7 47.6 .68
Heavy cocaine use 44.4 69.8 .001
DiscussionDiscussion
3 maternal characteristics:3 maternal characteristics:– Few prenatal care visitsFew prenatal care visits– Heavier cocaine useHeavier cocaine use– Clinically elevated psychological distressClinically elevated psychological distress
DiscussionDiscussion Other similarities between NMCOther similarities between NMC
Greater use of maladaptive coping skillsGreater use of maladaptive coping skills Less use of positive coping skills Less use of positive coping skills Relationship violenceRelationship violence Childhood abuseChildhood abuse
http://www.wmin.ac.uk/sabe/images/Girl%20-%20Domestic%20Violence.jpg
DiscussionDiscussion Three weaknesses of the study:Three weaknesses of the study:11. Reflect a specific, urban, human service agency from . Reflect a specific, urban, human service agency from
1994-19961994-1996 CPS practices vary from city to city, year to yearCPS practices vary from city to city, year to year
22. A potential bias exists. A potential bias exists Not all women at the hospital were screenedNot all women at the hospital were screened
Only those posing specific identifiable risksOnly those posing specific identifiable risks
3. 3. A reduced number of women received the CTQ, A reduced number of women received the CTQ, reliance on past memory, and differential timing of reliance on past memory, and differential timing of initial data collectioninitial data collection
Retrospective data are subject to errorsRetrospective data are subject to errors
DiscussionDiscussion Ways to Ways to
improve/expand the improve/expand the experiment:experiment: Longitudinal studyLongitudinal study
Multiple citiesMultiple cities
Screen all women, not Screen all women, not just those displaying just those displaying risksrisks
<http://www.destination360.com/north-america/us/new-york/images/s/new-york-city.jpg>.
http://bergoiata.org/fe/californie-paysages/Moon%20over%20San%20Francisco.jpg
ReferencesReferences "Domestic Violence and Housing." (Photograph) University of Westminster: School of
Architecture and the Built Environment. University of Westminster. <http://www.wmin.ac.uk/sabe/images/girl%20-%20domestic%20violence.jpg>.
Minnes, Sonia, Lynn T. Singer, Rashida Humphrey-Wall, and Sudtida Satayathum. "Psychosocial and behavioral factors related to the post-partum placements of infants born to cocaine-using women." Child Abuse and Neglect 32 (2008): 353-66.
"New York City (Photograph)." Destination 360. 12 Oct. 2008 <http://www.destination360.com/north-america/us/new-york/images/s/new-york-city.jpg>.
"San Francisco: 36th Annual San Francisco Blues Festival." (Photograph) Downtown Hotels and Events. 12 Oct. 2008 <http://bergoiata.org/fe/californie-paysages/moon%20over%20san%20francisco.jpg>.
"Sick Baby.“(Photograph) EURAD: Europe Against Drugs. Europe Against Drugs. 24 Sept. 2008 <http://www.eurad.net/images/sick-baby.jpg>.
"Toxicology Screening.“(Photograph) Mayo Clinic Proceedings. Mayo Clinic. 24 Sept. 2008 <http://www.mayoclinicproceedings.com/images/8005/8005a2-fig2.jpg>.
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