The relation of problem behaviors in preschool children to depressive symptoms in mothers and fathers

Early Family Conflict and Behavioral Outcomes in Children from Low-Income Families: The Indirect Effects of Parental Depression and Parenting Practices

Family conflict has been demonstrated as a risk factor impacting children's mental health and behaviors; however, the mechanisms underlying these connections are unclear. Focusing on 1622 children from low-income families (51.4% boys, 38.3% White, 35.5% Hispanic/Latino, 22.1% African American, 4.1% other), the current study examines the role that maternal depression and parenting behaviors play in the associations between family conflict in early childhood and children's internalizing and externalizing behaviors in early adolescence. Family conflict was positively associated with maternal depression at age 3 and detached parenting at age 5; however, maternal depression was linked to increased child internalizing and externalizing behaviors, and detached parenting was associated with decreased behavioral outcomes. Maternal depression at age 3 and intrusive parenting at age 5 successively mediated the association between family conflict and child externalizing. Multi-group analysis indicated different indirect paths of parenting behaviors in boys and girls. Specifically, in boys, the indirect effect of detached parenting on the links between family conflict and externalizing and internalizing behaviors was sustained. In girls, maternal depression and intrusive parenting sequentially explained the link between family conflict and externalizing behaviors. The findings highlighted the importance of addressing family well-being and parenting support, especially for children from low-income families.

Maternal suicidality interacts with blunted reward processing to prospectively predict increases in depressive symptoms in 8-to-14-year-old girls

Both a hypoactive reward system and maternal depression are associated with the onset of Major Depressive Disorder (MDD) in youth. Recent research indicates that blunted reward processing and maternal history of depression may interact to predict increases in depressive symptoms, however, the role of specific maternal depressive symptoms has not been examined. The current study investigated whether maternal depressive symptoms, history of MDD, and suicidal thoughts and/or behaviors (STBs) might lead to prospective increases in depressive symptoms one year later in the context of hypoactive reward processing. In a sample (N = 212) of 8 to 14-year-old girls, we assessed depressive symptoms in youth at baseline and follow up, while reward processing was measured using the Reward Positivity (RewP) event-related brain potential. Maternal STBs, current depressive symptoms, and history of maternal MDD were assessed at baseline. The results indicated that only girls with a blunted RewP and maternal STBs exhibited increased depressive symptoms one year later. These results were not evident when maternal depressive symptoms or maternal history of MDD was examined as the moderator. Overall, the current study provides evidence that maternal STBs uniquely impact youth with blunted reward processing.

Maternal Depression and Child and Adolescent Problem Behaviors: a Propensity Score Matching Approach

Prior studies have consistently revealed that maternal depression is significantly associated with children exhibiting higher levels of internalizing problem behaviors and externalizing problem behaviors. However, there is reason to believe that prior research may have suffered from model misspecification and confounding that biased the conclusions drawn from these studies. We use this possibility as the foundation for our analyses that examine the potential association between maternal depression and child internalizing and externalizing problem behaviors while addressing the methodological limitations of previous research. To do so, we analyzed data from the National Survey of Child and Adolescent Well-Being and used propensity score matching. The analyses revealed significant differences between depressed and non-depressed mothers that, once accounted for, significantly impacted the revealed associations between maternal depression and child internalizing and externalizing problem behaviors. Although the significant relationship with child internalizing problem behaviors remained in all of the cross-sectional and longitudinal models post-matching, once the mothers were properly matched, the significant relationship between maternal depression and child externalizing problem behaviors disappeared at Wave 3. We conclude by discussing the implications and limitations of our study as well as considerations for future research.

Parental depressive symptoms as a risk factor for child depressive symptoms; testing the social mediators in internationally adopted children

Parental depressive symptoms have shown to be associated with offspring depression but much of the research has been focused on maternal depression. The aim of our study was to investigate the extent to which depressive symptoms of both parents associate with offspring depressive symptoms and whether social factors mediate these associations using data from adopted children with no shared genetic background. Data were derived from the Finnish Adoption survey study (a subsample of adopted children aged between 9 and 12 years, n = 548). Parental depressive symptoms were measured using short version of the General Health Questionnaire and Children's Depression Inventory (CDI) was used to measure depressive symptoms in adoptees. Paternal depressive symptoms were related to the total CDI (B = 0.33, p = 0.05) and two dimensions of offspring depressive symptoms: negative mood (B = 0.10, p = 0.03) and interpersonal problems (B = 0.06, p = 0.009). These associations remained significant even when adjusted for child's age and gender, age at adoption, type of placement before adoption, continent of birth and adoptive family's SES. No associations were found between maternal and any dimensions of offspring depressive symptoms. No information about the mental health of biological parents was available. We interpret the results as demonstrating that intergenerational transmission of depressive symptoms is not solely related to shared genes. Also, the results highlight the association of paternal depression with offspring depressive symptoms.

Perinatal western-type diet and associated gestational weight gain alter postpartum maternal mood

INTRODUCTION

The role of perinatal diet in postpartum maternal mood disorders, including depression and anxiety, remains unclear. We investigated whether perinatal consumption of a Western-type diet (high in fat and branched-chain amino acids [BCAA]) and associated gestational weight gain (GWG) cause serotonin dysregulation in the central nervous system (CNS), resulting in postpartum depression and anxiety (PPD/A).

METHODS

Mouse dams were fed one of four diets (high-fat/high BCAA, low-fat/high BCAA, high-fat, and low-fat) prior to mating and throughout gestation and lactation. Postpartum behavioral assessments were conducted, and plasma and brain tissues assayed. To evaluate potential clinical utility, we conducted preliminary human studies using data from an extant sample of 17 primiparous women with high GWG, comparing across self-reported postpartum mood symptoms using the Edinburgh Postnatal Depression Scale (EPDS) for percent GWG and plasma amino acid levels.

RESULTS

Mouse dams fed the high-fat/high BCAA diet gained more weight per kcal consumed, and BCAA-supplemented dams lost weight more slowly postpartum. Dams on BCAA-supplemented diets exhibited increased PPD/A-like behavior, decreased dopaminergic function, and decreased plasma tyrosine and histidine levels when assessed on postnatal day (P)8. Preliminary human data showed that GWG accounted for 29% of the variance in EPDS scores. Histidine was also lower in women with higher EPDS scores.

CONCLUSIONS

These findings highlight the role of perinatal diet and excess GWG in the development of postpartum mood disorders.

Parental Predictors of Children's Shame and Guilt at Age 6 in a Multimethod, Longitudinal Study

Shame and guilt are self-conscious emotions that begin to develop early in life and are associated with various forms of psychopathology. However, little is known about the factors that contribute to these emotions in young children. Specifically, no longitudinal studies to date have examined a range of parent factors that shape the expression of children's shame and guilt. The current multimethod, longitudinal study sought to determine whether parenting style, parental psychopathology, and parents' marital satisfaction assessed when children were age 3 predict expressions of shame and guilt in children at age 6. A large community sample of families (N = 446; 87.4% Caucasian) with 3-year-old children (45.7% female) was recruited through commercial mailing lists. Parent variables were assessed when children were age 3 with mother- and father-report questionnaires and a diagnostic interview. Children's expressions of shame and guilt were observed in the laboratory at age 6. Fathers', but not mothers', history of depression and permissive parenting assessed when children were age 3 predicted children's expressions of shame and guilt when children were age 6; parents' marital dissatisfaction also predicted children's shame and guilt. These findings suggest that parents, and fathers in particular, contribute to expressions of self-conscious emotions in children. These data on emotional development may be useful for better characterizing the risk and developmental pathways of psychopathology.

A Longitudinal Study of Fathers' and Young Children's Depressive Symptoms

Considerable research has examined the effects of maternal depression on children, but few studies have focused on the relation between paternal and child depressive symptoms, particularly during early childhood. Even fewer studies have been longitudinal, leaving open questions about how paternal and child depression covary over time. The present study sought to address this gap by examining the relation between fathers' and children's depressive symptoms over a 3-year period. Participants were 153 preschool children with behavior problems and their parents. Three longitudinal analytic approaches were used to examine how father and child depression change together and predict one another over time. Additional analyses examined whether externalizing problems or maternal depression might account for the associations between fathers' and children's depressive symptoms. Changes in paternal depression significantly predicted changes in father-reported and mother-reported child depressive symptoms. These effects were evident both in year-to-year fluctuations and in linear trajectories across the 3-year period. Cross-lagged analyses suggested that these relations may have been driven by father-effects; paternal depression at one time point predicted child depression at the next time point, but child depression did not significantly predict later paternal depression. We found little evidence that externalizing problems or maternal depression accounted for the relations between fathers' and children's depressive symptoms. Results provide convergent evidence that fathers' depression may play an important role in the development of depressive symptoms in young children and underscore the importance of including fathers in studies of depression in families.

Is the maternal Q-Set a valid measure of preschool child attachment behavior?

The objective of this study is to examine preschool-age correlates of the maternal version of the Attachment Q-Set (AQS) (Waters & Deane, 1985) in order to provide validity data. Concurrent associations between the Attachment Q-Set and measures of separation-reunion attachment classifications (Cassidy & Marvin, 1992), quality of mother–child interaction, maternal stress, and child externalizing behavior problems were examined for a low-risk sample of 152 preschool children. Results showed that, even after controlling for maternal stress, ambivalent and disorganized children had lower scores on the AQS when compared with the secure group. However, avoidant and controlling children did not differ from secure children in maternal sorts. Significant associations between the maternal Q-Set and affective quality of mother–child interaction were also maintained, when controlling for maternal stress. The AQS was significantly associated with both mother and teacher reported externalizing behavior problem reports, but the association with teacher reports was not maintained when maternal stress was entered in the equation as a covariate. The discussion focuses on the validity of the maternal Q-Set as a measure of child attachment behavior in preschoolers.

Comorbid anxiety and depression in school-aged children with attention deficit hyperactivity disorder (ADHD) and selfreported symptoms of ADHD, anxiety, and depression among parents of school-aged children with and without ADHD

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in children that can extend into adulthood and that is often associated with a variety of comorbid psychiatric disorders.

AIM

Assess the comorbidity of ADHD with anxiety disorders and depressive disorders in school-aged children, and the relationship of the severity of ADHD, anxiety, and depressive symptoms in children who have ADHD with the severity of the corresponding symptoms in their parents.

METHODS

A two-stage screening process identified children 7-10 years of age with and without ADHD treated at the Xin Hua Hospital in Shanghai. ADHD and other DSM-IV diagnoses were determined by a senior clinician using the Schedule for Affective Disorder and Schizophrenia for School-Aged Children (K-SADS-PL). One parent for each enrolled child completed three self-report scales: the ADHD Adult Self Report Scale (ASRS), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). In total 135 children with ADHD and 65 control group children without ADHD were enrolled; parents for 94 of the children with ADHD and 63 of the children without ADHD completed the parental assessment scales.

RESULTS

Among the 135 children with ADHD, 27% had a comorbid anxiety disorder, 18% had a comorbid depressive disorder, and another 15% had both comorbid anxiety and depressive disorders. Parents of children with ADHD self-reported more severe ADHD inattention symptoms than parents of children without ADHD and were more likely to meet criteria for adult ADHD. Mothers (but not fathers) of children with ADHD had significantly more severe trait anxiety and depressive symptoms than mothers of children without ADHD. Among children with ADHD, the severity of ADHD symptoms was not significantly correlated with the severity of ADHD symptoms in parents, but depressive symptoms and anxiety symptoms in the children were significantly correlated with the corresponding symptoms in the parents.

CONCLUSION

School-aged children with ADHD commonly suffer from comorbid anxiety and depressive disorders, and the severity of these symptoms parallels the level of anxiety and depressive symptoms in their parents. Self-reported symptoms of ADHD are significantly more common in parents of children with ADHD than in parents of children without ADHD. Longitudinal studies are needed to disentangle the genetic, biological, and social factors responsible for these complex inter-relationships.

Depression, Alcohol Abuse, and Alcoholism in One versus Two Parents and the Implications for Child Attachment and Self-Regulation in Infancy through Adolescence

This study's purpose was to determine whether the influence of combined parental disorders can cause greater frequency in the occurrence of insecure child attachment and dysfunctions in self-regulation as opposed to the influence of one parent having a disorder. The research design is a quantitative meta-analysis that combined effects from 10 studies to establish differences in the frequency of occurrence for insecure child attachment and dysfunctions in self-regulation through an examination of Cohen's d. Global analysis of Cohen's effect (d) indicated that children being reared by two disordered parents had higher frequency in occurrence of insecure attachment and self-regulation dysfunction than those children reared by only one disordered parent. By addressing the issues surrounding the child population where both parents are disordered, children would have a better chance at healthy development by way of interventions that minimize the occurrence of child psychopathology and foster improvements in the social and overall human condition.

Long-term Effects of Fathers' Depressed Mood on Youth Internalizing Symptoms in Early Adulthood

While an accumulating body of research has documented increased risk for psychopathology among children of depressed fathers, most studies have used cross-sectional design and little is known about offspring outcomes beyond childhood. Using prospective data from a community sample (N = 395), we found that paternal depressive symptoms when children were in early adolescence (age 13) predicted offspring depressive and anxiety symptoms at age 21, controlling for baseline youth symptoms, maternal depressive symptoms, and other known correlates of internalizing problems in early adulthood. Associations were not moderated by maternal depressive symptoms or child gender. These results suggest that the unique and long-term effects of paternal depression on children's risk for mood disorders may persist into adulthood.

Family patterns of psychopathology in psychiatric disorders

OBJECTIVE

Familial loading and crucial outcomes of family history of psychopathology in psychiatric disorders have long been recognized. There has been ample literature providing convincing evidence for the importance of family psychopathology in development of emotional disturbances in children as well as worse outcomes in the course of psychiatric disorders. More often, maternal psychopathology seems to have been an issue of interest rather than paternal psychopathology while effects of second-degree familiality have received almost no attention. In this study, we addressed the relations between affected first- and second-degree relatives of probands and categories of psychiatric disorders.

METHOD

Subjects were 350 hospitalized psychiatric inpatients, consecutively admitted to psychiatry clinics in Van, Turkey. Mean age was 34.16 (SD±12) and 51.4% of the sample consisted of male patients. Assessment of psychopathology in psychiatric probands was conducted based on DSM-IV TR. Familial loading of psychiatric disorders amongst first- and second-degree relatives of patients were initially noted primarily relying on patients' retrospective reports, and confirmed by both phone call and following official health records via the Medical Knowledge System. We analyzed the data using latent class analysis approach.

RESULTS

We found four patterns of familial psychopathology. Latent homogeneous subsets of patients due to familial characteristics were as paternal kinship psychopathology with schizophrenia, paternal kinship psychopathology with mood disorders, maternal kinship psychopathology and core family psychopathology.

CONCLUSION

Family patterns were critical to exerting variation in psychiatric disorders of probands and affected relatives. Probands with a core family pattern of psychopathology exhibited the most colorful clinical presentations in terms of variation in psychopathology. We observed a specificity of intergenerational transmission of psychiatric disorders when family patterns of psychopathology were taken into consideration, even second-degree relatives of psychiatric probands.

The Indirect Effects of Parent Psychopathology on Offspring Affective Disorder Through Difficulty During the Leaving Home Transition

The current study examined risk for young adult affective disorder in the children of parents with alcohol use disorders (AUDs), and tested whether negative experiences during the leaving home transition mediated this effect. Using multiple reporter data from a high-risk community sample, the current study included 346 emerging adults (M = 21.97 years old; 49% female, 72% non-Hispanic Caucasian, and 47% with at least one alcohol-disordered parent) from a large metropolitan area. We found that offspring of parents with AUDs were more likely to have negative experiences during the leaving home transition, which in turn predicted increased risk of affective disorders in adulthood. Parents with alcohol disorders may attempt to limit their children's independence from the family of origin or fail to appropriately scaffold their leaving home transition, which is an important developmental task, placing children of alcohol-disordered parents at greater risk of affective disorders in adulthood.

Reciprocity among maternal distress, child behavior, and parenting: transactional processes and early childhood risk

Transactional theories support that parent-child processes are best studied in conjunction with one another, addressing their reciprocal influence and change across time. This study tested a longitudinal, autoregressive model exploring bidirectional relations among maternal symptomatology, child internalizing/externalizing symptoms, and maternal sensitivity during the preschool period (child ages 3 to 5 years), comparing relations among families of typically developing children and children with developmental risk. This study included 250 families, 110 of which had a child with early developmental delay. Analyses utilized data from maternal report, father report, and observational methods. The results indicated significant stability in maternal symptomatology, child internalizing/externalizing symptoms, and maternal sensitivity over time. Support for bidirectional effects between maternal symptomatology and child internalizing symptoms was found specifically for mothers of children with developmental risk. Maternal symptomatology was found to mediate the influence of child internalizing and externalizing symptoms on maternal sensitivity. The findings underscore critical transactional processes within families of children with early developmental risk that connect increased maternal symptomatology to emerging child internalizing symptoms during the preschool period.

[Infants and toddlers behavioral and functional disorders: characteristics, mother-child interactions, alliance and outcome after a brief parents-child psychotherapy. A pilot study]

OBJECTIVES

Functional and behavioral disorders are the most frequent reasons for consultation in infant psychiatry, but there are still few studies about the efficacy of parents-child psychotherapies. Functional disorders appear to be easier to treat than behavioral disorders. The aim of this study was: (1) to assess outcome after a brief psychotherapy in a population of 49 infants aged 3 to 30 months, presenting functional or behavioral disorders; (2) to compare characteristics before therapy and outcomes for children with functional disorders and with behavioral disorders, to have a better understanding of the worse outcome of children with behavioral disorders.

METHODS

Two assessments were performed, one before treatment and the second a month after the end of the therapy including the infant's symptoms (Symptom Check-list), parents' anxious and depressive symptoms (Hospital Anxiety and Depression scale) and mother-infant interactions (Crittenden Experimental Index of adult-infant relationship). The therapeutic alliance was assessed by the therapist and the parents after the first consultation (Working Alliance Inventory).

RESULTS

The assessments after therapy show complete or partial improvement in the child's symptoms, in the mother's anxious and depressive symptoms and in the father's anxious symptoms. During interaction, the mothers become more sensible, the number of controlling and of unresponsive mothers decrease, while the children become more cooperative and less passive. Initial characteristics and outcome are however different according to the type of the child's disorder. The children with behavioral disorders are older and present an association of several symptoms. The disorder onset is later. Their mothers are, before therapy, more anxious and depressive. The therapeutic alliance is weaker. After therapy, despite the fact that their mothers' affective state and that interactive behavior improves, the mothers are more anxious and less sensible, while the children no longer differ from the group without behavioral disorder from the point of view of opposition (assessed during mother-child interaction).

CONCLUSION

Although this study is limited by the lack of a control group and the sample size, it underlines some particularities of infants and toddlers presenting behavioral disorders and the difficulties involved in their treatment. One can wonder if these characteristics are specific of the behavioral disorders or if they are the result of an older dysfunction, complicated by the developmental evolution of the child and the duration of the difficulties. The small number of cases, among the children with behavioral disorders, presenting a preexistent functional disorder, the absence of difference in the duration of the disorders, and the different disorder's onset plead in favor of the first hypothesis. The behavioral disorders often associate child psychopathology, dysfunctional parents-child-relationships and environmental factors difficult to modify with a brief therapy focused on the relationship. It would appear necessary to develop specific treatments for this population.

Postpartum depression is a family affair: addressing the impact on mothers, fathers, and children

The purpose of this paper is to present research on the effects of postpartum depression (PPD) on mothers, fathers, and children that point to a re-conceptualization of PPD as a mental health condition that affects the whole family. As such, the objectives of this paper are to discuss: (1) the incidence and effects of PPD on mothers and fathers; (2) common predictors of PPD in mothers and fathers, and (3) the effects of PPD on parenting and parent-child relationships, and (4) the effects of PPD on children's health, and their cognitive and social-emotional development. Finally, the implications for screening and intervention if depression is re-conceptualized as a condition of the family are discussed.

Examining potential risk factors for anxiety in early childhood

Anxiety disorders are amongst the most prevalent psychiatric disorders in children and adolescents, with occurrence emerging early in the developmental trajectory. This study was one of the first to investigate potential risk factors for anxiety (i.e., behavioural inhibition, parental negative affect, parenting stress) in early childhood. Examination of risk factors was achieved through structural equation modelling and based on mothers' and fathers' report of 236 preschool aged children (4-6 years) in Brisbane, Australia. The structural model was found to fit the data well. All direct predictors of early childhood anxiety were significant and behavioural inhibition partially mediated parents' negative affectivity and mother's parenting stress. Results highlight the unique contribution of both parents in the aetiology of early childhood anxiety and assist in informing the development of intervention and prevention programs for young children.

The Moderating Effects of Mother-Adolescent Relations on the Longitudinal Association between Father and Offspring Depressive Symptoms

Little theoretical or empirical attention has been given to factors associated with better or worse outcomes in offspring of depressed fathers. Drawing from interpersonal models of intergenerational depression transmission in children of depressed mothers, the present investigation of adolescents and their families (N = 424) examined maternal warmth and hostility as moderators of the longitudinal association between paternal and adolescent depressive symptoms. Controlling for family demographic variables, previous adolescent depressive symptoms, and maternal depressive symptoms, fathers' depressive symptoms predicted offspring depressive symptoms among adolescents experiencing low maternal warmth or high maternal hostility. Adolescent girls reporting adversity in their relationships with their mothers were the most vulnerable to risk associated with paternal depressive symptoms. These findings highlight the implications of fathers' mental health for adolescent psychological well-being and add to the growing evidence that family relationships play a crucial role in the transmission of depression from one generation to the next.

What are the parenting experiences of fathers? The use of household survey data to inform decisions about the delivery of evidence-based parenting interventions to fathers

Participants were 933 fathers participating in a large-scale household survey of parenting practices in Queensland Australia. Although the majority of fathers reported having few problems with their children, a significant minority reported behavioral and emotional problems and 5% reported that their child showed a potentially problematic level of oppositional and defiant behavior. Reports of child problems were associated with fathers' levels of personal stress and socioeconomic disadvantage. Approximately half of all fathers reported the use of one or more coercive parenting strategies (shouting and yelling, hitting the child with their hand or with an object) with fathers' use of hitting being associated with child behavior difficulties. Fathers reported low rates of help seeking or participation in parenting courses, with socially disadvantaged fathers being less likely to complete parenting programs than other fathers. Implications for research on increasing fathers' participation rates in parenting programs are discussed and directions for future research highlighted.

The significance of insecure attachment and disorganization in the development of children's externalizing behavior: a meta-analytic study

This study addresses the extent to which insecure and disorganized attachments increase risk for externalizing problems using meta-analysis. From 69 samples (N = 5,947), the association between insecurity and externalizing problems was significant, d = 0.31 (95% CI: 0.23, 0.40). Larger effects were found for boys (d = 0.35), clinical samples (d = 0.49), and from observation-based outcome assessments (d = 0.58). Larger effects were found for attachment assessments other than the Strange Situation. Overall, disorganized children appeared at elevated risk (d = 0.34, 95% CI: 0.18, 0.50), with weaker effects for avoidance (d = 0.12, 95% CI: 0.03, 0.21) and resistance (d = 0.11, 95% CI: -0.04, 0.26). The results are discussed in terms of the potential significance of attachment for mental health.

Mütterliche Depressivität, Erziehung und kindliche Erlebens- und Verhaltensprobleme

Welche Auffälligkeiten zeigen sich in der Erziehung emotional belasteter Mütter sowie im Verhalten ihrer vier bis sieben Jahre alten Kinder im Vergleich zu einer unausgelesenen Kindergartenstichprobe? Gibt es Zusammenhänge zwischen mütterlicher Depressivität, verschiedenen Aspekten der Erziehung und kindlichen Erlebens- und Verhaltensproblemen? Welche Aspekte der Erziehung vermitteln diese Zusammenhänge? Um diese Fragen zu untersuchen, wurden subklinisch depressive Mütter (N = 380) zu kindlichem Verhalten, Erziehungspraktiken, elterlichem Stress sowie zu elterlichem Kompetenzerleben befragt. Die Daten wurden mit einer Kindergartenstichprobe ( Lösel et al., 2005 ) verglichen. Die depressiv gestimmten Mütter zeigten im Vergleich zu den unausgelesenen Müttern ein ungünstigeres Erziehungsverhalten, erlebten sich weniger kompetent in der Erziehung und sie berichteten über höheren elterlichen Stress. Ihre Kinder wiesen mehr Störungen des Erlebens und Verhaltens auf. Die Merkmale Elterlicher Stress und Kompetenzerleben in der Erziehung erwiesen sich als Mediatoren des Zusammenhangs von mütterlicher Depressivität und kindlichen Auffälligkeiten. Die Bedeutung der Ergebnisse für die Prävention wird diskutiert.

How does violence exposure affect the psychological health and parenting of young African-American mothers?

Urban, minority, adolescent mothers are particularly vulnerable to violence exposure, which may increase their children's developmental risk through maternal depression and negative parenting. The current study tests a conceptual model of the effects of community and contextual violence exposure on the mental health and parenting of young, African-American mothers living in Washington, DC. A path analysis revealed significant direct effects of witnessed and experienced violence on mothers' depressive symptoms and general aggression. Experiences of discrimination were also associated with increased depressive symptoms. Moreover, there were significant indirect effects of mothers' violence exposure on disciplinary practices through depression and aggression. These findings highlight the range of violence young African-American mothers are exposed to and how these experiences affect their mental health, particularly depressive symptoms, and thus disciplinary practices.

Predictors of outcome in infant and toddlers functional or behavioral disorders after a brief parent-infant psychotherapy

The efficacy of parent-child psychotherapies is widely recognized today. There are, however, less data on predictive factors for outcome in infants and toddlers and their parents. The aim of this study was to highlight predictive factors for outcome after a brief psychotherapy in a population of 49 infants and toddlers aged 3-30 months presenting functional or behavioral disorders. Two assessments were performed, the first before treatment and the second a month after the end of the therapy. These assessments included an evaluation of the child's symptoms, and of depressive or anxiety symptoms in the parents. The assessments after therapy show complete or partial improvement in the child's symptoms for nearly three quarters, and a decrease in the number of anxious and depressive mothers, and also in the number of depressive fathers. Three independent factors appear as predictive of unfavorable outcome for the child: frequency and intensity of behavioral problems and fears, and the absence of the father at more than two-thirds of consultations. The outcome for the mother is associated solely with her anxiety score at the start of the therapy. This study underlines the particular difficulties involved in the treatment of infants and toddlers presenting behavioral disturbances and emotional difficulties, and the value of involving the father in treatment.

Parenting and Child Externalizing Behaviors: Are the Associations Specific or Diffuse?

Building upon the link between inadequate parenting and child noncompliance, aggression, and oppositionality, behavioral parent training has been identified as a well-established treatment for externalizing problems in children. Much less empirical attention has been devoted to examining whether inadequate parenting and, in turn, behavioral parent training programs, have specific effects on child externalizing problems or more diffuse effects on both internalizing and externalizing problems. As an initial attempt to examine the specificity of parenting and childhood externalizing problems, this review examines prior research on the association of three parenting behaviors (parental warmth, hostility, and control) with child externalizing versus internalizing problems. Notably, findings revealed relatively little evidence for the specificity of parenting and child externalizing behaviors in the general parenting literature or in the family context of parent depression. Clinical implications and directions for future research are discussed.

Maternal mental health and child behaviour problems at 2 years: findings from the Pacific Islands Families Study

OBJECTIVE

The present study investigated associations between the timing and persistence of maternal psychological disorder and child behaviour problems in a cohort of Pacific 2-year-old children in New Zealand.

METHOD

Mothers of a cohort of 1,398 Pacific infants born in South Auckland, New Zealand were interviewed when their children were 6 weeks, 12 and 24 months of age. Within the context of a wider interview, data regarding maternal mental health were obtained at these times and maternal reports of child behaviour were gathered when the children were 2 years old.

RESULTS

Prevalence rates for internalizing problems were significantly higher in children of mothers who had self-reported symptoms of psychological disorder (11.9% in no symptoms, 27.8% in early symptoms of postnatal depression, 21.1% in late symptoms of psychological disorder and 42.9% in persistent or recurrent symptoms). The adjusted odds ratio (OR) of a child having internalizing problems was 1.38 (95% confidence interval (CI): 0.79-2.43) in those of mothers reporting early symptoms of postnatal depression, 1.45 (95%CI: 0.85-2.49) in late symptoms of psychological disorder, and 2.93 (95%CI: 1.54-5.57) in persistent or recurrent symptoms relative to the no symptoms group. For externalizing problems, the effects of maternal psychological disorder were not significant.

CONCLUSIONS

Maternal persistent or recurrent symptoms of psychological disorder may contribute to the behaviour problems of children as young as 2 years old. However, the timing of disorder, whether it is infant or toddler exposure, does not appear to be as crucial. Improved understanding of the associations between maternal psychological disorder and early child behaviour problems may help maternal and child health professionals design appropriate and effective screening and intervention programs to help Pacific mothers and children.

Maternal and Paternal Depressive Symptoms and Child Maladjustment: The Mediating Role of Parental Behavior

This study examined parental behaviors as mediators in links between depressive symptoms in mothers and fathers and child adjustment problems. Participants were 4,184 parents and 6,048 10- to 15-year-olds enrolled in the 1998 and 2000 cycles of the Canadian National Longitudinal Survey of Children and Youth. Mothers and fathers self-reported symptoms of depression at Times 1 and 2 and their children assessed parental nurturance, rejection, and monitoring and self-reported internalizing and externalizing problems and prosocial behavior at Time 2. Hierarchical linear modeling showed evidence of mediation involving all three domains of parental behavior. Findings supported the hypothesis that the quality of the child's rearing environment is one mechanism that carries risk to children of depressed parents. Interventions for parents whose symptoms of depression interfere with parenting responsibilities could help reduce the risk of some childhood disorders.

Depression in Mothers

Whether one takes a biological, psychological, or psychosocial perspective, depression in mothers raises concerns about risks for the development of psychopathology in the children. This review addresses the complexity of that risk and the essential role of development in a model that explains processes of transmission. This article addresses the following aims: (a) to provide convincing evidence that depression in mothers is an important topic for clinical psychologists; (b) to summarize current theoretical models of mechanisms of risk for the development of psychopathology in children of depressed mothers and the status of empirical support for those models; (c) to examine the theoretical bases and current status of evidence for moderators of this risk; (d) to argue for the advantages to be gained from a developmental psychopathology perspective on this topic; and (e) to point to future directions for theory, research, and practice.

A feasibility study on recruiting fathers of young children to examine the impact of paternal depression on child development

Fathers are underrepresented in research on mental health and child outcome. We tested a range of methods of recruitment of fathers to establish feasibility and recruitment rates to obtain a sample for a study on paternal depression and child development. The study took place in North London. Fathers of children aged 6 years and under were approached via: general practice surgeries by post and by face-to-face contact with attendees; child health surveillance clinics face-to-face or via their partners and via hospital postnatal wards face-to-face or by post. Researcher time and associated costs were monitored for each method, and symptoms of depression and anxiety measured using the Hospital Anxiety and Depression Scale (HADS). Face-to-face recruitment of fathers on the postnatal ward generated the highest return rate of HADS (28/37; 76%), followed by postal recruitment through general practice (41%;124/303). Lower response rates were observed with postal recruitment via postnatal wards (31%), recruitment in child health surveillance clinics (20%) and approaching attendees in general practice (16%). Twelve percent (23/194) and 30% (58/194) of fathers respectively reported depression and anxiety above the cut-off for case-definition. Costs were calculated on pro-rata researcher time. Costs of recruiting one participant ranged from 3 pounds sterling (general practice postal) to 11.75 pounds sterling (child health surveillance clinics), however the general practice attender method was disproportionately expensive (52.50 pounds sterling). This feasibility study shows that it is possible to recruit fathers to mental health studies and provides clear guidance on planning, costing and the expected levels of recruitment for future studies on fathers of young children.

Association of parental depression with psychiatric course from adolescence to young adulthood among formerly depressed individuals

The authors examined whether parental major depressive disorder (MDD) is associated with course of depression and other psychopathology among formerly depressed adolescents as they enter adulthood. The sample consisted of 244 individuals (age 24) in a longitudinal study who had experienced MDD by 19. Maternal MDD was associated with MDD recurrence, chronicity and severity, anxiety disorders, and (among sons only) lower psychosocial functioning in offspring between the ages of 19 and 24. Paternal MDD was associated with lower functioning. Sons of depressed fathers had elevated suicidal ideation and attempt rates in young adulthood. Recurrent paternal MDD was associated with depression recurrence in daughters but not sons. The impact of parental MDD on offspring could not be attributed to characteristics of the offspring's depression prior to age 19.

Father involvement moderates the effect of maternal depression during a child's infancy on child behavior problems in kindergarten

This research investigated whether father involvement in infancy may reduce or exacerbate the well-established adverse effect of maternal depression during a child's infancy on behavior problems in childhood. In a community sample (N = 350), the authors found that fathers' self-reported parenting styles interacted with the amount of time fathers spent caring for their infants to moderate the longitudinal effect of maternal depression during the child's infancy on children's internalizing, but not externalizing, behaviors. Low to medium amounts of high-warmth father involvement and high amounts of medium- or high-control father involvement at this time were associated with lower child internalizing behaviors. Paternal depression during a child's infancy exacerbated the effect of maternal depression, but this moderating effect was limited to depressed fathers spending medium to high amounts of time caring for their infants. Results emphasize the moderating role fathers may play in reducing or exacerbating the adverse long-term effects of maternal depression during a child's infancy on later child behavior problems.

Mutual influences on maternal depression and child adjustment problems

Often undetected and poorly managed, maternal depression and child adjustment problems are common health problems and impose significant burden to society. Studies show evidence of mutual influences on maternal and child functioning, whereby depression in mothers increases risk of emotional and behavioral problems in children and vice versa. Biological mechanisms (genetics, in utero environment) mediate influences from mother to child, while psychosocial (attachment, child discipline, modeling, family functioning) and social capital (social resources, social support) mechanisms mediate transactional influences on maternal depression and child adjustment problems. Mutual family influences in the etiology and maintenance of psychological problems advance our understanding of pathways of risk and resilience and their implications for clinical interventions. This article explores the dynamic interplay of maternal and child distress and provides evidence for a biopsychosocial model of mediating factors with the aim of stimulating further research and contributing to more inclusive therapies for families.

The relations among depression in fathers, children's psychopathology, and father–child conflict: A meta-analysis

Research on parental depression is beginning to recognize the importance of studying fathers in relation to maladaptive outcomes in their offspring. Paternal depression is hypothesized to correlate with internalizing and externalizing psychopathology in children and adolescents and to compromise adaptive parent-child relationships (e.g., increased conflict). In the present paper, meta-analytic procedures were applied to this literature to address the magnitude and direction of covariation between paternal depression and children's functioning. In addition, we tested whether variation in findings could be accounted for by study characteristics. Results indicated that paternal depression was significantly related to offspring internalizing and externalizing psychopathology and father-child conflict. Larger effects for internalizing symptoms were associated with the use of community samples and symptom rating scales of internalizing problems.

Mothers' and fathers' depressive symptoms and conflict-resolution strategies in the marriage and children's externalizing and internalizing behaviors

The authors examined mothers' and fathers' avoidance and attacking conflict-resolution strategies in the marriage and their depressive symptoms as they related to children's externalizing and internalizing behaviors. A nonclinical community sample of 51 families and their children's 1st-grade teachers (N = 41) participated. Both mothers and teachers completed a behavior-problem checklist in order to evaluate the incidence of internalizing and externalizing behaviors in the children. Correlational statistics revealed significant associations between parents' avoidance and attacking strategies and their depressive symptoms. Also, parents' use of avoidance was related to more internalizing behaviors in the children. When hierarchical regression analyses were used to examine the contributions of the parents' attributes to children's externalizing and internalizing behaviors, mothers' avoidance and an interaction between mothers' and fathers' avoidance were identified as significant predictors of children's internalizing behaviors.

Cumulative risk and population attributable fraction in prevention

Compares the use of relative risk versus population attributable fraction in determining the target population for multirisk prevention programs in psychology. Results show that relative risk generally increases as a function of cumulative risk. Guided by this measure, prevention programs should target populations with the largest cumulative risk. However, relative risk does not account for the prevalence of a particular level of cumulative risk in the population. Therefore, because the largest cumulative risk is experienced by only a small portion of the population, prevention programs guided by this measure will not always have the greatest public health benefit to reduce the incidence of problem outcomes in the population. On the other hand, the population attributable fraction, which does take into account the prevalence of a particular level of cumulative risk, does not increase appreciably after a cumulative risk of one, two, or three because the majority of people in the population will experience these levels of cumulative risk. Guided by this measure, prevention programs that target the higher proportion of people who have a more moderate level of risk would have the maximum impact on the population. National data sets from Great Britain (the British Births Cohort Study [BCS]) and the United States (National Longitudinal Study of Youth [NLSY]) are used to explore this pattern of effects.

The association between psychopathology in fathers versus mothers and children's internalizing and externalizing behavior problems: a meta-analysis

In light of the selective focus on maternal (vs. paternal) psychopathology as a risk factor for child development, this meta-analysis examines the relative strength of the association between psychopathology in mothers versus fathers and the presence of internalizing and externalizing disorders in children. Associations were stronger between maternal than paternal psychopathology and the presence of internalizing (but not externalizing) problems in children, with all average effect sizes being small in magnitude. Relations were moderated by variables that highlight theoretically relevant differences between psychopathology in mothers versus fathers (e.g., age of children studied, type of parental psychopathology) and by variables related to methodological differences across studies (e.g., method of assessing psychopathology in parents and children, type of sample recruited, familial composition).

Preschool and school age children under welfare reform

This study compared the behavioral and school problems of young children whose mothers participated in two different income support programs, Jobs First and AFDC. The analyses also included measures of maternal education, maternal health, maternal psychological factors, and family environment. There were no differences in child school or behavioral problems across the income support programs. Children, however, were more likely to have school problems if they were older or if their mothers received less than a high school education, reported child behavioral problems or made criteria for depression on the CIDI. Behavioral problems were more likely to occur if mothers reported violence in the home, many depressive symptoms on the CES-D, few child positive qualities, or if the child had repeated a grade. Several familial factors, then, must be addressed in order to ensure that children excel both academically and behaviorally.

Maternal depression and physical punishment as mediators of the effect of poverty on socioemotional problems of children in single-mother families

Data from a national sample of 878 4-9-year-old children in single-mother families were used to test a structural model of the effect of poverty on children's socioemotional problems. Results show that the effect of poverty is mediated by maternal depression and mothers' use of physical punishment. Maternal depression influence children's socioemotional problems directly, as well as indirectly through physical punishment.

Maternal depressive symptoms and child behavior problems in a nationally representative normal birthweight sample

OBJECTIVE

To evaluate the association between maternal depressive symptoms and child behavior problems in a nationally representative sample of U.S. mothers of normal birthweight babies.

METHODS

We analyzed data from the 1988 National Maternal and Infant Health Survey (NMIHS) and a 1991 follow-up survey. Depressive symptoms were measured at both surveys using the CES-D, and child behavior problems were assessed by maternal self-report at follow-up.

RESULTS

Approximately 28% of the 5303 mothers reported depressive symptoms at a mean of 17 months after delivery, as did 20% at 36 months. In multivariate analyses, women with depressive symptoms at either or both surveys were significantly more likely than women without depressive symptoms to report that their children had frequent temper tantrums or difficulty getting along with other children, and were difficult to manage, unhappy, or fearful. Compared to women without depressive symptoms, the risks of reporting three out of the five child behavior problems for women with depressive symptoms were OR = 1.6 (CI = 1.1-2.1), 1988 only; OR = 2.3 (CI = 1.6-3.3), 1991 only; and OR = 3.6 (2.6-5.0), both 1988 and 1991.

CONCLUSIONS

Study findings indicate that a substantial proportion of mothers of young children in the United States experience depressive symptoms and that their children are at significantly increased risk of maternally reported behavior problems. Our results suggest that efforts to identify and treat depression in new mothers should be increased and that mothers whose children are found to have behavior problems should be assessed for depression.