Relationship of childhood trauma to depression and smoking outcomes in pregnant smokers.

OBJECTIVE: We evaluated whether childhood trauma moderated the treatment effect on depression and smoking outcomes in pregnant smokers.

METHOD: The sample included pregnant smokers participating in a randomized trial evaluating the efficacy of a 10-session interpersonally focused therapy-cognitive behavioral analysis system of psychotherapy (CBASP)-versus a time-matched health and wellness control (HW) for smoking cessation and depression reduction. Women (N = 248) who completed the Childhood Trauma Questionnaire (CTQ) were included. On average, women were 25 years old (SD = 5.91) and smoked 10 (SD = 6.9) cigarettes per day. Depressive symptoms were assessed with the Center for Epidemiological Studies Depression Scale (CES-D), and women had an average score of 21 (SD = 11.03). Seventy-six percent of women had experienced some form of moderate to severe childhood trauma as assessed by the CTQ.

RESULTS: In women with a history of moderate to severe childhood trauma, there was a dose-response association of treatment on depression outcome through 6 months postpartum; those with increasing amounts of childhood trauma benefitted more from CBASP, whereas those in the HW condition did not. Childhood trauma did not moderate the treatment effect on abstinence, although increasing amounts of trauma were associated with reduced likelihood of abstinence at 6 months posttreatment.

CONCLUSIONS: An interpersonally focused therapy may be beneficial for the treatment of depression during the prenatal period in pregnant smokers with childhood trauma histories, and such treatment becomes increasingly more important with cumulative trauma experience. Childhood trauma increases risk for cessation failure in pregnant smokers. (PsycINFO Database Record (c) 2013 APA, all rights reserved).