Abstract
Objectives: Unwanted intrusive thoughts (UITs) of intentional infant-related harm are common among birthing parents. Evidence to date has failed to find any association with physical aggression toward the infant. However, the relationship between UITs of infant-related sexual harm and sexual behaviors toward the infant has yet to be assessed. This is the purpose of the current study.
Methods: Data were collected from February 9, 2014, to February 14, 2017, via a prospective, province-wide, unselected cohort of N = 763 English-speaking birthing parents, n = 502 of whom provided data for the current analysis. Interview assessments of UITs of infant-related sexual harm were administered at approximately 7 weeks postpartum and 4 months postpartum. Sexual harming behaviors toward the infant were assessed via an anonymized questionnaire at the end of the study.
Results: UITs of infant-related sexual harm were reported by 9.2% (n = 38; 95% CI, 6.6–12.4) of participants. We found no evidence of an association between UITs of this nature and sexual behavior toward one’s infant (Fisher exact, P = 1.00). Only 1 participant reported engaging in sexual behavior toward their infant, and they did not report any UITs of infant-related sexual harm.
Conclusions: Study findings add to growing evidence that UITs of infant-related harm are common, and when these thoughts are unwanted and intrusive, they are not associated with an increased risk of actually harming one’s infant. Although findings suggest that this is also true for UITs of infant-related sexual harm and sexual behavior, due to the small sample employed in this research, replication with a larger sample is needed.
J Clin Psychiatry 2026;87(1):25m15985
Author affiliations are listed at the end of this article.
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References (22)
- Fairbrother N, Woody SR. New mothers’ thoughts of harm related to the newborn. Arch Womens Ment Health. 2008;11(3):221–229.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). American Psychiatric Association Publishing; 2022. PubMed CrossRef
- Rachman S. A cognitive theory of obsessions: elaborations. Behav Res Ther. 1998;36(4):385–401. PubMed CrossRef
- Fairbrother N, Collardeau F, Woody SR, et al. Postpartum thoughts of infant-related harm and obsessive-compulsive disorder: relation to maternal physical aggression toward the infant. J Clin Psychiatry. 2022;83(2):39944. PubMed CrossRef
- Abramowitz JS, Schwartz SA, Moore KM. Obsessional thoughts in postpartum females and their partners: content, severity, and relationship with depression. J Clin Psychol Med Settings. 2003;10(3):157–164. PubMed CrossRef
- Abramowitz JS, Khandker M, Nelson CA, et al. The role of cognitive factors in the pathogenesis of obsessive–compulsive symptoms: a prospective study. Behav Res Ther. 2006;44(9):1361–1374. PubMed CrossRef
- Miller ML, O’Hara MW. Obsessive-compulsive symptoms, intrusive thoughts and depressive symptoms: a longitudinal study examining relation to maternal responsiveness. J Reprod Infant Psychol. 2020;38(3):226–242.
- Zambaldi CF, Cantilino A, Montenegro AC, et al. Postpartum obsessive-compulsive disorder: prevalence and clinical characteristics. Compr Psychiatry. 2009;50(6):503–509.
- Fontanella C, Harrington D, Zuravin SJ. Gender differences in the characteristics and outcomes of sexually abused preschoolers. J Child Sex Abuse. 2001;9(2):21–40. PubMed CrossRef
- Brilleslijper-Kater SN, Friedrich WN, Corwin DL. Sexual knowledge and emotional reaction as indicators of sexual abuse in young children: theory and research challenges. Child Abuse Neglect. 2004;28(10):1007–1017.
- Van Duin EM, Verlinden E, Tsang VMW, et al. A sexual abuse case series of infants and toddlers by a professional caregiver: a qualitative analysis of parents’ experiences during the initial crisis period post-discovery. Child Abuse Neglect. 2022;125:105460.
- Barth J, Bermetz L, Heim E, et al. The current prevalence of child sexual abuse worldwide: a systematic review and meta-analysis. Int J Public Health. 2013;58(3):469–483. PubMed CrossRef
- Mulcahy M, Rees C, Galbally M, et al. Health practitioners’ recognition and management of postpartum obsessive-compulsive thoughts of infant harm. Arch Womens Ment Health. 2020;23(5):719–726. PubMed CrossRef
- Challacombe FL, Wroe AL. A hidden problem: consequences of the misdiagnosis of perinatal obsessive–compulsive disorder. Br J Gen Pract. 2013;63(610):275–276. PubMed CrossRef
- Collardeau F, Corbyn B, Abramowitz J, et al. Maternal unwanted and intrusive thoughts of infant-related harm, obsessive-compulsive disorder and depression in the perinatal period: study protocol. BMC Psychiatry. 2019;19(1):94. PubMed CrossRef
- Goodman W, Price L, Rasmussen S, et al. The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability. Archives Gen Psychiatry. 1989;46(11):1006–1011. PubMed CrossRef
- Taylor S. Assessment of obsessions and compulsions: reliability, validity, and sensitivity to treatment effects. Clin Psychol Rev. 1995;15(4):261–296. CrossRef
- IBM Corp. IBM SPSS Statistics for Macintosh, Version 28.0. Published online. 2021.
- Kita S, Chan KL, Tobe H, et al. A follow-up study on the continuity and spillover effects of intimate partner violence during pregnancy on postnatal child abuse. J Interpers Violence. 2021;36(13-14):NP6904–NP6927. PubMed CrossRef
- Regalado M, Sareen H, Inkelas M, et al. Parents’ discipline of young children: results from the National Survey of Early Childhood Health. Pediatrics. 2004;113(supplement_5):1952–1958. PubMed CrossRef
- Zolotor AJ, Robinson TW, Runyan DK, et al. The emergence of spanking among a representative sample of children under 2 years of age in North Carolina. Front Psychiatry. 2011;2:36. PubMed CrossRef
- Fairbrother N. Ethical issues in the assessment of postpartum maternal aggression. Presented at: The 2019 Annual Conference and General Meeting of the Canadian Association of Research Ethics Boards (CAREB-ACCER); April 2019; Winnipeg, MB.
