Maternal post-traumatic stress disorder, depression and alcohol dependence and child behaviour outcomes in mother–child dyads infected with HIV: a longitudinal study
- 1Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- 2School of International Development and Global Studies, University of Ottawa, Ontario, Canada
- 3Department of Paediatrics and Child Health, The Children's Infectious Diseases Clinical Research Unit (KID-CRU), Stellenbosch University, Cape Town, South Africa
- Correspondence to Jani Nöthling;
- Received 22 July 2013
- Revised 11 November 2013
- Accepted 14 November 2013
- Published 10 December 2013
Objectives HIV and psychiatric disorders are prevalent and often concurrent. Childbearing women are at an increased risk for both HIV and psychiatric disorders, specifically depression and post-traumatic stress disorder (PTSD). Poor mental health in the peripartum period has adverse effects on infant development and behaviour. Few studies have investigated the relationship between maternal PTSD and child behaviour outcomes in an HIV vertically infected sample. The aim of this study was to investigate whether maternal postpartum trauma exposure and PTSD were risk factors for child behaviour problems. In addition, maternal depression, alcohol abuse and functional disability were explored as cofactors.
Setting The study was conducted in Cape Town, South Africa.
Participants 70 mother–child dyads infected with HIV were selected from a group of participants recruited from community health centres.
Design The study followed a longitudinal design. Five measures were used to assess maternal trauma exposure, PTSD, depression, alcohol abuse and functional disability at 12 months postpartum: Life Events Checklist (LEC), Harvard Trauma Scale (HTS), Alcohol Use Disorders Identification Test (AUDIT), Center for Epidemiological Studies Depression (CESD) Scale and the Sheehan Disability Scale (SDS). Child behaviour was assessed at 42 months with the Child Behaviour Checklist (CBCL).
Results The rate of maternal disorder was high with 50% scoring above the cut-off for depression, 22.9% for PTSD and 7% for alcohol abuse. Half of the children scored within the clinical range for problematic behaviour. Children of mothers with depression were significantly more likely to display total behaviour problems than children of mothers without depression. Maternal PTSD had the greatest explanatory power for child behaviour problems, although it did not significantly predict child outcomes.
Conclusions This study highlights the importance of identifying and managing maternal PTSD and depression in mothers of children infected with HIV. The relationship between maternal PTSD and child behaviour warrants further investigation.
- Maternal mental health
- Child behaviour and development
- Posttraumatic Stress Disorder
- Alcohol abuse
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