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

Maternal educational practices and mental health disorders of school-age children

OBJECTIVE

To investigate the association between emotional and behavioral difficulties in schoolchildren and maternal educational practices.

METHODS

Participants and Setting: 631 mother-child pairs were evaluated in a poor urban district in Recife, northeastern Brazil. Cross-sectional study carried out between 2013 and 2014. It integrates a prospective cohort study designed to investigate the consequences of intimate partner violence that occurred during pregnancy, postpartum, and seven years after birth for the physical and mental health of women and their children. Maternal educational practices were assessed using the Parent-Child Conflict Tactics Scale (CTSPC - mother-child version) and the child's behavioral and emotional disorders through the Strengths and Difficulties Questionnaire (SDQ) mother-version. The association was estimated through crude and adjusted prevalence ratios, using Poisson regression considering the 95% confidence interval.

RESULTS

The prevalence of violent maternal educational practices was 91.8% (572/631) being 89.7% (566/631) of psychological aggression and 75.6% of physical aggression, subdivided into corporal punishment (73.5%), physical maltreatment (35.8%) and severe physical maltreatment (1.7%). Corporal punishment (Adjusted PR 1.5; CI 95%: 1.1-2.1; p = 0.010) and severe physical maltreatment (Adjusted PR 1.9; CI 95%: 1.3-2.8; p = 0.002) were associated with emotional and behavioral difficulties in schoolchildren.

CONCLUSION

The high prevalence of violent maternal educational practices, especially corporal punishment and severe physical maltreatment is associated with emotional and behavioral disorders in children. Therefore, it is necessary to interventions that promote parental support and effective use of non-violent discipline in conducting the educational process to establish healthier family relationships and to prevent/mitigate the impact of emotional and behavioral problems in children.

Prevalence of mental health problems in preschoolers and the impact of maternal depression

A large number of children of depressed mothers have one or more mental disorders. This study aimed to evaluate the impact of maternal depression on the mental health of 4-5-year-old children of adolescent mothers, according to the hypotheses generated from the model of accumulation. Between October 2009 and March 2011, all pregnant adolescents who received prenatal care from the public health system in Pelotas (southern Brazil) were invited to participate in the study and have been prospectively followed. Of these individuals, 413 participants were evaluated in the postpartum period and when the child was 2-3 years old and 4-5 years old (current stage). The Strengths and Difficulties Questionnaire was used to assess mental health problems in children, and the Mini International Neuropsychiatric Interview (MINI)-Plus version was used to assess maternal depression. We applied a structured modeling approach to examine the relations between three different hypothesized life course models (accumulation, critical period, and mobility) and maternal depression. After selecting the most appropriate model, we used a logistic regression analysis to assess the effect of depression on mental health problems in 4-5-year-old children of adolescent mothers. We used the Chi square test to estimate the prevalence of mental health problems in 4-5-year-old children. The longer the time of exposure to maternal depression, the greater the probability that the child would present behavioral problems. Investments in strategies to prevent mental disorders beginning in the gestational period are important.

Working with Parents and Children Separated at the Border: Examining the Impact of the Zero Tolerance Policy and beyond

The crisis of family separation caused by Trump Administration's zero tolerance policy (ZTP) on the southern border has focused the nation's attention and provoked public uproar due to the violation of basic rights and the expected negative impact on children and parents. There is decades' worth of research documenting the damage of separating children from their parents in a wide diversity of circumstances and for a wide variety of reasons. There is also ample research evidence of the impact of any form of childhood trauma and consequent disruptions in development, cognitive impairments, and health problems through adulthood. However, there is no first-hand documentation published of how these children and families specifically experienced separation at the border and the effects it is having on them to date. The present article first provides an overview of the historical and socio-political context of family separation policies in the US, and a thorough description of how ZTP was implemented in actuality. Second, this article offers a review of the literature on the impact of family separation on children and parents in diverse contexts. Third, we describe direct clinical experiences with these children and parents receiving services at the Terra Firma program in the Bronx community in New York. Finally, this article delineates important recommendations for policy makers, service providers, and the community as a whole.