The representation of fathers by children of depressed mothers: refining the meaning of parentification in high‐risk samples

Background: Children’s representations of mothers in doll‐play are associated with child adjustment. Despite the importance of fathers for children’s adjustment, especially in the context of maternal psychopathology, few studies have considered children’s representations of their fathers. Method: We examined the portrayal of fathers by 5‐year‐old children of depressed (N = 55) and non‐depressed (N = 39) mothers in a doll‐play procedure concerning family experience. Results: Children gave equal prominence in their play to mothers and fathers. Representations of fathers were unrelated to maternal mood, but were associated with parental conflict. Representations of child care for the father that was unreciprocated predicted poor child adjustment in school, but only in children exposed to maternal postnatal depression. Conclusions: It may be clinically useful to consider children’s distinctive representations of their mother and father; but the concept of parentification in relation to risk and resilience effects requires refinement.     

Emotion regulation strategies in offspring of childhood-onset depressed mothers

BACKGROUND: This study examines emotion regulation strategies used by children of mothers with childhood-onset depression (COD) and children of never-depressed mothers (NCOD). METHODS: Participants were 49 COD offspring (ages 4-7) and 37 NCOD offspring (ages 4-7) and their mothers. Emotion regulation strategies were assessed observationally during a laboratory mood induction paradigm. RESULTS: COD offspring were more likely to focus on the delay object or task than NCOD offspring. Daughters of COD mothers were also more likely to wait passively and less likely to engage in active distraction than daughters of NCOD mothers. These findings were replicated using number of maternal depressive episodes. CONCLUSIONS: COD offspring, especially daughters, exhibit a more passive style of regulating emotion that may place them at risk for developing psychopathology.     

Negative and atypical story content themes depicted by children with behaviour problems

Background: Specific thematic content arising from children’s doll play is often considered to give clinically meaningful information regarding their mental state, but has received little systematic enquiry. This exploratory study examined the negative and atypical content themes in the attachment story narratives of children with behaviour problems, and their associations with child symptomatology and parental depressed mood. Method: Videotaped mother–child attachment doll play completions of 77 children from a clinical sample were blind coded for negative content themes. Mothers completed questionnaires for maternal depression and child behaviour. Results: Children rating positive for behaviour disorder were more likely to represent maternal injury, role reversal and marked maternal sadness. Severe behavioural symptoms were associated with more pervasive negative themes. Half of the overall sample depicted child accidents and maternal unresponsiveness, whereas child aggression, child anger and maternal absence were rare. Girls with depressed mothers showed an absence of particular negative representations (e.g., child sadness) compared to boys. Conclusions: Specific atypical themes are associated with the extent of child psychopathology and may be modified by exposure to maternal depressed mood. The methodological limitations in this exploratory study are also discussed.     

Developmental trajectories of positive and negative affect in children at high and low familial risk for depressive disorder

Background: Although low positive affect (PA) and high negative affect (NA) have been posited to predispose to depressive disorders, little is known about the developmental trajectories of these affects in children at familial risk for mood disorders. Methods: We examined 202 offspring of mothers who had a history of juvenile‐onset unipolar depressive disorder (n = 60) or no history of major psychopathology (n = 80). Offspring participated in up to seven annual, structured laboratory tasks that were designed to elicit PA and NA. Results: Growth curve analyses revealed that PA increased linearly and similarly for all children from late infancy through age 9. However, there also were individual differences in early PA. Relative to control peers, offspring of mothers with lifetime unipolar depression had consistently lower levels of PA, and this association remained significant even when controlling for current maternal depression and maternal affect displays. Growth curve analyses also revealed a significant linear decrease in NA in children across time; however, there was no significant inter‐individual variation either in early NA or rate of change in NA. Conclusion: Attenuated PA (rather than excessive NA) may be an early vulnerability factor for eventual unipolar depressive disorder in at‐risk children and may represent one pathway through which depression is transmitted.     

The association between paternal depressogenic cognitive styles during pregnancy and offspring depressogenic cognitive styles: an 18‐year prospective cohort study

Background

Preventing the development of depressogenic or negative cognitive styles could also prevent the development of depression, a leading public health problem worldwide. Maternal negative cognitive styles are a modifiable risk factor for the development of negative cognitive styles in offspring. However, evidence on the role of paternal negative cognitive styles is inconclusive and there have only been a few small studies, which may also have lacked statistical power.

Methods

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate the association between paternal negative cognitive styles, measured when mothers were 18 weeks pregnant, and offspring negative cognitive styles 18 years later (N = 6,123). Associations were calculated using linear regression models, before and after adjustment for confounders including maternal negative cognitive styles. We compared associations before and after controlling for depression in parents and offspring, and used multiple imputation to reduce biases that may have arisen due to missing data.

Results

A two‐standard deviation increase in paternal negative cognitive style was associated with a 3‐point increase in offspring negative cognitive style (95% CI 1.36–4.37). This association remained after adjustment for confounders and was independent of depression in both parents and offspring. The effect size was equivalent to that of maternal negative cognitive style, and was also independent of maternal negative cognitive style.

Conclusions

Our results suggest that fathers should be included in individual‐ and family‐based interventions designed to prevent the development of depressogenic cognitive styles in adolescent offspring. This could possibly also prevent the development of depression.     

Antepartum and postpartum exposure to maternal depression: different effects on different adolescent outcomes

Background: Postpartum depression (PPD) is considered a major public health problem that conveys risk to mothers and offspring. Yet PPD typically occurs in the context of a lifelong episodic illness, and its putative effects might derive from the child’s exposure to other episodes, in pregnancy or later childhood. The aim of the study is to test two hypotheses: (1) that the effects of PPD on adolescent outcomes are partly explained by antepartum depression (APD) and (2) that the effects of APD and PPD are both explained by later exposure to the mother’s depression. Method: A random sample of 178 antenatal patients was drawn from two general medical practices in South London; 171 gave birth to live infants, and 150 (88%) were assessed at 3 months post partum, with 121 of their offspring (81%) assessed for emotional disorders (ED), disruptive behaviour disorders (DBD) and IQ, at 11 and 16 years of age. Results: When APD and subsequent episodes of depression were taken into account, PPD had a significant effect on adolescent IQ, especially for boys, but did not predict psychopathology. ED and DBD in adolescence were predicted by the extent of exposure to maternal depression after 3 months post partum; a significant effect of APD on ED in girls was accounted for by later exposure to the mother’s illness. Mothers’ symptoms of anxiety, smoking and alcohol use in pregnancy did not predict adolescent outcomes, once maternal depression was taken into account. Conclusions: Some effects attributed to mothers’ mental health problems in pregnancy or post partum may be mediated by cumulative exposure to maternal illness, probably reflecting genetic influence and gene–environment correlation. However, PPD has a direct effect on cognition. Clinicians should endeavour to identify women with depression in pregnancy (31% of this sample) and help them to manage their lifelong illness.     

Mediating links between maternal depression and offspring psychopathology: the importance of independent data

BACKGROUND: Research examining intergenerational transmission of psychopathology is often limited by reliance on the same individuals for information on multiple constructs of interest. To counteract this limitation, data from a prospective, longitudinal study of at-risk youth were analyzed to test the hypothesis that parenting and family environmental factors mediate the association between maternal depressive symptoms and offspring psychopathology in late adolescence. METHOD: Data were taken from 184 families of the Minnesota Longitudinal Study of Parents and Children. Measures included the CES-D and Beck depression inventories, home environment ratings and a family conflict scale, and CBCL behavior problem checklist and K-SADS psychiatric symptom scores. Regression analyses were conducted to test for mediation of maternal depression effects by family environmental factors. RESULTS: Analyses using a single informant and time point showed evidence for substantial mediation; however, in analyses spanning independent informants and multiple time points mediating effects were markedly reduced. Sex differences were found, in that parenting and family environmental factors related to psychopathology for males, whereas maternal depression was more directly related to psychopathology for females. CONCLUSIONS: Results emphasize the importance of independent data for testing mediational claims, and support claims that the processes involved in the intergenerational transmission of psychopathology are different for male and female youth.     

Genetic and environmental influences on the transmission of parental depression to children’s depression and conduct disturbance: an extended Children of Twins study

Background: Despite the increased risk of depression and conduct problems in children of depressed parents, the mechanism by which parental depression affects their children’s behavioral and emotional functioning is not well understood. The present study was undertaken to determine whether parental depression represents a genuine environmental risk factor in children’s psychopathology, or whether children’s depression/conduct can be explained as a secondary consequence of the genetic liability transmitted from parents to their offspring. Methods: Children of Twins (COT) data collected on 2,674 adult female and male twins, their spouses, and 2,940 of their children were used to address whether genetic and/or family environmental factors best account for the association between depression in parents and depression and conduct problems in their children. Data collected on juvenile twins from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) were also included to estimate child‐specific genetic and environmental influences apart from those effects arising from the transmission of the parental depression itself. The fit of alternative Children of Twin models were evaluated using the statistical program Mx. Results: The most compelling model for the association between parental and juvenile depression was a model of direct environmental risk. Both family environmental and genetic factors accounted for the association between parental depression and child conduct disturbance. Conclusions: These findings illustrate how a genetically mediated behavior such as parental depression can have both an environmental and genetic impact on children’s behavior. We find developmentally specific genetic factors underlying risk to juvenile and adult depression. A shared genetic liability influences both parental depression and juvenile conduct disturbance, implicating child conduct disturbance (CD) as an early indicator of genetic risk for depression in adulthood. In summary, our analyses demonstrate differences in the impact of parental depression on different forms of child psychopathology, and at various stages of development.     

Depressed mothers and their children

Abstract This paper reviews the current state of research on the relationship between depressed mothers and their children. Several issues are considered: how depressed women function as mothers; the possible origins of depression in the childhood experiences of the mothers; the impact of maternal depression upon the child; the potential consequences for the child's ultimate development; the induction in the child of a depression and the causes of depression in children; the interaction between depressed mothers and their children; and the question of whether there are certain children invulnerable to their mothers'depression. Based on the author's intensive case-design study of 10 mother-child dyads, a model of the interaction between the depressed mother and her child is described. The implications are considered in terms of the need for further research on outcome, risk, and vulnerability, the application to paediatrics, and the broader social and cultural considerations.     

Facial emotion expression recognition by children at familial risk for depression: high‐risk boys are oversensitive to sadness

Background: Offspring of depressed parents are at greatly increased risk for mood disorders. Among potential mechanisms of risk, recent studies have focused on information processing anomalies, such as attention and memory biases, in the offspring of depressed parents. In this study we examined another information processing domain, perceptual sensitivity to emotion cues in facial expressions, as a potential mechanism of risk that characterizes the offspring of depressed parents. Methods: The study included 64 children at familial‐risk for depression and 40 low‐risk peers between the ages 7 and 13(Mage = 9.51; SD = 2.27). Participants were presented with pictures of facial expressions that varied in emotional intensity from neutral to full‐intensity sadness or anger (i.e., emotion recognition), or pictures of faces morphing from anger to sadness (emotion discrimination). After each picture was presented, children indicated whether the face showed a specific emotion (i.e., sadness, anger) or no emotion at all (neutral) using a forced choice paradigm. We examined group differences in the intensity of emotion that suggested greater sensitivity to specific emotions. Results: In the emotion recognition task, boys (but not girls) at familial‐risk for depression identified sadness at significantly lower levels of emotional intensity than did their low‐risk peers. The high and low‐risk groups did not differ with regard to identification of anger. In the emotion discrimination task, both groups displayed over‐identification of sadness in ambiguous mixed faces but high‐risk youth were less likely to show this labeling bias than their peers. Conclusion: Our findings are consistent with the hypothesis that enhanced perceptual sensitivity to subtle traces of sadness in facial expressions may be a potential mechanism of risk among boys at familial‐risk for depression. This enhanced perceptual sensitivity does not appear to be due to biases in the labeling of ambiguous faces.     

Parental depressive and anxiety symptoms during pregnancy and attention problems in children: a cross‐cohort consistency study

Background: Maternal depression and anxiety during pregnancy have been associated with offspring‐attention deficit problems. Aim: We explored possible intrauterine effects by comparing maternal and paternal symptoms during pregnancy, by investigating cross‐cohort consistency, and by investigating whether parental symptoms in early childhood may explain any observed intrauterine effect. Methods: This study was conducted in two cohorts (Generation R, n = 2,280 and ALSPAC, n = 3,442). Pregnant women and their partners completed questionnaires to assess symptoms of depression and anxiety. Child attention problems were measured in Generation R at age 3 with the Child Behavior Checklist, and in ALSPAC at age 4 with the Strengths and Difficulties Questionnaire. Results: In both cohorts, antenatal maternal symptoms of depression (Generation R: OR 1.23, 95% CI 1.05–1.43; ALSPAC: OR 1.33, 95% CI 1.19–1.48) and anxiety (Generation R: OR 1.24, 95% CI 1.06–1.46; ALSPAC: OR 1.32, 95% CI 1.19–1.47) were associated with a higher risk of child attention problems. In ALSPAC, paternal depression was also associated with a higher risk of child attention problems (OR 1.11, 95% CI 1.00–1.24). After adjusting for maternal symptoms after giving birth, antenatal maternal depression and anxiety were no longer associated with child attention problems in Generation R. Moreover, there was little statistical evidence that antenatal maternal and paternal depression and anxiety had a substantially different effect on attention problems of the child. Conclusions: The apparent intrauterine effect of maternal depression and anxiety on offspring‐behavioural problems may be partly explained by residual confounding. There was little evidence of a difference between the strength of associations of maternal and paternal symptoms during pregnancy with offspring‐attention problems. That maternal symptoms after childbirth were also associated with offspring‐behavioural problems may indicate a contribution of genetic influences to the association.     

Emotion identification in girls at high risk for depression

Background: Children of depressed mothers are themselves at elevated risk for developing a depressive disorder. We have little understanding, however, of the specific factors that contribute to this increased risk. This study investigated whether never‐disordered daughters whose mothers have experienced recurrent episodes of depression during their daughters’ lifetime differ from never‐disordered daughters of never‐disordered mothers in their processing of facial expressions of emotion. Method: Following a negative mood induction, daughters completed an emotion identification task in which they watched faces slowly change from a neutral to a full‐intensity happy, sad, or angry expression. We assessed both the intensity that was required to accurately identify the emotion being expressed and errors in emotion identification. Results: Daughters of depressed mothers required greater intensity than did daughters of control mothers to accurately identify sad facial expressions; they also made significantly more errors identifying angry expressions. Conclusion: Cognitive biases may increase vulnerability for the onset of disorders and should be considered in early intervention and prevention efforts.     

Childhood adversity,parental vulnerability and disorder: examining inter-generational transmission of risk

BACKGROUND: An investigation of intergenerational factors associated with psychiatric disorder in late adolescence/early adulthood was undertaken to differentiate influences from maternal disorder, maternal poor psychosocial functioning and poor parenting, on offspring. METHOD: The sample comprised an intensively studied series of 276 mother-offspring pairs in a relatively deprived inner-city London area with high rates of lone parenthood and socio-economic disadvantage. The paired sample was collected over two time periods: first a consecutively screened series of mothers and offspring in 1985-90 (n = 172 pairs) and second a 'vulnerable' series of mothers and offspring in 1995-99 (n = 104 pairs). The vulnerable mothers were selected for poor interpersonal functioning and/or low self-esteem and the consecutive series were used for comparison. Rates of childhood adversity and disorder in the offspring were examined in the two groups. Maternal characteristics including psychosocial vulnerability and depression were then examined in relation to risk transmission. RESULTS: Offspring of vulnerable mothers had a fourfold higher rate of yearly disorder than those in the comparison series (43% vs. 11%, p < .001). They were twice as likely as those in the comparison series to have experienced childhood adversity comprising either severe neglect, physical or sexual abuse before age 17. Physical abuse, in particular, perpetrated either by mother or father/surrogate father was significantly raised in the vulnerable group. Analysis of the combined series showed that maternal vulnerability and neglect/abuse of offspring provided the best model for offspring disorder. Maternal history of depression had no direct effect on offspring disorder; its effects were entirely mediated by offspring neglect/abuse. Maternal childhood adversity also had no direct effect. CONCLUSIONS: Results are discussed in relation to psychosocial models of risk transmission for disorder. Maternal poor psychosocial functioning needs to be identified as a factor requiring intervention in order to stem escalation of risk across generations.     

Relationship between maternal depression symptoms and child weight outcomes in Latino farmworker families

This study sought to characterize depressive symptoms among mothers in Latino farmworker families, determine if maternal depression increases children's risk of obesity, and ascertain whether relevant risk factors such as physical activity, diet, and feeding style mediate this relationship. Mothers from 248 families completed the 10‐item Center for Epidemiologic Studies Depression Scale 9 times over a 2‐year period. Four distinct patterns were used to describe mothers: few symptoms, moderate episodic symptoms, severe episodic symptoms, and chronic symptoms. Approximately two‐thirds of women experienced moderate symptoms of depression at least once. Children of mothers fitting each pattern were compared. At the end of the study, children of mothers with severe episodic and chronic symptoms were significantly more likely to be overweight and obese than children of mothers with few symptoms (p < .05). After controlling for covariates, differences in weight status for children of mothers with severe episodic symptoms remained significant. Children of mothers with either moderate episodic or chronic symptoms were fed in a less responsive fashion (p < .05), and children of chronically symptomatic mothers had lower diet quality (p < .01). Although nonresponsive feeding has been linked to childhood obesity, in this analysis, feeding style did not mediate the relationship between maternal depression and diet quality. Elevated levels of depressive symptoms are common in this population, and those symptoms, especially when severe or chronic in nature, may increase children's risk of obesity. Additional research is needed to characterize the pathways through which maternal depression influences children's weight.     

Long‐term effects of a home‐visiting intervention for depressed mothers and their infants

Background: Whereas preventive interventions for depressed mothers and their infants have yielded positive short‐term outcomes, few studies have examined their long‐term effectiveness. The present follow‐up of a randomised controlled trial (RCT) is one of the first to examine the longer‐term effects of an intervention for mothers with postpartum depression and their infants at school‐age. In early infancy, the intervention was found effective in improving mother–infant interaction and the child’s attachment to its mother. Methods: Twenty‐nine mother–child pairs who completed the intervention are compared with 29 untreated mother–child dyads as to the quality of maternal interactive behaviour and the child outcomes of attachment security to the mother, self‐esteem, ego‐resiliency, verbal intelligence, prosocial behaviour, school adjustment, and behaviour problems at age 5 (M = 68 months). Results: In the total sample no lasting treatment benefits were found, but in families reporting a higher number of stressful life events, children in the intervention group had fewer externalising behaviour problems as rated by their mothers than children in the control group. Conclusions: In the context of multiple stressful life events the intervention served as a buffer by preventing the development of externalising problems in the child. The results warrant cautious interpretation because of the relatively small sample size and differential attrition revealing the mothers that completed the follow‐up assessment to have improved less on maternal sensitivity following the intervention than the mothers who did not participate in the follow‐up.     

The effects of pre‐ and postnatal depression in fathers: a natural experiment comparing the effects of exposure to depression on offspring

Background: Depression in fathers in the postnatal period is associated with an increased risk of behavioural problems in their offspring, particularly for boys. The aim of this study was to examine for differential effects of depression in fathers on children’s subsequent psychological functioning via a natural experiment comparing prenatal and postnatal exposure. Methods: In a longitudinal population cohort study (the Avon Longitudinal Study of Parents and Children (ALSPAC)) we examined the associations between depression in fathers measured in the prenatal and postnatal period (measured using the Edinburgh Postnatal Depression Scale), and later behavioural/emotional and psychiatric problems in their children, assessed at ages 3½ and 7 years. Results: Children whose fathers were depressed in both the prenatal and postnatal periods had the highest risks of subsequent psychopathology, measured by total problems at age 3½ years (Odds Ratio 3.55; 95% confidence interval 2.07, 6.08) and psychiatric diagnosis at age 7 years (OR 2.54; 1.19, 5.41). Few differences emerged when prenatal and postnatal depression exposure were directly compared, but when compared to fathers who were not depressed, boys whose fathers had postnatal depression only had higher rates of conduct problems aged 3½ years (OR 2.14; 1.22, 3.72) whereas sons of the prenatal group did not (OR 1.41; .75, 2.65). These associations changed little when controlling for maternal depression and other potential confounding factors. Conclusions: The findings of this study suggest that the increased risk of later conduct problems, seen particularly in the sons of depressed fathers, maybe partly mediated through environmental means. In addition, children whose fathers are more chronically depressed appear to be at a higher risk of emotional and behavioural problems. Efforts to identify the precise mechanisms by which transmission of risk may occur should be encouraged to enable the development of focused interventions to mitigate risks for young children.     

Postnatal depression and SIDS: A prospective study

Abstract This study was carried out in response to reports from nurses to a post-neonatal mortality review committee that a number of mothers of infants dying from sudden infant death syndrome (SIDS) appeared to be depressed before the child's death. The New Zealand Cot Death Study was a 3 year multicentre case-control study for SIDS. There were 485 SIDS cases in the post-neonatal age group in the study regions, and these were compared with 1800 control infants. Infants of mothers with either a self-reported use of medication for psychiatric disorders, a history of hospitalization for psychiatric illness or a family history of postnatal depression had a significantly increased risk of SIDS compared with infants of mothers who were either not using medication (odds ratio (OR) = 1.45; 95% confidence interval (Cl) = 1.03, 2.04) or were without a history of hospitalization for psychiatric illness (OR = 1.80; 95% Cl = 1.03, 3.11) or a family history of postnatal depression (OR = 1.61; 95% Cl = 1.06, 2.43). All mothers of infants born in the study areas over a 1 year period were eligible to complete a questionnaire measuring maternal depression when the infant was 4 weeks of age. Thirty-three infants subsequently died from SIDS, and they were compared with 174 controls. Fifteen (45.5%) of the mothers of cases were depressed, compared with 28 (16.1%) of the mothers of controls. This prospective study found that the infants of those mothers that were depressed were more likely to die from SIDS than those of the non-depressed mothers (OR = 4.35; 95% Cl = 1.82, 10.37) and postnatal depression as a risk factor for SIDS was still significant after controlling for possible confounding variables (OR = 3.37; 95% Cl = 1.24, 9.12). We conclude that postnatal depression is a risk factor for SIDS.     

The effects of maternal postnatal depression and child sex on academic performance at age 16 years: a developmental approach

Background: Postnatal depression (PND) is associated with poor cognitive functioning in infancy and the early school years; long‐term effects on academic outcome are not known. Method: Children of postnatally depressed (N = 50) and non‐depressed mothers (N = 39), studied from infancy, were followed up at 16 years. We examined the effects on General Certificate of Secondary Education (GCSE) exam performance of maternal depression (postnatal and subsequent) and IQ, child sex and earlier cognitive development, and mother–child interactions, using structural equation modelling (SEM). Results: Boys, but not girls, of PND mothers had poorer GCSE results than control children. This was principally accounted for by effects on early child cognitive functioning, which showed strong continuity from infancy. PND had continuing negative effects on maternal interactions through childhood, and these also contributed to poorer GCSE performance. Neither chronic, nor recent, exposure to maternal depression had significant effects. Conclusions: The adverse effects of PND on male infants’ cognitive functioning may persist through development. Continuing difficulties in mother–child interactions are also important, suggesting that both early intervention and continuing monitoring of mothers with PND may be warranted.     

母亲孕期或产后抑郁情绪对子代情绪和行为的影响:Meta分析北大核心CSCD

目的分析母亲孕期和产后抑郁情绪对儿童情绪和行为的影响。方法在PubMed、Embase、Web of Knowledge、PsycINFO、Cochrane、万方数据库和中国知网,以"母亲(maternal)AND抑郁(depression)AND儿童或子代(child OR offspring)AND神经心理(neuropsychology)"为检索词检索有关母亲抑郁情绪对子代情绪和行为产生影响的病例对照研究和队列研究,检索时间为2000年1月1日至2020年10月31日。根据纳入标准和排除标准筛选文献,采用RevMan 5.3进行Meta分析。结果共纳入14篇文献,包括病例组3914例,对照组17016例。结果显示,母亲在孕期或产后存在抑郁情绪,儿童罹患情绪或行为障碍的风险是母亲无抑郁情绪儿童的2.03倍(OR=2.03,95%CI:1.55~2.65);孕期和产后抑郁情绪均可增加子代情绪或行为障碍的发生风险,但2个时期的差异无统计学意义(Z=-0.371,95%CI:0.796~1.168);这种影响可持续至子代学龄前和学龄期,且学龄期儿童发生情绪或行为障碍的风险大于学龄前期(Z=-2.340,95%CI:0.643~0.962)。结论孕期和产后抑郁情绪均会增加子代情绪或行为障碍的发生风险,而且这种影响不会随着年龄的增长而减少。