Maternal Depressive Symptomatology Research Articles

Does Childcare Attendance Moderate the Associations Between Mother-Child Depressive Symptoms and Children’s Peer Victimization Experiences?

Peer victimization experiences is suggested to play a mediating role in the transmission of depression symptoms between mothers and children. Childcare attendance has been found to reduce the association between mother and child depressive symptoms. However, it is not clear whether this protective effect unfolds via a reduction of peer victimization experiences in middle childhood. The aims of this study were to test (1) whether peer victimization in middle childhood mediated the association between exposure to maternal depressive symptomatology in early childhood and child depressive symptoms in late childhood, (2) whether childcare attendance moderate the direct associations between maternal depressive symptoms and children’s peer victimization experiences in middle childhood as well as depressive symptoms in late childhood and (3) whether childcare attendance moderates this mediated association. Data come from the Avon Longitudinal Study of Children and Parents (N = 5526) where exposure to maternal depressive symptoms and intensity of childcare attendance were assessed repeatedly during early childhood. Children’s peer victimization and depressive symptoms were self-reported at eight and 10 years of age, respectively. We used weighted structural equation modeling and found that the association between mothers and children’s depression was partially mediated by peer victimization. Childcare attendance did not moderate the indirect effect of maternal depression on child depressive symptoms via peer victimization. However, we found that for children who attended childcare, maternal depression was no longer associated child depressive symptoms in late childhood. In conclusion, peer victimization experiences partly explain the intergenerational transmission of depressive symptoms, but this mechanism is not altered by children’s childcare attendance. Future research should examine potential socio-emotional and school readiness mechanisms that may break the cycle of depressive symptomatology from mothers to children.

Longitudinal effects of maternal depressive and anxious symptomatology on child hair cortisol and cortisone from pregnancy to 5-years: The EDEN mother-child cohort

Exposure to maternal depressive and anxious symptomatology in utero and after birth can affect child outcomes. One proposed mechanism is through changes in child stress hormone levels, however current studies present inconsistent findings, and further research is needed to better understand the impact of maternal mental health on child stress response. This study aims to add to the limited literature by analysing longitudinal data ranging from 24 weeks amenorrhea to 5 years postpartum among 281 mother-child pairs from the French EDEN mother-child birth cohort. Hair cortisol and cortisone data were collected from children at four time points: birth, 1, 3, and 5 years. Mothers reported depressive symptomatology via the Center for Epidemiologic Studies Depression Scale (CES‐D) (at 24-weeks amenorrhea, 3-, and 5-year follow-up), and the Edinburgh Postnatal Depression Scale (EPDS) (at 4, 8 and 12 months postpartum). Prenatal anxiety symptomatology was measured via the State Anxiety Inventory (STAI) at 24 weeks amenorrhea. Group-based trajectory modelling indicated a 1-cluster classification of longitudinal child hair cortisol, cortisone and cortisol-to-cortisone ratio, as analyses did not reveal a classification by subgroups representing different child profiles. After inverse probability weighting, small effects showed prenatal depressive symptomatology was significantly associated to higher levels of child hair cortisone at one year. Prenatal anxiety symptomatology was significantly linked to higher levels of child cortisol measured at birth and cortisone at birth and at 1 year. Postpartum depressive symptomatology at 8 months was related to higher levels of cortisone among 3-year-olds. These effects were not moderated by child sex or maternal socio-economic status. Further research is needed to understand why there are associations at some time points and not others to determine any potential buffering factors.

Maternal aggressive behavior in interactions with adolescent offspring: Proximal social-cognitive predictors in depressed and nondepressed mothers.

Maternal depressive symptoms are associated with elevations in harsh parenting behavior, including criticism, negative affect, and hostile or coercive behavior, and these behaviors contribute to associations between maternal depressive symptomatology and child functioning. We used multilevel survival analysis to examine social-cognitive processes as proximal predictors of the onset and offset of maternal aggressive behavior during interactions with their adolescent children. Low-income women (N = 180) were selected for either: (a) elevated depressive symptoms and a history of treatment for depression (depressed group) or (b) not more than mild levels of current depressive symptomatology, no history of depression treatment, and no current mental health treatment (nondepressed group). These women and their adolescent children (ages 11-14, M = 12.93; 96 male sex, as assigned at birth) participated in a dyadic problem-solving interaction and mothers completed a video-mediated recall procedure, in which they watched a segment of the interaction, labeled their adolescents' affect, and made attributions for their behavior. Mothers in the depressed group were more likely to initiate aggressive behavior and, once initiated, were less likely to transition out of it. Mothers in both groups were less likely to transition out of aggressive behavior when they made negative attributions for their adolescents' behavior. Findings point to promising cognitive and behavioral targets for intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Socioeconomic resources moderate the relationship between maternal prenatal obsessive-compulsive symptoms and infant negative affectivity

Perinatal maternal depression, anxiety, and stress are associated with poor infant outcomes. However, no known study has investigated the effects of perinatal maternal obsessive-compulsive symptomatology on infant outcomes while considering important situational factors such as socioeconomic resources. Therefore, we investigated the effects of prenatal and postnatal obsessive-compulsive symptomatology on infant behavioral reactivity, beyond the effects of postnatal depressive symptomatology, at 6 months of age. It was expected that socioeconomic resources would moderate this relationship. We recruited 125 pregnant women from a Health Professional Shortage Area for mental health and primary care in the Midwest United States and interviewed them at approximately 34 weeks gestation and again at 6 months postnatally. They were administered questionnaires at both time points measuring obsessive-compulsive and depressive symptoms. Infant behavioral reactivity was gathered during 6-month follow-up through behavioral observation coding and maternal-report modalities. Maternal-reported infant negative affectivity at 6 months was related to greater severity of maternal postnatal depressive symptomatology, and socioeconomic resources moderated the relationship between maternal prenatal obsessive-compulsive symptoms and maternal-reported infant negative affectivity. However, neither of these relations was statistically significant when infant reactivity was quantified using behavioral observations.

Maternal Adverse Childhood Experiences and Young Adult Latino Children's Mental Health

Maternal adverse childhood experiences have been linked to a variety of negative health outcomes in young children; however, young adults and, specifically, young adult Latinos have been vastly understudied. This study investigates the intergenerational pathway between maternal adverse childhood experiences and behavioral health outcomes of their young adult children, as mediated through young adults' own adverse childhood experiences and maternal depression. Structural equation modeling was used to analyze data (in 2023) from mothers and their young adult children (n=398 dyads) enrolled in the Center for the Health Assessment of Mothers and Children of Salinas cohort, a primarily Latino agricultural sample. Maternal and young adult adverse childhood experiences were self-reported retrospectively during a visit at the age of 18 years (2018-2020). Young adult- and maternal-reported internalizing and maternal-reported externalizing behaviors were assessed at the age of 18 years with the Behavior Assessment for Children, second edition. Maternal depression was assessed during a visit at the age of 9 years (2010-2012) using the Center for Epidemiologic Studies Depression Scale. Maternal and young adult adverse childhood experiences were weakly but statistically significantly correlated (r=0.22). Maternal adverse childhood experiences were statistically significantly associated with maternal-reported youth internalizing symptoms (β=0.29; 95% CI=0.19, 0.38; p<0.001) and externalizing symptoms (β=0.24; 95% CI=0.14, 0.33; p<0.001) and marginally associated with youth-reported internalizing symptoms (β=0.08; 95% CI= -0.02, 0.18; p=0.13). Youth adverse childhood experiences and maternal depressive symptomatology mediated the associations between maternal adverse childhood experiences and young adult outcomes. Findings demonstrate the potential impacts of adversity across generations in Latino immigrant families, an understudied population. Understanding the mechanisms and factors associated with these pathways may lead to strategies that prevent poor mental health outcomes in young adults.

Effect of Neonatal Abstinence Syndrome Treatment Status and Maternal Depressive Symptomatology on Maternal Reports of Infant Behaviors.

The objective of this study is to investigate the effects of maternal perinatal depression symptoms and infant treatment status for neonatal abstinence syndrome (NAS) on maternal perceptions of infant regulatory behavior at 6 weeks of age. Mothers and their infants (N = 106; 53 dyads) were recruited from a rural, White cohort in Northeast Maine. Mothers in medication-assisted treatment (methadone) and their infants (n = 35 dyads) were divided based on the infant's NAS pharmacological treatment (n = 20, NAS+ group; n = 15, NAS- group) and compared with a demographically similar, nonexposed comparison group (n = 18 dyads; COMP group). At 6 weeks postpartum, mothers reported their depression symptoms Beck Depression Inventory-2nd Edition) and infant regulatory behaviors [Mother and Baby Scales (MABS)]. Infant neurobehavior was assessed during the same visit using the Neonatal Network Neurobehavioral Scale (NNNS). Mothers in the NAS+ group showed significantly higher depression scores than the COMP group (p < .05) while the NAS- group did not. Across the sample, mothers with higher depression scores reported higher infant "unsettled-irregularity" MABS scores, regardless of group status. Agreement between maternal reports of infant regulatory behaviors and observer-assessed NNNS summary scares was poor in both the NAS+ and COMP groups. Postpartum women in opioid recovery with infants requiring pharmacological intervention for NAS are more at risk for depression which may adversely influence their perceptions of their infants' regulatory profiles. Unique, targeted attachment interventions may be needed for this population.

Maternal perinatal depression and child brain structure at 2-3 years in a South African birth cohort study

Maternal perinatal depression is associated with risk of adverse child developmental outcomes and differences in offspring brain structure. Evidence from low- and middle-income countries is lacking as is an investigation of antenatal, postnatal, and persistent depression in the same sample. In a South African birth cohort, we investigated the effect of antenatal and postpartum maternal depressive symptoms on offspring brain structure at 2–3 years of age. Magnetic resonance imaging was performed, extracting cortical thickness and surface areas in frontal cortex regions of interest and subcortical volumes using FreeSurfer software. Maternal depressive symptoms were measured using the Edinburgh Postpartum Depression Scale and the Beck Depression Inventory II antenatally and at 6–10 weeks, 6 months, 12 months, and 18 months postpartum and analyzed dichotomously and continuously. Linear regressions were used controlling for child age, sex, intracranial volume, maternal education, age, smoking, alcohol use and HIV. 146 children were included with 38 (37%) exposed to depressive symptoms antenatally and 44 (35%) exposed postnatally. Of these, 16 (13%) were exposed to both. Postpartum, but not antenatal, depressive symptoms were associated with smaller amygdala volumes in children (B = −74.73, p = 0.01). Persistent maternal depressive symptoms across pregnancy and postpartum were also independently associated with smaller amygdala volumes (B = −78.61, p = 0.047). Differences in amygdala volumes among children exposed to postnatal as well as persistent maternal depressive symptomatology underscore the importance of identifying women at-risk for depression during the entire perinatal period.

Maternal and infant touching behaviours during perturbed interactions: Associations with maternal depressive symptomatology and infant crying

Touch is an important means through which mothers and infants co-regulate during periods of stress or perturbation. The present study examined the synchrony of maternal and infant touching behaviours among 41 mother-infant dyads, some of whom were deemed at-risk due to maternal depressive symptomatology. Mothers and their 4-month-old infants participated in the Still-Face (maternal emotional unavailability; SF) and Separation (maternal physical unavailability; SP) procedures. Infant crying was examined across procedures and investigated as a brief period of perturbation. Results revealed that mothers and infants displayed a positive pattern of tactile synchrony (coordinated, analogous changes in touch) during infant crying episodes. However, dyads in the high depression group displayed significantly less affectionate touch during instances of infant crying. Furthermore, more depressive symptoms were associated with less maternal and infant touch and lower rates of infant crying. This group of dyads may be less expressive via touch, be less affected by disruptions in their interactions, have impaired regulatory abilities, or simply require minimal amounts of touch to mutually regulate following social stressors and during brief perturbation periods. These findings enrich our limited knowledge about the dynamic interplay of maternal and infant touch and inform preventative intervention programs for at-risk groups.

Traumatic Experiences in Childhood and Maternal Depressive Symptomatology: Their Impact on Parenting in Preschool.

The goal of this study is to describe and analyze the relationship between childhood trauma and depressive symptoms and its relation to the parental interactions of mothers (19-47 years) with their 3-4 year old preschool children. Parental interactions, traumatic experiences in mothers' childhood, and current depressive symptoms were measured using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO), the Childhood Trauma Questionnaire Short Form (CTQ), and the Beck Depression Inventory (BDI-I), respectively. A nonclinical sample of 81 Chilean mothers with their children was used. Results show that the presence of trauma in mothers' childhood has an impact on parenting; specifically, mothers with an emotional neglect experience showed greater difficulties in adequately promoting autonomy in their children.

Prevalence and risk factors of postpartum depression among women living in the United Arab Emirates

PurposePostpartum depression received almost no attention in the United Arab Emirates (UAE). The aim was to examine the prevalence of depressive symptomatology and the associated risk factors among women in the UAE.MethodsA prospective cohort study recruited women from postpartum wards in hospitals across four emirates in the UAE. Women completed questionnaires immediately after childbirth and at 3 and 6 months postpartum. Depressive symptomatology was measured using the Edinburgh Postnatal Depression Scale (EPDS > 12). Risk factors were identified using the generalized estimating equation. A stratified analysis of the postpartum period was performed.ResultsAmong the 457 women recruited, 35% exhibited depressive symptomatology within the first 6 months postpartum. Younger women (< 25 years), part-time employment, the receipt of financial support from the family, and difficulty in managing monthly income were associated with a higher risk of postpartum depression. Husband’s employment, husband’s support, and living in own house were associated with a lower risk of postpartum depression. Maternity leave of more than 3 months increased the risk of depression during the first 3 months postpartum. From 3 to 6 months postpartum, Muslim women had a higher risk of depression whereas women who breastfed other children and in the past 7 days, and perceived their infant as healthy had a lower risk of depression.ConclusionsThe prevalence of maternal depressive symptomatology is considerable in the UAE. Risk factors change over the 6-month postpartum period suggesting the need for an innovative multidisciplinary approach to the management of postpartum depression, including follow-up screening.

Role of parenting practices, mother’s personality and depressive symptoms in early child development

In this study we explore the possibility that maternal depressive symptomatology and personality would influence parenting practices which would in turn influence their offspring's socio-emotional and cognitive-motor development. We used a large representative sample of Uruguayan children and their mothers. The Big Five Inventory (BFI), subscales of the Home Observation for Measurement of Environment (HOME), Ages & Stages Questionnaires – third edition (n = 3596), Child Behavior Checklist (n = 3750), and a sociodemographic (SES) questionnaire were administered. We found that favorable scores in child development measures were correlated with maternal openness, extraversion, conscientiousness, agreeableness, low neuroticism, depressive symptomatology, positive parenting practices and high income households. We then elaborated pathway models that allowed us to account for covariance between relevant variables. We found that openness was indirectly associated with aspects of both socioemotional and cognitive motor development via parenting practices and maternal depressive symptomatology. The association between SES and both child development outcomes was fully explained by intermediary variables. Collectively, our results provide support for Belsky’s model of child development and can be used by professionals to better target interventions geared at infants and young children and their mothers.

Do preterm babies sleep differently than their peers? Sleep characteristics and their associations with maternal depression and parenting stress

ObjectivesThe findings regarding the association between prematurity, sleep problems, and maternal psychological well-being are mixed. This study examined preterm- and term-born infants’ sleep patterns, ecology, and problems, in addition to the associations of these patterns with maternal parenting stress and depressive symptomatology. MethodsIn total, 84 mothers of infants between 6 and 17 months of corrected age, in which 40 were preterm infants and 44 were healthy full-term infants, participated in the study. Children's sleep was evaluated by the Brief Infant Sleep Questionnaire. Maternal depressive symptoms were screened by the Edinburgh Postnatal Depression Scale. Maternal parenting stress was measured via the Parenting Stress Index-Short Form. ResultsIn preterm infants, lower total and nocturnal sleep duration and later falling asleep time were identified compared to term infants. Regarding sleep ecology, the percentages of poor sleepers, mother's perception of child's and her own sleep problems were similar in both groups. While the most common method of falling asleep was ‘rocking the baby’ in the preterm group, it was ‘breastfeeding’ in the term group. In both groups, the maternal perception of sleep problems positively predicted maternal parenting stress. Lastly, compared to good sleepers, higher maternal parenting stress, higher maternal perception of mother's and child's sleep problems, and lower infants' age were identified among poor sleepers. ConclusionsDespite many similarities in the sleep characteristics of preterm and term infants, several differences in sleep patterns and sleep ecology of preterm infants were identified. Since the maternal perception of sleep problems was found to predict parenting stress, guidance on infant sleep is suggested to support families.

Family dynamics. An exploration of parental sensitivity and depressive symptoms among mothers and fathers of toddlers.

In studies of maternal sensitivity, the influence of mothers’ depressive symptomatology has been consistently highlighted. Additionally, the relevance of both maternal and paternal sensitive responses to children’s development has been recognized. However, literature regarding the dynamics of the mother-father-toddler triad is scarce. This is particularly true when understanding how parental sensitivity may be bidirectionally shaped by both parents’ (i.e., mothers’ and fathers’ depressive symptomatology) and children’s characteristics (i.e., age). Hence, the present study aims to describe and analyse the associations between parental depression, paternal sensitivity and children’s socioemotional difficulties and age with mothers’ sensitive responses to highlight the appropriateness of considering fathers’ depressive symptoms and sensitivity to better understand the impact of maternal depressive symptomatology on mothers’ sensitivity. The participants included 80 Chilean mother-father-child triads in which all children were between 1 and 3 years of age and presented some degree of socioemotional difficulty. The results reveal no differences in maternal and paternal sensitivity or higher depressive symptomatology in mothers than in fathers. Additionally, while mothers’ depression was significantly associated with their sensitivity, this was not the case for fathers. Paternal depressive symptomatology was associated with the mother’s depression. Finally, paternal sensitivity emerged as a mediator between maternal depressive symptoms and sensitivity. This result calls attention to the use of paternal variables to understand how maternal depression impacts mothers’ sensitivity and to thus develop appropriate interventions that expand the scope of such impacts from the dyad to the triad.

Social inequalities in maternal depressive symptomatology after childbirth: Comparison across birth cohorts in Brazil

• Depressive symptomatology increased amongst southern women in the postpartum period;. • Depressive symptomatology amongst women residents in the north decreased over time;. • Black/brown women showed higher frequencies of depressive symptomatology;. • Poor mothers showed the highest frequencies of depressive symptomatology;. • Socioeconomic and skin colour inequalities remained stable over the studied period. Approximately 40% of women experience their first depressive episode during the postpartum period. In Brazil, several maternal health outcomes are affected by profound social inequalities. Investigating inequalities in maternal depressive symptomatology in two different regions of the country in the first 24 months after childbirth may help clarify these patterns and appropriate support services. Data from three birth cohorts from two Brazilian cities (Cruzeiro do Sul, North region, and Pelotas, South region) were analysed. The baseline of each cohort consisted of 4,231 (2004 Pelotas), 4,275 (2015 Pelotas), and 1,246 (MINA-Brazil) live births. Depressive symptomatology was repeatedly measured using the Edinburgh Postnatal Depression Scale (EPDS) at 3, 12, and 24 months postpartum. Socioeconomic status and skin colour inequalities in depressive symptomatology were analysed at each point. Between the 3rd and 24th months postpartum, maternal depressive symptomatology increased amongst women from the south, but decreased amongst women in the north. Black/brown women and those belonging to the lowest socioeconomic stratum showed the highest frequency of depressive symptomatology. Absolute and relative inequalities remained stable throughout the study period. Depressive symptomatology was most common amongst women with few years of schooling, multiparae, and amongst those who smoked during pregnancy. There was no information regarding any psychological/psychiatric treatment at the time the EPDS was evaluated, and economic status was assessed differently amongst the cohorts. Marked social inequalities were found in postpartum depressive symptoms. Actions aimed at early detection and reducing social inequalities in maternal postpartum depressive symptomatology are vital.

The impact of preschool child and maternal attention-deficit/hyperactivity disorder (ADHD) symptoms on mothers\u2019 perceived chronic stress and hair cortisol

Providing care for a child with attention-deficit/hyperactivity disorder (ADHD) is associated with parenting stress. Moreover, adults with elevated ADHD symptoms report increased perceived stress. Despite this, it has rarely been examined whether and how child and maternal ADHD symptoms may affect maternal perceived stress and the stress-sensitive hypothalamic–pituitary–adrenal axis. This study therefore investigated the possible impact of child and maternal ADHD symptoms on mothers' perceived chronic stress and hair cortisol concentration (HCC), while simultaneously considering the effects of child oppositional defiant/conduct disorder (ODD/CD) and maternal depressive symptomatology. In total, 124 mothers (35.96 ± 5.21 years) of preschool children were included. Maternal perceived stress, ADHD and depressive symptoms were assessed using self-report measures. Child ADHD symptoms were assessed using an interview and questionnaires completed by mothers and teachers. Additionally, mothers provided information about their children’s ODD/CD symptoms. Hair samples were taken from mothers to assess HCC. Child and maternal ADHD, child ODD/CD, and maternal depressive symptoms accounted for 50% of the variance in perceived chronic stress (F(4, 119) = 30.24; p < 0.01), with only maternal ADHD (β = 0.52, p < 0.01) and depressive symptoms (β = 0.49, p < 0.01) being uniquely significant. Maternal ADHD symptoms did not moderate the relationship between child ADHD symptoms and maternal perceived chronic stress (b = − 0.01; SE b = 0.17; t(5, 118) = − 0.05; p = 0.96). Mother’s age became the only significant predictor of maternal HCC (β = 0.29; p < 0.01). Based on these findings, practitioners are advised to be aware of and take into account possible maternal ADHD and depressive symptomatology and perceived chronic stress when treating children diagnosed with ADHD.

Patterns of family negativity in the perinatal period: Implications for mental health among Mexican-origin women.

Negativity in the family environment during the perinatal period is likely to have detrimental effects on maternal well-being, especially among low-income ethnic minority mothers who are at increased risk for experiencing postpartum depressive symptoms. With a sample of 322 Mexican and Mexican American families, this study used latent class growth analysis to identify meaningful subgroups of women based on their perceived family negativity reported prenatally and at 6, 12, 18, and 24 weeks postpartum. A 4-trajectory model of family negativity fit the data well: low-stable (58%), moderate-increasing (26%), high-decreasing (8%), and high-increasing (8%). Higher prenatal depressive symptomatology predicted membership in the moderate-increasing, high-decreasing, and high-increasing trajectories, relative to the low-stable trajectory. Findings suggest substantial heterogeneity in family negativity, identifying three significant growth patterns during the perinatal period with differential implications for maternal depressive symptomatology at 24 weeks and 12 months after delivery. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Relations of Maternal Depression and Parenting Self-Efficacy to the Self-Regulation of Infants in Low-Income Homes.

There is increasing recognition that young children's self-regulation provides a foundation for overall wellness later in life. Yet, infants reared in poverty may exhibit less-developed self-regulation compared to their more advantaged peers. Factors associated with poverty that may influence early self-regulation include maternal depression and parenting self-efficacy. However, few researchers have examined how both parenting self-efficacy and maternal depression may affect young children's self-regulation. The purpose of this study was to investigate the associations among maternal depression, parenting self-efficacy, and infant self-regulation for a racially diverse sample of 142 mother-infant dyads living in low-income households in the United States. Maternal depressive symptomatology was determined with the Edinburgh Postnatal Depressive Scale. Parenting self-efficacy was determined with a self-report measure, reflecting caregivers' mindset or feelings reflecting competency as a parent of an infant. Infant self-regulation was measured by parental report of the Infant Behavior Questionnaire Short Form Effortful Control subscale. While maternal depressive symptomatology and self-efficacy were directly and significantly correlated with infant self-regulation, results of a mediation model suggested that parenting self-efficacy mediated the relationship between maternal depressive symptomatology and infant self-regulation. Lower maternal depressive symptomatology predicted better parenting self-efficacy, in turn predicting better infant self-regulation. This study increases our understanding of how early factors shape the self-regulation of infants reared in low-income homes - highlighting the potential role of targeting parenting self-efficacy for parenting interventions for mothers experiencing depressive symptoms.

The syndemic effects of food insecurity, water insecurity, and HIV on depressive symptomatology among Kenyan women

Depression is a leading cause of disability worldwide and a major contributor to the overall global burden of disease, especially for women of childbearing age. Social science scholarship has demonstrated significant relationships between mental health, food insecurity (FI), water insecurity (WI), and HIV. Little is known, however, about the temporal relationships between food and water insecurity or the mechanisms through which these multiple stressors may operate or interact to impact depression. We therefore used syndemic theory to explore the complex relationships between FI, WI, and HIV on depressive symptomatology among Kenyan women of mixed HIV status (n=183, NCT02979418). We sought to 1) understand the temporal relationships between time-variant risk factors for depression, i.e. FI and WI, and 2) assess how these factors potentially interacted with HIV to impact depressive symptomatology. We first assessed the bidirectional relationship between WI and FI using a cross-lagged three-wave, two-variable panel model. Next, we modeled depressive symptomatology at 21 months as a linear function of the potentially syndemic interaction between FI, WI, and HIV status, adjusting for household wealth. WI had a predominant predictive effect on FI (Bayesian posterior predictive p-value=0.13); there was no reverse causality for the influence of FI on WI. The interaction effect of FI, WI, and HIV was significantly associated with greater depressive symptomatology (β=0.06) at 21 months postpartum. These data suggest that water insecurity may be an important determinant of food insecurity. Further, the co-occurrence of FI, WI, and HIV increases the likelihood of maternal depressive symptomatology, i.e. there is a syndemic relationship. These findings suggest that the role of household WI in other adverse health outcomes beyond mental well-being should be examined, and that interventions to improve mental health will be more effective if they also consider concurrent resource insecurities, regardless of HIV status.

Can a traumatic childbirth experience affect maternal psychopathology and postnatal attachment bond?

The aim of the present study was to explore the relationship between the experience of childbirth as a traumatic event and the quality of postnatal attachment to child, analyzing the role of depressive symptomatology on this relationship. A sample of 103 women, aged from 26 to 46 years (M = 35.05, SD = 4.51) filled in questionnaires to assess postpartum stress symptoms related to the childbirth experience, postnatal attachment toward their newborns, and level of depressive symptomatology. A mediation analysis was carried out. The level of postpartum stress symptoms positively affects maternal depressive symptomatology and negatively affects the quality of postnatal attachment. Moreover, the relationship between a traumatic childbirth experience and postnatal attachment is both direct and indirect. In fact, a traumatic childbirth experience also affects the level of postnatal depression that, in turn, negatively affects the quality of postnatal attachment bond. The presence of postpartum distress symptoms affects the well-being of mothers, and these conditions interfere with the ability of women to develop good attachment bonds with their children. These results showed the relevance of paying attention to pregnant women, to help them to live childbirth in a positive and non-stressful way.

The Mediating Role of Parenting Stress in the Relationship Between Anxious and Depressive Symptomatology, Mothers’ Perception of Infant Temperament, and Mindful Parenting During the Postpartum Period

To investigate whether mindful parenting differs according to maternal anxious and/or depressive symptomatology and mothers’ perception of infant temperament and to explore the potential mediating role of parenting stress in the relationship between anxious and depressive symptomatology, perception of infant temperament, and mindful parenting. The sample comprised 560 mothers (18–46 years) with a child 12 months old or younger, who completed the Hospital Anxiety and Depression Scale, the Parental Stress Scale and the Interpersonal Mindfulness in Parenting Scale—Infant version. Approximately 22.1% of the mothers presented clinically significant anxious and depressive symptomatology levels. Those mothers had significantly higher levels of parenting stress and lower levels of mindful parenting than mothers with normal levels of anxious and depressive symptomatology. Mothers who perceived their infant temperament as difficult had significantly higher levels of parenting stress and lower levels of mindful parenting than those who perceived their infant temperament as easier. A path model was tested through structural equation modeling. Parenting stress mediated the relationship between anxious and depressive symptomatology and mothers’ perception of infant temperament and mindful parenting. Parenting stress seems to be an important mechanism explaining the associations between maternal anxious and depressive symptomatology, the perception of infant temperament, and mindful parenting. During the postpartum period, it is important to identify mothers with anxious/depressive symptomatology, as they appear to contribute to parenting stress and to be related to parenting skills. Psychological interventions may focus on reducing that symptomatology and parenting stress and promoting mindful parenting skills.