The Association of Post-Separation Abuse and Coercion With Children's Health and Flourishing.

Authors

Kathryn J Spearman, Nancy Perrin, Christina Bethell, Kamila A Alexander, Jennifer Hardesty, Jacquelyn Campbell

Published in

Journal of advanced nursing. Jul 17, 2026. Epub Jul 17, 2026.

Abstract

The purpose of this study is to compare health outcomes and flourishing between children (age 6-17) whose mothers experience high versus low exposure to post-separation abuse and coercive control (PSA).
Exploratory sequential mixed-methods study.
Cross-sectional survey with community-based, convenience sample of family court-involved mothers in the United States (N = 497). Independent variable measured by subscales of the Healthcare, Economic, and Legal PSA and Coercive Tactics Scale (HELP-T). Health outcomes measured by items from National Survey of Children's Health.
Children whose mothers experience more frequent PSA face a dual burden: increased odds of unmet mental health needs coupled with increased odds of mental health diagnoses, somatic symptoms and special health care needs. Children in the high-exposure Healthcare PSA group were twice as likely (aOR: 2.01, p-value < 0.001, 95% CI: 1.4-2.9) to report stomach/intestinal problems, 2.3 times more likely (p-value < 0.001, 95% CI: 1.5-3.4) to report chronic pain including headaches in the last 12 months, 2.13 times more likely (p-value < 0.001, 95% CI: 1.4-3.8) to have ever received a diagnosis of anxiety and 2.72 times (p-value < 0.001, 95% CI: 1.60-4.63) more likely to have unmet mental health needs as compared to children in the low-exposure group.
The findings from this study advance the growing body of evidence on how co-parent perpetrated PSA and coercive control harm children's health and access to healthcare.
This study is the first to our knowledge to demonstrate the association between maternal exposure to co-parent perpetrated PSA and children's health outcomes, establishing a foundation for future intervention work to improve children's health and access to health care.
Members of the public were involved in recruitment and cognitive interviewing.

PMID:
42469602
Bibliographic data and abstract were imported from PubMed on 18 Jul 2026.

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