Archives of Women’s Mental Health

, Volume 8, Issue 3, pp 191–199 | Cite as

Impact of domestic violence and drug abuse in pregnancy on maternal attachment and infant temperament in teenage mothers in the setting of best clinical practice

  • J. A. Quinlivan
  • S. F. Evans
Original contribution


We examined whether the prenatal detection of family violence and initiation of a comprehensive prenatal individualised care program could ameliorate the impact of family violence on maternal attachment to her infant at 6-months of age. An assessment of domestic violence was established for each subject at the 1st antenatal visit and women were classified as being exposed to domestic violence in pregnancy (EDV) or as being not exposed to domestic violence. Outcomes were determined 6 months postpartum. Of 173 consecutive women who met the eligibility criteria, consent was obtained from 150 (87% response). Women who had been subjected to domestic violence showed reduced overall attachment scores to their infants. Following multivariate analysis, drug use in pregnancy and domestic violence showed a significant independent effect on maternal attachment. Drug abuse and domestic violence were also associated with an increase in the easy-difficult scale of infant temperament. Thus, despite excellence in prenatal care, drug abuse and domestic violence were associated with poorer maternal attachment and assessment of infant temperament, suggesting that additional interventions are still required.

Keywords: Domestic violence; drug abuse; mother to child attachment; toddler temperament; prospective study; pregnancy. 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Asling-Monemi, K, Pena, R, Ellsberg, MC, Persson, LA 2003Violence against women increases the risk of infant and child mortality: a case-referent study in Nicaragua.Bull WHO811016PubMedGoogle Scholar
  2. Bensley, L, Van Eenwyk, J, Wynkoop Simmons, K 2003Childhood family violence history and women’s risk for intimate partner violence and poor health.Am J Preven Med253844CrossRefGoogle Scholar
  3. Chalk R, King P (eds) (1998) Violence in families: assessing prevention and treatment programs. National Academy Press, Washington, DC.Google Scholar
  4. Condon, JT, Corkindale, CJ 1998The assessment of parent-to-infant attachment: Development of a self-report questionnaire instrument.J Reprod Infant Psych165776Google Scholar
  5. Cox, JL, Holden, JM, Sagovsky, R 1987Detection of postnatal depression.Br J Psychiatry150782786PubMedGoogle Scholar
  6. Ehrensaft, MK, Cohen, P, Brown, J, Smailes, E, Chen, H, Johnson, JG 2003Intergenerational transmission of partner violence: a 20-year prospective study.J Consult Clin Psychol71741753CrossRefPubMedGoogle Scholar
  7. Karen R (1998) Becoming attached: First relationships and how they shape our capacity to love. Oxford University Press, New York.Google Scholar
  8. Kitzmann, KM, Gaylord, NK, Holt, AR, Kenny, ED 2003Child witnesses to domestic violence: a meta-analytic review.J Consult Clin Psychol71339352CrossRefPubMedGoogle Scholar
  9. Mahony, DL, Campbell, JM 1998Children witnessing domestic violence: a developmental approach.Clin Excel Nurse Pract2362369Google Scholar
  10. McKie, L 2003Review article: gender, violence and health care: implications for research, policy and practice.Sociol Health Illness25120131CrossRefGoogle Scholar
  11. McLennon W (1996) Women’s Safety Survey. Australian Bureau of Statistics, Canberra, Australia.Google Scholar
  12. Moran, T 1995‘I fell down the stairs.’ Physicians can help by learning to recognize the signs of domestic violence.Texas Med911821Google Scholar
  13. Murray, L, Fiori-Cowley, A, Hooper, R, Cooper, P 1996aThe impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome.Child Dev6725122526Google Scholar
  14. Murray, L, Hipwell, A, Hooper, R, Stein, A, Cooper, P 1996bThe cognitive development of 5-year-old children of postnatally depressed mothers.J Child Psychol Psych Allied Dis37927935Google Scholar
  15. Murray, L, Sinclair, D, Cooper, P,  et al. 1999The socioemotional development of 5 year-old children of postnatally depressed mothers.J Child Psychol Psychiat Allied Dis4012591271CrossRefGoogle Scholar
  16. Oberklaid, F, Sanson, AV,  et al. 1986The development of Australian normative data for infant temperament.Aust Paediatr J22185187PubMedGoogle Scholar
  17. Oberklaid, F, Prior, M, Golvan, D, Clements, A, Williamson, A 1984Temperament in Australian infants.Aust Paediatr20181184Google Scholar
  18. Pascoe, JM, Ialongo, NS, Horn, WF, Reinhart, MA, Perradatto, D 1988The reliability and validity of the maternal social support index.Fam Med20271276PubMedGoogle Scholar
  19. Prior MR, Sanson AV, Golvan D, Clements A, Williamson A (1989) The Australian temperament project. In: Kohnstamm GA, Bates JE (eds), Temperament in childhood. John Wiley & Sons, New York, pp 537–554.Google Scholar
  20. Quinlivan, JA, Evans, SF 2001A prospective cohort study of the impact of domestic violence on young teenage pregnancy outcomes.J Pediatr Adol Gynecol141723CrossRefGoogle Scholar
  21. Quinlivan, JA, Evans, SF 2004Teenage antenatal clinics may reduce the rate of preterm birth: a prospective study.BJOG111551578Google Scholar
  22. Quinlivan, JA, Box, H, Evans, SF 2003Postnatal home visits in teenage mothers: A randomised controlled trial.Lancet361893900CrossRefPubMedGoogle Scholar
  23. Rosenberg M, Fenley M (1991) Violence in America. A public health approach. Oxford University Press, New York.Google Scholar
  24. Sinclair, D, Murray, L 1998Effects of postnatal depression on children’s adjustment to school. Teacher’s reports.Br J Psychiatry1725863PubMedGoogle Scholar
  25. Taket, A, Nurse, J, Smith, K, Watson, J, Shakespeare, J, Lavis, V, Cosgrove, K, Mulley, K, Feder, G 2003Routinely asking women about domestic violence in health settings.BMJ327673676CrossRefPubMedGoogle Scholar
  26. Tjaden P, Thoennes N (2000) Full report of the prevalence, incidence and consequences of violence against women: Research Report. National Institute of Justice, Washington, DC, NCJ 183781.Google Scholar
  27. U.S. Department of Health and Human Services (1995) Healthy people 2000: Midcourse review and 1995 revisions. U.S. Department of Health and Human Services Washington, DC.Google Scholar
  28. Wathen, CN, MacMillan, HL 2003Interventions for violence against women: scientific review.JAMA289589600CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag/Wien 2005

Authors and Affiliations

  • J. A. Quinlivan
    • 1
  • S. F. Evans
    • 2
  1. 1.University Department of Obstetrics and GynaecologyThe University of MelbourneMelbourneAustralia
  2. 2.King Edward Memorial Hospital for WomenPerthAustralia

Personalised recommendations