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The Role of Sexual Abuse and Dysfunctional Attitudes in Perceived Stress and Negative Mood in Pregnant Adolescents: An Ecological Momentary Assessment Study - 29/06/15

Doi : 10.1016/j.jpag.2014.09.012 
Kate Walsh, PhD 1, , Archana Basu, PhD 2, Catherine Monk, PhD 2, 3, 4
1 Department of Epidemiology, Columbia University Medical Center, New York, New York 
2 Department of Psychiatry, Columbia University Medical Center, New York, New York 
3 Department of Psychiatry, Weill Medical College of Cornell University, New York, New York 
4 Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York 

Address correspondence to: Kate Walsh, PhD, 722 W 168th St, New York, NY 10032
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Monday 29 June 2015

Abstract

Study Objective

Latinas have the highest rates of adolescent pregnancy in the United States. Identifying means to improve the well-being of these young women is critical. The current study examined whether a history of child sexual abuse—itself a risk factor for adolescent pregnancy—was associated with more perceived stress and negative mood over the course of pregnancy and whether dysfunctional attitudes explained these associations.

Design and Setting

This mixed methods study involved laboratory-based assessments of perceived stress, sexual abuse history, and dysfunctional attitudes, as well as Ecological Momentary Assessments (EMA) of mood states every 30 minutes during a 24-hour period once during each trimester of pregnancy.

Participants

Pregnant adolescents (N = 204, 85% Latina).

Main Outcome Measures

EMA mood states and laboratory-based retrospective self–reports of perceived stress.

Results

One in 4 pregnant adolescents had a history of sexual abuse. Sexually abused adolescents reported greater perceived stress during the first trimester relative to those without, though the groups did not differ on EMA negative mood ratings. Dysfunctional attitudes explained associations between sexual abuse and perceived stress. Sexual abuse was indirectly associated with the intercept and slope of negative mood through dysfunctional attitudes. Findings were circumscribed to sexual abuse and not other types of child abuse.

Conclusions

Identifying sexually abused pregnant adolescents and providing support and cognitive therapy to target dysfunctional beliefs may decrease stress during the first trimester as well as negative affect throughout pregnancy.

El texto completo de este artículo está disponible en PDF.

Key Words : Adolescent pregnancy, Child sexual abuse, Dysfunctional attitudes, Perceived stress, Negative mood, Ecological momentary assessment


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 The authors would like to acknowledge the following funding sources: Funded by National Institute on Drug Abuse (NIDA) with Grant # T32DA031099 (Dr Walsh), Sackler Institute Fellowship in Parent-Infant Studies from the Sackler Institute for Developmental Psychobiology (Dr Basu), and Funded by National Institute of Mental Health (NIMH) with Grant # MH077144 - 01A2 (Dr Monk). The authors indicate no conflicts of interest.


© 2015  North American Society for Pediatric and Adolescent Gynecology. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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