Clinical Psychology, Duke University
Cohort 5 Fellow

Academic Mentor
Kathleen Sikkema
Department of Psychology & Neuroscience, Duke University

Policy Mentor
Michelle Hughes
Executive Director, NC Child

Research Interests
Impact of childhood trauma across life course; intergenerational transmission of maltreatment; maternal mental health (perinatal); coping and resilience; global healthild neglect prevention

Areas of Expertise

Evidence-Based/Evidence-Informed Programs, Home Visiting and Maltreatment Prevention, Maternal Health, Mental Health and Well-Being, Regression Modeling, Structural Equation Models, Grounded Theory, Mixed Methods, Infants and Toddlers, Low-Income Families and Individuals

Karmel Choi is a doctoral student in the Clinical Psychology program at Duke University. Her current research focuses on how trauma affects the health and mental health of mothers and children, particularly during the perinatal period. This research is informed by prior and ongoing work with children and families in diverse settings across Asia, Europe, and North America. Prior to doctoral training, Ms. Choi spent one year in India as a research fellow with a public health NGO, working on projects related to safe childbirth and postpartum care. She is currently a graduate researcher on several federally funded projects on women’s health and trauma in South Africa, with a focus on pregnant and postpartum mothers. Ms. Choi completed her undergraduate studies at Duke, earning a B.A. in psychology along with a Child Policy Research certificate. She holds a M.A. in clinical psychology from Duke.


Intergenerational transmission of childhood maltreatment and its sequelae: the mediating role of postpartum depression
Mothers who have experienced childhood maltreatment are more likely to have children exposed to maltreatment, a phenomenon referred to as intergenerational transmission of maltreatment. Factors in the perinatal period, the earliest point of intersection between generations, may offer an opportunity to interrupt such transmission. The proposed study will test the mediating role of postpartum depression in the intergenerational transmission of maltreatment and related sequelae. A longitudinal cohort of over 1,000 British mothers and their twin children will be used to: (1) explore maternal childhood maltreatment as a risk factor for postpartum depression; (2) test the bridging role of postpartum depression between maternal childhood maltreatment and various child outcomes, specifically child victimization, internalizing/externalizing disorders, and physical health; (3) examine the effects of maltreatment subtypes. Similar aims will also be explored in a smaller cohort of South African mothers and their infants, with more proximal outcomes. Findings are expected to generate important knowledge regarding how postpartum depression may play a role in perpetuating childhood maltreatment and/or its sequelae across generations, and underscore the perinatal period as a prime window for efforts to prevent adverse child outcomes.