The effect of maternal depression on maternal ratings of child behavior

Maternal Emotion Regulation Strategies, Internalizing Problems and Infant Negative Affect

Recent work has identified links between mothers' self-regulation and emotion regulation (ER) and children's social-emotional outcomes. However, associations between maternal ER strategies (e.g., reappraisal, suppression), known to influence internalizing problems in adults, and children's negative affect (NA) have not been considered. In the current study, the direct and indirect relationships, through maternal internalizing problems, between maternal use of ER strategies and infant NA are examined. The potential effects of infant NA on maternal internalizing difficulties are also considered. Ninety-nine mothers and their infants participated across three time points during the first year postpartum. Higher maternal suppression was indirectly related to higher infant NA, through maternal internalizing problems; lower maternal reappraisal also was indirectly related to higher infant NA through maternal internalizing problems. Infant NA at four months postpartum was related to mothers' internalizing problems 6 months postpartum. The implications of these findings for future research and intervention are discussed.

Sluggish cognitive tempo is associated with suicide risk in psychiatrically hospitalized children

BACKGROUND

Although identified as a significant public health concern, few studies have examined correlates of suicide risk in school-aged children. Recent studies show a relation between sluggish cognitive tempo (SCT) symptoms and a range of adverse outcomes linked to suicidal ideation, including depression, emotion dysregulation, lowered self-esteem, and peer problems/social withdrawal, yet no study to date has examined SCT in relation to suicide risk.

METHODS

We tested the hypothesis that SCT would be associated with suicide risk in a sample of 95 psychiatrically hospitalized children (74% male; 62% black) between the ages of 8 and 12 (M = 10.01, SD = 1.50). Parents completed measures of their child's psychiatric symptoms, including SCT and depression, as well as a measure of their own psychopathology. Children completed measures assessing loneliness and depression. Both parents and children completed measures of suicide risk.

RESULTS

White children reported greater suicide risk than nonwhite children. After controlling for demographic characteristics, loneliness, parental psychopathology, and correlated psychiatric symptoms, including both parent- and child self-reported depressive symptoms, SCT remained uniquely associated with children's suicide risk. Results were consistent across both parent and child measures of suicide risk.

CONCLUSIONS

This multi-informant study provides strong preliminary support for an association between SCT symptoms and suicide risk in psychiatrically hospitalized children, above and beyond loneliness, depression, and demographic characteristics. Findings are discussed in the context of the interpersonal theory of suicide. Additional studies are needed to replicate and extend these findings, with a particular need for studies that examine the cognitive processes and daydreaming content of individuals displaying elevated SCT symptomatology.

Y.BottonJ.CharlesM. A.Dargent-MolinaP.de Lauzon-GuillainB.DucimetièreP.de AgostiniM.FoliguetB.ForhanA.FritelX.GermaA.GouaV.HankardR.HeudeB.KaminskiM.Larroque†B.LelongN.LepeuleJ.MagninG.MarchandL.NabetC.PierreF.SlamaR.Saurel-CubizollesM. J.SchweitzerM.ThiebaugeorgesO.. Relationship between early language skills and the development of inattention/hyperactivity symptoms during the preschool period: Results of the EDEN mother-child cohort

BACKGROUND

This study aims to examine bidirectional relationships between children's language skills and Inattention/Hyperactivity (IH) symptoms during preschool.

METHOD

Children (N = 1459) from the EDEN mother-child cohort were assessed at ages 3 and 5.5 years. Language skills were evaluated using the WPPSI-III, NEPSY and ELOLA batteries. Children's behavior, including IH symptoms, was assessed using the parent-rated Strengths & Difficulties Questionnaire (SDQ). Using a Structural Equation Modeling (SEM) approach, we examined the relationship between language skills and IH symptoms, as well as potential mediating processes.

RESULTS

SEM analyses indicated a small negative effect of language skills at 3 years on ADHD symptoms at 5.5 years after adjusting for IH symptoms at 3 years (β =-0.12, SE = 0.04, p-value = 0.002). Interpersonal difficulties did not mediate the relationship between early language skills and later IH symptoms, nor was this association reduced after adjusting for a broad range of pre- and postnatal environmental factors and performance IQ. Among different language skills, receptive syntax at 3 years was most strongly related to IH symptoms at 5.5 years.

CONCLUSIONS

Poor language skills at age 3 may predict IH symptoms when a child enters primary school. Implications for the understanding and the prevention of the co-occurrence of language disorders and ADHD are discussed.

Discrimination and Acculturation Stress: A Longitudinal Study of Children's Well-Being from Prenatal Development to 5 Years of Age

OBJECTIVE

To examine whether cumulative family discrimination and acculturation stress (prenatally to 24 months postpartum) among Mexican-origin adolescent mothers and their mother-figures predicted children's socio-emotional functioning and academic achievement at 5 years of age, and the role of maternal depressive symptoms and mother-child interactions in the association.

METHOD

Mexican-origin families (N = 204) with an adolescent mother, a child, and a mother-figure participated in a 6-wave longitudinal study (2007-2013). Families were recruited and interviewed during the adolescent mother's pregnancy; adolescent mothers, mother-figures, and children were then assessed annually for the next 5 years using a combination of interview-based survey and observational methods. Maternal reports of children's socio-emotional behaviors (measured using the Child Behavior Checklist) and children's academic achievement (assessed with the Woodcock Johnson III Tests of Achievement/Bateria III Woodcock-Muñoz) were used.

RESULTS

Structural equation modeling revealed that greater cumulative family discrimination and acculturation stress from pregnancy to 24 months postpartum predicted higher adolescent mothers' depressive symptoms, greater mother-child intrusive interactions, and less mother sensitivity at 36 months postpartum. Maternal depressive symptoms were positively related to children's CBCL symptoms at 60 months postpartum. Greater cumulative discrimination and acculturation stressors directly predicted children's lower Woodcock Johnson/Bateria test scores after accounting for socio-economic status.

CONCLUSION

Mexican-origin adolescent mothers' and mother figures' cumulative discrimination and acculturation stress from pregnancy through children's second birthday predicted children's socio-emotional and academic achievement at age 5. Overall, the findings underscore the cumulative impact of these stressors on well-being in a population with substantial public health significance.

Transactional effects among maternal depression, neighborhood deprivation, and child conduct problems from early childhood through adolescence: A tale of two low-income samples

The current study sought to advance our understanding of transactional processes among maternal depression, neighborhood deprivation, and child conduct problems (CP) using two samples of low-income families assessed repeatedly from early childhood to early adolescence. After accounting for initial levels of negative parenting, independent and reciprocal effects between maternal depressive symptoms and child CP were evident across both samples, beginning in early childhood and continuing through middle childhood and adolescence. In addition, neighborhood effects were consistently found in both samples after children reached age 5, with earlier neighborhood effects on child CP and maternal depression found in the one exclusively urban sample of families with male children. The results confirm prior research on the independent contribution of maternal depression and child CP to the maintenance of both problem behaviors. The findings also have implications for designing preventative and clinical interventions to address child CP for families living in high-risk neighborhoods.

Personality in the Age of Industry: Structure, Heritability, and Correlates of Personality in Middle Childhood from the Perspective of Parents, Teachers, and Children

Middle childhood is a crucial juncture in the lifespan where children work towards achieving a sense of competence foundational for future development. However, middle childhood has historically been underrepresented in the personality literature. The current study provides a comprehensive examination of personality in middle childhood using a large (N = 2510), longitudinal sample of 10- to 12-year-old twins. The structure, heritability, and correlates of personality in this period were investigated using personality ratings of parents, teachers, and children. Results showed that personality in middle childhood has a coherent structure, is heritable, and is relevant for developmentally salient outcomes such as externalizing behavior, substance use, and academic engagement. Results emphasize the importance of investigating personality in middle childhood across multiple informants.

Maternal psychological distress in primary care and association with child behavioural outcomes at age three

Observational studies indicate children whose mothers have poor mental health are at increased risk of socio-emotional behavioural difficulties, but it is unknown whether these outcomes vary by the mothers' mental health recognition and treatment status. To examine this question, we analysed linked longitudinal primary care and research data from 1078 women enrolled in the Born in Bradford cohort. A latent class analysis of treatment status and self-reported distress broadly categorised women as (a) not having a common mental disorder (CMD) that persisted through pregnancy and the first 2 years after delivery (N = 756, 70.1 %), (b) treated for CMD (N = 67, 6.2 %), or (c) untreated (N = 255, 23.7 %). Compared to children of mothers without CMD, 3-year-old children with mothers classified as having untreated CMD had higher standardised factor scores on the Strengths and Difficulties Questionnaire (d = 0.32), as did children with mothers classified as having treated CMD (d = 0.27). Results were only slightly attenuated in adjusted analyses. Children of mothers with CMD may be at risk for socio-emotional and behavioural difficulties. The development of effective treatments for CMD needs to be balanced by greater attempts to identify and treat women.

Sibling sleep-What can it tell us about parental sleep reports in the context of autism?

Sleep problems are common in families raising children with Autism Spectrum Disorder (ASD). Clinicians often depend on parent reports of child sleep but minimal research exists to address the accuracy or biases in these reports. To isolate parent-report accuracy (from differences in sleep behaviors), the sleep of younger siblings were assessed within a two-group design. The present study compared parent diary reports of infant sibling sleep to videosomnography and actigraphy. In the high-risk group, families had at least one child with ASD and a younger sibling (n = 33). The low-risk comparison group had no family history of ASD (n = 42). We confirmed comparable sleep behaviors between the groups and used paired t tests, two-one-sided-tests (TOST), and Bland-Altman plots to assess parent report accuracy. The parameters of sleep onset, nighttime sleep duration, awakenings, morning rise time, and daytime sleep duration were evaluated. Diary and videosomnography estimates were comparable for nighttime sleep duration, morning rise time, and awakenings for both groups. Diary and actigraph estimates were less comparable for both groups. Daytime sleep duration estimates had the largest discrepancy with both groups reporting (on average) 40 additional minutes of sleep when compared to actigraphy estimates. In the present study, families raising children with ASD were just as accurate as other families when reporting infant sleep behaviors. Our findings have direct clinical implications and support the use of parent nighttime sleep reports.

Measurement invariance and child temperament: An evaluation of sex and informant differences on the Child Behavior Questionnaire

Parent reports of temperament are used to study many important topics in child development, such as whether boys and girls differ in their levels of emotional reactivity and self-regulation. However, questions regarding measurement equivalence in parental reports of temperament are largely unexplored, despite the fact that this issue is critical for drawing the correct conclusions from mean-level comparisons. In the current study, measurement invariance across boys and girls (as targets), and mothers and fathers (as informants), was investigated in the Child Behavior Questionnaire (CBQ; Rothbart et al., 2001) using a sample of children ranging in age from 3 to 7 years (N = 605). Several instances of noninvariance were identified across both girls and boys, and mothers and fathers. An evaluation of effect size indices suggests that the practical impact of this noninvariance ranges from negligible to moderate. All told, this study illustrates the importance of taking a psychometrically informed approach to the use of parent reports of child temperament. (PsycINFO Database Record

Early childhood psychological factors and risk for bedwetting at school age in a UK cohort

There is evidence for a link between psychological factors and bedwetting, but the direction of this association is unclear. Using data on 8769 children from the Avon Longitudinal Study of Parents and Children, we examined whether difficult temperament (Toddler Temperament Scale at 24 months; Emotionality Activity Sociability Questionnaire at 38 months) and psychological problems (Revised Rutter Parent Scale for Preschool Children at 42 months) are linked to bedwetting at school age. We examined the association between these risk factors and different patterns of bedwetting from 4 to 9 years using multinomial regression. Difficult temperament and psychological problems in early childhood were associated with increased odds of bedwetting at 4-9 years. The strongest associations were most often found for the pattern of bedwetting that was both frequent (at least twice a week) and persistent (up to age 9) e.g. the temperament traits of 'adaptability' and 'mood' were associated with a 33 % increase (95 % confidence interval = 1.14-1.55) and a 27 % increase (1.10-1.47) respectively in the odds of persistent and frequent bedwetting per one standard deviation increase in risk score. Early behaviour problems (e.g. conduct problems [1.43 (1.25, 1.63)] and hyperactivity [1.29 (1.11, 1.50), p < 0.001]) were also associated with frequent and persistent bedwetting, but there was less evidence that early emotional difficulties were risk factors for bedwetting. Adjustment for confounders did not alter these conclusions. The presence of difficult temperament and behaviour problems in early childhood might help to identify children who will continue to experience bedwetting at school age.

Disagreement between parents on assessment of child temperament traits

BACKGROUND

Accuracy of temperament assessment is a prerequisite in research studies. To identify the extent to which parental assessment of child temperament is biased by their personal attributes, we proposed a new structural equation model, in which biases of parental attributes in their assessment of child temperament can be separated from the true (i.e. non-biased) associations between the two.

METHODS

We examined 234 father-mother pairs using questionnaires including Emotionality, Activity, Sociability, and Impulsivity; Social Desirability Scale; Hospital Anxiety and Depression Scale; Temperament and Character Inventory; and State-Trait Anger Expression Inventory.

RESULTS

Paternal Depression and Persistence, maternal Trait Anger, and parental Novelty Seeking showed significant bias in assessment of Emotionality. Maternal Self-transcendence showed significant bias in assessment of child Impulsivity.

CONCLUSION

Researchers should be cautious about biases in parental assessment of children's Emotionality and Impulsivity, but other temperament traits may be free from such biases.

Perinatal Maternal Mental Health, Fetal Programming and Child Development

Maternal mental disorders over pregnancy show a clear influence on child development. This review is focused on the possible mechanisms by which maternal mental disorders influence fetal development via programming effects. This field is complex since mental health symptoms during pregnancy vary in type, timing and severity and maternal psychological distress is often accompanied by higher rates of smoking, alcohol use, poor diet and lifestyle. Studies are now beginning to examine fetal programming mechanisms, originally identified within the DOHaD framework, to examine how maternal mental disorders impact fetal development. Such mechanisms include hormonal priming effects such as elevated maternal glucocorticoids, alteration of placental function and perfusion, and epigenetic mechanisms. To date, mostly high prevalence mental disorders such as depression and anxiety have been investigated, but few studies employ diagnostic measures, and there is very little research examining the impact of maternal mental disorders such as schizophrenia, bipolar disorder, eating disorders and personality disorders on fetal development. The next wave of longitudinal studies need to focus on specific hypotheses driven by plausible biological mechanisms for fetal programming and follow children for a sufficient period in order to examine the early manifestations of developmental vulnerability. Intervention studies can then be targeted to altering these mechanisms of intergenerational transmission once identified.

Does Mother-Child Interaction Mediate the Relation Between Maternal Depressive Symptoms and Children's Mental Health Problems?

The relation between maternal depressive symptoms and children's mental health problems has been well established. However, prior studies have predominantly focused on maternal reports of children's mental health problems and on parenting behavior, as a broad and unilateral concept. This cross-sectional study examined specific observed mother-child interaction behaviors through which maternal depressive symptoms are assumed to affect children's mental health problems. We expected higher rates of maternal depressive symptoms to predict higher rates of children's mental health problems, and we expected this relation to be mediated by low maternal warmth and high maternal psychological control. The sample consisted of 111 mother-child dyads referred for treatment. The mother-child interaction behaviors were coded according to the observed mother-child interaction tasks. Children's mental health problems were assessed using both maternal reports and children's self-reports. As expected, the results showed that maternal depressive symptoms were strongly related to maternal reports of children's internalizing and externalizing mental health problems. Surprisingly, maternal depressive symptoms were unrelated to children's self-reported depressive symptoms. Furthermore, mother-child interactions did not mediate the relation between maternal depressive symptoms and child mental health problems. Maternal depressive symptoms were associated with high maternal warmth, and high psychological control was associated with high levels of mother-reported externalizing mental health problems in children. These results partially replicate previous findings but add to these by using observational methods and multi-informant data. The importance of using a multi-informant and multi-method approach in assessing children's mental health problems in clinical practice and research are discussed.

Diary Reports of Concerns in Mothers of Infant Siblings of Children with Autism Across the First Year of Life

We examined the home-based concerns reported by mothers of infant siblings of children with autism across the first year of life. At all three ages measured, mothers of high-risk infants were significantly more likely than mothers of low-risk infants to report language, social communication, and restricted and repetitive behavior concerns but were not more likely to report general, medically based concerns. At 6 and 9 months of age, maternal concerns were poorly related to infant or family variables. At 12 months of age, there were moderate correlations between maternal concerns and infant behavior, and concerns were associated with the proband's autism symptoms and mothers' concurrent depressive symptoms. These findings highlight the need to examine high-risk infants' development in the family context.

Maternal borderline personality disorder symptoms and convergence between observed and reported infant negative emotional expressions

To date, the influence of maternal borderline personality disorder (BPD) on perceptions of infants' emotional expressions has not been examined. This study investigated the relation of maternal BPD symptoms to discrepancies between mother-reported and observed infant expressions of fear and anger. Emotional expressions in response to fear- and anger-eliciting stimuli were observed among 101 12- to 23-month-old infants of mothers with a range of BPD symptoms. Mothers also reported on their infants' past-month fear and anger expressions. Findings from polynomial regression analyses revealed that maternal BPD symptoms (particularly BPD interpersonal symptoms) are associated with greater convergence of mother-reported and observed infant anger expressions. Furthermore, although maternal BPD symptoms were not related to discrepancies between mother-reported and observed infant fear, findings did reveal a relation between maternal BPD symptoms and observed infant fear expressions, such that maternal BPD symptoms related to both low and high (vs. moderate) levels of fear expressions in the laboratory. Moreover, BPD behavioral symptoms in particular were associated with greater convergence of mother-reported and observed infant fear expressions. Overall, findings contribute to the literature on the impact of maternal BPD on parenting and infant outcomes, and highlight the relevance of maternal BPD symptoms to discrepancies between perceived and observed infant negative emotional expressions.

Maternal mental health and children's internalizing and externalizing behaviors: Beyond maternal substance use disorders

Maternal substance abuse and mental disorders can have adverse impacts on child development. We investigated the impact of maternal mental health on child behaviors based on a long-term follow-up study of mothers and their children approximately 10 years after mothers' admission to drug abuse treatment. Mothers (n=396) were assessed at admission to drug treatment during 2000 to 2002, and at follow-up in 2010-2011. At follow-up, each mother was asked to assess one target child using the Child Behavior Checklist for ages 6-18 (CBCL). Mothers' mental disorder diagnoses were obtained from records maintained by the California Department of Mental Health in 2009. About 46% of mothers had comorbid mental disorders; 27% had depressive disorder, 15% bipolar disorder, 15% adjustment disorder, 13% anxiety disorder, and 6% psychotic disorder. Of these mothers, more than half had two or more mental disorder diagnoses. The average age of the target child was approximately 10 years old (range 6 to 17). Relative to children of mothers without comorbid mental disorders, children were more likely to demonstrate internalizing behaviors if their mothers had comorbid depression/anxiety disorders (OR=2.0, 95%CI:1.0-4.0) or severe mental disorders (psychoses, bipolar) (OR=3.4, 95%CI:1.5-7.6). For externalizing behaviors, family problems was the only significant predictor (OR=3.2, 95%CI:1.7-6.0 for children of mothers with depression/anxiety disorders, OR=3.9, 95%CI:1.9-7.8 for severe mental disorders). Addressing maternal mental disorders (particularly severe mental disorders) and family problems are important for child well-being as these factors were significantly related to emotional and problem behaviors of children.

Parent-child conflict and early childhood adjustment in two-parent low-income families: parallel developmental processes

Parent-child conflict is central to most intervention models focused on reducing child problem behavior, yet few longitudinal studies have examined these processes during early childhood. The current study investigates (1) growth in mother-child and father figure (FF)-child conflict, (2) associations between trajectories of mother-child and FF-child conflict and children's adjustment; and (3) intervention effects in attenuating conflict. Participants are 195 ethnically diverse mother-FF-child triads drawn from a larger parenting intervention study for families with children at risk for developing conduct problems. Mother-child conflict decreased from ages 2 to 4, but decreases were unrelated to changes in children's adjustment problems. In contrast, the slope of FF-child conflict was positively related to the slope of child externalizing behaviors. Random assignment to a family-centered parenting intervention predicted rate of decline in mother-child conflict. Findings are discussed with respect to developmental patterns of parent-child conflict in early childhood and implications for prevention.

Unstable and Multiple Child Care Arrangements and Young Children's Behavior

Growing evidence suggests that child care instability is associated with child behavior problems, but existing studies confound different types of instability; use small, convenience samples; and/or control insufficiently for selection into child care arrangements. This study uses survey and calendar data from the Fragile Families and Child Well-Being Study to estimate the associations between three different types of child care instability-long-term instability, multiplicity, and the use of back-up arrangements-and children's internalizing, externalizing, and prosocial behaviors at age 3, controlling for a large number of child and family background characteristics. Long-term instability between birth and age 3, as measured in both the survey and calendar data, is associated with higher levels of externalizing behavior problems. Current multiplicity at age 3 (as measured by survey data) is associated with higher levels of both externalizing and internalizing behavior problems, but stable multiplicity over time (as measured using calendar data) is not. Finally, the use of back-up arrangements at age 3 is associated with higher levels of internalizing behaviors. We find no consistent differences in these results by the timing of instability, child gender, family income, or type of care.

What patterns of postpartum psychological distress are associated with maternal concerns about their children's emotional and behavioural problems at the age of three years?

Mothers experiencing psychological distress in the postpartum period may have difficulties parenting their children. Inconsistent and unresponsive parenting may increase the risk of later emotional and behavioural problems in children. The purpose of this study was to identify how maternal psychological characteristics cluster at eight weeks postpartum, and whether these clusters were associated with maternal-reported child emotional and behavioural problems at the age of three years, as measured by the Parents' Evaluation of Developmental Status (PEDS) questionnaire. In a longitudinal pregnancy cohort (N = 647), three clusters of postpartum psychological characteristics were identified. Contrary to expectations, mothers with the greatest psychological distress did not report concerns about their child's emotional and behavioural problems; rather, they reported concerns about global developmental delay. These findings suggest that infants of mothers experiencing postpartum psychological distress should receive additional follow-up to reduce the risk for global developmental delay.

Secondhand smoke exposure, parental depressive symptoms and preschool behavioral outcomes

Little is known about the association of secondhand smoke (SHS) exposure and behavioral conditions among preschoolers. A cross-sectional analysis was used to examine billing and pharmacy claims from November 2004 to June 2012 linked to medical encounter-level data for 2,441 children from four pediatric community health clinics. Exposure to SHS was associated with attention deficit-hyperactivity disorder/ADHD and disruptive behavior disorder/DBD after adjusting for potential confounding factors. Assessment of exposure to SHS and parental depressive symptoms in early childhood may increase providers' ability to identify children at higher risk of behavioral issues and provide intervention at the earliest stages.

Emotion regulation mediates the association between ADHD and depressive symptoms in a community sample of youth

The purpose of this study was to examine the longitudinal relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms, emotion regulation (ER) ability, and depressive symptoms within a diverse community sample of 277 youth, ages 9-12 (56 % male). Participants were drawn from a larger study examining adolescent risk behaviors, and completed annual assessments over 3 years. Youth ADHD symptoms were assessed at Time 1 (T1) using the parent-reported Disruptive Behavior Disorders Rating Scale, ER was assessed with the parent-reported Emotion Regulation Checklist at Time 2 (T2), and youth depressive symptoms were assessed using the self-reported Revised Child Anxiety and Depression Scales at Time 3 (T3). Analyses examined T2 ER as a mediator between T1 ADHD symptoms (including the unique contributions of inattentive [IA] versus hyperactive/impulsive [HI] symptoms) and T3 depressive symptoms. Structural equation modeling (SEM) indicated the path model specified provided an excellent fit to the data. Tests of indirect effects suggested that T2 ER appears to be a significant mechanism that underlies the relationship between T1 ADHD and T3 depression, even when accounting for T1 oppositional defiant and depressive symptoms. Furthermore, while both T1 IA and HI symptoms had significant indirect effects on T3 depression through the mechanism T2 ER, HI proved a more robust predictor of T2 ER than IA. Results of this prospective study support cross-sectional findings pointing to ER as a potential mechanism linking ADHD and depressive symptoms in youth. Clinical implications and future directions are discussed.

The effects of parental mood on reports of their children's psychopathology

OBJECTIVE

In this study, we aimed to assess whether current mood state (depressed or manic/hypomanic) among parents with a mood disorder would affect their reports of their offspring's psychopathology.

METHOD

Sixty-five parents with current depression, 42 parents with current mania/hypomania, 181 parents with mood disorder in remission, and their offspring (n = 479, aged 6-18 years) completed assessments of offspring psychopathology as part of the Pittsburgh Bipolar Offspring Study (BIOS). We compared rates of offspring psychopathology assessed using the following: a clinician-administered semi-structured interview with parent and child using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS); parent-reported Child Behavior Checklist (CBCL); offspring self-reported Youth Self Reports (YSR) for those 11 years and older (n = 250); and teachers' reports when available (n = 209).

RESULTS

There were no between-group differences in rates of psychopathology yielded from the K-SADS, except for more depressive disorders in offspring of parents with current mania/hypomania compared to offspring of parents in remission. Conversely, using the CBCL and comparing with parents who were in remission, parents with current depression reported significantly more externalizing psychopathology in offspring, whereas parents with current mania/hypomania reported more externalizing and internalizing psychopathology in their offspring. On the YSR, offspring of parents with current mania/hypomania had more internalizing psychopathology compared to offspring of parents in remission. Teacher's reports showed no between-group differences in rates of any psychopathology.

CONCLUSION

Parental active mood symptomatology, especially during a manic/hypomanic episode, significantly affects their reports of their offspring's psychopathology. Trained interviewers reduce potential report bias. Clinicians and studies assessing children's psychopathology should take into account parental current mood state.

What Predicts Method Effects in Child Behavior Ratings

The purpose of this research was to determine whether child, parent, and teacher characteristics such as sex, socioeconomic status (SES), parental depressive symptoms, the number of years of teaching experience, number of children in the classroom, and teachers’ disciplinary self-efficacy predict deviations from maternal ratings in a multitrait-multimethod (MTMM) confirmatory factor analysis. The study included 978 families from the National Institute of Child Health and Development Study of Early Child Care and Youth Development. Results indicated that teachers with more disciplinary self-efficacy, teaching experience, and children in their classrooms generally rated their students’ behavior in a more consistent manner with ratings completed by the students’ mothers. In addition, fathers who reported more symptoms of depression rated their children’s behavior in a less consistent manner with ratings completed by mothers. Finally, the perspectives of mothers generally deviated more from the perspectives of fathers and teachers when they were rating boys.

Associations between maternal mental health and child emotional and behavioral problems: does prenatal mental health matter?

This study examined associations between elevated symptoms of prenatal depression or anxiety and offspring emotional and behavioral problems during mid to late childhood taking into account the impact of later maternal mental health symptoms. The sample consisted of 2,891 women and their children (49 % male) from a prospective, community-based study, the Avon Longitudinal Study of Parents and Children. Women completed measures of depressive (Edinburgh Postnatal Depression Scale) and anxious (Crown Crisp Experiential Index) symptoms at regular intervals beginning in pregnancy. Mothers and teachers assessed offspring emotional and behavioral problems using the Strengths and Difficulties Questionnaire when children were 10-11 years old. Multivariable regression models were fit to address study hypotheses. Exposure to elevated symptoms of maternal depression during pregnancy was associated with increased total offspring emotional and behavioral problems, even after controlling for later maternal mental health problems and a range of sociodemographic and psychosocial characteristics, according to mothers' but not teachers' reports. Similarly, children exposed to elevated symptoms of maternal anxiety during pregnancy were reported to have increased total emotional and behavioral problems by mothers but not by teachers. We found support for modest associations between elevated symptoms of maternal depression and anxiety during the prenatal period and certain domains of offspring emotional and behavioral problems in mid to late childhood above and beyond the impact of later maternal mental health problems. These findings highlight the need for additional clinical and research attention to the prenatal period and to both maternal depression and anxiety.

Differentiating Anxiety and Depression in Relation to the Social Functioning of Young Adolescents With ADHD

The present study examined anxiety and depressive symptoms in relation to the social functioning of young adolescents with attention-deficit/hyperactivity disorder (ADHD) and builds upon prior work by incorporating youths' self-reports of internalizing symptoms and examining distinct anxiety and depression dimensions to increase specificity. Participants were 310 young adolescents (ages 10-14; 71% male, 78% Caucasian) diagnosed with ADHD. Youth provided ratings of anxiety/depression, and parents provided ratings of their own depression. Parents and youth both reported on youths' social skills and perceived social acceptance. Path analyses indicated that above and beyond child demographics, ADHD and oppositional defiant disorder symptom severity, and parents' own depression, self-reported social anxiety and anhedonia were both associated with lower youth-reported social skills and both parent- and youth-reported social acceptance. Negative self-evaluation was associated with poorer parent-reported social skills. Finally, harm avoidance was positively associated with both youth- and parent-reported social skills. A path analysis using comorbid diagnoses (rather than symptom dimensions) indicated that that having a comorbid disruptive behavior disorder or depression diagnosis (but not a comorbid anxiety diagnosis) was associated with poorer parent-reported social functioning. Results demonstrate that the relation between internalizing symptoms and social functioning among young adolescents with ADHD is nuanced, with social anxiety and anhedonia symptoms associated with lower social skills and social acceptance in contrast to harm avoidance being associated with higher ratings of social skills (and unrelated to social acceptance). In terms of comorbid diagnoses, depression is more clearly related than anxiety to poorer social functioning among young adolescents with ADHD. These results point to the importance of attending to specific facets of anxiety and depression in clinical care and future research.

Childhood internalizing symptoms are negatively associated with early adolescent alcohol use

BACKGROUND

The relationship between childhood internalizing problems and early adolescent alcohol use has been infrequently explored and remains unclear.

METHODS

We employed growth mixture modeling of internalizing symptoms for a large, population-based sample of U.K. children (the Avon Longitudinal Study of Parents and Children Cohort) to identify trajectories of childhood internalizing symptoms from age 4 through age 11.5. We then examined the relationship between membership in each trajectory and alcohol use in early adolescence (reported at age 13.8).

RESULTS

Overall, children experiencing elevated levels of internalizing symptoms were less likely to use alcohol in early adolescence. This finding held true across all internalizing trajectories; that is, those exhibiting increasing levels of internalizing symptoms over time, and those whose symptoms desisted over time, were both less likely to use alcohol than their peers who did not exhibit internalizing problems.

CONCLUSIONS

We conclude that childhood internalizing symptoms, unlike adolescent symptoms, are negatively associated with early adolescent alcohol experimentation. Additional studies are warranted to follow up on our preliminary evidence that symptoms of phobia and separation anxiety drive this effect.

Correction of distortion in distressed mothers' ratings of their preschool-aged children's Internalizing and Externalizing scale score

Increased maternal psychopathology may bias mothers' ratings about child psychopathology. In this study we examined whether internalizing and externalizing behavior problems in young children were biased through maternal psychopathology. The clinical sample comprised 247 preschool-age patients who attended the Family Day Hospital in Münster, Germany. Internalizing and externalizing behavior problems were assessed by the CBCL/1.5-5, and maternal psychopathology was assessed by the SCL-90-R Global Severity Index (GSI). Three theoretical perspectives were tested by comparing the model fit of three structural equation models, namely the accuracy, distortion, and combinatory model. All of the models aimed to integrate multi-informant ratings from mother, therapists, and kindergarten teachers, but differed in the question which paths had to be significant. The distortion model fit the data best and supported the notion that there was a psychopathology-related bias in mothers' ratings. On the basis of this finding, we developed correction formulas comparable to Müller and Furniss (2013), in order to statistically control for this distortion. We discussed post-hoc explanations about why mothers with increased psychopathology gave higher ratings on the CBCL/1.5-5, including a better recall of internalizing symptoms, less flexible and effective parenting, and more perceived distress by child externalizing behavior.

The long-term effects of maternal depression: early childhood physical health as a pathway to offspring depression

PURPOSE

Cross-sectional and retrospective studies have highlighted the long-term negative effects of maternal depression on offspring physical, social, and emotional development, but longitudinal research is needed to clarify the pathways by which maternal depression during pregnancy and early childhood affects offspring outcomes. The current study tested one developmental pathway by which maternal depression during pregnancy might negatively impact offspring mental health in young adulthood, via poor physical health in early childhood.

METHODS

The sample consisted of 815 Australian youth and their mothers who were followed for 20 years. Mothers reported on their own depressive symptoms during pregnancy and offspring early childhood. Youth completed interviews about health-related stress and social functioning at age 20 years, and completed a questionnaire about their own depressive symptoms 2 to 5 years later.

RESULTS

Path analysis indicated that prenatal maternal depressive symptoms predicted worse physical health during early childhood for offspring, and this effect was partially explained by ongoing maternal depression in early childhood. Offspring poor physical health during childhood predicted increased health-related stress and poor social functioning at age 20. Finally, increased health-related stress and poor social functioning predicted increased levels of depressive symptoms later in young adulthood. Maternal depression had a significant total indirect effect on youth depression via early childhood health and its psychosocial consequences.

CONCLUSIONS

Poor physical health in early childhood and its effects on young adults' social functioning and levels of health related stress is one important pathway by which maternal depression has long-term consequences for offspring mental health.

A trifactor model for integrating ratings across multiple informants

Psychologists often obtain ratings for target individuals from multiple informants such as parents or peers. In this article we propose a trifactor model for multiple informant data that separates target-level variability from informant-level variability and item-level variability. By leveraging item-level data, the trifactor model allows for examination of a single trait rated on a single target. In contrast to many psychometric models developed for multitrait-multimethod data, the trifactor model is predominantly a measurement model. It is used to evaluate item quality in scale development, test hypotheses about sources of target variability (e.g., sources of trait differences) versus informant variability (e.g., sources of rater bias), and generate integrative scores that are purged of the subjective biases of single informants.

Correction of distortions in distressed mothers' ratings of their preschool children's psychopathology

The often-reported low informant agreement about child psychopathology between multiple informants has lead to various suggestions about how to address discrepant ratings. Among the factors that may lower agreement that have been discussed is informant credibility, reliability, or psychopathology, which is of interest in this paper. We tested three different models, namely, the accuracy, the distortion, and an integrated so-called combined model, that conceptualize parental ratings to assess child psychopathology. The data comprise ratings of child psychopathology from multiple informants (mother, therapist and kindergarten teacher) and ratings of maternal psychopathology. The children were patients in a preschool psychiatry unit (N=247). The results from structural equation modeling show that maternal ratings of child psychopathology were biased by maternal psychopathology (distortion model). Based on this statistical background, we suggest a method to adjust biased maternal ratings. We illustrate the maternal bias by comparing the ratings of mother to expert ratings (combined kindergarten teacher and therapist ratings) and show that the correction equation increases the agreement between maternal and expert ratings. We conclude that this approach may help to reduce misclassification of preschool children as 'clinical' on the basis of biased maternal ratings.

Relations between Temperament and Anger Regulation over Early Childhood

Theory suggests temperamental reactivity [negative affectivity (NA)] and regulation [effortful control (EC)] predict variation in the development of emotion regulation (ER). However, few studies report such relations, particularly studies utilizing observational measures of children's ER behaviors in longitudinal designs. Using multilevel modeling, the present study tested whether (1) between-person differences in mean levels of mother-reported child NA and EC (aggregated across age) and (2) within-person changes in NA and EC from the ages of 18 to 42 months predicted subsequent improvements in laboratory-based observations of children's anger regulation from the ages of 24 to 48 months. As expected, mean level of EC (aggregated across age) predicted longer latency to anger; however, no other temperament variables predicted anger expression. Mean level of EC also predicted the latency to a child's use of one regulatory strategy, distraction. Finally, decreases in NA were associated with age-related changes in how long children used distractions and how quickly they bid calmly to their mother. Implications for relations between temperament and anger regulation are discussed in terms of both conceptual and methodological issues.

The role of parent psychopathology in the development of preschool children with behavior problems

The present study examined associations between early parental self-reported psychopathology symptoms and the later behavioral, emotional, and social functioning of preschool children with behavior problems. Mothers and fathers of preschoolers with behavior problems (N = 132; 55 girls, 77 boys) completed parent psychopathology questionnaires when children were 3 years old and completed measures of children's externalizing, internalizing, and social problems annually from age 3 to age 6. The sample included 61% European American, 16% Latino (predominantly Puerto Rican), 10% African American, and 13% multiethnic children. Every dimension of mothers' and fathers' psychopathology symptoms when children were 3 years old was associated with their own reports of children's externalizing and internalizing problems 3 years later. Several dimensions of maternal psychopathology symptoms at age 3 were associated with mother-reported social skills 3 years later. However, the relation between many dimensions of psychopathology symptoms and child outcome appears to be accounted for by co-occurring psychopathology symptoms. Only maternal attention-deficit hyperactivity disorder (ADHD) and Cluster A symptoms, and paternal ADHD and depression/anxiety symptoms emerged as unique predictors of child functioning. These findings suggest that most types of mothers' and fathers' self-reported psychopathology symptoms may play a role in the prognosis of behavioral, social, and emotional outcomes of preschoolers with behavior problems, but that co-occurring symptoms need to be considered.

The Aftercare and School Observation System (ASOS): Reliability and Component Structure

This study examines the psychometric properties and component structure of a newly developed observational system, the Aftercare and School Observation System (ASOS). Participants included 468 children drawn from a larger longitudinal intervention study. The system was utilized to assess participant children in school lunchrooms and recess and various afterschool environments. Exploratory factor analyses examined whether a core set of component constructs assessing qualities of children's relationships, caregiver involvement and monitoring, and experiences in school and aftercare contexts that have been linked to children's behavior problems would emerge. Construct validity was assessed by examining associations between ASOS constructs and questionnaire measures assessing children's behavior problems and relationship qualities in school and aftercare settings. Across both settings, two factors showed very similar empirical structures and item loadings, reflecting the constructs of a negative/aggressive context and caregiver positive involvement, with one additional unique factor from the school setting reflecting the extent to which caregiver methods used resulted in less negative behavior and two additional unique factors from the aftercare setting reflecting positivity in the child's interactions and general environment and negativity in the child's interactions and setting. Modest correlations between ASOS factors and aftercare provider and teacher ratings of behavior problems, adult-child relationships, and a rating of school climate contributed to our interpretation that the ASOS scores capture meaningful features of children's experiences in these settings. This study represents the first step of establishing that the ASOS reliably and validly captures risk and protective relationships and experiences in extra-familial settings.

Associations of early exposure to intimate partner violence and parental depression with subsequent mental health outcomes

IMPORTANCE

Children with known exposure to intimate partner violence (IPV) or maternal depression are at risk for negative mental health outcomes as early as preschool age. Active ongoing surveillance for these risk factors can lead to earlier mental health intervention for children.

OBJECTIVE

To examine the association between parent reports of IPV and depressive symptoms within the first 3 years of a child's life with subsequent mental health conditions and psychotropic drug treatment.

DESIGN

Prospective cohort study linking parental IPV and depression with subsequent billing and pharmacy data between November 1, 2004, and June 7, 2012.

SETTING

Four pediatric clinics.

PARTICIPANTS

A total of 2422 children receiving care from clinics that implemented the Child Health Improvement Through Computer Automation (CHICA) system.

MAIN OUTCOME MEASURES

Any report of IPV and/or parental depressive symptoms from birth to age 3 years, mental health diagnoses made with International Classification of Diseases, Ninth Revision criteria, and any psychotropic drug treatment between ages 3 and 6 years.

RESULTS

Fifty-eight caregivers (2.4%) reported both IPV and depressive symptoms before their children were aged 3 years, 69 (2.8%) reported IPV only, 704 (29.1%) reported depressive symptoms only, and 1591 (65.7%) reported neither exposure. Children of parents reporting both IPV and depressive symptoms were more likely to have a diagnosis of attention-deficit/hyperactivity disorder (adjusted odds ratio = 4.0; 95% CI, 1.5-10.9), even after adjusting for the child's sex, race/ethnicity, and insurance type. Children whose parents reported depressive symptoms were more likely to have been prescribed psychotropic medication (adjusted odds ratio = 1.9; 95%, CI 1.0-3.4).

CONCLUSIONS AND RELEVANCE

Exposure to both IPV and depression before age 3 years is associated with preschool-aged onset of attention-deficit/hyperactivity disorder; early exposure to parental depression is associated with being prescribed psychotropic medication. Pediatricians play a critical role in performing active, ongoing surveillance of families with these known social risk factors and providing early intervention to negate long-term sequelae.

Assessment of self-reported negative affect in the NIH Toolbox

We report on the selection of self-report measures for inclusion in the NIH Toolbox that are suitable for assessing the full range of negative affect including sadness, fear, and anger. The Toolbox is intended to serve as a "core battery" of assessment tools for cognition, sensation, motor function, and emotional health that will help to overcome the lack of consistency in measures used across epidemiological, observational, and intervention studies. A secondary goal of the NIH Toolbox is the identification of measures that are flexible, efficient, and precise, an agenda best fulfilled by the use of item banks calibrated with models from item response theory (IRT) and suitable for adaptive testing. Results from a sample of 1763 respondents supported use of the adult and pediatric item banks for emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS(®)) as a starting point for capturing the full range of negative affect in healthy individuals. Content coverage for the adult Toolbox was also enhanced by the development of a scale for somatic arousal using items from the Mood and Anxiety Symptom Questionnaire (MASQ) and scales for hostility and physical aggression using items from the Buss-Perry Aggression Questionnaire (BPAQ).

The prevalence of different kinds of child abuse and the characteristics that differentiate abused from nonabused male adolescents

Child abuse has proved to be one of the most important social challenges. The present study attempts (a) to determine the prevalence of child abuse in an urban area in Iran and (b) to differentiate abused from non-abused adolescent boys using parental and child characteristics. A survey was conducted to determine the prevalence of different types of child abuse. The prevalence sample comprised 2,100 students selected through a multistage random sampling procedure. Data were collected using the Childhood Trauma Questionnaire (CTQ), Beck Depression Inventory, II (BDI-II), State Trait Anxiety Inventory (STAI), modified Hazan & Shaver Attachment Style Questionnaire (ASQ) and Symptom Check List 90 (SCL-90-R). Descriptive statistics and discriminant function analysis were used to analyze the data. The results showed that 14.85% of the subjects were exposed to child abuse, with emotional abuse being most prevalent (52.09%). Also, it appeared that variables such as parental depression and anxiety and children's attachment styles, anxiety, and aggression can help discriminate abused boys from their non-abused counterparts.

Latino youth's internalising behaviours: links to immigrant status and neighbourhood characteristics

OBJECTIVES

Latinos are the fastest-growing immigrant group in the U.S.A. Yet, little is known about the emotional well-being of this population, such as the links among family, neighbourhood context and Latino immigrant youth mental health. Understanding this link will help determine which contexts negatively impact Latino immigrant youth mental health.

DESIGN

Drawing data from the Project on Human Development in Chicago Neighbourhoods collected in 1994-1995 and 1997-1999, this study examined links between Latino youth's internalising behaviours, based on the Child Behavior Checklist (CBCL), and neighbourhood characteristics as a function of immigrant status. The sample included 1040 (aged 9-17) Latino immigrant youth seen twice over three years and identified as first, second or third generation. In this study, neighbourhoods are made up of two to three census tracts that reflect similar racial/ethnic and socioeconomic composition. Using hierarchical linear regression models, the study also explored links between internalising behaviours and neighbourhood characteristics, including concentrated disadvantage, immigrant concentration and residential stability.

RESULTS

First- and second-generation youth had higher internalising behaviour scores (i.e., worse mental health) than third-generation youth after controlling for youth internalising behaviours at Wave 1, maternal depression and family characteristics. First- and second-generation youth were more likely to live in high immigrant-concentrated neighbourhoods and first-generation youth were more likely to live in residentially unstable neighbourhoods. Controlling for neighbourhood clusters eliminated the immigrant-generation internalising association. However, second-generation Latino youth living in neighbourhoods with higher residential stability had higher levels of internalising behaviour problems compared to first- and third-generation youth living in similar neighbourhoods.

CONCLUSIONS

We found that the interaction between immigrant generation and neighbourhood context helps to explain differences observed in the mental health of second-generation immigrant youth, a result that may help other communities in the USA and other countries better understand the factors that contribute to immigrant youth well-being.

Preterm infants who are prone to distress: differential effects of parenting on 36-month behavioral and cognitive outcomes

BACKGROUND

The differential susceptibility (DS) model suggests that temperamentally prone-to-distress infants may exhibit adverse outcomes in negative environments but optimal outcomes in positive environments. This study explored temperament, parenting, and 36-month cognition and behavior in preterm infants using the DS model. We hypothesized that temperamentally prone to distress preterm infants would exhibit more optimal cognition and fewer behavior problems when early parenting was positive; and less optimal cognition and more behavior problems when early parenting was less positive.

METHODS

Participants included 109 preterm infants (gestation <37 weeks) and their mothers. We assessed neonatal risk and basal vagal tone in the neonatal intensive care unit; infant temperament and parenting interactions at 9 months post-term; and child behavior and cognitive skills at 36 months post-term. Hierarchical regression analyses tested study hypotheses.

RESULTS

Temperamentally prone-to-distress infants exhibited more externalizing problems if they experienced more critical parenting at 9 months (β = -.20, p < 0.05) but fewer externalizing problems with more positive parenting. Similarly, variations in maternal positive affect (β = .25, p < .01) and intrusive behaviors (β = .23, p < .05) at 9 months predicted 36-month cognition at high but not at low levels of infant temperamental distress. Higher basal vagal tone predicted fewer externalizing problems (β = -.19, p < .05).

CONCLUSIONS

Early parenting behaviors relate to later behavior and development in preterm infants who are temperamentally prone to distress, and neonatal basal vagal tone predicts subsequent externalizing behaviors. These findings suggest that both biological reactivity and quality of caregiving are important predictors for later outcomes in preterm infants and may be considered as foci for developmental surveillance and interventions.

Postpartum depression prevalence and impact on infant health, weight, and sleep in low-income and ethnic minority women and infants

This study aimed to investigate the prevalence of maternal depressive symptoms at 5 and 9 months postpartum in a low-income and predominantly Hispanic sample, and evaluate the impact on infant weight gain, physical health, and sleep at 9 months. Participants included 132 low-income mother-infant pairs who participated in a larger investigation on prenatal care utilization. Mothers were interviewed in person 24-48 h after birth and by phone at 5 and 9 months postpartum. Clinically significant levels of depressive symptoms were reported in 33% of the women at 5 months postpartum, and 38% at 9 months postpartum. Higher depressive symptoms at 5 months were associated with less infant weight gain from 5 to 9 months, p = .002, increased infant physical health concerns, p = .05, and increased infant nighttime awakenings at 9 months, p = .001. Results suggest a striking prevalence of clinically significant depressive symptoms through 9 months postpartum in this very low income, largely ethnic minority sample. Further, the effects of postpartum depression include significant ramifications for infant physical health.