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Adverse Childhood Experiences and the Psychosocial Functioning of Women in Early Adulthood

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Adverse Childhood Experiences and the Psychosocial Functioning of Women in Early Adulthood - \ ! U ADVERSE CHILDHOOD EXPERIENCES AND THE PSYCHOSOCIAL FUNCTIONING OF WOMEN IN EARLY ADULTHOOD by DAVID LLOYD QUINTON PhD Degree 1984 BEDFORD COLLEGE, UNIVERSITY OF LONDON ProQuest Number: 10098495 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest. ProQuest 10098495 Published by ProQuest LLC(2016). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. Microform Edition © ProQuest LLC. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 ABSTRACT ^ This thesis is concerned with the issue of continuities and discontinuities between adverse famii> experiences in childhood, and the ps) chosocial functioning of >oung adult women, with particular reference to parenting behaviour. The thesis seeks to determine v/hether intergenerational links between adverse childhoods and adult functioning arise through the direct effects of adversity on personalit) development or through its impact on subsequent life chances and circumstances. The processes promoting discontinuities are also examined. These issues are explored in two studies, using reception of children into care as in index of family problems and adversity. In the first study a consecutive sample of 48 women with children multiply admitted to Residential Care by one London borough and a contrast group of 47 from the same area were interv iewed concerning their early experiences, subsequent life histories and current functioning to determine retrospectively whether their current problems v7ere associated with similar difficulties in their own childhoods, or whether they arose predominantly in response to current fam ily and environmental stresses. The second study concerned 93 women admitted to long-stay Children's Homes in early childhood and a contrast group of 51 brought up in inner London but who had never been in care. Both groups were interviewed concerning their early experiences, their life histories and their current psy chosocial functioning, with a particular focus on parenting skills. This study was concerned to establish the extent of intergenerational continuities in psychosocial problems, and the factors involved in continuities and discontinuities. The results from the studies show that although the great majority of families with currently marked parenting problems are drawn from those who had markedly adverse childhoods, such problems occur in a minority of those who suffered such experiences. Where continuities occur the links are predominantly indirect, involving complex chains of circumstances and adverse environments. These links are partly' independently determined by earlier environments experienced by the young women and partly selected through their impact on individual functioning at particular times. The data show marked beneficial effects of positive changes in experience in adulthood, especially where marital relationships are good. ACKNOWLEDGEMENTS This research could not have been completed w ithout the help and encouragement of many people. In particular I would like to thank Professors George Brown and Michael Rutter for advice, criticism and support; Dr Graham Dunn and Brian Everitt for statistical advice; and, Barbara Maughan and Janet Ouston for many discussions on method and Linda Dowdney for the insightful contribution to the problems of assessing parenting. Those who helped w ith the interviewing made a major contribution. Gerrilyn Smith, Maggie Winkworth and Freda Sklair were skilled, and persistent; and Christine Liddle, who took the major interviewing load in the prospective study, was an invaluable and supportive colleague. I would also like to thank the two Group General Practices and their attached Health Visitors for allowing their patients to be approached for the retrospective study comparison sample, and the staff at the Borough Social Services department and all area teams for helping identify and contact the In-Care families. In the prospective study the NHS Central Register staff were efficient and helpful in tracing Ex-Care subjects and the local FPCs and the family doctors in making contact with them. Finally, I would like especially to thank Mrs Jenny Smith without whose speed and expertise on the word processor this thesis could never have been prepared. TABLE OF CONTENTS Page Title 1 Abstract 2 Acknowledgements 4 Table of Contents 5 Statistical Tables 12 PART 1; BACKGROUND TO THE RESEARCH AND METHODOLOGY 18 CHAPTER 1. RESEARCH ISSUES, DESIGN AND METHODOLOGY 19 Introduction 19 SECTION A; PARENTING; CONTINUITIES AND CORRELATES 21 L INTERGENERATIONAL CONTINUITIES IN PARENTING 21 (1) THE CONCEPT OF PARENTING 21 (2) CONTINUITIES IN PARENTING 23 C i) Parenting Practices 23 ( ii) Parenting Skills 27 ( iii) Severe Abnormalities in Parenting 3 0 ( iv) Animal Studies 33 ( v) Summary 34 II. CORRELATES OF PARENTING DIFFICULTIES 35 ( i) Single Parent Status 35 ( ii) Parental Psychiatric Disorder 37 ( iii) Marital Discord 41 ( iv) Social Class 43 ( v) Early Pregnancy and Childbirth 44 ( vi) Environmental Circumstances 4 9 ( vii) Social Support 50 ( viii) Correlates of Painting Problems : summary 51 III. CONTINUITIES IN PSYCHOSOCIAL FUNCTIONING 52 ( i) Psychiatric Disorders . 52 ( ii) Marital Discord and Disruption 53 IV. CONTINUITIES IN SOCIO-ECONOMIC DISADVANTAGE 55 C i) Poverty 56 ( ii) Housing 57 V. EVIDENCE FOR CONTINUITIES: METHODOLOGICAL PROBLEMS 58 SECTION B; THEORETICAL PERSPECTIVES AND PROCESSES OF 60 CONTINUITY I. THEORETICAL PERSPECTIVES 60 (1) SOCIOLOGrCAL MODELS 60 (2) CONCEPTS OF CONTINUITY IN INDIVIDUAL FUNCTIONING 64 II. THE PROCESS OF CONTINUITY 6 8 ( i) Impacts of Adverse Early Environments on Personal 69 Functioning ii) Studies of Changed Environments in Childhood 71 iii) Adult Outcomes for Changed Environments 75 iv) Specific versus Overall Effects on Functioning 77 v) Genetic Influences 7 9 vi) Modifying Influences 82 III. MODELS FOR PERSON/ENVIRONMENT TRANSACTIONS 8 6 (1) ECOLOGICAL MODELS 8 6 (2) VULNERABIUTY/STRESS MODELS 91 (3) BIOGRAPHICAL MODELS 93 ( i) The Nature of Biographical Models 93 ( ii) Self-Concepts as Mediating Factors 96 ( iii) Early Pregnancy as a Linking Factor 100 ( iv) Assort at ive Mating and Spouse's Characteristics 102 as Linking Factors ( v) Mate Selection 103 SECTION C: RESEARCH ISSUES, DESIGN AND METHODOLOGY 107 I. RESEARCH ISSUES 1 07 II. THE CHOICE OF A PARENTING INDEX 11 0 III. OUTLINE OF THE TWO STUDIES 111 IV. INTERVIEWING METHODOLOGY 112 ( i) Interviewing Techniques 112 ( ii) The Issue of Long-term Recall 116 PART E: THE RETROSPECTIVE STUDY; FAMILIES WITH CHILDREN 120 CURRENTLY IN-CARE CHAPTER 2: CURRENT CIRCUMSTANCES AND PARENTING 121 I. SAMPLES 121 ( i) The 'In Care' Sample 121 ( ii) The Comparison Group 122 ( iii) Checks on Sample Completeness 122 ( iv) Interview Rates 123 n. MULTIPLE ADMISSIONS AND PARENTING PROBLEMS 124 ( i) Family Care History 124 ( ii) Reasons for Admission 125 ( iii) Interview Measures of Parenting 126 (a) Mother-Child Relationships 126 (b) Maternal Discipline 127 ( iv) Dependent Variable of Parenting 128 III. CURRENT CIRCUMSTANCES 130 ( i) Family Structure 130 ( ii) Social Status and Housing 131 ( iii) Psychiatric Disorder and Deviance 134 ( iv) Characteristics of Cohabitees 136 ( v) Parenting by Cohabitees 137 ( vi) Mothers'Social Relationships and Supports 138 ( vii) Practical Help 140 IV. DISCUSSION 1 41 ( i) Parenting Current Disadvantage 141 ( ii) Parenting and Admissions to Care 142 CHAPTER 3: INTERGENERATIONAL CONTINUITIES 144 I. PARENTS' CHILDHOOD EXPERIENCES 1 44 ( i) Mothers'Social Background 144 ( ii) Deviance and Disorder in Mothers' Parents 144 ( iii) Family Relationships in Mothers'Childhood 145 ( iv) Mothers'Early Teenage Difficulties 147 ( v) Mothers'Later Teenage Difficulties 148 ( vi) Characteristics and Background of Current Cohabitees 14 9 ( vii) Overview of Parents' Childhood Experiences 151 II. INTERGENERATIONAL CONTINUITIES IN PARENTING PROBLEMS 153 ( i) Introduction 153 ( ii) Early Experiences and Parenting Breakdown 154 HI. PROCESSES OF TRANSMISSION 1 56 ( i) Relative Importance of Parental Deviance and Adverse 156 Childhood Experiences ( ii) The Role of Teenage D ifficultie s 158 ( iii) The Role of Fathers and Husbands 161 ( iv) Housing Problems 162 ( v) Psychiatric Disorder 164 IV. CURRENT HANDLING PROBLEMS 1 64 ( i) In Care Mothers 165 ( ii) Comparison Group Mothers 166 V. DISCUSSION 170 PART m: THE PROSPECTIVE STUDY: FOLLOW-UP OF WOMEN FROM 173 TWO GROUP COTTAGE CHILDREN'S HOMES CHAPTER 4: SAMPLING, TRACING AND DATA COLLECTION 174 I. SAMPLING 174 II. TRACING 175 III. THE INTERVIEW 177 IV. SOCIAL SERVICE CASE NOTES 1 78 V. THE VALIDITY OF INTERVEW DATA 1 80 ( i) Agreement between Self Ratings of Malaise and 180 Psychiatric Disorder ( ii) Agreement between Self Reports of Criminality 182 and Official Records ( iii) The Validity of Long Term Recall 183 ( iv) Agreement on Early Experiences between Subjects' 184 Reports and Official Records ( v) Agreement between Sibs 189 VI. BIASES IN REPORTING: LONG TERM RECALL 190 ( i) Overlap between Accounts of Relationships 190 ( ii) Current Functioning and Accounts of Early Experiences 192 CHAPTER 3: THE CHILDHOODS OF THE TWO SAMPLES 198 I. THE HOMES 198 ( i) General Characteristics
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