(PS2-86) Postpartum Thoughts of Infant-related Sexual Harm: Clinical Correlates and Association with Infant Sexual Abuse

Background

Unwanted, intrusive thoughts (UITs) of intentionally harming one’s infant are common among new parents. Previous research has failed to find an association between UITs of intentional physical harm and physical aggression toward the infant. The association between UITs of sexual harm and sexual behavior toward the infant has yet to be explored. This was the primary goal of this analysis. The association of sexual UITs with social support, depression, and symptoms of obsessive-compulsive disorder (OCD) was also explored.

Methods

Participants (N = 763) were recruited in pregnancy via community advertisements and maternity health clinics. A total of n = 424 participants provided data for this analysis. Questionnaires and interviews were completed in pregnancy and at 5-weeks and 3-months postpartum. UITs of infant-related harm, social support, OC symptoms, and depression were assessed via the Postpartum Intrusions Interview (PPII), the Medical Outcomes Study Social Support Survey (MOS-SSS), the Dimensional Obsessive-Compulsive Scale (DOCS), and the Edinburgh Postnatal Depression Scale (EPDS), respectively. Following all other data collection, participants anonymously completed a self-report measure of infant-harming behaviors (the Parenting Behaviors Questionnaire; PBQ). Fisher’s Exact Tests examined the association of sexual UITs with sexual behavior toward the infant. One-way ANCOVAs tested for differences in social support and depressive and OC symptoms between participants with no UITs, non-sexual UITs, and sexual UITs, while controlling for maternal age, education, and number of biological children.

Results

Among the n = 336 participants who provided PBQ data, a single participant engaged in sexual behaviors toward their infant. This person was not among the n = 31 (9.2%) participants who reported UITs of sexual harm, revealing no association between sexual UITs and sexual behavior toward the infant (p = .902). Among all n = 424 participants, n = 185 (43.6%) reported no UITs, n = 202 (47.6%) reported non-sexual UITs, and n = 37 (8.7%) reported sexual UITs. There was a significant effect of UIT type on MOS-SSS, DOCS, and EPDS scales at 3 months postpartum; F(2,322) = 7.85, p < .001, F(2, 337) = 5.91, p = .003, F(2, 328) = 10.39, p < .001 respectively. Post-hoc analyses revealed that those with sexual UITs reported lower social support than those with no UITs (p < .001) and those with non-sexual UITs (p = .028). Depressive and OC symptoms did not differ significantly between the sexual and non-sexual UITs group, but both groups reported significantly higher symptom severity than those with no UITs.

Discussion

Consistent with previous work, our study found no association between UITs of sexual harm and sexual behavior toward the infant. Postpartum individuals may hesitate to disclose these UITS out of fear of negative repercussion, including child protection involvement. Those experiencing UITs of sexual harm reported lower social support in postpartum, even when compared with those experiencing UITs of a non-sexual nature. Our findings highlight the importance of psychoeducation for postpartum individuals, care providers, and the general public, so that individuals experiencing UITs of sexual harm can safely seek support.