Restraining orders: A frequent marker of adverse maternal health

Objective. Women with histories of interpersonal violence are poorly identi fied because of barriers in self-disclosure. This study identified differen ces on maternal health and child behavior between women who report filing a restraining order (RO) and those who do not among a nonreferred sample of women living in high-crime neighborhoods. Methods, During a maternal interview mothers were asked whether they ever f iled a RO, the victim/defendant relationship, the number of times, and the year of the filing. Four types of violence were coded independently based o n maternal narratives: verbal harassment, verbal threats or intimidation, p hysical assault, and destruction of property. We controlled for differences between RO and non-RO groups regarding demographic background, partner cha racteristics, other types of maternal past victimization, and use of alcoho l and illicit drugs. Outcomes for mothers include partner aggression (Confl ict Tactics Scale-R), perception of health and bodily pain (SF-36 Health Su rvey), distress symptoms (SCL90-R), posttraumatic stress (PTS)-related symp toms, and partial posttraumatic stress disorder (PTSD) diagnosis (modified Diagnostic Interview Schedule PTSD-Module). Outcomes for the child include partner aggression (Conflict Tactic Scale-R), behavior problems (CBC 2-3 or Child Behavior Checklist), and PTS-related symptoms (PTS-related symptom c hecklist). Patients. One hundred sixty patients between 3.0 to 6.1 years who resided w ithin five residential ZIP codes with a high rate of local crime in the Cit y of Boston were drawn from a pediatric care clinic practice. Patients were participants of a larger study about the impact of community violence on m other-child relations. Results. Sixty-four (40%) of 160 mothers reported a history of filing a RO against a current boyfriend or husband (39%), ex-boyfriend or husband (44%) , someone known (8%), or other (9%), with a mean of 3.9 years (standard dev iation = 3.5 years) since RO filing. After controlling for covariates of ma rital status, immigrant status, public assistance, and lifetime sexual vict imization, we found a significant multivariate analysis of covariance group effect on maternal outcomes. Analysis of covariance analyses indicated tha t mothers in the RO group experienced higher current partner verbal aggress ion and physical violence to mother, poorer health, and higher PTS-related symptoms, compared with mothers in the non-RO group. More mothers in the RO group met partial lifetime PTSD diagnosis. Unadjusted for maternal covaria tes, the multivariate analysis of variance analyses on child outcomes (part ner aggression to child, behavior problems, and PTS-related symptoms) indic ated a nonsignificant group effect. Conclusions. Among dyads residing in high-risk crime areas, the incidence o f RO histories is substantive considering this was a nonshelter, nonreferre d sample. The inquiry about the history of a RO may provide a new and effic ient marker to quality of current partner relationship, maternal health, an d maternal stress-related symptomatology.