It's not always binary: Connecting the continuum of caregiver depression with child adjustment in children who are high risk for maltreatment

Abstract

BackgroundYoung children living with a depressed parent are at risk for developing social, behavioral, and emotional problems. The purpose of this study was to evaluate whether an increase in subclinical caregiver depression scores was associated with increases in internalizing and externalizing behavior in children who are at high risk for maltreatment. MethodsThe 1019 U.S.-based dyads consisted of predominantly single (45.53%) and Black/African American (53.29%) caregivers and high-risk 4-year-olds from the LONGSCAN study. Multivariate regression analyzes were used to evaluate the relationship between caregiver Center for Epidemiological Studies-Depression (CES-D) scores, above and below the at-risk for depression CES-D score, and preschooler internalizing, externalizing, and total problem behaviors, measured with the Child Behavior Checklist (CBCL). ResultsCaregiver CES-D score increases, above and below the at-risk for depression score, were significantly associated (p < 0.05) with increased child internalizing, externalizing, and total problem behaviors. After adjusting for covariates, among dyads whose caregivers had subclinical (CES-D < 16) scores, a one-unit score increase was significantly associated with a 0.43 increase (p = 0.00) in children's CBCL internalizing score. LimitationsThese findings are restricted to preschool children who are at risk for maltreatment, limiting generalizability. ConclusionsLow and moderate levels of caregiver depressive symptomatology were associated with a negative influence on preschoolers' adjustment. Practitioners should consider that the link between caregiver depression and child wellbeing may lie on a continuum. With consideration of the full continuum of symptoms, early intervention and anticipatory guidance may decrease the impact of depression on the caregiver, child, and system.