Maternal postnatal depression and anxiety and their association with child emotional negativity and behavior problems at two years.

Jason M Prenoveau,Maria Zioga,Valerie West,Jessica Cardy,Peter Cooper,Elena Netsi,Annukka Lehtonen,Lynne Murray,Beverley Davies,Andreas Giannakakis,Alan Stein,Michelle G Craske

doi:10.1037/dev0000221

Abstract

Postnatal maternal depression is associated with poorer child emotional and behavioral functioning, but it is unclear whether this occurs following brief episodes or only with persistent depression. Little research has examined the relation between postnatal anxiety and child outcomes. The present study examined the role of postnatal major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptom chronicity on children’s emotional and behavioral functioning at 24 months. Following postnatal screening mothers (n = 296) were identified as having MDD, GAD, MDD and GAD, or no disorder at 3 months postnatal; the average age was 32.3 (SD = 5.0), 91.9% self-identified as Caucasian, and 62.2% were married. Maternal disorder symptom severity was assessed by questionnaires and structured interview at 3, 6, 10, 14, and 24 months postpartum. At 24 months, child emotional negativity and behavior were assessed using questionnaires and by direct observation. Latent trait–state-occasion modeling was used to represent maternal disorder symptom chronicity; both stable trait and time-specific occasion portions of maternal symptomatology were examined in relation to child outcomes. Only the stable trait portion of maternal MDD and GAD symptom severity were related to maternal report of child behavior problems and higher levels of emotional negativity. Persistent maternal MDD, but not GAD, symptom severity was related to higher levels of child emotional negativity as measured observationally. These data suggest that children’s behavior problems and emotional negativity are adversely affected by persistent maternal depression, and possibly anxiety. This has implications for interventions to prevent negative effects of postnatal psychopathology on children.

Highlights

Parental psychopathology in a child’s early years is associated with adverse effects on infant and child development
The present study examined the role of postnatal major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptom chronicity on children’s emotional and behavioral functioning at 24 months
About 54% of the variance in maternal MDD symptom severity state standing (St) is explained by standing on the stable trait factor, whereas 9.5% is explained by the prior occasion factor through the auto-regressive pathway, and 36.4% is unexplained

Summary

Introduction

Parental psychopathology in a child’s early years is associated with adverse effects on infant and child development. Persistence of maternal disorders predicts later problems in child development, whereas brief postnatal depressive episodes have less impact (e.g., Brennan et al, 2000; Cornish et al, 2005; NICHD Early Child Care Research Network, 1999). Brennan and colleagues (2000) attempted to disentangle the contributions of maternal depressive severity and chronicity by simultaneously examining continuous measures of both constructs, and categorizing mothers into four groups: neither severe nor chronically depressed, chronically but not severely depressed, severely but not chronically depressed, and both severely and chronically depressed They observed a significant interaction between chronicity and severity in the prediction of child problems (as assessed by the total problems scale on the Child Behaviour Checklist). Findings revealed that child outcomes were significantly poorer for mothers who were depressed only at 6 months postpartum compared to those who were only depressed during pregnancy or only depressed shortly after birth of their child

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