Impact Of Maternal Depressive Symptoms Research Articles

Impact of maternal depressive symptoms on offspring executive functions: a systematic review.

This systematic review aims to thoroughly examine the current understanding of the effect of maternal depression exposure on the executive functions of offspring. Following the PRISMA statement, a comprehensive search for peer-reviewed cohort studies was performed on Pubmed, ScienceDirect, LILACS, PsychINFO, and SciELO. Study quality was assessed using the NIH National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-sectional studies. The evidence was evaluated using the Grading of Recommendation, Assessment, Development, and Evaluation. This review analyzed 33 cohort studies from different countries with a total of 38,981 participants. Twenty-four studies confirmed the hypothesis of the harmful effect of maternal depressive symptoms on the performance of children's executive functions. However, a high heterogeneity among studies was found, and meta-analysis was not feasible. Fetal programming, genetics, and parental practices have been identified as potential mechanisms that can affect the executive functions of children born to mothers who have experienced depressive symptoms. The results suggest a negative association between maternal depressive symptoms and offspring executive functioning. Further studies on the effects of chronicity/severity of maternal symptoms and changes in executive functions in different sensitive periods are needed.

Long-Term Effects of Maternal Depression during Postpartum and Early Parenthood Period on Child Socioemotional Development.

Most research on the impact of maternal depressive symptoms on child development is conducted during the first year postpartum. Findings on long-term effects of maternal depression are still contradictory and underexplored. The present study investigates the long-term impact of maternal depression during the postpartum and early parenthood periods on child behavioral problems at the mean age of 2.25 years. The Edinburgh postnatal depression scale and Beck depression Inventory were used to assess postpartum and early parenthood depression, respectively. The Child Behavior Checklist was used to examine child's behavioral problems. The regression analysis showed statistically significant associations between child behavioral problems and maternal depression during early parenthood and no significant associations with postpartum depression. Four maternal depressive symptoms' trajectories were identified: consistently low, consistently high, decreased, and increased. The children of mothers with consistently high depressive symptoms at both research stages had the most significant total, internalizing, and externalizing problems. Children of mothers whose depressive symptoms decreased over time had the lowest scores in all three domains of behavioral problems. It is extremely important to implement programs for screening and early intervention for maternal mental health problems that could greatly influence the well-being of women and their children's development.

Associations between mother's depressive symptoms during pregnancy and newborn's brain functional connectivity.

Depression during pregnancy is common and the prevalence further increased during the COVID pandemic. Recent findings have shown potential impact of antenatal depression on children's neurodevelopment and behavior, but the underlying mechanisms are unclear. Nor is it clear whether mild depressive symptoms among pregnant women would impact the developing brain. In this study, 40 healthy pregnant women had their depressive symptoms evaluated by the Beck Depression Inventory-II at ~12, ~24, and ~36weeks of pregnancy, and their healthy full-term newborns underwent a brain MRI without sedation including resting-state fMRI for evaluation of functional connectivity development. The relationships between functional connectivities and maternal Beck Depression Inventory-II scores were evaluated by Spearman's rank partial correlation tests using appropriate multiple comparison correction with newborn's gender and gestational age at birth controlled. Significant negative correlations were identified between neonatal brain functional connectivity and mother's Beck Depression Inventory-II scores in the third trimester, but not in the first or second trimester. Higher depressive symptoms during the third trimester of pregnancy were associated with lower neonatal brain functional connectivity in the frontal lobe and between frontal/temporal lobe and occipital lobe, indicating a potential impact of maternal depressive symptoms on offspring brain development, even in the absence of clinical depression.

The impact of maternal depressive symptoms and traumatic events on early childhood mental health in conflict-affected Timor-Leste.

Longitudinal studies are needed to examine the association between maternal depression, trauma and childhood mental health in conflict-affected settings. To examine maternal depressive symptoms, trauma-related adversities and child mental health by using a longitudinal path model in conflict-affected Timor-Leste. Women were recruited in pregnancy. At wave 1, 1672 of 1740 eligible women were interviewed (96% response rate). The final sample comprised 1118 women with complete data at all three time points. Women were followed up when the index child was aged 18 months (wave 2) and 36 months (wave 3). Measures included the Edinburgh Postnatal Depression Scale, lifetime traumatic events and the Child Behaviour Checklist. A longitudinal path analysis examined associations cross-sectionally and in a cross-lagged manner across time. Maternal depressive symptom score was associated with child mental health (cross-sectional association at wave 2, β = 0.35, P < 0.001; cross-sectional association at wave 3, β = 0.33, P < 0.001). The maternal depressive symptom score at wave 1 was associated with child mental health at wave 2 (β = 0.12, P < 0.001), and the maternal depressive symptom score at wave 2 showed an indirect association with child mental health at wave 3 (indirect standardised coefficient 0.23, P < 0.001). There was a time-lagged relationship between child mental health at wave 2 and maternal depression at wave 3 (β = 0.08, P = 0.02). Maternal depressive symptoms are longitudinally associated with child mental health, and traumatic events play a role. Maternal depression symptoms are also affected by child mental health. Findings suggest the need for skilled assessment for depression, trauma-informed maternity care and parenting support in a post-conflict country such as Timor-Leste.

The impact of maternal post-partum depressive symptoms on child diet at 18 months.

Post‐partum depression (PPD) is a serious mental health problem, which can impair maternal behaviours and adversely affect the cognitive, emotional and behavioural development of children. This study aims to explore the impact of maternal depressive symptoms at 3 months post‐partum (baseline) on child diet at 18 months of age (follow‐up). This study used longitudinal data from 263 first‐time mothers from the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Extend. Women self‐reported depressive symptoms (10‐item Center for Epidemiological Studies Depression Scale [CES‐D]) and child diet (fruits, vegetables and discretionary foods). Multiple linear regression analyses were used to explore the relationship between maternal depressive symptoms at baseline and child fruit and vegetable intake and discretionary food intake (g day−1) at follow‐up. Baseline maternal depressive symptoms were associated with higher childhood consumption of discretionary foods at 18 months of age (β = 0.45, 95% confidence interval [CI] 0.03 to 0.87, P = 0.034 [adjusted]). There was no evidence of association for maternal depressive symptoms and child intake of fruits and vegetables. Further longitudinal studies are warranted to confirm these findings, with the hope of translating this knowledge into optimal clinic care and improved physical and mental health for mother and child.

Impact of maternal depressive symptoms on the development of infant temperament: Cascading effects during the first year of life

AbstractMaternal depression is associated with a range of child development outcomes, including difficult temperament. This longitudinal study investigated whether depressive symptoms (DS) that mothers experience after childbirth predict infant negative affect (NA), as well as potential effects of infant NA on maternal DS, across the first year of life. In the study (N = 63), questionnaires (the Beck Depression Inventory Second Edition, and the Infant Behavior Questionnaire–Revised Very Short Form) were administered at 2 weeks, 4, 6, and 9 months after birth. Using path analysis, we tested five different models that could explain the relationship between maternal DS and infant NA. The best‐fitting model showed that the days immediately following childbirth represent an important time for the development of infant temperament as maternal mood significantly predicts infant NA for at least 4 months after birth. This does not constitute a single sensitive period; a new predictive effect emerges around 4 months of age, suggesting cascading influences of maternal DS across the first 6 months of life. These results suggest a need for support, should a mother experience DS, not only immediately after birth, but also throughout the early stages of parenting.

The Impact of Family Rituals and Maternal Depressive Symptoms on Child Externalizing Behaviors: An Urban–Rural Comparison

The association between maternal depression and child negative behavior outcomes has been well established in the literature. However, understanding how maternal depression is associated with child behaviors will have important implications for research and intervention strategies. We used samples from two distinct family contexts: urban, middle-class families (N = 454); and rural, low-income families (N = 240), to compare the impact of family rituals and maternal depressive symptoms on child externalizing behaviors. We also examined the impact of maternal depressive symptoms on family rituals. Structural equation modeling and multiple group analyses were conducted. Child age, child gender, mother age, mother education, mother partner status, family income, and family size served as control variables. Indirect effect tests and incremental validity tests were performed. Depressive symptoms were linked to externalizing behaviors in both samples. The impacts of family rituals on child externalizing behaviors were more context-specific. For urban, middle-class families, vacations played a particularly helpful intermediate role. Also, in these families, maternal depressive symptoms were associated with less involvement in religious holidays. For rural, low-income families, involvement in annual celebrations was associated with less child externalizing behaviors, although maternal depressive symptoms did not impact involvement in any family rituals. Results suggest that family context matters in determining the impacts of maternal depression on the practice of family rituals, as well as the benefits of family rituals for child behaviors, and that certain family rituals can do more than others to reduce child externalizing behaviors (e.g., vacation).

Maternal Depressive Symptoms and Adolescent Health Risk Problems: The Role of School Engagement.

Maternal depressive symptoms disrupt positive youth development, though the pervasiveness of this disruption is understudied. Additionally, it remains unknown whether prosocial factors such as adolescent school engagement may buffer against this risk factor. Using multigenerational, longitudinal data spanning ten years from an ethnically diverse sample of mother-child dyads (66% Black, 17% Hispanic, and 17% White), this study examines the effect of maternal depressive symptoms in late childhood (ages 8-13) on the development and progression of offspring depressive symptoms, substance use, and delinquent behavior during adolescence (ages 14-17). Further, the study examines whether school engagement moderates the ill effects of maternal depressive symptoms. Mother-son (n = 212) and mother-daughter (n = 215) dyads are compared to assess for similarities and differences between male and female offspring. The results indicate that offspring of mothers with greater maternal depressive symptoms are more likely to display higher levels of depressive symptoms, substance use, and delinquency throughout adolescence, although important nuances emerge across outcome and child sex. Additionally, while school engagement itself is associated with reduced depressive symptoms, substance use and delinquency among adolescents, it is not profound enough to offset the risk posed by maternal depressive symptoms. The findings of this study reinforce the pervasive, negative, intergenerational impact of maternal depressive symptoms and has implications for prevention and intervention efforts for adolescent health risk problems.

Intergenerational Continuity in Depression: The Importance of Time-Varying Effects, Maternal Co-morbid Health Risk Behaviors and Child's Gender.

Intergenerational continuity in depressive symptoms is well established between mother and child, but there are still important facets of this relationship that are underexplored. We examine intergenerational continuity in depressive symptoms between mother-child dyads as a flexible function of child age and account for the potential moderating role of maternal co-morbid health risk behaviors. Using prospective, self-report data collected yearly from 413 mother-child dyads (210 mother-son dyads and 203 mother-daughter dyads) between child ages 12-17, the results indicate that the effect of maternal depressive symptoms on daughters' depressive symptoms steadily increases throughout adolescence whereas the effect of maternal depressive symptoms on sons' depressive symptoms is relatively small, stable, and non-significant during mid-adolescence before increasing in effect in later adolescence. A positive interactive effect between maternal depressive symptoms and intimate partner violence is observed for sons and maternal depressive symptoms and substance use for daughters. A negative interactive effect of maternal depressive symptoms and substance use is observed among sons. Overall, this study identifies particular subgroups for whom intervention programming is most beneficial and suggests targeting health risk behaviors of mothers to lessen the impact of maternal depressive symptoms on offspring.

Gender Specificity of Children’s Narrative Representations in Predicting Depressive Symptoms at Early School Age

Our longitudinal study contributes to the body of literature on depression in childhood by examining potential protective factors. We investigated the influence of maternal depressive symptoms on child depressive symptoms at early school age and its gender-specific moderation by children’s narrative representations of the maternal figure, over and above children’s own depressive symptoms at preschool age. Children’s narrative representations were assessed using the MacArthur Story Stem Battery in 170 preschool children (92 girls; 54.1 %) oversampled for internalizing symptoms. Children’s depressive symptoms were assessed at preschool age (Time 1; 4–6 years) and at early school age (Time 2; 6–8 years) by maternal report; mothers’ depressive symptoms were assessed at Time 1. The results showed that for boys, only their own depressive symptoms at Time 1 predicted their depressive symptoms at Time 2. For girls, maternal depressive symptoms were a significant risk factor for their own depressive symptoms at Time 2. Regarding this association, we also found a moderation effect: girls with more positive narrative representations of the maternal figure showed a reduced negative impact of maternal depressive symptoms on their own depressive symptoms at Time 2. This implies that clinical practice should screen a child for early depressive symptoms, especially if the mother displays depressive symptoms. Clinicians might also assess children’s inner working models, which can serve as a protective factor.

DRD2 and SLC6A3 moderate impact of maternal depressive symptoms on infant cortisol

Both maternal depressive symptoms and infants’ dopamine-related genetic characteristics have been linked to infants’ hypothalamic-pituitary-adrenal (HPA) functioning. This study investigated the interactive influence of maternal depressive symptoms and infant DRD2 and SLC6A3 genotypes on infant cortisol reactivity; whether this interaction reflects diathesis-stress or differential susceptibility; and whether this interaction influences the flexibility of the infant cortisol response across challenges known to exert differential effects on infant cortisol reactivity. A community sample of 314 mother-infant dyads participated in toy frustration (age 16 months) and maternal separation (age 17 months) challenges, and salivary cortisol was collected at baseline, +20, and +40min. Maternal depressive symptoms were assessed with the Beck Depression Inventory-II at infant age 16 months. Infant buccal cells were collected at both time points for genotyping. DRD2 and SLC6A3 genotypes moderated the relation between maternal depressive symptomatology and infant cortisol reactivity in a diathesis-stress manner in the context of toy frustration, and in a differential susceptibility manner in the context of maternal separation. Higher levels of maternal depressive symptoms predicted reduced cortisol flexibility across challenges for infants with at least one A1 allele of DRD2 and infants with the 10/10 genotype of SLC6A3. Results suggest that maternal depressive symptomatology is related to infants' cortisol reactivity and to the flexibility of that reactivity across psychosocial challenges, but this relation is dependent on the infant's genetic characteristics.

Impact of maternal depressive symptoms and infant temperament on early infant growth and motor development: Results from a population based study in Bangladesh

BackgroundEvidence linking maternal depressive symptoms with infant’s growth and development in low-income countries is inadequate and conflicting. This study investigated the independent effect of maternal perinatal depressive symptoms on infant’s growth and motor development in rural Bangladesh. MethodsA cohort of 720 pregnant women was followed from the third trimester of pregnancy to 6–8 months postpartum. For growth and developmental outcomes, 652 infants at 2–3 months and 6–8 months were assessed. Explanatory variables comprised maternal depressive symptoms, socioeconomic status, and infant’s health and temperament. Outcome measures included infant’s underweight, stunting and motor development. Multiple linear regression analyses identified predictors of infant growth and development. ResultsMaternal postpartum depressive symptoms independently predicted infant’s underweight and impaired motor development, and antepartum depressive symptoms predicted infant’s stunting. Infant’s unadaptable temperament was inversely associated with infant’s weight-for-age and motor development, and fussy and unpredictable temperament with height-for-age and motor development. LimitationsRepeated measures design might threaten the internal validity of the results 8.3% of the participant does not participate in the measurements at different times. As the study was conducted in two sub-districts of rural Bangladesh, it does not represent the urban scenario and cannot be generalized even for other rural areas of the country. ConclusionThis study provides evidence that maternal ante- and postpartum depressive symptoms predict infant’s growth and motor development in rural Bangladesh. It is recommended to integrate psychosocial components in maternal and child health interventions in order to counsel mothers with depressive symptoms.

Impact of Maternal Depressive Symptoms on Growth of Preschool- and School-Aged Children

The aim of our study was to examine whether maternal depressive symptoms at 9 months postpartum adversely affect growth in preschool- and school-aged children. We used data from the US nationally representative Early Childhood Longitudinal Study, Birth Cohort. We fit multivariable logistic regression models to study maternal depressive symptoms at 9 months postpartum (using the Center for Epidemiologic Studies Depression Scale) in relation to child growth outcomes, ≤ 10% height-for-age, ≤ 10% weight-for-height, and ≤ 10% weight-for-age at 4 and 5 years. At 9 months, 24% of mothers reported mild depressive symptoms and 17% moderate/severe symptoms. After adjustment for household, maternal, and child factors, children of mothers with moderate to severe levels of depressive symptoms at 9 months' postpartum had a 40% increased odds of being ≤ 10% in height-for-age at age 4 (odds ratio = 1.40, 95% confidence interval: 1.04-1.89) and 48% increased odds of being ≤ 10% in height-for-age at age 5 (odds ratio = 1.48, 95% confidence interval: 1.03-2.13) compared with children of women with few or no depressive symptoms. There was no statistically significant association between maternal depressive symptoms and children being ≤ 1 0% in weight-for-height and weight-for-age at 4 or 5 years. Maternal depressive symptoms during infancy may affect physical growth in early childhood. Prevention, early detection, and treatment of maternal depressive symptoms during the first year postpartum may prevent childhood height-for-age ≤ 10th percentile among preschool- and school-aged children.

Impact of Maternal Depressive Symptoms on Growth of Preschool- and School-Aged Children

Impact of Maternal Depressive Symptoms on Growth of Preschool- and School-Aged Children

Maternal Depressive Symptoms and the Risk of Overweight in Their Children

To examine the association between maternal depressive symptoms during early childhood of their offspring and later overweight in the children. Only children (n = 1,090) whose weights and heights were measured at least once for three time points (grades one, three and six) from the National Institute of Child Health and Human Development Study were included. Maternal depressive symptoms, defined as a Center for Epidemiologic Studies Depression Scale (CES-D) score of 16 or greater, were assessed using CES-D when the child was 1, 24, and 36 months. Childhood overweight was based on standardized height and weight measures taken during the interviews, and was defined according to appropriate CDC age- and sex-specific BMI percentiles. Generalized estimating equation was used to examine the impact of maternal depressive symptoms on the childhood overweight after adjusting for covariates. Compared to children of mothers without depression at any of the three time points, when children were one, 24 and 36 months of age, children of mothers with depression at all three time points were 1.695 times more likely to be overweight after adjusting for other child characteristics (95 % CI = 1.001-2.869). When further adjusted for maternal characteristics, children of mothers with depression at all three time points were 2.13 times more likely to be overweight (95 % CI = 1.05-4.31). Persistent maternal depressive symptoms may be associated with an increased risk of childhood overweight in their offspring. Children of mothers with depression may benefit from special attention in terms of obesity prevention.

Depressive mood in women at childbirth predicts their mood and relationship with infant and partner during the first year postpartum

Although many studies have reported negative impact of maternal depressive symptoms on family relations, few studies have explored whether or not early depressive symptoms influence interfamily relationships. The aim was to describe first-time mothers' feelings for their infant and partner during the first postpartum year in relation to maternal depressive symptoms. Research questions were addressed about: What is the prevalence of maternal depressive symptoms 10 days postpartum? How does maternal depressive symptoms on day 10 relate to her mood and feelings for the infant and partner at days 3 and 10, and at 6 and 12 months postpartum? A longitudinal study with first-time mothers, normal pregnancies, giving birth to healthy babies participated in the study; altogether, n = 419. Depressive symptoms were measured by Edinburgh Postnatal Depression Scale (EPDS) at 3 and 10 days. Additional questionnaires assessing the woman's mood and relationship with her infant and partner were filled out at days 3 and 10, and at 6 and 12 months postpartum. Twenty-two per cent of the women scored high on EPDS on day 10 postpartum. In addition, low mood seemed to remain prevalent over the baby's first year, as confirmed by the mood scale at 6 and 12 months postpartum. Women with depressive symptoms showed less closeness, warmth and confidence as measured by the infant and partner relationship scales over the first year. Mothers with a high EPDS score on day 3 scored less optimal on the relationship scale to the infant at days 3 and 10, but not 6 or 12 months postpartum. To screen women for depressive symptoms, 10 days postpartum seems to be predictive of maternal assessment of maternal-infant relationship throughout the first year and enables early intervention.

The Impact of Maternal Depressive Symptoms on Adolescents’ Aggression: Role of Parenting and Family Mediators

Previous research has found an association between mothers’ depressive symptoms and their adolescents’ involvement in aggression. The present study examined three mechanisms believed to account for this relation: parenting practices, family functioning, and informant discrepancy. Participants were a high-risk sample of 927 mother–adolescent dyads (66% African American) who completed baseline assessments for the Multisite Violence Prevention Project. Maternal depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale. Adolescents’ aggression was assessed using parent- and teacher-report on the Behavior Assessment System for Children and student-report on the Problem Behavior Frequency Scale. Mothers’ reports of depressive symptoms were significantly related to their adolescents’ aggression based on student, teacher, and mothers’ reports, with the strongest correlations found with mothers’ reports. Multilevel modeling indicated that maternal depressive symptoms were related to the degree of discrepancy between mothers’ ratings of their adolescents’ aggression and ratings by adolescents and their teachers. Smaller discrepancies between mothers’ and teachers’ ratings of adolescents’ aggression were found for depressed mothers, as compared to non-depressed mothers. Structural equation models indicated that the relation between maternal depressive symptoms and mothers’ report of adolescents’ aggression was mediated by several parenting and family functioning variables, with the clearest effects for parenting practices. Similar findings were not found in analyses predicting adolescents’ ratings and teachers’ ratings. These findings underscore the potential direct and indirect benefits of interventions focused on reducing depression among mothers with adolescent children.

The impact of maternal depressive symptoms on health‐related quality of life in children with epilepsy: A prospective study of family environment as mediators and moderators

To examine the impact of maternal depressive symptoms (DS) on health-related quality of life (HRQL) in children with new-onset epilepsy and to identify family factors that moderate and mediate this relationship during the first 24 months after epilepsy diagnosis. A sample of 339 mother-child dyads recruited from pediatric neurologists across Canada in the Health-related Quality of Life in Children with Epilepsy Study. Mothers' and neurologists' reports were collected at four times during the 24-month follow-up. Mothers' DS were measured using the Center for Epidemiological Studies Depression Scale (CES-D) and children's HRQL using the Quality of Life in Childhood Epilepsy (QOLCE). Data were modeled using individual growth curve modeling. Maternal DS were observed to have a negative impact on QOLCE scores at 24 months (β = -0.47, p < 0.0001) and the rate of change in QOLCE scores during follow-up (β = -0.04, p = 0.0250). This relationship was moderated by family resources (β = 0.25, p = 0.0243), and the magnitude of moderation varied over time (β = 0.09, p = 0.0212). Family functioning and demands partially mediated the impact of maternal DS on child HRQL (β = -0.07, p = 0.0007; β = -0.12, p = 0.0006). Maternal DS negatively impact child HRQL in new-onset epilepsy during the first 24 months after diagnosis. This relationship is moderated by family resources and mediated by family functioning and demands. By adopting family centered approaches, health care professionals may be able to intervene at the maternal or family level to promote more positive outcomes in children.

Depressive symptoms among mothers of children with epilepsy: A review of prevalence, associated factors, and impact on children

The impact of epilepsy is not limited to the child experiencing seizures, but affects all members of the family. As primary caregivers, mothers are particularly at risk for experiencing increased depressive symptoms and risk for clinical depression. The objective of this systematic review was to critically assess available evidence regarding the prevalence, associated factors, and impact of maternal depressive symptoms on child outcomes in epilepsy. Using a modified version of the Quality Index, studies were rigorously evaluated in terms of reporting, external validity, and internal validity. Limitations in the study designs and analytic techniques of previous research are discussed, and study methods to overcome these barriers are presented in order to advance this research area. Up to 50% of mothers of children with epilepsy are at risk for clinical depression. Correlates of maternal depressive symptoms include a number of modifiable risk factors such as role ambiguity, worry, and satisfaction with relationships. In addition, studies suggest that depressive symptoms in mothers have a negative impact on child outcomes in epilepsy including behavior problems and health-related quality of life. The overall mean score on the Quality Index was 9.7, indicating a midrange quality score, suggesting a need for more methodologically robust studies.

The course of maternal depressive symptoms and maternal sensitivity as predictors of attachment security at 36 months.

We examined the course of maternal depressive symptoms and children's attachment security at 36 months in a large sample of mother-child pairs from 10 sites across the country participating in the NICHD Study of Early Child Care (N = 1077). Maternal depressive symptoms predicted higher rates of insecure attachment. Women who reported intermittent symptoms across the first 36 months had preschoolers who were more likely to be classified as insecure C or D; women with chronic symptoms were more likely to have preschoolers who were classified as insecure D. Symptoms reported only during the first 15 months were not associated with elevated rates of later insecurity. After controlling for potentially confounding demographic variables, maternal sensitivity (observed at 6, 15, 24, and 36 months) did not meaningfully account for links between attachment security and patterns of depressive symptoms. However, the course and timing of maternal depressive symptoms interacted with maternal sensitivity to predict insecurity. Women with late, intermittent, or chronic symptoms who were also low in sensitivity were more likely to have preschoolers who were insecure, in contrast to symptomatic women who were high in sensitivity. These data have implications for understanding the combined impact of maternal depressive symptoms and maternal sensitivity on children's socioemotional development.