Prevention Science

, Volume 18, Issue 3, pp 361–370 | Cite as

History of Maltreatment in Childhood and Subsequent Parenting Stress in At-Risk, First-Time Mothers: Identifying Points of Intervention During Home Visiting

  • Chad E. ShenkEmail author
  • Robert T. Ammerman
  • Angelique R. Teeters
  • Heather E. Bensman
  • Elizabeth K. Allen
  • Frank W. Putnam
  • Judith B. Van Ginkel


Home visiting is an effective preventive intervention that can improve parenting outcomes for at-risk, new mothers, thereby optimizing subsequent child development. A history of maltreatment in childhood is common in mothers participating in home visiting, yet the extent to which such a history is related to parenting outcomes during home visiting is unknown. The current study evaluated whether mothers with a history of maltreatment in childhood respond less favorably to home visiting by examining the direct and indirect pathways to subsequent parenting stress, a key parenting outcome affecting child development. First-time mothers (N = 220; age range = 16–42) participating in one of two home visiting programs, Healthy Families America or Nurse Family Partnership, were evaluated at enrollment and again at 9-and 18-month post-enrollment assessments. Researchers administered measures of maternal history of maltreatment in childhood, depressive symptoms, social support, and parenting stress. Maternal history of maltreatment in childhood predicted worsening parenting stress at the 18-month assessment. Mediation modeling identified two indirect pathways, one involving social support at enrollment and one involving persistent depressive symptoms during home visiting, that explained the relation between a history of maltreatment in childhood and parenting stress at the 18-month assessment. Ways to improve the preventive effects of home visiting for mothers with a history of maltreatment in childhood through the identification of relevant intervention targets and their ideal time of administration are discussed.


Child maltreatment Home visiting Depression Social support Parenting stress 



The authors express thanks to all the organizations contributing to Every Child Succeeds. We also wish to thank Alonzo T. Folger, Ph.D., for his assistance in preparing this manuscript. This study is supported by Grant R40 MC 06632-01 (Ammerman) from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services. Angelique R. Teeters is currently with TriHealth, Group Health Physicians, Cincinnati, Ohio. The authors acknowledge the participation and support of the United Way of Greater Cincinnati, Kentucky HANDS, and Ohio Help Me Grow.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Society for Prevention Research 2017

Authors and Affiliations

  • Chad E. Shenk
    • 1
    • 2
    Email author
  • Robert T. Ammerman
    • 3
  • Angelique R. Teeters
    • 3
  • Heather E. Bensman
    • 3
  • Elizabeth K. Allen
    • 1
  • Frank W. Putnam
    • 4
  • Judith B. Van Ginkel
    • 3
  1. 1.Department of Human Development and Family StudiesThe Pennsylvania State UniversityUniversity ParkUSA
  2. 2.Department of Pediatrics, College of MedicineThe Pennsylvania State UniversityState CollegeUSA
  3. 3.Department of Pediatrics, College of MedicineCincinnati Children’s Hospital Medical Center and University of CincinnatiCincinnatiUSA
  4. 4.Department of Psychiatry, School of MedicineUniversity of North CarolinaChapel HillUSA

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