Newborns of depressed mothers

Eighty-three newborns (M GA = 37 weeks) were assigned to depressed (N = 47) and nondepressed mother (N = 36) groups based on Beck Depression Inventory (BDI) scores. The Brazelton Neonatal Assessment Scale was administered to the infants within 24 hours after birth. Infants of depressed mothers demonstrated poorer performance on the orientation cluster. Further analysis of the orientation cluster items revealed inferior orientation to the inanimate stimuli. Infants of depressed mothers also showed less motor tone and activity and more irritability and less robustness and endurance (unavailability, lethargy, and stress behaviors) during the examination.     

Differential sucking by neonates of depressed versus non-depressed mothers

Forty-two neonates (M = 39-h old) of depressed and non-depressed mothers sucked on cold (50 °F) and warm (78 °F) nipples on alternating trials. Half the infants received the cold nipple on the first of the eight trials (20 s each) and the other half received the warm nipple first. Neonates of depressed mothers sucked twice as much as neonates of non-depressed mothers, suggesting arousal dysregulation, overactivity or greater hedonic behavior in the newborns of depressed mothers. Although the newborns did not show a preference for cold or warm nipples, a temperature order effect revealed that neonates who received the cold nipple on the first trial sucked significantly more on trials 2–8 than those who received the warm nipple on the first trial, suggesting that an initially cold nipple might elicit greater sucking. More research is needed on maternal mood effects and temperature of objects to determine how these factors affect neonatal sucking behaviors.     

Happy faces are habituated more slowly by infants of depressed mothers

Three-month-old infants of depressed (n=16) and non-depressed mothers (n=16) were habituated to video clips of a female model reciting phrases while posing happy or sad facial/vocal expressions and dishabituated to the alternate expressions. Overall, infants of depressed mothers took longer to habituate the video clips compared to infants of non-depressed mothers, and those assigned to habituate the sad video clips displayed a novelty response or dishabituated to the happy expressions. These findings suggest that 3-month-old infants of depressed mothers discriminate sad from happy expressions, however, they do not appear to perceive sad expressions as novel.     

Sleep disturbances in depressed pregnant women and their newborns

Pregnant women (N=253) were recruited during their second trimester of pregnancy (M=22.3 weeks gestation) and assigned to depressed (N=83) and non-depressed groups based on a SCID diagnosis of depression. They were then given self-report measures on sleep disturbance, depression, anxiety and anger, and their urine was assayed for norepinephrine and cortisol. These measures were repeated during their third trimester (M=32.4 weeks). Their newborns were then observed during sleep. During both the second and third trimesters, the depressed women had more sleep disturbances and higher depression, anxiety and anger scores. They also had higher norepinephrine and cortisol levels. The newborns of the depressed mothers also had more sleep disturbances including less time in deep sleep and more time in indeterminate (disorganized) sleep, and they were more active and cried/fussed more.     

Altering withdrawn and intrusive interaction behaviors of depressed mothers

Interaction coaching was given to 44 depressed mothers who had either a withdrawn or intrusive interaction style with their infants. The intrusive and withdrawn mothers were given instructions either to imitate their infants' behavior or to keep their infants' attention. The results suggested that the specific type of interaction coaching for the specific type of depressed mother (imitation for the intrusive mothers and attention-getting for the withdrawn mothers) significantly improved their interaction behaviors with their infants.     

Discrimination of facial expression by 5-month-old infants of nondepressed and clinically depressed mothers

Five-month-old infants of nondepressed and clinically depressed mothers were habituated to either a face with a neutral expression or the same face with a smile. Infants of nondepressed mothers subsequently discriminated between neutral and smiling facial expressions, whereas infants of clinically depressed mothers failed to make the same discrimination.     

Mediators of aggression among young adult offspring of depressed mothers

The current article explores the connection between maternal depression and offspring aggression during the transition to adulthood, expanding the scope of prior research on this topic. Both family-level factors (including parent-child relationship quality and maternal romantic relationship quality) and youth factors (including depression history and social functioning in midadolescence) were tested as potential mediators in a longitudinal community sample of 710 youth at ages 15 and 20. The results suggest that maternal depression confers a risk for higher levels of aggressive behavior by offspring at age 20. Structural equation models suggested that the association between maternal depression and youth aggression is fully mediated by youth history of depression by midadolescence, even when accounting for the stability of aggression between ages 15 and 20. Parent-child relationship quality, youth social functioning, and maternal relationship quality were not unique mediators of this association. Limitations and implications are discussed.     

Affective interactions of depressed and nondepressed mothers and their children

The expressed affect of clinically depressed and nondepressed mothers as measured by the Schedule for Affective Disorders and Schizophrenia: Lifetime Version (SADSL) and their children (1 1/2 to 3 1/2 years) was observed in seminatural situations. The objectives were to investigate how maternal depression enters into affective interactions between mother and child and how the affect patterns of mother and child are related. Fortynine unipolar and 24 bipolar depressed mothers and 45 nondepressed mothers were observed on 2 days, 2 weeks apart, for a total of 5 h. Each minute was coded for the predominant affect of mother and child. Affects relevant to depression (anxioussad, irritableangry, downcast, pleasant, tenderaffectionate) were coded. Depressed mothers expressed significantly more negative affect than did control mothers. Mothers' expressed affect and their selfreports of affect on days of observation were unrelated. Mother's and child's affects, measured on different days, were significantly correlated. Unipolar mothers and mothers severely depressed spent significantly more time in prolonged bouts of negative affect. There was significant synchrony between their bouts and the negative bouts of their daughters. Gender of child was related to mother's and child's affect, and to relations between mother's and child's affect.     

Object perception in 5-month-old infants of clinically depressed and nondepressed mothers

Five-month-old infants of clinically depressed and nondepressed mothers were familiarized to a wholly novel object and afterward tested for their discrimination of the same object presented in the familiar and in a novel perspective. Infants in both groups were adequately familiarized, but infants of clinically depressed mothers failed to discriminate between novel and familiar views of the object, whereas infants of nondepressed mothers successfully discriminated. The difference in discrimination between infants of depressed and nondepressed mothers is discussed in light of infants' differential object processing and maternal sociodemographics, mind-mindedness, depression, stress, and interaction styles that may moderate opportunities for infants to learn about their world or influence the development of their perceptuocognitive capacities.     

Pathways to violence in the children of mothers who were depressed postpartum

The impact of postnatal depression on a child's risk for violent behavior was evaluated in an urban British community sample (N=122 families). Mothers were interviewed during pregnancy, at 3 months postpartum, and when the child was 1, 4, and 11 years of age. Mothers, teachers, and children reported on violent symptoms at age 11. Structural equation modeling revealed that the child's violence was predicted by the mother's postnatal depression even when her depression during pregnancy, her later history of depression, and family characteristics were taken into account. Violence was associated with symptoms of attention-deficit/hyperactivity disorder and problems with anger management. Children were most violent if mothers had been depressed at 3 months and at least once thereafter.     

Right frontal EEG asymmetry and behavioral inhibition in infants of depressed mothers

Recent studies have shown associations between maternal psychopathology and inhibited behaviors in infants. Moreover, physiological factors have been identified as affecting the continuity of behavioral inhibition across childhood. The purpose of the present study was to examine electroencephalogram (EEG) activity and inhibited behavior in 12-month-old infants of depressed versus non-depressed and mothers. Repeated measures MANOVAs indicated that the infants of mothers with stable psychopathology had greater relative right frontal EEG asymmetry, a pattern that typically accompanies greater negative affect and greater withdrawal behaviors. Infants of affectively ill mothers also showed more proximal behaviors toward a stranger and a novel toy than infants of well mothers, but fewer non-proximal behaviors toward their mothers. These results are discussed within a framework of behavioral inhibition for infants exposed to early psychopathologies in their mothers.     

Cognitive reactivity and depressotypic information processing in children of depressed mothers.

Although high-risk research suggests that children of depressed mothers are at increased risk for psychological disorders, the mechanisms of this risk are not well understood. In the current study, the information processing of children of depressed mothers was compared with that of children whose mothers were not depressed. Half of each group received a priming induction designed to activate cognitive schemas prior to assessment. All children then completed a self-referent processing task that examined the recall of negative and positive information. Results indicate that when primed, at-risk children showed a less positive self-concept and more negative information processing than did the children in the other groups. These data may offer potential clues into the mechanisms of cognitive vulnerability in at-risk children.     

Social skill in self-assertive strategies of toddlers with depressed and nondepressed mothers

The authors examined the effects of maternal depression on the skillfulness of toddlers' self-assertive strategies in interactions with their mother and with a female examiner. The participants were 110 mothers and their 26-month-old toddlers. Of these mothers, 57 had experienced an episode of clinical depression sometime since their child's birth, and 53 had had no history of depression. Toddlers exposed to maternal depression demonstrated significantly less social skill in their self-assertive strategies and more defiance when interacting with their mothers than did toddlers who were never exposed to maternal depression. The chronicity and severity of toddlers' exposure to maternal depression did not account for more pronounced differences in toddlers' skill in self-assertion toward mothers; however, toddlers exposed to more chronic courses of depression demonstrated less skill in their self-assertion toward the examiner. Toddlers who were exposed to maternal depression with a comorbid anxiety disorder did not exhibit less skill in their self-assertion toward mothers than did toddlers in either the depression-only or nondepressed groups. These findings suggest that exposure to maternal depression may interfere with toddlers' development of socially competent self-assertion strategies and may pose risks for future problems in the mother-toddler relationship.     

Facial expressions and vagal tone of infants of depressed and non-depressed mothers

Mothers classified as ‘depressed’, ‘non-depressed’ or ‘low scoring’ on the Beck Depression Inventory and their 3-month-old infants were videotaped during 3-minute face-to-face play interactions. Infants' facial expressions were coded using the AFFEX facial expression coding system and their EKG was recorded during the interactions to assess the relationship between cardiac measures and facial expressivity. Infants of both ‘depressed’ and ‘low scoring’ mothers showed significantly more sad and anger expressions and fewer interest expressions than infants of nondepressed mothers. Cardiac vagal tone, (quantified from the amplitude of respiratory sinus arrhythmia) was correlated with infants' joy and interest expressions and with self-comfort behaviours in the non-depressed and low scoring groups, but not in the depressed group. The results suggest that matermal depression affects infants' affective state and appearance as well as their biobehavioural emotional regulation systems.     

Adjustment of children of depressed mothers: a 10-month follow-up.

There is considerable concern about the adjustment of children of depressed mothers. Earlier we studied the specificity of these difficulties to maternal depression. Child adjustment difficulties were evident in 7- to 13-year-old children of both depressed and nondepressed psychiatric patient mothers but not in the children of community mothers or nondepressed medical patient mothers (Lee & Gotlib, 1989a). This report describes a 10-month follow-up of 44 of these subjects. Despite the alleviation of maternal depressive symptomatology, children in the 2 psychiatric groups continued to manifest adjustment difficulties that were evident to both clinicians and mothers. These findings suggest that the adjustment difficulties found in the children of psychologically distressed mothers do not abate within the 1st year after the mothers' recovery.     

Self-cognitions,stressful events,and the prediction of depression in children of depressed mothers

In a preliminary effort to integrate cognitive, life stress, and interpersonal approaches to vulnerability to depression, children's cognitions about themselves, their stressful life events, and the interaction of self-cognitions and life events were tested as predictors of depression. Children of normal, medically ill, and bipolar and unipolar depressed mothers were assessed initially and 6 months later for diagnostic status using the Kiddie-SADS interview. As predicted, Piers-Harris self-concept scores and interview-assessed children's stressful life events significantly predicted changes in depression status over the 6-month follow-up. Stressors and the interaction of stressors and self-concept also predicted changes in diagnosis of nonaffective disorders. A self-schema measure of accessibility of negative self-cognitions, known to be mood-dependent, failed to add to the prediction of depression severity. The results are consistent with a model of depression vulnerability that emphasizes cognition about self-worth and self-efficacy as mediators of the impact of stressful events, and we speculate that such self-schemas are acquired in part in the context of parent-child relationships. Recommendations are given for further studies of the acquisition and the mechanisms of self-schemas.This research was supported by an award from the William T. Grant Foundation. The assistance of Cheri Adrian, Dorli Burge, David Gordon, Donald Hiroto, Carol Jaenicke, our research staff, and cooperating agencies is gratefully acknowledged.     

Newborns of depressed mothers who received moderate versus light pressure massage during pregnancy

Sixty-four neonates (M age=6.8 days) of depressed mothers who received moderate pressure massage versus light pressure massage therapy during pregnancy (month 5 through month 8) were compared on their behaviors during 15-min observations and on their performance on the Brazelton Neonatal Behavior Assessment Scale. The group of neonates whose mothers received moderate pressure massage spent a greater percent of the observation time smiling and vocalizing, and they received better scores on the orientation, motor, excitability, and depression clusters of the Brazelton scale.     

Thinking about and working with depressed mothers in the early months of their infant's life

This paper illustrates how my work has developed over the years and informed my thinking about, and work with, depressed mothers. It also describes the work of the Parent Infant Foundation in Sydney where pregnant women and mothers with infants and toddlers are seen in groups and individually through home visits. The relevance of the support of a peer group when doing such difficult work is described. The paper draws on a central theme: the depressed mother, returning to her own infant beginnings through pregnancy and birth, confronts a dead mother-dead infant dyad. Trauma from the mother's own infancy is seen to have created an internal, autistic, deadened, psychic space. It is argued that behind this deadness lies the primeval pain of abandonment and loss. The associated rage, previously repressed but now awakened by her alive infant and his powerful primitive demands, invade the mother's psyche. The internal deadness freezes her alive processes as mother to her baby. Unbearable pain is awakened - and she may be in terror and unable to move, or she may experience herself as drowning in something catastrophic. SUMMARY This paper illustrates how my work has developed over the