Economic Hardship, Parents' Depression, and Relationship Distress among Couples With Young Children

Adverse childhood experiences and externalizing, internalizing, and prosocial behaviors in children and adolescents: A longitudinal study

BACKGROUND

Adverse childhood experiences (ACEs) have a profound impact on individuals, shaping their long-term health and life opportunities. This study delves into the complex ties between ACEs and the socioemotional development of Australian children and youth by examining the relationships between adverse childhood experiences and externalizing, internalizing, and prosocial behaviors.

METHODS

This study utilized data from the Longitudinal Study of Australian Children and employed the generalized estimating equation method to investigate the relationships between adverse childhood experiences and externalizing, internalizing, and prosocial behaviors in Australian children and adolescents.

RESULTS

Adverse childhood experiences such as physical punishment, hostile parenting, parental conflicts, separation, financial strain, and parental mental health issues increased the risk of externalizing and internalizing behaviors while reducing prosocial behaviors. The risk increases with the number of ACEs, as evidenced by the incidence ratio (IR); for example, for externalizing behaviors, an ACEs score of one leads to IR = 1.69, while an ACEs score of 4 results in IR = 3.34. Similar trends were observed for internalizing and prosocial behaviors.

LIMITATIONS

The presence of imbalanced longitudinal data, arising from variations in the number of observations across different time points, challenges robust inferences. Furthermore, this study investigates the relationship between ACEs and behavioral problems, without establishing causality. Consequently, the results should be interpreted with caution.

CONCLUSIONS

The findings of this study highlight that adverse childhood experiences significantly influence behavioral outcomes in children and adolescents. These findings underscore the critical need for early detection and intervention to mitigate the consequences of traumatic childhood experiences.

Examination of co-parenting support and parenting stress as mediators of the food insecurity-maternal depression/anxiety relationship

BACKGROUND

Identifying family environment factors related to food insecurity and maternal mental health could inform additional support for mothers who experience food insecurity. This study seeks to examine the mechanistic roles of co-parenting support and parenting stress on the food insecurity-maternal mental health relationship.

METHODS

Data from the Future of Families and Child Well-being Study, which recruited mothers post-delivery from 75 urban hospitals, was utilized. Analysis includes 1808 mothers followed for 15 years. Food insecurity was assessed at year 5, co-parenting support and parenting stress at year 9, and maternal depression and anxiety at year 15. Structural equation models evaluated the role of food insecurity on maternal depression (model 1) and anxiety (model 2) through co-parenting support and parenting stress simultaneously, adjusting for socio-demographics.

RESULTS

Co-parenting support did not mediate the relationships of food insecurity and maternal depression and anxiety, controlling for parenting stress. Controlling for co-parenting support, parenting stress did not mediate the food insecurity-maternal depression relationship, but partially mediated the food insecurity-maternal anxiety relationship (specific indirect: B = 0.026, CI:0.01, 0.05; specific direct: B = 0.131, CI:-0.04, 0.32).

LIMITATIONS

There was a significant period of time (10 years) between assessment of food insecurity and assessment of maternal mental health. Self-reported data on sensitive topics may be susceptible to bias. With observational research, it is possible that unobserved confounding variables impact the findings.

CONCLUSIONS

Cumulative support in the form of - parenting, economic (e.g., utilities), and food - may help reduce parenting stress and anxiety among mothers who experience food insecurity.

Examining mechanisms linking economic insecurity to interparental conflict among couples with low income

Objective

The current study used the family stress model to test the mechanisms by which economic insecurity contributes to mothers' and fathers' mental health and couples' relationship functioning.

Background

Although low household income has been a focus of poverty research, material hardship-defined as everyday challenges related to making ends meet including difficulties paying for housing, utilities, food, or medical care-is common among American families.

Methods

Participants were from the Building Strong Families project. Couples were racially diverse (43.52% Black; 28.88% Latinx; 17.29% White; 10.31% Other) and living with low income (N = 2,794). Economic insecurity included income poverty and material hardship. Bayesian mediation analysis was employed, taking advantage of the prior evidence base of the family stress model.

Results

Material hardship, but not income poverty, predicted higher levels of both maternal and paternal depressive symptoms. Only paternal depressive symptoms were linked with higher levels of destructive interparental conflict (i.e., moderate verbal aggression couples use that could be harmful to the partner relationship). Mediation analysis confirmed that material hardship operated primarily through paternal depressive symptoms in its association with destructive interparental conflict.

Conclusion

The economic stress of meeting the daily material needs of the family sets the stage for parental mental health problems that carry over to destructive interparental conflict, especially through paternal depressive symptoms.

Implications

Family-strengthening programs may want to consider interventions to address material hardship (e.g., comprehensive needs assessments, connections to community-based resources, parents' employment training) as part of their efforts to address parental mental health and couples' destructive conflict behaviors.

Family Well-Being During the COVID-19 Pandemic: The Risks of Financial Insecurity and Coping

During the COVID-19 pandemic, families have experienced unprecedented financial and social disruptions. We studied the impact of preexisting psychosocial factors and pandemic-related financial and social disruptions in relation to family well-being among N = 4091 adolescents and parents during early summer 2020, participating in the Adolescent Brain Cognitive DevelopmentSM Study. Poorer family well-being was linked to prepandemic psychosocial and financial adversity and was associated with pandemic-related material hardship and social disruptions to routines. Parental alcohol use increased risk for worsening of family relationships, while a greater endorsement of coping strategies was mainly associated with overall better family well-being. Financial and mental health support may be critical for family well-being during and after a widespread crisis, such as the COVID-19 pandemic.

Reciprocal relations between financial hardship, sense of societal belonging and mental health for social assistance recipients

This study assesses the extent to which reciprocal relations exist between financial hardship, sense of societal belonging and mental health for social assistance recipients. This provides crucial information on how a desired change in these outcomes may be realized, and which factors to target to improve recipients' disadvantaged situation most. In order to answer our research question, we drew on three-wave panel data (N = 348) from a social experiment in the municipality of Nijmegen, the Netherlands, which ran from December 2017 to January 2020. The data were analyzed using cross-lagged panel models. Our findings show that financial hardship and sense of societal belonging did not predict change in recipients' mental health. A better mental health at baseline, in contrast, predicted an increase in sense of societal belonging one and two years later. In addition, both a better mental health and a stronger sense of societal belonging at baseline predicted a decrease in financial hardship one year later, but this relation was not found between other waves. These findings emphasize that improving recipients' mental health may be a promising policy strategy to improve their situation.

Maternal depression and adolescent optimism

The life course perspective posits that parents' and children's lives are linked through shared experiences and interdependent contexts such as the household. In this paper, we draw on the life course perspective to examine the relationship between maternal depression and adolescent optimism, an important trait that reflects adolescents' positive expectations for the future, and how features of the family context explain this association. We use data from the Fragile Families and Child Wellbeing Study (N = 3013), taking advantage of the study's longitudinal measures of maternal depression that span a 15-year period. First, we find that current maternal depression is negatively associated with optimism among adolescents. Second, we find that the family environment and parent-child relationships, but not economic wellbeing, explain the association between maternal depression and adolescent optimism. These findings inform our understanding of how parent and adolescent wellbeing are linked and, importantly, how the family environment conditions how adolescents envision their futures.

Father involvement, couple relationship quality, and maternal Postpartum Depression: the role of ethnicity among low-income families

OBJECTIVES

Maternal postpartum depression (PPD) has been recognized as a serious and wide-spread mental health disorder that has long-term negative impacts on children's cognitive, social, and emotional development. This study extends prior research by examining the associations among predictors of PPD, including two different facets of father involvement and couple relationship quality, with a focus on testing these pathways across ethnic groups.

METHOD

This study analyzed data from the Fragile Families and Child Wellbeing Study (FFCWS) including mothers' baseline interviews and one-year follow-up data sets (n = 2,794). Several models were tested using bootstrapping in structural equation modeling to explore the mediating paths and ethnic differences.

RESULTS

This study found that father involvement in sharing childcare responsibility had direct effects on reducing mothers' parenting stress and promoted maternal psychological adjustment, which was consistent across the three ethnic groups. The mediation pathways through couple relationship quality between father involvement (both father involvement in direct infant care and shared responsibilities) and PPD were detected significant for Black and white mothers.

CONCLUSIONS FOR PRACTICE

This study provided empirical evidence that father involvement in infant care is critical for mothers' perceived relationship quality. Maternal postpartum mental health may benefit from interventions and policies that encourage positive father engagement in infant care.

The Long-Term Impact of Parental Mental Health on Children's Distress Trajectories in Adulthood

Using six waves of data from the Panel Study of Income Dynamics (2007-2017) and the Childhood Retrospective Circumstances Study (2014) (n=3,240), this paper estimates how childhood experiences with parental mental health problems shape trajectories of children's own distress in adulthood. Findings indicate that those who experience poor parental mental health have consistently greater distress than their non-exposed counterparts throughout adulthood. More severe and longer exposures to parental mental health problems corresponds to even greater distress in adulthood. The gender of the parent afflicted does not predict differences in adult mental health, but those individuals exposed to both maternal and paternal poor mental health have the greatest distress in adulthood. Together, results suggest that parental mental health during children's formative years is a significant predictor of life course distress and that heterogeneity in this experience corresponds to unique mental health trajectories.

Unemployment rate, opioids misuse and other substance abuse: quasi-experimental evidence from treatment admissions data

BACKGROUND

The relationship between economic conditions and substance abuse is unclear, with few studies reporting drug-specific substance abuse. The present study examined the association between economic conditions and drug-specific substance abuse admissions.

METHODS

State annual administrative data were drawn from the 1993-2016 Treatment Episode Data Set. The outcome variable was state-level aggregate number of treatment admissions for six categories of primary substance abuse (alcohol, marijuana/hashish, opiates, cocaine, stimulants, and other drugs). Additionally, we used a broader outcome for the number of treatment admissions, including primary, secondary, and tertiary diagnoses. We used a quasi-experimental approach -difference-in-difference model- to estimate the association between changes in economic conditions and substance abuse treatment admissions, adjusting for state characteristics. In addition, we performed two additional analyses to investigate (1) whether economic conditions have an asymmetric effect on the number of substance use admissions during economic downturns and upturns, and (2) the moderation effects of economic recessions (2001, 2008-09) on the relationship between economic conditions and substance use treatment.

RESULTS

The baseline model showed that unemployment rate was significantly associated with substance abuse treatment admissions. A unit increase in state unemployment rate was associated with a 9% increase in treatment admissions for opiates (β = 0.087, p < .001). Similar results were found for other substance abuse treatment admissions (cocaine (β = 0.081, p < .001), alcohol (β = 0.050, p < .001), marijuana (β = 0.036, p < .01), and other drugs (β = 0.095, p < .001). Unemployment rate was negatively associated with treatment admissions for stimulants (β = - 0.081, p < .001). The relationship between unemployment rate and opioids treatment admissions was not statistically significant in models that adjusted for state fixed effects and allowed for a state- unique time trend. We found that the association between state unemployment rates and annual substance abuse admissions has the same direction during economic downturns and upturns. During the economic recession, the negative association between unemployment rate and treatment admissions for stimulants was weakened.

CONCLUSION

These findings suggest that economic hardship may have increased substance abuse. Treatment for substance use of certain drugs and alcohol should remain a priority even during economic downturns.

Maternal behavioral health symptom profiles in early family life: complexity and context

Behavioral health problems affect at least 15% of mothers, but few studies have examined how different problems cluster together. Characterizing symptom profiles and their correlates early in the family life cycle can extend existing understanding beyond that provided by studies based on single problems. Mothers in the Fragile Families and Child Wellbeing study, a national birth cohort of racially diverse and mostly unmarried mothers (N = 4205), reported depression, anxiety, and substance dependence symptoms. Latent class analysis (LCA) identified mothers' symptom profiles in their children's third year. We explored associations between symptom profiles and demographics, reproductive health outcomes, functional limitations, and postpartum behavioral health. LCA identified five profiles: (1) Depression only (14.5% of sample), (2) Severe depression and anxiety (5.3%), (3) Anxiety only (2.2%), (4) Depression and substance use (1.4%), and (5) Currently symptom free (76.6%). Depressive symptoms were more moderate when co-occurring with substance dependence and more severe when co-occurring with anxiety. Postpartum depression, postpartum anxiety, and smoking during pregnancy were the most robust correlates of being symptomatic in year 3. Mothers in the "Severe depression and anxiety" group were more likely to be in that profile if they reported functional impairment and/or relationship dissolution. Mothers in the "Depression only" profile were more likely to have higher parity and/or functional impairment. A quarter of mothers of young children had significant behavioral health symptoms, with most reporting depression symptoms. Psychosocial and physical health factors in the pregnancy and postpartum periods were associated with future symptoms, warranting obstetrician and pediatrician attention.

Life situation and support during pregnancy among Thai expectant mothers with depressive symptoms and their partners: a qualitative study

Background

Expectant parents may have positive and negative emotions during pregnancy and receive support from different sources. Studies on life situation and support among couples have rarely been conducted. This study aims to explore life situation and support during pregnancy among expectant mothers with depressive symptoms and their partners.

Methods

Twenty-seven expectant mothers, in the last trimester of pregnancy with depressive symptoms (Edinburgh Postnatal Depression Scale score ≥ 7) from seven public antenatal care clinics in Sakonnakhon, a north-eastern province of Thailand, and their partners were interviewed. In total, 54 semi-structured interviews were subjected to content analysis.

Results

Four categories emerged: (1) Having obstacles in life, (2) Facing life transition, (3) Enhancing confidence, and (4) Dissatisfaction with support. The informants described obstacles regarding economy, fear of health problems, getting an abnormal child and partners’ behaviours. They received support from family members and social networks, but some were dissatisfied with the support from the healthcare. For example, expectant fathers wished to receive more health information and be more involved.

Conclusions

Healthcare professionals should be aware of the influence of cultural and contextual factors when providing antenatal care to expectant parents. Male involvement in the care must not be neglected.

Early childhood family instability and immune system dysregulation in adolescence

Exposure to stress is one way in which social disadvantages during childhood may alter biological and psychological systems with long-term consequences. Family social and economic conditions are critical for early childhood development and exposure to difficult family conditions may have lasting physiological effects. However, there is little research linking early childhood conditions with physiological indicators of stress and system dysregulation in adolescence. In this study, we assess how family social and economic instability that occurred in early childhood (birth to age 5) is associated with immune system dysregulation in adolescence, as indicated by DNA shedding of the Epstein-Barr virus (EBV). We utilize a biomarker of EBV obtained through saliva, a non-invasive method of collecting immune-system biomarkers, in 674 adolescents 11-17 years old. Multivariable regression results indicated that experiences of moving into a new parent/caregiver household or moving in with a grandparent during early childhood was associated with an estimated 100% increase in EBV DNA shedding among prior EBV-infected adolescents. Other measures of early childhood family instability, total number of family structure changes and economic insecurity, were marginally significant. Contemporaneous family conditions were not associated with adolescents' EBV DNA shedding.

Parental Depression and Cooperative Coparenting: A Longitudinal and Dyadic Approach

OBJECTIVE

To examine the relationship between parental depression and cooperative coparenting among couples over the first 5 years after a birth.

BACKGROUND

Previous research has considered how depression affects coparenting but has not focused on the association as a longitudinal and dyadic process. Understanding coparenting is important as it is linked to parents' and children's well-being.

METHOD

Data from the Fragile Families and Child Wellbeing (FFCW) study were analyzed using actor-partner interdependence models. The FFCW follows families and their children as part of a birth cohort of children who were born in large urban cities of the United States in the late 1990s.

RESULTS

The actor-partner interdependence models indicated that (a) parents' depression is associated with decreased coparenting perceptions for both mothers and fathers, and the effects endure over time; (b) fathers' depression was also associated with mothers' perceptions of cooperative coparenting over the later years; and (c) differences between mothers and fathers emerged only during the early years, with the effect of depression on coparenting being larger for fathers than mothers.

CONCLUSION

The results not only highlight the importance of both parents' mental health on coparenting but also the added role that fathers' depression plays in shaping their own and their partners' perceptions of coparenting.

IMPLICATIONS

Policy makers and family practitioners who are invested in building healthy families may find it valuable to screen for and treat mental illness in the context of creating programs to increase cooperative coparenting.

Paternal Perinatal Depression Assessed by the Edinburgh Postnatal Depression Scale and the Gotland Male Depression Scale: Prevalence and Possible Risk Factors

Several studies have used the Edinburgh Postnatal Depression Scale (EPDS), developed to screen new mothers, also for new fathers. This study aimed to further contribute to this knowledge by comparing assessment of possible depression in fathers and associated demographic factors by the EPDS and the Gotland Male Depression Scale (GMDS), developed for “male” depression screening. The study compared EPDS score ≥10 and ≥12, corresponding to minor and major depression, respectively, in relation to GMDS score ≥13. At 3–6 months after child birth, a questionnaire was sent to 8,011 fathers of whom 3,656 (46%) responded. The detection of possibly depressed fathers by EPDS was 8.1% at score ≥12, comparable to the 8.6% detected by the GMDS. At score ≥10, the proportion detected by EPDS increased to 13.3%. Associations with possible risk factors were analyzed for fathers detected by one or both scales. A low income was associated with depression in all groups. Fathers detected by EPDS alone were at higher risk if they had three or more children, or lower education. Fathers detected by EPDS alone at score ≥10, or by both scales at EPDS score ≥12, more often were born in a foreign country. Seemingly, the EPDS and the GMDS are associated with different demographic risk factors. The EPDS score appears critical since 5% of possibly depressed fathers are excluded at EPDS cutoff 12. These results suggest that neither scale alone is sufficient for depression screening in new fathers, and that the decision of EPDS cutoff is crucial.

Dual Food and Energy Hardship and Associated Child Behavior Problems

OBJECTIVE

To examine dual food and energy hardship and internalizing and externalizing behavior problems in 9-year-old children.

METHODS

We conducted a cross-sectional analysis of the Fragile Families and Child Wellbeing Study, a prospective national urban birth cohort, when the children were 9 years old. Maternal-reported "food hardship" (ever hungry and/or ever received free food) and "energy hardship" (ever unable to pay utility bill and/or utility shutoff) within the past year, and child behavior using the Child Behavior Checklist for Ages 6-18 were assessed. Multiple logistic regression analyses estimated associations between individual and dual food and energy hardship and child behavior problems, adjusting for a priori covariates (ie, child sex, health insurance, maternal sociodemographic characteristics, poverty, reported health, attention deficit hyperactivity disorder, depressive symptoms, smoking, and substance and alcohol abuse).

RESULTS

Approximately 10% of households reported dual food and energy hardship. Children experiencing dual food and energy hardship had 3 times greater odds of withdrawn/depressed behaviors (adjusted odds ratio [AOR], 2.8; 95% confidence interval [CI], 1.4-5.5), threefold greater odds of somatic complaints (AOR, 3.2; 95% CI, 1.5-6.9), and 4 times greater odds of rule-breaking behavior (AOR, 3.7; 95% CI, 1.5-9.2) in the borderline/clinical range than children with no hardship, and had fourfold greater odds of borderline/clinical range somatic complaints (AOR, 4.2; 95% CI, 1.7-10.3) than children with only energy hardship.

CONCLUSIONS

Children experiencing dual food and energy hardship have greater odds of coexisting internalizing and externalizing behaviors after controlling for possible confounders. Providers can consider screening and resource referrals for these addressable hardships alongside behavior assessments in the clinical setting.