Abstracts
Abstract
Intergenerational trauma explains why populations subjected to long-term and mass trauma show a higher prevalence of disease, even several generations after the original events. Residential schools and other legacies of colonization continue to impact Aboriginal populations, who have higher rates of mental health concerns. Poor maternal mental health during pregnancy can have serious health consequences for the mother, the baby, and the whole family; these include impacting the cognitive, emotional, and behavioural development of children and youth. This paper has the following objectives: to define intergenerational trauma and contextualize it in understanding the mental health of pregnant and parenting Aboriginal women; to summarize individual-level and population-level approaches to promoting mental health and examine their congruence with the needs of Aboriginal populations; and to discuss the importance of targeting intergenerational trauma in both individual-level and population-level interventions for pregnant Aboriginal women. Various scholars have suggested that healing from intergenerational trauma is best achieved through a combination of mainstream psychotherapies and culturally-entrenched healing practices, conducted in culturally safe settings. Pregnancy has been argued to be a particularly meaningful intervention point to break the cycle of intergenerational trauma transmission. Given the importance of pregnant women’s mental health to both maternal and child health outcomes, including mental health trajectories for children and youth, it is clear that interventions, programs, and services for pregnant Aboriginal women need to be designed to explicitly facilitate healing from intergenerational trauma. In this regard, further empirical research on intergenerational trauma and on healing are warranted, to permit an evidence-based approach.
Keywords:
- intergenerational trauma,
- historical trauma,
- colonization,
- residential schools,
- Sixties Scoop,
- pregnancy,
- maternal-child health,
- mental health
Appendices
Bibliography
- Aboriginal Nurses Association of Canada (ANAC) (2009). Cultural competence and cultural safety in First Nations, Inuit and Métis nursing. Ottawa, ON: Author.
- ANAC, & Planned Parenthood Federation of Canada. (2002). Finding our way: A sexual and reproductive health sourcebook for Aboriginal communities. Ottawa, ON: Author.
- American Psychiatric Association (APA) (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- Balsam, K., Huang, B., Fieland, K., Simoni, J., & Walters, K. (2004). Culture, trauma, and wellness: A comparison of heterosexual and lesbian, gay, bisexual, and two-spirit Native Americans. Cultural Diversity and Ethnic Minority Psychology, 10(3), 297-301.
- Belik, J. (2008). Fetal and neonatal effects of maternal drug treatment for depression. Seminars in Perinatology, 32(5), 350-4. https://doi.org/10.1053/j.semperi.2008.08.001
- Bennett, M. (2005). Annotated bibliography of Aboriginal women’s health and healing research. Vancouver, BC: Aboriginal Women’s Health and Healing Research Group.
- Bennett, M., Blackstock, C., & De La Ronde, R. (2005). A literature review and annotated bibliography on aspects of Aboriginal child welfare in Canada (2nd ed.). Winnipeg, MB/Ottawa, ON: First Nations Research Site of the Centre of Excellence for Child Welfare, the First Nations Child & Family Caring Society of Canada.
- Blackstock, C. (2009). First Nations children count: Enveloping quantitative research in an Indigenous envelope. First Peoples Child & Family Review, 4(2), 135-143.
- Bowen, A., & Muhajarine, N. (2006a). Antenatal depression. Canadian Nurse, 102(9), 26-30.
- Bowen, A., & Muhajarine, N. (2006b). Prevalence of antenatal depression in women enrolled in an outreach program in Canada. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35(4), 491- 498. https://doi.org/10.1111/j.1552-6909.2006.00064.x
- Brave Heart, M. (2003). The historical trauma response among Natives and its relationship with substance abuse: A Lakota illustration. Journal of Psychoactive Drugs, 35(1), 7-13. https://doi.org/10.1080/02791072.2003.10399988
- Brave Heart, M., & DeBruyn, L. (1998). The American Indian Holocaust: Healing historical unresolved grief. American Indian and Alaska Native Mental Health Research, 8(2), 56-78.
- Bronfenbrenner, U. (1994). Ecological models of human development. In International Encyclopedia of Education (2nd ed.). Oxford, UK: Elsevier.
- Cedar Project Partnership, Pearce, M. E., Christian, W. M., Patterson, K., Norris, K., Moniruzzaman, . . . & Spittal, P. M. (2008). The Cedar Project: Historical trauma, sexual abuse and HIV risk among young Aboriginal people who use injection and non-injection drugs in two Canadian cities. Social Science and Medicine, 66(11), 2185-2194. https://doi.org/10.1016/j.socscimed.2008.03.034
- Chandler, M., & Lalonde, C. (1998). Cultural continuity as a hedge against suicide in Canada’s First Nations. Transcultural Psychiatry, 35(2), 191-219. https://doi.org/10.1177%2F136346159803500202
- Chansonneuve, D. (2005). Reclaiming connections: Understanding residential school trauma among Aboriginal people. Ottawa, ON: Aboriginal Healing Foundation.
- Dennis, C. L. (2010). Postpartum depression peer support: Maternal perceptions from a randomized controlled trial. International Journal of Nursing Studies. 47(5), 560–568. https://doi.org/10.1016/j.ijnurstu.2009.10.015
- Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129-136. https://doi.org/10.1126/science.847460
- Elhwuegi, A. S. (2004). Central monoamines and their role in major depression. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 28(3), 435-451. https://doi.org/10.1016/j.pnpbp.2003.11.018
- Elliott, D., Bjelajac, P., Fallot, R., Markoff, L., & Reed, B. (2005). Trauma-informed or trauma-denied: Principles and implementation of trauma-informed services for women. Journal of community psychology, 33(4), 461–477. https://doi.org/10.1002/jcop.20063
- Federal, Provincial and Territorial Advisory Committee on Population Health. (1999). Toward a healthy future: Second report on the health of Canadians. Ottawa, ON: Health Canada.
- First Nations Centre. (2005). First Nations regional longitudinal health survey (RHS) 2002/03. Ottawa, ON: First Nations Centre.
- Frohlich, K., & Potvin, L. (2008). The inequality paradox: The population approach and vulnerable populations. American Journal of Public Health, 98(2), 216-221.
- Garcia-Toro, M., & Aguirre, I. (2007). Biopsychosocial model in depression revisited. Medical Hypotheses, 68(3), 683-691. https://doi.org/10.1016/j.mehy.2006.02.049
- Health and Welfare Canada. (1974). New perspectives on the health of Canadians. Ottawa, ON: Author.
- Health Canada. (2011). First Nations and Inuit Health Program compendium. Ottawa, ON: Author.
- Heilbron, C. L., & Guttman, M. A. J. (2000). Traditional healing methods with First Nations women in group counselling. Canadian Journal of Counselling, 34(1), 3-13.
- Herrman, H., Saxena, S., & Moodie, R. (2005). Promoting mental health: Concepts, emerging evidence, practice. Geneva, SW: World Health Organization.
- Jesse, D. E., Blanchard, A., Bunch, S., Dolbier, C., Hodgson, J., & Swanson, M. (2010). A pilot study to reduce risk for antepartum depression among women in a public health prenatal clinic. Issues in Mental Health Nursing, 31(5), 355–364. https://doi.org/10.3109/01612840903427831
- Joca, S. R., Ferreira, F. R., & Guimaraes, F. S. (2007). Modulation of stress consequences by hippocampal monoaminergic, glutamatergic and nitrergic neurotransmitter systems. Stress, 10(3), 227-249. https://doi.org/10.1080/10253890701223130
- Johnston, P. (1983). Native children and the child welfare system. Toronto, ON: Canadian Council on Social Development.
- Kirmayer, L. J., Brass, G. M., & Tait, C. L. (2000). The mental health of Aboriginal peoples: Transformations of identity and community. Canadian Journal of Psychiatry, 45(7), 607-16. https://doi.org/10.1177%2F070674370004500702
- LaRocque, E. D. (1994). Violence in Aboriginal communities. Ottawa, ON: Health Canada.
- Letourneau, N. L., Dennis, C. L., Benzies, K., Duffett-Leger, L., Stewart, M., Tryphonopoulos, P. D., . . . & Watson, W. (2012). Postpartum depression is a family affair: Addressing the impact on mothers, fathers, and children. Issues in Mental Health Nursing, 33(7), 445–457. https://doi.org/10.3109/01612840.2012.673054
- Little Brown Bear [Matton, E.]. (2012, May). Developing a new understanding and creating a new healing journey. Presented at Grounding Trauma Conference, CAST Canada, Alliston, ON.
- Mandell, D., Carlson, J. C., Fine, M., & Blackstock, C. (2007). Aboriginal child welfare. In G. Cameron, N. Coady, & G. R. Adams (Eds.), Moving toward positive systems of child and family welfare: Current issues and future directions (pp. 115-159). Waterloo, ON: Wilfred Laurier University Press.
- McCormick, R. (2008). Aboriginal approaches to counseling. In L. J. Kirmayer & G. G. Valaskakis (Eds.), Healing traditions: The mental health of Aboriginal peoples in Canada (pp. 337-354). Vancouver, BC: UBC Press.
- McLaren, L., McIntyre, L., & Kirkpatrick, S. (2010). Rose’s population strategy of prevention need not increase social inequalities in health. International Journal of Epidemiology, 39(2), 372–377. https://doi.org/10.1093/ije/dyp315
- Menzies, P. (2008). Developing an Aboriginal healing model for intergenerational trauma. International Journal of Health Promotion & Education, 46(2), 41-48. https://doi.org/10.1080/14635240.2008.10708128
- Morse, J. M., & Niehaus, L. (2009). Mixed method design: Principles and procedures. Walnut Creek, CA: Left Coast Press, Inc.
- National Aboriginal Health Organization. (2008). Cultural competency and safety: A guide for health care administrators, providers and educators. Ottawa, ON: Author.
- Native Women’s Association of Canada. (2002). Violations of Indigenous human rights. Ottawa, ON: Author.
- Public Health Agency of Canada. (2005). Depression in pregnancy. Retrieved from http://www.phac-aspc.gc.ca/mh-sm/preg_dep-eng.php
- Rose, G. (1985). Sick individuals and sick populations. International Journal of Epidemiology, 14(1), 32- 38. https://doi.org/10.1093/ije/30.3.427
- Roy, A., & Campbell, M. K. (2013). A unifying framework for depression: Bridging the major biological and psychosocial theories through stress. Clinical and Investigative Medicine, 36(4), E170-E190. https://doi.org/10.25011/cim.v36i4.19951
- Roy, A. (2014). Aboriginal worldviews and epidemiological survey methodology: Overcoming incongruence. International Journal of Multiple Research Approaches, 8(1), 134-145. https://doi.org/10.5172/mra.2014.8.1.117
- Sadock, B. J., & Sadock, V. A. (2007). Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry (10th ed.). Philadelphia, PA: Wolter Kluwer/Lippincott Williams & Wilkins.
- Sandelowski, M. (2000). Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method studies. Research in Nursing & Health, 23(3), 246–255. https://doi.org/10.1002/1098-240X(200006)23:3%3C246::AID-NUR9%3E3.0.CO;2-H
- Schiepers, O. J., Wichers, M. C., & Maes, M. (2005). Cytokines and major depression. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 29(2), 201-217. https://doi.org/10.1016/j.pnpbp.2004.11.003
- Schotte, C. K., Van Den, B. B., De, D. D., Claes, S., & Cosyns, P. (2006). A biopsychosocial model as a guide for psychoeducation and treatment of depression. Depression and Anxiety, 23(5), 312-324. https://doi.org/10.1002/da.20177
- Sdorow, L. M., & Rickabaugh, C. A. (2002). Psychology (5th ed.). Boston, MA: McGraw-Hill.
- Sinclair, R. (2007). Identity lost and found: Lessons from the sixties scoop. First Peoples Child & Family Review, 3(1), 65-82.
- Smith, D., Edwards, N., Varcoe, C. Martens, P. J., & Davies, B. (2006). Bringing safety and responsiveness into the forefront of care for pregnant and parenting Aboriginal people. Advances in Nursing Science, 29(2), E27-44.
- Smith, M. V., Shao, L., Howell, H., Lin, H, & Yonkers, K. A. (2011). Perinatal depression and birth outcomes in a healthy start project. Maternal and Child Health Journal, 15(3),401-409. https://doi.org/10.1007/s10995-010-0595-6
- Smylie, J. (2000). A Guide for health professionals working with Aboriginal peoples. SOCG policy statement. Ottawa, ON: Council of the Society of Obstretricians and Gynaecologists of Canada
- Sotero, M. (2006). A conceptual model of historical trauma: Implications for public health practice and research. Journal of Health Disparities Research and Practice, 1(1), 93-108.
- Swaab, D. F., Bao, A. M., & Lucassen, P. J. (2005). The stress system in the human brain in depression and neurodegeneration. Ageing Research Reviews, 4(2), 141-194. https://doi.org/10.1016/j.arr.2005.03.003
- Tough, S. C., Johnstone, D. W., Siever, J. E., Jorgenson, G., Slacombe, L., Lane, C., & Clarke, M. (2006). Does supplementary prenatal nursing and home visitation support improve resource utilization in a system of universal health care? Results from a randomized controlled trial in Canada. Birth, 33(3), 183-194. https://doi.org/10.1111/j.1523-536X.2006.00103.x
- Truth and Reconciliation Commission of Canada (2011). About us. Retrieved from http://www.trc.ca/websites/trcinstitution/index.php?p=4
- University of Ottawa (2009). Aboriginal medicine and healing practices. Retrieved from http://www.med.uottawa.ca/sim/data/Aboriginal_Medicine_e.htm
- Whitbeck, L. B., Adams, G. W., Hoyt , D. R., & Chen, X. (2004). Conceptualizing and measuring historical trauma among American Indian people. American Journal of Community Psychology, 33, 119-130. https://doi.org/10.1023/B:AJCP.0000027000.77357.31
- World Health Organization (WHO) (1986). Ottawa charter for health promotion. Retrieved from https://www.who.int/healthpromotion/conferences/previous/ottawa/en/
10.7202/1069337ar