Maternal depression and its relationship to life stress,perceptions of child behavior problems,parenting behaviors,and child conduct problems

This study examined the relationship of reported maternal depression to prior and current life stressors, and to mother perceptions of child adjustment, parenting behaviors, and child conduct problems. Forty-six depressed mothers and 49 nondepressed mothers and their clinic-referred children (aged 3-8 years) participated. Depressed mothers were more critical than nondepressed mothers, but the behavior of children of depressed and nondepressed mothers showed no significant differences. Depressed mothers were more likely to have experience child abuse, spouse abuse, or more negative life events than nondepressed mothers. Maternal reports of stress related to mother characteristics and to negative life events were the most potent variables discriminating depressed from nondepressed mother families.     

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.     

Maternal depression: Effects on social cognition and behavior in parent-child interactions

The social interactions of depressed and nondepressed mothers and their preschool-age children were observed and mothers' perceptions of child behavior assessed. Depressed mothers, as a group, exhibited more negative behavior than controls; however, no differences were found for maternal positive behavior or contingent responding. There was a high degree of reciprocity between child and mother behavior in both groups and there was a trend for children of the depressed mothers to be more negative than the control children. The results with cognitive measures were consistent with depressive realism in perception of social interactions: Depressed mothers recalled more negative child behavior than nondepressed mothers; however, these perceptions paralleled the observed interactions. Overall, the results suggest that maternal depression is associated with negative parent-child interactions and more negative, albeit fairly accurate, perceptions of child behavior.This study is based on portions of a doctoral dissertation completed in the Department of Psychology at the University of Iowa. I appreciate the guidance of my advisors Michael O'Hara and Donald K. Routh and committee members Leonard Feldt, John Knutson, and Sue Rosner.     

Preschoolers' response to maternal sadness: Relationships with maternal depression and emotional availability

Previous research has documented that children of depressed mothers are at risk for a variety of emotional/behavioral problems and impairments in mother-child interaction. Depressed mothers have been characterized as withdrawn and unavailable. The present study examined behavior of preschool children of depressed and nondepressed mothers in response to their mothers' feigned sadness. The study assessed maternal depression and maternal emotional availability to determine how these related to preschoolers' expression of empathy. Sixty-two mothers and their 3 1/2-year-olds participated in the study. Mother-child interaction was coded from four tasks: free play, eating a snack, problem solving, and sadness simulation. Children of depressed mothers were not less empathic than children of nondepressed mothers. However, the mother's mood on day of testing related to child response. Maternal emotional availability interacted with the credibility/intensity of her simulation of sadness to predict child empathy.     

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.     

The impact of postpartum depressed mood on mother-infant interaction: Like mother like baby?

The purpose of this study was to test the hypothesis that mothers with depressed mood would exhibit less optimal interaction than their nondepressed counterparts and that their infants would show similar deficits in interactional behavior. Twenty-two mothers and their 2-month-old infants were videotaped in to-minute free-play segments in a laboratory playroom, and their interactions were coded using both time-sampling and global clinical ratings of behavior. Mothers with depressed mood were judged significantly lower on overall positive interaction, Expressivity/Affective Involvement, and Responsivity/ Sensitivity than were nondepressed mothers. Infants of mothers with depressed mood were rated significantly lower than infants of nondepressed mothers on corresponding interaction domains. Mothers with depressed mood were also rated as more variable than nondepressed mothers along a continuum of withdrawal to controlling/intrusive behavior. Contrary to prediction, level of maternal stimulation and infant activity did not differ as a function of depression in maternal mood. We conclude that mild to moderate symptoms of maternal depression may have salient but selective effects on mother-infant interaction.     

Prospective study of postpartum depression: 4 1/2-year follow-up of women and children

The consequences of maternal postpartum depression for mothers and children were investigated in a 4 1/2-year follow-up study, which included 70 of 99 women who had participated in an earlier study of postpartum depression. Information about maternal adjustment and depression during the follow-up period and child adjustment at age 4 1/2 years was obtained. Women who had experienced a postpartum depression were predicted to be at increased risk for subsequent depression and poor adjustment of their child. Postpartum depression was directly related to subsequent depression but not child problems. Later depression was related to child problems at 4 1/2 years. We concluded that postpartum depression may increase risk for later maternal depression and in turn increases risk for child behavior problems. Intervening with women who have experienced a postpartum depression may reduce likelihood of future depressions and child behavior problems.     

Interactions between depressed and nondepressed Latina mothers and their premature infants

The impact of depression upon mother–infant interaction was studied longitudinally in a sample of very low income, immigrant Latina mothers with premature, very low birth weight infants. Both maternal characteristics and infant characteristics were examined using a rating scale which measured feeding interactions. Results indicate that mothers who were depressed at one month did not interact differently with their premature infants than nondepressed mothers. In addition, infants of mothers who were depressed at one month did not interact differently with their mothers than infants of nondepressed mothers. There were no differences between groups of mothers who remained depressed across the one-year period and groups whose scores reflected no depression or changes in depression levels. These findings challenge previous assumptions about interactions between depressed mother–infant dyads. Results indicate the need to broaden study attention to include socioeconomic, cultural, and life circumstances of families that may have greater impact on child outcomes than single assessments of maternal depression. Such studies may lead to changes in the way services are delivered and the types of interventions provided to non-mainstream families. © 1997 Michigan Association for Infant Mental Health     

Emotional and behavioral problems in children of depressed mothers: a school-based study in Southern Brazil

The present study aimed to verify the association between maternal depression and emotional and behavioral problems in school children in Pelotas, Southern Brazil, considering that maternal depression increases children’s vulnerability for developing psychiatric disorders. This is a cross-sectional study with a school-based sample conducted between August 2015 and November 2016 and it is part of a major project entitled ‘Healthy Childhood in Context: A Multidisciplinary Investigation’. Schoolchildren aged between 7 and 8 years and one of their respective parents or a primary caregiver were included in the study. Maternal depression was assessed using the Mini International Neuropsychiatric Interview (MINI). The presence of emotional and behavioral problems in children was verified by the Strengths and Difficulties Questionnaire (SDQ) – parents version. Children of depressed mothers exhibited higher mean scores in all SDQ domains and in the total score when compared to children of non-depressed mothers. Lower socio-economic status was also associated with higher SDQ scores. Our results showed the effects of both maternal depression and poverty on children emotional and behavioral problems, which evidence the need for child mental health preventive care, and free quality assistance for both mothers and their children.     

Attributional style and self-control behavior in depressed and nondepressed children and their parents

Do the reformulated model of learned helplessness and the self-control model apply to clinically depressed children? Are the related cognitive patterns specific to depression? Are the cognitive deficits associated with depression learned from one's parents? To address these questions this investigation examined three groups of children (ages 8–12) and their parents: nonclinic (n =25),nondepressed clinic (n=22),and depressed clinic (n=15).Children were diagnosed depressed on the basis of Kiddie-SADS interview data. Depressed clinic children self-reported more depression, had a more depressive attributional style, and had more self-control problems. There were more depressed mothers in the clinic than in the nonclinic sample. Depressed clinic children had more depressed mothers than did nondepressed clinic children. There were no differences among the three groups of parents in their cognitive patterns. No relationship was found between the attributional style and self-control behavior of children and their parents.     

Effects of Maternal Depression Symptoms and Alcohol Use Problems on Child Internalizing and Externalizing Behavior Problems

Empirical evidence suggests maternal behavioral health problems are significant predictors of child behavioral health difficulties, but it is unclear of the specific relation of maternal alcohol use problems and depression symptoms with child internalizing and externalizing behavior problems. The purpose of the study is to examine the impact of maternal depression symptoms and alcohol use problems on children’s internalizing and externalizing behavior problems over a period of 5 years. Implications for intervention may differ depending on which type of maternal behavioral health concerns predicts which child behavior problem. A total of 1874 families eligible for Early Head Start participated. Maternal depression symptoms and alcohol use problems were assessed when children were in preschool, and internalizing and externalizing behavior problems were assessed when children were in fifth grade. Clinical internalizing behavior problems was best predicted by maternal depression symptoms, whereas clinical externalizing behavior problems was best predicted by maternal alcohol use problems. Children were almost twice as likely to have clinical internalizing behavior problems when mothers exhibited very elevated depression symptoms compared to when mothers displayed minimal symptoms. A similar relation was found with maternal alcohol use problems and clinical externalizing behavior problems. Our findings highlight the importance of understanding and treating various kinds of behavioral health concerns in mothers of young children.     

Current and Past Maternal Depression, Maternal Interaction Behaviors, and Children’s Externalizing and Internalizing Symptoms

Relations among past maternal depressive disorder, current depressive symptoms, current maternal interaction behaviors, and children's adjustment were examined in a sample of 204 women and their young adolescent offspring (mean age = 11.86, SD = 0.55). Mothers either had (n = 157) or had not (n = 57) experienced at least one depressive disorder during the child's life. Mothers and children participated in a problem-solving task, video-taped for later coding. Mothers with current depressive symptoms and those with histories of chronic/severe depressive disorders displayed fewer positive behaviors toward their children; mothers with current depressive symptoms also showed more negative behaviors with their children. The relation between mothers' depression history and their behavior during the interaction with their child was partially mediated by mothers' current mood state. Moreover, high levels of maternal negativity and low levels of positivity during the problem-solving task were related to children's externalizing problems. Maternal positivity partially mediated the relation between maternal depression and children's externalizing symptoms. These findings highlight the importance of providing parenting interventions for depressed mothers.     

A model‐based intervention for depressed mothers and their infants

Many studies have reported on the adverse effects of maternal depression on offspring. Infants of depressed mothers are found to be more likely at risk to develop mental and socioemotional problems. In this study, an early intervention program is presented that aims to improve the interaction between depressed mothers and their infants to prevent developmental problems in the children. The program has recently been introduced in the Dutch Community Mental Health Centers as part of a national multicomponent program to reduce the risk of psychiatric and social problems in the offspring of parents with a mental disorder. The intervention for depressed mothers with babies is based on a transactional model in which the mother–child interaction plays a key role in explaining the development of socioemotional problems in the children. The model as discussed in the first part of this article addresses a range of evidenced‐based parental, child, and contextual risk factors that effect the quality of the interactions between depressed mothers and their infants and that contribute to both vulnerability and resilience of the children during later childhood and adolescence. ©2005 Michigan Association for Infant Mental Health.     

Putting the pieces together: Maternal depression,maternal behavior,and toddler helplessness

This study assessed relations between maternal depression, maternal behavior, and helplessness in toddlers. Helplessness was assessed behaviorally in 25‐ and 32‐month‐old toddlers while the toddlers were engaged with an impossible task. Maternal behavior (warmth, negativity, control, intrusiveness) was assessed during a mother–child teaching task when toddlers were 18 and 25 months of age. Mothers who reported more depressive symptoms on the BDI had 32‐month‐old toddlers who displayed more affect‐related helplessness. No direct relations were found between maternal diagnosis of depression and helplessness in toddlers. Few differences emerged in the behavior of depressed and nondepressed mothers while interacting with their toddlers, and few relations were found between maternal behavior alone and toddlers' helplessness. However, results suggest that maternal behavior moderates the relation between maternal depression (diagnosis, recency, and symptoms) and helplessness. ©2003 Michigan Association for Infant Mental Health.     

Revisiting the accuracy hypothesis in families of young children with conduct problems

Revisited the accuracy hypothesis in an examination of the relation between maternal depressive symptomatology and child conduct problems. All data were gathered as part of the pretreatment assessment in an outcome study of families with clinic-referred children with conduct problems (age 3 to 6). The mothers varied in their depressive symptomatology, from not at all symptomatic to severely symptomatic. Correlations indicated that with increasing depressive symptomatology, mothers (N = 97) displayed a higher rate of physical negative behaviors towards their child and reported more child conduct problems. Regression analyses revealed that at the lowest levels of maternal depressive symptomatology there was a discrepancy between mothers' reports of child behavior problems and child deviant behaviors observed during mother-child interaction. In contrast, at higher levels of depression, mothers' reports of child behavior were consistent with laboratory observations of their child's behavior. These findings provide evidence to support the accuracy hypothesis in reference to mothers who display a high degree of depressive symptomatology, but the results also call into question the validity of maternal report in families with children with conduct problems.     

Infants of “depressed” mothers interact better with their nondepressed fathers

To determine whether infants of “depressed” mothers interact better with their nondepressed fathers, twenty-six 3- to 6-month-old infants were videotaped during face-to-face interactions with their parents. The “depressed” mother group consisted of twelve 3- to 6-month-old infants and their “depressed” mothers and nondepressed fathers. The control group was composed of 14 nondepressed mothers and nondepressed fathers and their 3- to 6-month-old infants. In the “depressed” mother group, the nondepressed fathers received better interaction ratings than the “depressed” mothers. In turn, the infants received better interaction ratings when they interacted with their nondepressed fathers than with their “depressed” mothers. In contrast, nondepressed fathers and mothers and their infants in the control group did not differ on any of their interaction ratings. These findings suggest that infants' difficult interaction behaviors noted during interactions with their “depressed” mothers may not extend to their nondepressed fathers. The data are discussed with respect to the notion that nondepressed fathers may “buffer” the effects of maternal depression on infant interaction behavior.     

Depression in children: Parent,teacher, and child perspectives

Depressed and nondepressed children were found to differ in the types of behavior problems manifested at home and at school. Children rated as depressed by their parents on the Personality Inventory for Children evidenced significantly more conduct problems, anxiety, impulsive hyperactivity, learning problems, psychosomatic problems, perfectionism, and muscular tension at home than children rated as nondepressed. Depressed children were rated by their teachers as displaying more inattentionpassivity than nondepressed children. A significant but modest relationship was found between parent report and child selfreport of the child's depression. Depressed children attributed positive events to external causes and negative events to internal causes significantly more than did nondepressed children. The specificity of these results to depression was also examined;the particular features of childhood depression are compared to the features of adult depression. The investigators would like to thank Jim McFerren and Ralph Zalazar for their work as research assistants and David Watson for his help with the statistical analyses. The helpful comments of Eric Klinger and Auke Tellegen are gratefully acknowledged. The cooperation of Dr. Loren Benson, director of personnel services of the Hopkins School District #274; Mr. Edward Ryshavy, principal of Glen Lake Elementary School; and the teachers of that school is greatly appreciated.     

Family interaction patterns and childhood depression

Rehm's (1977) self-control model for depression and Bandura's (1977) concept that children internalize external controls placed upon them are united to predict family interaction patterns that may contribute to the etiology or maintenance of depression in children. Families of depressed, nondepressed, and nonclinic children were compared on rates of, and criteria for, parental and self-reinforcement. Mother-father-child interactions were sequentially coded to reveal that mothers of depressed and nonclinic children both set very high criteria for rewarding their children, compared to mothers of clinic/nondepressed children. However, mothers of depressed children rewarded their depressed children at much lower rates than mothers of either clinic/nondepressed or nonclinic children. These factors, taken together, are discussed in terms of their possible etiological role in childhood depression.     

Children of Prenatally Depressed Mothers: Externalizing and Internalizing Symptoms are Accompanied by Reductions in Specific Social-Emotional Competencies

Studies have shown that child development is negatively affected by prenatal depression. A dysregulated hypothalamic-pituitary-adrenal axis in the pregnant woman, passed to the fetus, is one discussed key mechanism. Studies, investigating primary-school age children, have found effects on antisocial behavior. Effects on internalizing symptoms were not found, but the analysis did not distinguish between anxiety and depression symptoms. Additionally, until now, no objective test data operationalizing social-emotional competencies have been included. The present study examined: 1.Whether the effects on child externalizing symptoms could be replicated; 2. If there are specific effects on child internalizing symptoms, separated for anxiety and depression; and 3. Are child clinical symptoms reflected in reductions in social-emotional competencies. A sample of 61 prenatally depressed and 143 prenatally not-depressed women and their 6–9 year old children were compared, controlling for key confounders in both the perinatal period and in middle childhood. Children of prenatally depressed mothers had more antisocial behavior and depression symptoms reported by their mothers. The prediction of antisocial behavior scores tended to be more significant for boys than for girls. Child anxiety symptoms were primarily explained by current maternal depressive symptoms. Children of prenatally depressed mothers also showed a reduction in social-emotional competencies, specifically regarding the ability to interpret complex social situations. This study showed that, even in a non-clinical sample, there are distinct effects of prenatal depression on child externalizing and internalizing symptoms which are accompanied by reductions in specific social-emotional competencies. These results emphasize that treatment for depressed pregnant women and/or early support for affected families is worthwhile. Additional work is required to identify the underlying biological mechanisms.     

Does Neighborhood Social Capital Buffer the Effects of Maternal Depression on Adolescent Behavior Problems?

Neighborhood characteristics have been shown to impact child well-being. However, it remains unclear how these factors combine with family characteristics to influence child development. The current study helps develop that understanding by investigating how neighborhoods directly impact child and adolescent behavior problems as well as moderate the influence of family characteristics on behavior. Using multilevel linear models, we examined the relationship among neighborhood conditions (poverty and social capital) and maternal depression on child and adolescent behavior problems. The sample included 741 children, age 5–11, and 564 adolescents, age 12–17. Outcomes were internalizing (e.g. anxious/depressed) and externalizing (e.g. aggressive/hyperactive) behavior problems. Neighborhood poverty and maternal depression were both positively associated with behavior problems for children and adolescents. However, while neighborhood social capital was not directly associated with behavior problems, the interaction of social capital and maternal depression was significantly related to behavior problems for adolescents. This interaction showed that living in neighborhoods with higher levels of social capital attenuated the relationship between maternal depression and adolescent behavior problems and confirmed the expectation that raising healthy well-adjusted children depends not only on the family, but also the context in which the family lives.