Mothers' depressive symptoms and infant negative emotionality in the prediction of child adjustment at age 3: Testing the maternal reactivity and child vulnerability hypotheses

Maternal Stress Mediates Association of Infant Socioemotional Development with Perinatal Mental Health in Socioeconomically Vulnerable Peruvian Settings

Increased maternal mental health during the perinatal period has been widely associated with a variety of positive outcomes for both mothers and infants. However, no studies in Peru have yet focused on studying maternal mental health and related psychological variables during this stage. Thus, the aim of this study was to test a model to associate a mother's parental stress with infant socioemotional difficulties and maternal mental health. The sample included 988 mothers of infants aged 6 to 18 months from Peru, all from socioeconomically vulnerable settings. The findings showed that infant socioemotional difficulties were associated with poorer maternal mental health through the mother's parental stress (χ2(7) = 28.89, p < 0.001, CFI = 0.98, RMSEA = 0.06, SRMR = 0.03). These results provide a better understanding of the key elements associated with maternal mental health during the perinatal period in Peru and offer valuable insights for developing interventions and support strategies for socioeconomically vulnerable mothers and their young children.

Maternal alcohol dependence symptoms, maternal insensitivity to children's distress, and young children's blunted emotional reactivity

Maternal insensitivity to children's emotional distress (e.g., expressions of sadness or fearfulness) is one mechanism through which maternal alcohol dependence may increase children's risk for psychopathology. Although emotion dysregulation is consistently associated with psychopathology, it remains unclear how or why alcohol dependence's effects on caregiving responses to children's distress may impact children's emotion regulation over time, particularly in ways that may engender risks for psychopathology. This study examined longitudinal associations between lifetime maternal alcohol dependence symptoms, mothers' insensitivity to children's emotional distress cues, and children's emotional reactivity among 201 mother-child dyads (Mchild age = 2.14 years; 56% Black; 11% Latino). Structural equation modeling analyses revealed a significant mediational pathway such that maternal alcohol dependence predicted increases in mothers' insensitivity to children's emotional distress across a one-year period (β = .16, p = .013), which subsequently predicted decreases in children's emotional reactivity one year later (β = -.29, p = .009). Results suggest that mothers with alcohol dependence symptoms may struggle to sensitively respond to children's emotional distress, which may prompt children to suppress or hide their emotions as an adaptive, protective strategy. The potential developmental benefits and consequences of early, protective expressive suppression strategies are discussed via developmental psychopathology frameworks.

Multiple Risk in Pregnancy- Prenatal Risk Constellations and Mother-Infant Interactions, Parenting Stress, and Child Externalizing and Internalizing Behaviors: A Prospective Longitudinal Cohort Study from Pregnancy to 18 Months Postpartum

Multiple risk is associated with adverse developmental outcomes across domains. However, as risk factors tend to cluster, it is important to investigate formation of risk constellations, and how they relate to child and parental outcomes. By means of latent class analysis patterns of prenatal risk factors were identified, and relations to interactional quality, parenting stress, and child internalizing and externalizing behaviors were investigated. An array of prenatal risk factors was assessed in 1036 Norwegian pregnant women participating in a prospective longitudinal community-based study, Little in Norway. Mother-infant interactions were videotaped and scored with the Early Relational Health Screen (ERHS) at 12 months. The Parenting Stress Index (PSI) and Infant-Toddler Social and Emotional Assessment (ITSEA) were administered at 18 months. First, we analyzed response patterns to prenatal risks to identify number and characteristics of latent classes. Second, we investigated whether latent class membership could predict mother-child interactional quality, parenting stress, and child internalizing and externalizing behavior after the child was born. Results revealed three prenatal risk constellations: broad risk (7.52%), mental health risk (21.62%) and low-risk (70.86%). Membership in the broad risk group predicted lower scores on interactional quality, while membership in the mental health risk group predicted less favorable scores on all outcome measures. Prenatal risks clustered together in specific risk constellations that differentially related to parent, child and interactional outcomes.

Unique Characteristics of Women and Infants Moderate the Association between Depression and Mother-Infant Interaction

Research has shown mixed results regarding the association between women's postpartum depression and mother-infant interactions, suggesting that a woman's unique experience and context may moderate how depression shapes these interactions. We examined the extent to which a woman's comorbid anxiety, her exposure to adversity, and infant characteristics moderate the relationship between depressive symptoms of women and interactions with their infants at 6 (n = 647) and 12 months (n = 346) postpartum. The methods included standardized coding of mother-infant interactions and structural regression modeling. The results at 6 months of infant age indicated that infant male sex and infant negative affectivity were risk factors for mothers' depression being associated with less optimal interactions. At 12 months of infant age, two moderators appeared to buffer the influence of depression: a woman's history of trauma and infant preterm birth (≤37 weeks gestation). The results reinforce the salience of infant characteristics in the relationship between maternal depression and mother-infant interactions. The findings also suggest that experiences of trauma may offer opportunities for psychological growth that foster constructive management of depression's potential effect on mother-infant interactions. Further research is needed to clarify the underlying processes and mechanisms that explain the influence of these moderators. The ultimate goals are to reduce the risk of suboptimal interactions and reinforce healthy dyadic relations.

Transactional associations between infant negative emotionality and maternal sensitivity: Maternal emotion dysregulation as a moderator

The relations between maternal sensitivity and infant negative emotionality have been tested extensively in the previous literature. However, the extent to which these associations reflect unidirectional or bidirectional effects over time remains somewhat uncertain. Further, the possibility that maternal characteristics moderate the extent to which infant negative emotionality predicts maternal sensitivity over time has yet to be tested in cross-lag models. The goal of the present study is to address these gaps. First time mothers (N = 259; 50% White; 50% Black) and their infants participated when infants were 6, 14, and 26 months of age. Infant negative emotionality was assessed via maternal report and direct observation during standardized laboratory tasks, which were subsequently combined to yield a multimethod measure at each wave. Maternal sensitivity was observationally coded at each wave and mothers self-reported emotion dysregulation at 6 and 14 months. A random intercepts cross-lagged model with maternal emotion dysregulation specified as a moderator revealed that infant negative emotionality at 6 months was negatively associated with maternal sensitivity at 14 months, but only among mothers higher in emotion dysregulation. Higher maternal sensitivity was in turn associated with lower infant negative emotionality when infants were 26 months of age. The indirect pathway was significant, lending support for the transactional model. Implications for future research and prevention/intervention are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

From temperament and parenting to attachment: a review of the interplay of gene and environment factors in the developmental pathway to attachment

PURPOSE OF REVIEW

Attachment represents an aspect of the parent-child relationship by encapsulating behaviours and stress management strategies. Although attachment is not considered a measure of psychopathology, some attachment styles place children at higher risk for psychopathologies. The origins of attachment have historically thought to be either parenting-related variables, or temperament. More recently, there has been accumulated evidence of gene × environment interactions in attachment, temperament, and parenting. This review aims to cover shared gene × environment pathways between these variables, introduce recent relevant insights from prenatal programming research, and offer a synthesized developmental cascade model of attachment.

RECENT FINDINGS

Carriers of gene polymorphisms related to stress neurobiology respond differently to environments than noncarriers according to two patterns: attachment research shows inconsistent diathesis-stress between gene polymorphisms and environment, and temperament, stress physiology, and prenatal programming research show clear patterns of differential susceptibility.

SUMMARY

By synthesizing prenatal and postnatal findings, a model of attachment emerges in which individuals more susceptible to environmental influences are carriers of specific genes, whose endophenotypic markers include stress biology and phenotypic markers include temperament. Intervention should, therefore, focus on parenting and stress regulation strategies for these individuals.

Maternal depressive symptoms and infant temperament in the first year of life predict child behavior at 36 months of age

In a longitudinal study, mothers (N = 50) self-reported on their depressive symptoms (DS) and their child's behavior during the first year and at 36 months postpartum. Maternal DS during infancy were associated with child conduct problems (CP), suggesting a long-term association between maternal mental health and the development of child behavior. Infant temperament was also associated with child behavior so that negative affect predicted child CP, while infant surgency was associated with later hyperactivity-inattention. This study contributes to the literature by jointly assessing the role of maternal DS and infant temperament and showing that these are independent predictors of childhood behavior.

Transactions between Maternal and Child Depressive Symptoms Emerge Early in Life

Maternal depression is a robust risk factor for children's internalizing symptoms; however, the intergenerational transmission of mood disorders is likely more complex than unidirectional parent-directed effects. Theoretical models support transactional associations between maternal and child symptomatology over time but have not been well examined, especially in younger high-risk samples. The present investigation examined predictive transactional relations between maternal depression and children's internalizing in toddlerhood and early childhood using a cross-lagged panel model. Participants were 162 low-income, largely racial/ethnic minority mothers and their offspring (32% African American, 16% White, 52% Other/Multiethnic; 53% female) who were assessed when children were 18 months and 4 years old. There were significant cross-sectional relations between maternal depressive and child internalizing symptoms when children were 18 months but not 4 years of age. Cross-lagged associations were evident such that maternal depression symptoms at 18 months were positively associated with internalizing symptoms among children at 4 years, adjusting for prior maternal symptom levels and the cross-sectional correlations between maternal-child symptoms at 18 months. Within the same model, children's internalizing symptoms at 18 months were also positively associated with maternal depressive symptoms at 4 years, adjusting for prior child symptom levels and cross-sectional correlations. This study is among the first to demonstrate that transactional relations between maternal and child mood symptoms occur as early as toddlerhood/early childhood. Findings highlight the potential utility of inclusive, family-focused interventions that support both parents and children in the treatment of early emotional problems.

The Role of Social and Emotional Adjustment in Mediating the Relationship Between Early Experiences and Different Language Outcomes

Background: Studies have highlighted the relationship between early childhood experiences and later language and communication skills on the one hand and social and emotional adjustment on the other. Less is known about this relationship between different types of early experiences and their relationship to different communication skills over time. Equally important is the extent to which the child's behaviour is related to later outcomes affecting the relationship between the child's environment and aspects of their communication development. Method: Drawing on data from 5,000 children in Growing Up in Scotland, a representative sample of children born in 2003. This paper looks are the differential relationships between home learning environment (HLE) (reads books/storeys, engages in painting or drawing, reads nursery rhymes and teaches letter/shapes and parental mental health (PMH) (Depression, Anxiety and Stress Scale (DASS) in the first year of life and both structural language skills ("Listening Comprehension" and "Expressive Vocabulary" subtests of The Wechsler Individual Achievement Tests) and pragmatic competence (The Children's Communication Checklist) at 11 years and explores the extent to which they are mediated by social and emotional adjustment at school entry. Results: PMH was associated with pragmatics but not listening comprehension or vocabulary. By contrast HLE was associated with all three measures of communication. In the final mediated model social and emotional adjustment mediated the relationship between PMH and all three measures of communication. The mediation was statistically significant for the relationship between HLE and both pragmatics and listening comprehension but not for expressive vocabulary. The results are discussed in terms of the relationships concerned and what they tell us about the potential for targeted early interventions. Conclusions: The mediating role of socio-emotional adjustment at school entry points to the need for careful monitoring of children's social and emotional development in primary and middle childhood. Services and policy aimed at improving child outcomes through improving home learning environments must work hand in hand with those responsible for offering support for the mental health, social-emotional adjustment and wellbeing of parents and children from birth and into the school years.

Caregiver Psychological Distress Predicts Temperament and Social-Emotional Outcomes in Infants with Autism Traits

Child temperament and caregiver psychological distress have been independently associated with social-emotional difficulties among individuals with autism. However, the interrelationship among these risk factors has rarely been investigated. We explored the reciprocal interplay between child temperament (surgency, negative affectivity, and self-regulation) and caregiver psychological distress in the development of child internalizing and externalizing symptoms, in a cohort of 103 infants showing early autism traits. Caregivers completed questionnaires when children were aged around 12-months (Time 1 [T1]), 18-months (Time 2 [T2]), and 24-months (Time 3 [T3]). Cross-lagged path models revealed a significant pathway from T1 caregiver psychological distress through lower T2 child self-regulation to subsequently greater T3 child internalizing symptoms. No such caregiver-driven pathway was evident through T2 child negative affectivity or in the prediction of T3 child externalizing symptoms. Further, no support was found for temperament-driven pathways through caregiver psychological distress to child social-emotional difficulties. Child surgency was mostly unrelated to caregiver psychological distress and social-emotional difficulties. These findings implicate the need to support the mental health of caregivers with an infant with autism traits in order to enhance the emotion regulation and social-emotional development of their infants.

Exploring childhood temperament as a moderator of the association between adolescent sexual minority status and internalizing and externalizing behavior problems

INTRODUCTION

Sexual minority youth experience worse mental health compared to their heterosexual peers, reflecting the consequences of sexual minority-based stigma. Previous research has focused on contextual variation to understand variability within this vulnerability. Childhood temperament factors such as negative affect, effortful control and surgency/extraversion are important for understanding differential susceptibility to environmental stressors. The objective of the current study was to understand how childhood temperament factors, measured prior to the most difficult developmental period for sexual minority youth, moderated the association between sexual minority status and internalizing and externalizing behavior problems.

METHODS

Youth reporting same-sex attraction in an ongoing longitudinal project on the development of conduct problems in Quebec, Canada were matched with heterosexual peers, for an analytic sample of 280 youth (62% girls). Structural equation models were used to examine (1) the association between youth-reported same-sex attraction (ages 13-16) and parent and youth-reported internalizing and externalizing problems a year later at ages 14-17, and (2) the moderating role of temperament (ages 6-9) in this association between sexual minority status and internalizing and externalizing problems.

RESULTS

Same-sex attraction was associated with higher levels of youth-reported internalizing and externalizing behavior problems. Surgency/extraversion moderated the association between sexual minority status and youth-reported internalizing and externalizing problems.

CONCLUSIONS

These findings suggest that temperament linked to individual visibility may be important for understanding variation in self-reported mental health among sexual minority youth, and supports the use of developmental constructs like temperament to better understand vulnerability to psychosocial difficulties within this population.

Offspring Personality Mediates the Association between Maternal Depression and Childhood Psychopathology

Offspring of mothers diagnosed with major depression are at increased risk for a wide range of psychological problems. Previous research has shown that individual differences in personality development can be informative for predicting risk and resilience to psychopathology, especially within at-risk populations. In the present study, we examined whether individual differences in offspring personality development during early to middle childhood could account for the association between maternal depression and offspring behavior problems later in childhood. Participants included 64 offspring of mothers diagnosed with major depression and 68 offspring of healthy comparison mothers. Personality was assessed via parent report at ages 3, 4, 5, and 9. Offspring internalizing and externalizing symptoms were assessed at age 9 via parent and teacher report. Results of latent growth curve models indicated that offspring Neuroticism, Conscientiousness, and Agreeableness mediated the link between early maternal depression and later childhood behavior problems, though results varied across maternal and teacher reports. Findings suggest that individual differences in youth personality and personality development are important predictors of emerging psychopathology among offspring of mothers diagnosed with depression.

Self-reported symptoms of depression, anxiety and stress in Portuguese primary school-aged children

BACKGROUND

Symptoms of depression, anxiety and stress experienced during childhood might have a negative impact on development. This study explores factors associated with such symptoms among Portuguese primary school-aged children.

METHODS

A sample of children (n = 1022, mean age = 8.77 years old) was recruited in public and private schools from the cities of Coimbra, Lisbon and Porto, Portugal. The children's version of the Depression, Anxiety and Stress Scale (DASS-C) was self-administered. Multivariate logistic regression models were fitted to measure associations (expressed as Odds Ratio, OR and 95% Confidence Intervals, CI) between each DASS-C subscale, dichotomized by its 4th vs. 3rd or less quartiles (symptoms increase with scores), and covariates: child sex, age, socioeconomic status (SES), sports activity beyond school, children self-assessed health status, child and mother's body mass index and mother's DASS scores.

RESULTS

Age was negatively associated with anxiety symptoms (adjusted OR, 95% CI: 0.70, 0.57-0.87) and girls, compared to boys, presented lower odds of depressive and stress symptoms (adjusted OR, 95% CI: 0.65, 0.47-0.92 and 0.57, 0.41-0.80, respectively). A low socioeconomic status was associated with more frequent symptoms of stress (adjusted OR, 95%CI for low compared to high SES: 1.61, 1.01-2.56). Children with poorer self-assessed health status and whose mothers scored higher in the DASS also presented significantly higher odds of scoring in the 4th quartile (vs. 3rd or less) of the three DASS-C subscales.

CONCLUSIONS

These results suggest the need to tailor preventive efforts targeting childhood mental health symptoms.

Emotion Regulation and Parent Distress: Getting at the Heart of Sensitive Parenting among Parents of Preschool Children Experiencing High Sociodemographic Risk

OBJECTIVES

Sensitive parenting requires modulation of emotions in order to effectively organize and orient behavioral responses. There is considerable evidence that psychological distress can impair sensitive parenting practices, and also that psychological distress is associated with deficits in emotion regulation capacities. The negative effect that psychological distress has on parents' emotion regulation capacities may be a mechanistic pathway through which psychological distress impacts parenting, as dysregulated emotions may be more proximal to parenting behaviors than distress itself; however, this specific link between psychological distress, emotion regulation, and parenting is not often examined in parenting models.

METHODS

The current study tested these relations in a high sociodemographic risk community-sample, oversampled for violence exposure, of caregivers of preschoolers. Caregivers self-reported on their psychological distress and emotion regulation difficulties. Parent sensitivity was assessed via observations of parent-child interactions.

RESULTS

Results indicated that difficulties in emotion regulation were a mediator for the relation between parents' psychological distress and sensitive parenting behaviors. Difficulties in emotion regulation predicted decreased sensitivity above and beyond the effect of psychological distress.

CONCLUSIONS

These findings emphasize the importance of regulation of emotional reactions in order to orient and engage in sensitive parenting behaviors. Additionally, they suggest clinically that supporting parents' emotion regulation capacities specifically may promote more sensitive parenting in contexts of parental psychological distress.

Perinatal depression and infant mental health

A mother's mental health during pregnancy and the first year postpartum is of the utmost importance to the cognitive, social, and emotional development of her child. Perinatal depression is associated with increased risk for wide-ranging adverse child development effects that can affect infant and early childhood mental health. Although effective treatments for perinatal depression exist, it is currently unclear if treatment of maternal depression alone is sufficient to ameliorate the negative effects of maternal depression on child outcomes. Interventions focused on the mother-infant relationship and dyadic interaction may be required to address the potential effect of maternal depression on the child. This paper provides an overview of maternal perinatal depression, the risk it poses for infant/early-childhood mental health, strategies for intervention that include mitigating depression and decreasing risk to the child, and implications for psychiatric nurses who work with perinatal women. Early identification and treatment of perinatal depression are critical to ensure optimal infant development and the child's future mental health.

Maternal positive responses to a distressed infant simulator predict subsequent negative affect in infants

Existing evidence indicates that maternal responses to infant distress, specifically more sensitive and less inconsistent/rejecting responses, are associated with lower infant negative affect (NA). However, due to ethical and methodological constraints, most existing studies do not employ methods that guarantee each mother will be observed responding to infant distress. To address such limitations, in the current study, a distressed infant simulator (SIM), programmed to be inconsolable, was employed to ensure that mothers (N = 150; 4 months postpartum) were observed responding to infant distress. Subsequently, maternal report of infant NA and an early aspect of regulatory capacity, sootheability, were collected at eight-months postpartum, and observational assessments of infant fear and frustration, fine-grained aspects of NA, were collected at 12-months of age. After controlling for infant sex, the proportion of time mothers spent using soothing touch during the SIM task was related to less overall maternal reported NA and sadness at eight-months postpartum. Similarly, greater use of touch was associated with less fear reactivity, and greater maternal use of vocalizations was related to lower infant frustration, at 12-months postpartum. Specific maternal soothing behaviors were not related to infant soothability at 8 months postpartum. Total time spent interacting with the SIM was not related to infant temperament, suggesting that type of soothing, not quantity of interactions with distressed infants, is important for reducing infant NA. The implications of these findings and important future directions are discussed.

Prenatal programming of postnatal plasticity revisited-And extended

Two sets of evidence reviewed herein, one indicating that prenatal stress is associated with elevated behavioral and physiological dysregulation and the other that such phenotypic functioning is itself associated with heightened susceptibility to positive and negative environmental influences postnatally, raises the intriguing hypothesis first advanced by Pluess and Belsky (2011) that prenatal stress fosters, promotes, or "programs" postnatal developmental plasticity. Here we review further evidence consistent with this proposition, including new experimental research systematically manipulating both prenatal stress and postnatal rearing. Collectively this work would seem to explain why prenatal stress has so consistently been linked to problematic development: stresses encountered prenatally are likely to continue postnatally, thereby adversely affecting the development of children programmed (by prenatal stress) to be especially susceptible to environmental effects. Less investigated are the potential benefits prenatal stress may promote, due to increased plasticity, when the postnatal environment proves to be favorable. Future directions of research pertaining to potential mechanisms instantiating postnatal plasticity and moderators of such prenatal-programming effects are outlined.

Prenatal stress and enhanced developmental plasticity

Two separate lines of inquiry indicate (a) that prenatal stress is associated with heightened behavioral and physiological reactivity, and (b) that these postnatal phenotypes are associated with increased susceptibility to both positive and negative developmental experiences and environmental exposures. This research considered together raises the intriguing hypothesis first advanced by Pluess and Belsky (Dev Psychopathol 23:29-38, 2011) that prenatal-stress fosters, promotes or "programs" postnatal developmental plasticity. In this paper, we review further evidence consistent with this proposition, including a novel animal study which experimentally manipulated both prenatal stress and postnatal rearing. Directions for future work focused on mechanisms mediating the plasticity-inducing effects of prenatal stress and the moderators of such effects are outlined.

Mothers' Perspectives on Managing the Developmental Delay of a Child With Considerations for Contextual Influences and Maternal Functioning

Developmental delay in very young children is trending upward. Maternal depressive symptoms are known to negatively impact child development and may also impact family management of the child's condition. Research on family management guided this second phase of a sequential mixed methods study. The purpose of this study was to explore mothers' perceptions of family management of their children's developmental delays. Mothers of very young children who received early intervention services were interviewed. A team-based content analysis approach revealed key findings: (a) views of the child that were not holistic, (b) condition management ability was informed by what the mother thought her child needed, (c) views of condition impact were related to adapting to possible child outcomes and experiences of isolation, and (d) parental/caregiver mutuality was impaired by conflict. Understanding perceptions of family management and influence of depressive symptoms in this context is essential to extend assessment and intervention.

Does infant negative emotionality moderate the effect of maternal depression on motor development?

Maternal depression represents an important social/environmental factor in early childhood; however, its effect on children's motor development may vary depending on the role of infants' dispositional variables. The objective of this study is to investigate the effect of the interaction between maternal depressive symptoms in the first two years of a child's life and the child's temperamental negative emotionality on motor development during this time. Using a cross-sectional study, we assessed 272 infants aged 0 to 24 months old and their mothers. We measured the following variables: maternal depression, infant's negative emotionality, and motor development. A three-way interaction effect highlights that negative emotionality in infants and maternal depression together affect children's overall motor growth trajectory. Infants with low negative emotionality display no effect of maternal depression on motor development. Conversely, infants with high negative emotionality seem to be more susceptible to the effect of maternal depression. Specifically, high maternal depression tends to foster the negative effect of infant's negativity on motor development across time, albeit not significantly. Finally, the absence of maternal depression significantly buffers negative temperament in infants. Findings highlighted the importance of integrating different perspectives when describing early motor growth. In fact, only when considering the interdependence of potential predictors their effect on the motor growth significantly emerges. Screening for early temperamental vulnerability might help in tailoring interventions to prevent maternal depression from affecting infants' motor development.

Maternal depression in the intergenerational transmission of childhood maltreatment and its sequelae: Testing postpartum effects in a longitudinal birth cohort

Mothers who have experienced childhood maltreatment are more likely to have children also exposed to maltreatment, a phenomenon known as intergenerational transmission. Factors in the perinatal period may contribute uniquely to this transmission, but timing effects have not been ascertained. Using structural equation modeling with 1,016 mothers and their 2,032 children in the Environmental Risk Longitudinal Twin Study, we tested the mediating role of postpartum depression between maternal childhood maltreatment and a cascade of negative child outcomes, specifically child exposure to maltreatment, internalizing symptoms, and externalizing symptoms: (a) adjusting for later maternal depression, (b) comparing across sex differences, and (c) examining the relative role of maltreatment subtypes. Mothers who had been maltreated as children, especially those who had experienced emotional or sexual abuse, were at increased risk for postpartum depression. In turn, postpartum depression predicted children's exposure to maltreatment, followed by emotional and behavioral problems. Indirect effects from maternal childhood maltreatment to child outcomes were robust across child sex and supported significant mediation through postpartum depression; however, this appeared to be carried by mothers' depression beyond the postpartum period. Identifying and treating postpartum depression, and preventing its recurrence, may help interrupt the intergenerational transmission of maltreatment and its sequelae.

Intergenerational Transmission of Depressive Symptoms: The Role of Parental Negative Perceptions and Behaviors

This study examined parental proximal processes involving in the intergenerational transmission of depressive symptoms from parents to their children. Extant literature has predominantly focused on maternal depressive symptoms. Yet, the mechanisms that may underlie the transmission of paternal depressive symptoms is less often studied. Participants were Chinese parents of first-graders (N = 2282). Results of structural equation modeling suggested that maternal and paternal depressive symptoms may be transmitted to their children through differential processes. Depressive symptoms in mothers, but not in fathers, were associated with their negatively-biased perceptions and dysfunctional parenting practices, which then predicted depressive symptoms in children. Moreover, mothers' depressive symptoms were associated with children's depressive symptoms regardless of child gender, whereas fathers' depressive symptoms were associated with boys', but not girls', depressive symptoms. Findings expand the understandings on parental processes in the intergenerational transmission of depressive symptoms in families, the role of paternal depressive symptoms in promoting children's depressive symptoms, and who may be at particular risks for psychopathology in the face of parental depressive symptoms.

Association between maternal depression and maternal sensitivity from birth to 12 months: a meta-analysis

Maternal sensitivity plays a central role in shaping children's development across a number of domains, and may be disrupted by depression. The current meta-analysis quantified the magnitude of the association between depression and maternal sensitivity, defined broadly as timely, contingent, and appropriate responding to infants' cues, from birth to 12 months. Across k = 48 studies and n = 4,934 mother-infant dyads, the aggregate effect size between depression and maternal sensitivity was r = -.16, p < .0001, indicating that mothers with higher depression levels were less sensitive than mothers with lower depression levels. Studies that compared a depressed group with a nondepressed/control group had larger effect sizes (r = -.35, p < .0001) than studies that examined depression within a single sample of either unselected cases or clinical-only cases (r = -.11, p < .001), suggesting that clinical levels of depression may pose a particular threat to sensitive parenting. Clinical implications (e.g. screening, prevention) are discussed.

I. INTRODUCTION: UNDERSTANDING THE TRANSITION TO SIBLINGHOOD FROM A DEVELOPMENTAL PSYCHOPATHOLOGY AND ECOLOGICAL SYSTEMS PERSPECTIVE

The birth of an infant sibling is a common occurrence in the lives of many toddler and preschool children. Early childhood is also a time for the emergence of disruptive behavior problems that may set the stage for later problem behaviors. The current study examined individual differences in young children’s behavioral and emotional adjustment after the birth of a sibling in an effort to uncover developmental trajectories reflecting sudden and persistent change (maladaptation), adjustment and adaptation (resilience), gradual linear increases, and no change (stability and continuity). Growth mixture modeling (GMM) was conducted with a sample of 241 families expecting their second child using a longitudinal research design across the first year after the sibling’s birth (prenatal, 1, 4 8 and 12 months) on seven syndrome scales of the Child Behavior Checklist (CBCL 1.5–5:(Achenbach & Rescorla, 2000 ): aggression, attention problems, anxiety/depression, emotional reactivity, withdrawal, somatic complaints, and sleep problems. For all scales, multiple classes describing different trajectory patterns emerged that reflected predominantly intercept differences; children high on problem behavior after the birth were those high before the birth. There was no evidence of a sudden, persistent maladaptive response indicating children underwent a developmental crisis for any of the problem behaviors examined. Most children were low on all problem behaviors examined and showed little change or actually declined in problem behaviors over time, although some children did experience more pronounced changes in the borderline clinical or clinical range. Only in the case of aggressive behavior was there evidence of an Adjustment and Adaptation Response showing a sudden change (prenatal to 1 month) that subsided by 4 months, suggesting that some young children react to stressful life events but adapt quickly to these changing circumstances. Further, children’s withdrawal revealed a curvilinear, quadratic path, suggesting children both increased and decreased in their withdrawal over time. Guided by a developmental ecological systems framework, we employed data mining procedures to uncover the child, parent, and family variables that best discriminated the different trajectory classes and found that children’s temperament, coparenting, parental self-efficacy, and parent-child attachment relationships were prominent in predicting children’s adjustment after the birth of an infant sibling. Finally, when trajectory classes were used to predict sibling relationship quality at 12 months, children high on aggression, attention problems, and emotional reactivity in the year after the birth engaged in more conflict and less positive involvement with the infant sibling at the end of the first year.

Mothers' Early Depressive Symptoms and Preschoolers' Behavioral Problems: The Moderating Role of Genetic Influences

As a stressful environment in families, mothers' depressive symptoms might increase children's risks of developing behavioral problems by exacerbating genetic influences. Using data from the nationally representative Early Childhood Longitudinal Study-Birth Cohort data of approximately 750 pairs of twins, we examined whether genetic influences on preschoolers' behavioral problems depended upon mothers' depressive symptoms. Results indicated that the genetic etiology for both internalizing and externalizing behaviors varied with maternal depressive symptoms at 9-months child age. Genetic effects on externalizing behaviors increased as mothers' depressive symptoms increased; however, genetics effects on internalizing behaviors increased when depressive symptoms either increased or decreased from the median level. These different patterns of interactive effects suggest potentially different mechanisms for the etiology of children's externalizing and internalizing behaviors.

Maternal depression and anxiety disorders (MDAD) and child development: A Manitoba population-based study

Objective

To examine the association between maternal depression and anxiety disorders (MDAD) and child development assessed during the kindergarten year.

Methods

Administrative data from several health and social databases in Manitoba, Canada, were used to study 18,331 mother-child pairs. MDAD over the period from one year prior to the child's birth to the kindergarten year was defined using physician diagnoses and filled prescriptions. Child development was assessed during the kindergarten year using the Early Development Instrument (EDI) which measures vulnerability across five domains of development. Structural equation modeling was used to examine associations between timing, recurrence and severity of MDAD and child outcomes. Health at Birth (preterm, low birth weight, neonatal intensive care stay and long birth hospitalization), Family Context (teen mother, lone parent, socio-economic status (SES)), child age and child sex were covariates.

Results

MDAD had a modest negative association with child EDI scores across all models tested, particularly for social, emotional and physical development. Prenatal MDAD had a stronger negative association with outcomes than other time periods; however, recurrent MDAD had a stronger negative association with outcomes than any specific time period or MDAD severity. The influence of MDAD was mediated by Family Context, which had a strong, negative association with outcomes, particularly language and cognitive development.

Conclusion

The number of time periods a child was exposed to MDAD in early childhood was more negatively associated with five areas of child development than timing or severity. Prenatal exposure may be more sensitive to MDAD than other time periods. The familial context (teen mother, lone parenthood and low SES) had a stronger influence on child outcomes than MDAD. Findings can be used to inform interventions which address maternal mental health from the prenatal period onward, and to support disadvantaged families to encourage healthy birth outcomes, early childhood development and school readiness.

Temperament in infancy and behavioral and emotional problems at age 5.5: The EDEN mother-child cohort

OBJECTIVE

Early temperamental characteristics may influence children's developmental pathways and predict future psychopathology. However, the environmental context may also shape or interact with infant temperament and indirectly contribute to increased vulnerability to adverse developmental outcomes. The aim of the present study is to explore the long-term contribution of temperamental traits at twelve months of age to the presence of emotional and behavioral problems later in childhood, and whether this association varies with the child's sex, parental separation, family socioeconomic status and maternal depression.

METHOD

1184 mother-child pairs from the EDEN mother-child birth cohort study based in France (2003-2011), were followed from 24-28 weeks of pregnancy to the child's fifth birthday. Infant temperament at 12 months was assessed with the Emotionality Activity and Sociability (EAS) questionnaire and behavior at 5.5 years was assessed with the Strengths and Difficulties Questionnaire (SDQ).

RESULTS

Emotional temperament in infancy predicts children's overall behavioral scores (β = 1.16, p<0.001), emotional difficulties (β = 0.30, p<0.001), conduct problems (β = 0.51, p<0.001) and symptoms of hyperactivity/inattention (β = 0.31, p = 0.01) at 5.5 years. Infants' active temperament predicts later conduct problems (β = 0.30, p = 0.02), while shyness predicts later emotional problems (β = 0.22, p = 0.04). The association between the child's temperament in infancy and later behavior did not vary with children's own or family characteristics.

CONCLUSION

An emotional temperament in infancy is associated with higher levels of emotional and behavioral difficulties at the age of 5.5 years. Children who show high emotionality early on may require early prevention and intervention efforts to divert possible adverse developmental pathways.

Association between maternal postnatal depressive symptoms and infants' communication skills: A longitudinal study

Postnatal depression (PND) is associated with adverse effects on a broad range of child outcomes, including language problems. The current study aimed to investigate if the time of exposure to maternal PND symptoms measured with the Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks, 4 months and 6 months postpartum were related to the infants' communication skills measured with the Ages and Stages Questionnaires (ASQ) at 12 and 24 months. Secondly, to study to what extent the number of exposures to high level of PND symptoms (i.e., EPDS score≥10) might be associated with level of communication skills later (at 12 and 24 months), and last, to determine to what extent maternal PND symptoms at 6 weeks were related to changes in the developmental course of communication skills from 4 to 24 months. 1555 children and their mothers participate in the study. Regression analyses indicated that PND at 4 months were associated with lower levels of communicative skills at 12 (coefficient -0.37, 95% CI -0.63 to -0.12, p=0.004) and 24 months (coefficient -0.34, CI -0.56 to -0.13, p=0.002). Infants of mothers with an EPDS sum score≥10 obtained at a minimum of two time points, had significantly worse communicative skills at 12 months than infants of mothers with no indication of PND (difference -6.12, CI -11.14 to -1.09, p=0.017). No such significant relations were found at 24 months. However, linear mixed effects analysis showed that mothers' depressive symptoms at 6 weeks were not significantly related to changes in infant communication scores from age 4 to 24 months. These findings suggest that symptoms of maternal PND symptoms should be taken into account for communication development in infancy.

Parental self-regulation, emotional regulation and temperament: Implications for intervention

This work presents a theoretical and integrative review about parental self-regulation and emotional regulation processes, and its connections with parental coping and temperament. Parents' adaptation requires the ability to regulate their own behavior in reaction to their perception and interpretation of the child's behavior. These self-regulation processes are often intertwined with intense emotions that need to be regulated. Parenting attitudes and behaviors cannot be fully understood without considering the parents' emotional dysregulation and their emotional regulation strategies. However, only few studies focus the effects of parents' emotional regulation strategies on the parenting behavior. Experiential avoidance and overprotection are discussed as extreme cases of parental emotional regulation strategies that may have particularly detrimental effects in childrearing. The authors propose that, although the main parenting interventions already use a self-regulation approach, specific training in adaptive emotional regulation strategies should be included in these programs.

Quasi-experimental evaluation of a telephone-based peer support intervention for maternal depression

AIMS

To evaluate the effect of telephone-based peer support on maternal depression and social support

BACKGROUND

Postpartum depression is a global health concern and lack of treatment options mean many mothers are depressed beyond the first year after birth. Strong evidence has shown telephone-based peer support, provided by a mother recovered from depression, effectively improves depression outcomes. This model has not been tested with mothers with depression any time up to two years postpartum.

DESIGN

Quasi-experimental, one group pre-test, posttest.

METHOD

The study population was mothers in New Brunswick, Canada with depression up to 24 months after delivery. The sample (N = 64) was recruited between May 2011-October 2013. Peer volunteers recovered from postpartum depression were trained and delivered an average of 8·84 (Range 1-13) support telephone calls. Depression and social support outcomes were assessed at intervention mid-point (average 7·43 weeks, n = 37) and end (average 13·9 weeks, n = 34).

RESULTS

Mean depression significantly declined from baseline, 15·4 (N = 49), to mid-point, 8·30 and end of the study, 6·26. At mid-point 8·1% (n = 3/37) of mothers were depressed and at endpoint 11·8% (4/34) were depressed suggesting some relapse. Perceptions of social support significantly improved and higher support was significantly related with lower depression symptoms.

CONCLUSION

Findings offer promise that telephone-based peer support is effective for both early postpartum depression and maternal depression up to two years after delivery.

Mothers' early depressive symptoms predict children's low social competence in first grade: mediation by children's social cognition

BACKGROUND

This study examined whether social-cognitive processes in children mediate relations between mothers' depressive symptoms across the first 3 years and children's first-grade social competence. Three maladaptive cognitions were examined: self-perceived social inadequacy, hostile attribution, and aggressive response generation.

METHOD

One thousand three hundred and sixty-four mothers reported depressive symptoms across early development, first-grade children reported target social cognitions, and children's first-grade social competence was observed and reported by multiple informants.

RESULTS

Findings demonstrated that (a) mothers' average depressive symptoms from 6 to 36 months predicted children's maladaptive social cognition in first grade, (b) low mother-child responsiveness mediated this relation, and (c) maladaptive social cognition mediated relations between mothers' early depressive symptoms and low first-grade social competence independent of later depressive symptoms.

CONCLUSION

When mothers' depressive symptoms occur early in development, they may set in motion low-responsive dyadic patterns that promote children's maladaptive social cognition and, as a result, low social competence.

Mothers’ Depressive Symptoms Predict Both Increased and Reduced Negative Reactivity

This study examined whether, as mothers’ depressive symptoms increase, their expressions of negative emotion to children increasingly reflect aversion sensitivity and motivation to minimize ongoing stress or discomfort. In multiple interactions over 2 years, negative affect expressed by 319 mothers and their children was observed across variations in mothers’ depressive symptoms, the aversiveness of children’s immediate behavior, and observed differences in children’s general negative reactivity. As expected, depressive symptoms predicted reduced maternal negative reactivity when child behavior was low in aversiveness, particularly with children who were high in negative reactivity. Depressive symptoms predicted high negative reactivity and steep increases in negative reactivity as the aversiveness of child behavior increased, particularly when high and continued aversiveness from the child was expected (i.e., children were high in negative reactivity). The findings are consistent with the proposal that deficits in parenting competence as depressive symptoms increase reflect aversion sensitivity and motivation to avoid conflict and suppress children’s aversive behavior.

Mothers' early depressive symptoms and children's first-grade adjustment: a transactional analysis of child withdrawal as a mediator

BACKGROUND

The depression-inhibition hypothesis suggests that mothers' depressive symptoms undermine development because they lead children to withdraw from social contact. To test this, this study examined whether poor first-grade adjustment among children of mothers with depressive symptoms is mediated by the emergence of child withdrawal in early development.

METHOD

Based on 1,364 dyads, four waves of data spanning from 24 months to first grade (7 years) were used to examine paths by which children's withdrawal mediates relations between mothers' early depressive symptoms and three first-grade outcomes: social competence, academic performance, and externalizing behavior problems.

RESULTS

Structural equation modeling revealed three principal paths. First, direct relations were observed: Mothers' depressive symptoms predicted early child withdrawal and increases in child withdrawal over time, which predicted poor first-grade adjustment. Second, reciprocal relations were observed: Mothers' depressive symptoms predicted child withdrawal, which predicted increases in depressive symptoms. Third, relations via mother-child mutual responsiveness were observed: Depression-related increases in child withdrawal predicted declines in mutual responsiveness, which predicted poor first-grade adjustment.

CONCLUSION

The findings suggest that, due to its interdependence with maternal depression and low mother-child mutual responsiveness over time, child withdrawal may play an important role in the poor first-grade adjustment of children whose mothers are high in depressive symptoms.