Separation Anxiety Symptoms Research Articles

Anxiety, Depression, and Body Weight in Children and Adolescents With Migraine.

Background: There is a lack of studies that explore the possible association between body weight, psychological symptoms, and migraine severity in pediatric populations. The purpose of the study was to explore: (1) the association between body weight and the frequency of migraine attacks, (2) the possible differences in anxiety and depression symptoms according to the frequency of attacks and body weight, and (3) the possible mediating role of anxiety and/or depression in the association between body weight and frequency of migraine attacks in children.Methods: One hundred and eleven children/adolescents with migraine were included (47 boys and 64 girls; mean age 11.7; ±2.4 years). The patients were classified as: (1) high frequency patients, reporting from weekly to daily episodes and (2) low frequency patients, with ≤3 episodes per month. According to their body mass index percentiles, the patients were divided in “Normal weight” (from ≥5 to <85 percentile), “Overweight” (from ≥85 to <95 percentile), and “Obese” (≥95 percentile). Given the low number of obese patients, the overweight and obese groups were considered together in the “Overweight” group. Anxiety and depression symptoms were assessed by the Self-Administered Psychiatric Scales for Children and Adolescents (SAFA).Results: Fifty-four patients were normal in weight (49.6%), while 56 patients (50.4%) were overweight. The overweight patients showed a higher frequency of migraine attacks (64.7%; p < 0.05). Patients with a high frequency of attacks reported higher scores in all SAFA-Anxiety subscales (SAFA-A Tot: F = 15.107; p = 0.000). Overweight patients showed a significantly higher score in the “Separation anxiety” subscale (F = 7.855; p = 0.006). We found a mediating role between the overweight and high frequency for total anxiety (z = 2.11 ± 0.03; p < 0.05) and social anxiety (z = 2.04 ± 0.03; p < 0.05).Conclusions: Our results suggest that, among the children suffering from migraine, the overweight status is associated with a higher frequency of attacks and separation anxiety symptoms. In particular, our study provides the first evidence of the role of anxiety in linking overweight and the frequency of migraine attacks in children and adolescents.

Parental Occupational Exposure is Associated With Their Children's Psychopathology: A Study of Families of Israeli First Responders.

To examine the association between parental occupational exposure to traumatic events and their children's mental health in families of First Responders (FRs), a neglected area of research. In 208 families of Israeli FRs, children's symptoms and comorbidity patterns of seven psychiatric disorders were regressed on parental work-related variables, controlling for relevant covariates. Having a father working as a FR and higher paternal exposure were associated with a greater number of separation anxiety and posttraumatic stress symptoms, respectively. Maternal exposure was associated with a greater number of symptoms of generalized anxiety, panic disorder, depression, and oppositional defiant disorder, and with increased odds of comorbid internalizing symptomatology. Additional research on children of FRs is encouraged. An adaption to this understudied population of family-centered interventions available for military families could inform targeted prevention efforts.

Restrictive eating disorders in children and adolescents: a comparison between clinical and psychopathological profiles.

DSM-5 describe three forms of restrictive and selective eating: Anorexia Nervosa-Restrictive (AN-R), Anorexia Nervosa-Atypical (AN-A), and Avoidant/Restrictive Food Intake Disorder (ARFID). While AN is widely studied, the psychopathological differences among these three diseases are not clear. The aim of this study was to (i) compare the clinical features of AN-R, AN-A, and ARFID, in a clinical sample recruited from a specialized EDs program within a tertiary care children's Hospital; (ii) identifying three specific symptom profiles, to better understand if restrictive ED share a common psychopathological basis. Data were collected retrospectively. Psychometric assessment included: the Children's Depression Inventory (CDI), the Multidimensional Anxiety Scale for Children (MASC), the Child Behavior Checklist (CBCL), and the Eating Disorder Inventory-3 (EDI-3). A final sample of 346 children and adolescent patients were analyzed: AN-R was the most frequent subtype (55.8%), followed by ARFID (27.2%) and AN-A (17%). Patients with ARFID presented different features from AN-R and AN-A, characterized by lower weight and medical impairment, younger age at onset, and a frequent association with separation anxiety and ADHD symptoms. EDI-3 profiles showed specific different impairment for both AN groups compared to ARFID. However, no differences was detected for items: 'Interpersonal Insecurity', "Interoceptive Deficits", "Emotional Dysregulation", and "Maturity Fears". Different ED profiles was found for the three groups, but they share the same general psychopathological vulnerability, which could be at the core of EDs in adolescence. III. Evidence obtained from case-control analytic studies.

Infant sleep and child mental health: a longitudinal investigation

ObjectiveTo determine whether infants with severe persistent sleep problems are at increased risk of (1) meeting diagnostic criteria for a psychiatric disorder (age 10 years), and (2) having elevated symptoms...

Anxiety Symptoms Differ in Youth With and Without Tic Disorders.

We compared anxiety symptoms in youth with and without tic disorders by comparing scores on the Multidimensional Anxiety Scale for Children (MASC) in youth with tic disorders to those in a concurrent community control group and in a group of treatment-seeking anxious youth from the Child/Adolescent Anxiety Multimodal Study (CAMS). Data from 176 youth with tic disorders, 93 control subjects, and 488 CAMS participants were included. Compared to youth with tic disorders, controls had lower total MASC scores (p < 0.0001) and CAMS participants had similar total MASC scores (p = 0.13). Separation Anxiety (p = 0.0003) and Physical Symptom (p < 0.0001) subscale scores were higher in youth with tic disorders than in CAMS participants. We conclude that the anxiety symptom profile differs in youth with and without tic disorders, which may have important implications for targeting treatment of anxiety in youth with tic disorders.

Psychometric analysis of the adult separation anxiety symptom questionnaire: Item functioning and invariance across gender and time.

The Adult Separation Anxiety Symptom Questionnaire (ASA-27) is the most widely used self-report assessment of adult separation anxiety (ASA). Despite its widespread use, relatively little is known about its psychometric properties, specifically whether it is unidimensional, its degree of precision (or information) across latent levels of ASA, the functioning of individual items in general and of DSM-derived versus non-DSM-derived items in particular, and whether the measure is invariant across gender and time. We addressed these issues in a sample of 509 adult women and 407 adult men from the local community participating in a longitudinal study of temperament and psychopathology in children. Two items from the ASA-27 were removed so that the measure met the item response theory (IRT) assumption of unidimensionality. Findings from a graded response model for categorical items suggested that the ASA-27 assesses ASA most reliably at moderate to high levels and that the DSM-derived items were more closely related to latent ASA than the non-DSM-derived items. Invariance tests employing single-factor confirmatory factor analysis models suggested that the measure is partially invariant across gender and time at the unique factor level, with fewer than 7% of parameters freed in both cases; this implies that the means and variances of the latent factors and differences in the observed responses are attributable to true differences in ASA. Future work should replicate these findings in a sample that includes individuals with a wider range of ASA severity and may consider removing additional items that provide little or redundant information. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Associations between Pretend Play, Psychological Functioning and Coping Strategies in Pediatric Chronic Diseases: A Cross-Illness Study.

Children with chronic illnesses are called to undertake complicated processes of adjustment and re-organization in their daily lives; as a result, they could experience several internalizing problems. Symbolic play could be a useful way to cope with these difficulties. The main aim of this paper is to assess pretend play, coping, and psychological symptoms in three groups of school-aged children with pediatric chronic diseases. The study involved 44 Italian school-aged, chronically ill children: 16 with type 1 diabetes mellitus (T1DM), 12 with cystic fibrosis (CF), and 15 with Leukemia. All patients were assessed by the Affect in Play Scale–Brief version (APS-Br), and the Children’s Coping Strategies Checklist–Revision1 (CCSC-R1). Children with T1DM and CF also completed the Separation Anxiety Symptom Inventory for Children (SASI-C) and the Strengths and Difficulties Questionnaire (SDQ)–children’s version. Cohen’s d (effect size) was applied between clinical and normative samples, and it showed a more organized play (APS-BR), but a more negative affect tone, comfort, and frequency of affect expression. Comparing APS-BR and CCSC-R1 rates between the three groups, significant differences were found for all the APS-BR dimensions, except for tone, and for CCSC-R1 seeking understanding. Comparing SASI-C score between T1DM and CF, higher scores were found for children with CF. In the end, correlations between all dimensions highlighted several relationships between play, coping, and adjustment problems for children with T1DM, and relationship between affect play and all variables for children with CF. Symbolic play helps chronically ill children to express emotions; helping them, as well as clinicians, to understand the difficulties caused by chronic conditions, and to cope with them.

Persistent Complex Bereavement Disorder Symptoms Predict Grief Interview Emotions.

This study examined persistent complex bereavement disorder (PCBD) symptoms' ability to predict emotional reactions of 69 bereaved adults who participated in grief interviews. The results supported the predictive validity of PCBD symptoms for both self-report and behavioral observation measures of sadness but with only one behavioral measure of happiness. Furthermore, PCBD symptoms uniquely predicted sadness in all but one measure of that emotion while accounting for symptoms of depression, posttraumatic stress, and separation anxiety. Because interviews are the primary method of psychological evaluation for clinicians, these findings collectively support the validity of the PCBD construct.

Variation in Social Anxiety and Separation Anxiety over Age in ASD and Non-ASD Young Males: Issues for Clinical Assessment and Treatment-Planning

ABSTRACT To further understand how young males with Autism Spectrum Disorder (ASD) experience anxiety, two specific forms of anxiety were examined in samples of boys with ASD and their non-ASD (NASD) peers. Self-reports on the Child and Adolescent Symptom Inventory (4th rev.) were collected from 117 ASD boys and 50 NASD boys, aged from 6 yr to 17 yr who were matched for IQ and age. Data regarding their Social Anxiety and Separation Anxiety were examined and indicated that the ASD boys had significantly elevated levels of both forms of anxiety compared to their NASD peers. When examined at two-yearly age intervals, the ASD boys continued to exhibit high levels of Social Anxiety over age but the NASD boys showed a gradual decrease in this form of anxiety with age. Although Separation Anxiety showed a gradual decrease with age in the ASD group, that result was different for four of the Separation Anxiety symptoms, thus identifying aspects of Separation Anxiety that may remain elevated despite decreases in some other aspects with age. These results have implications for assessment of anxiety in boys with ASD and for the development of treatment plans aimed at assisting them to function effectively.

Separation Anxiety Symptom Profiles and Parental Accommodation Across Pediatric Anxiety Disorders.

Parental accommodation refers to ways in which caregivers modify their behavior to decrease child distress in the short-term. Accommodation is prevalent among anxious youth and related to decreased treatment and functional outcomes. Although separation anxiety disorder (SAD) is associated with increased accommodation, SAD is not a predictor of treatment response, suggesting that a diagnosis of SAD alone may not be enough to clarify the relationship between accommodation and separation anxiety symptoms within a clinical context. Participants were youth with a primary anxiety disorder (N = 186; aged 7-17) enrolled in an outpatient anxiety clinic. Latent class analysis was used to extract profiles from parent-reported SAD symptoms using the Anxiety Disorders Interview Schedule for DSM-IV/5. Profiles were compared on pre-treatment accommodation. Low, moderate, and interfering SAD classes emerged. Interfering SAD was associated with high accommodation. Results help to clarify the association between SAD and accommodation and has implications for personalized intervention.

Prevalence of anxiety separation disorder in adult outpatients with non-psychotic mental disorders

To investigate the prevalence and symptoms of separation anxiety (SA) and separation anxiety disorder (SAD) in adult outpatients with non-psychotic mental disorders. Five hundred and fifty-seven outpatients over 18 years of age with nonpsychotic mental disorders were examined. Clinical, psychopathological, psychometric (the Adult Separation Anxiety Questionnaire (ASA-27), the Structured Clinical Interview for Anxiety Symptoms (SCI-SAS), the Mini-International Neuropsychiatric Interview (MINI), the Quality of Life Enjoyment and Satisfaction Questionnaire (QLES-Q) methods were used. SAD and SA accompany a wide range of nonpsychotic mental disorders, predominantly anxious and affective, and are highly prevalent among outpatients (24.8% and 5.4%, respectively). Patients with SAD are characterized by a high level of SA; the symptoms specific to SAD predominate in the structure of the disorder. It has been shown that during the manifestation of the disorder in childhood, the range of attachment objects widens with age, and the quality of life in such patients is lower.

How does a CBT-based transdiagnostic program for separation anxiety symptoms work in children? Effects of Super Skills for Life

Super Skills for Life (SSL) is a transdiagnostic program of Anglo-Saxon origin based on cognitive behavioural therapy, aimed at treating emotional problems in children. It has been translated and implemented in the Spanish population, achieving significant reductions in anxious and depressive symptoms. The objective of the current study was to examine the short- and long-term efficacy of SSL in schoolchildren with separation anxiety. The program was attended by 86 Spanish-speaking children aged 8-12 years, who were evaluated before receiving the intervention, immediately after and 12 months later. Results indicated statistically significant improvements both in the main problem, separation anxiety and other comorbid symptoms or problems (depression, behaviour problems, problems with peers, interference of anxiety in daily life, etc.). Overall, the results show that the program was more effective in the long-term than in the short-term. The findings of the study suggest that SSL can be useful for treating emotional problems in children with separation anxiety. Clinical implications of these findings are discussed.

Brief, Intensive Treatment for Separation Anxiety in an 8-Year-Old Boy: A Case Study

Cognitive behavioral therapy (CBT) is the evidence-based treatment modality for children with anxiety disorders; yet, many youth do not receive treatment. To overcome barriers associated with standardized CBT approaches, brief, intensive treatments have been proposed. This case study illustrates a brief, intensive CBT intervention for a preadolescent male client who presented with severe separation anxiety. The intervention consisted of five sessions (one each day for five consecutive days) and a follow-up assessment 4 months later to evaluate treatment outcomes. The intervention strategies were based in CBTs and included exposures, cognitive reappraisal work with both the client and the parents, and reduction of parental accommodation. Reliable Change Indices were calculated to evaluate change from preintervention to the follow-up assessment. There were large and statistically significant decreases in the main outcome measure of separation anxiety symptoms, indicating significant improvements in separation symptoms over treatment per the client’s and parents’ reports. At the follow-up session, the client no longer met diagnostic criteria for separation anxiety disorder. The results highlight the utility of brief, intensive interventions for separation anxiety in young children.

Working memory moderates the association between early institutional care and separation anxiety symptoms in late childhood and adolescence.

Adverse caregiving, for example, previous institutionalization (PI), is often associated with emotion dysregulation that increases anxiety risk. However, the concept of developmental multifinality predicts heterogeneity in anxiety outcomes. Despite this well-known heterogeneity, more work is needed to identify sources of this heterogeneity and how these sources interact with environmental risk to influence mental health. Here, working memory (WM) was examined during late childhood/adolescence as an intra-individual factor to mitigate the risk for separation anxiety, which is particularly susceptible to caregiving adversities. A modified "object-in-place" task was administered to 110 youths (10-17 years old), with or without a history of PI. The PI youths had elevated separation anxiety scores, which were anticorrelated with morning cortisol levels, yet there were no group differences in WM. PI youths showed significant heterogeneity in separation anxiety symptoms and morning cortisol levels, and WM moderated the link between caregiving and separation anxiety and mediated the association between separation anxiety and morning cortisol in PI youth. Findings suggest that (a) institutional care exerts divergent developmental consequences on separation anxiety versus WM, (b) WM interacts with adversity-related emotion dysregulation, and (c) WM may be a therapeutic target for separation anxiety following early caregiving adversity.

Anais Nin: An Incest Between a Father and a Daughter

In 1933, Anais Nin thirty years old, meets again with her beloved father, the pianist and composer Joachin Nin. She did not see him since the age of eleven when he left his family for a mistress. She then started to write a diary. I want to show that you can make links and interpret the material and associations of her diary like the material of a psychoanalysis or a psychotherapy. When they meet again, he behaves like an incestual father telling her his love affairs and his sexual life with her mother. Then he relates to her an incestuous dream with her and acts like a lover until the consummate incest. She seems to consent but feels guilty, between fear and desire, and disgust. She will complain of intense heart beats, death anxiety and loss of joy. Through her Journal of Incest (1932-1934) and her Youth Journal (1914-1919), I will try to understand how such an incest can happen. The father is an incestuous father who has no taboo of the incest, does not recognize the difference between generations, does not respect the body intimacy of his daughter and treat her like a narcissistic object. He fluctuates between psychosis without symptoms and narcissistic perversion. Anais has a hysterical personality, with separation anxiety, psychosomatic and pervert symptoms. This patchwork evokes a borderline state. She acts sometimes like a narcissistic pervert.

A Population-Based Twin Study of Childhood Irritability and Internalizing Syndromes

Childhood irritability exhibits significant theoretical and empirical associations with depression and anxiety syndromes. The current study used the twin design to parse genetic and environmental contributions to these relationships. Children ages 9–14 from 374 twin pairs were assessed for irritability and symptoms of depression, generalized anxiety, panic, social phobia, and separation anxiety using dimensional self-report instruments. Multivariate structural equation modeling decomposed the correlations between these syndromes into genetic and environmental components to examine shared and specific risk domains. Irritability had significant associations with each internalizing symptom domain. Genetic contributions to irritability are moderately correlated with genetic risk for symptoms of depression, generalized anxiety, and separation anxiety with weaker overlap with the other anxiety syndromes. Familial and specific environmental risk factors explained covariation among syndromes and indicated potential syndrome-specific risk. There is substantial overlap among the genetic and environmental factors that influence individual differences in irritability and those that increase liability for depression and anxiety symptoms in children. These findings deepen the current understanding of childhood internalizing risk factors and provide important implications for syndrome prediction and susceptibility gene discovery efforts.

Algılanan Stres ve Üniversite Yaşamına Uyum İlişkisinde Bir Aracı Değişken: Ayrılık Anksiyetesi

This study aimed to investigate the mediator role of separation anxiety symptoms on the relationship between perceived stress and adaptation to university life of students. 269 freshmen participated in the study (86 men, 183 women). Participants completed the University Life Scale, Separation Anxiety Symptoms Inventory and Perceived Stress Scale. Results indicated that there was a positive relation between perceived stress and separation anxiety. Both perceived stress and separation anxiety showed negative relation with adaptation to university life. There was no significant difference between genders for the level of adaptation to university life, adaptation to university environment, emotional adaptation, personal adaptation, adaptation to relationships with opposite sex, academic adaptation and social adaptation. Levels of adaptation to relationships with opposite sex showed differences according to having a romantic relationship or not; however, adaptation to university life, adaptation to university environment, emotional adaptation, personal adaptation, academic adaptation and social adaptation did not. Besides, there were no differences between the levels of adaptation to university life, adaptation to university environment, emotional adaptation, personal adaptation, adaptation to relationships with opposite sex, academic adaptation and social adaptation depending on the place the participant spent most of his/her life. Finally, separation anxiety symptoms had a partial mediation effect on the relationships between perceived stress and adaptation subscales (adaptation to university life, academic adaptation, emotional adaptation and adaptation to relationships with opposite sex).

The Relationship Between Motor Skills, Psychosocial Adjustment and Peer Victimization in School-Aged Children

The aim of this study was to investigate the relationships between childrens’ motor competence, psychosocial adjustment, peer victimization, physical activity participation and obesity. Using the Elaborated Environmental Stress Hypothesis as the framework, we hypothesized that multiple stressors influence children with poor motor competence and that the pathway from motor competence to psychosocial maladjustment is more complex than initially thought. A sample of child-parent dyads (n = 51; children ages 7 to 10 years), were recruited from two educational institutions in Sudbury, Ontario. Child participants completed self-report measures on peer victimization, depression symptoms, loneliness and anxiety symptoms across five dimensions (social phobia, obsessive-compulsive disorder, separation anxiety, panic disorder and generalized anxiety). Child participants also completed the Test of Gross Motor Development-3. Parent participants completed a sociodemographic questionnaire and a questionnaire on their child’s levels of participation in physical activity. For boys, Pearson product-moment correlations revealed that lower motor competence was significantly related to depressive symptoms, social phobia, separation anxiety symptoms, loneliness and peer victimization. For girls, lower motor competence was significantly related to separation anxiety symptoms and loneliness. No correlations were found between motor competence, weight status and physical activity participation. Findings are consistent with previous literature. These findings suggest that (1) boys are more psychosocially affected and victimized than girls when measured against motor competence and, (2) children are experiencing these issues as early as age 7, which is a time when children are starting to build social relationships. More research is required strengthen these findings.

Acceptability and caregiver-reported outcomes for young children with autism spectrum disorder whose parents attended a preventative population-based intervention for anxiety: A pilot study.

This pilot study explored acceptability to parents and outcomes for children of a preventive intervention for anxiety problems in pre-schoolers with autism spectrum disorder (ASD) who were an identified sub-group within a population-based randomised trial of the Cool Little Kids parenting group programme. The population trial included 545 temperamentally inhibited pre-schoolers recruited across eight economically diverse areas of Melbourne, Australia. Within this sample, 26 parents reported that their child had received an ASD diagnosis. Trial measures included baseline inhibited temperament and developmental problems, post-intervention feedback on the programme, and caregiver-reported child mental health outcomes (anxiety diagnoses and internalising symptoms) at 1- and 2-year follow-up. Sample retention for the children with ASD over 2 years was strong (92%). At follow-up, fewer intervention than control children with ASD had anxiety disorders after 1 year (% (n): 25 (3) vs. 77 (10), P = .028) and separation anxiety symptoms after 2 years (M (SD): 4.22 (2.68) vs. 9.38 (5.91), P = .017). Similar effects favouring the intervention group were apparent across other child emotional outcome measures but without statistical significance in this small sample. Parents of the children with ASD reported that Cool Little Kids was "quite useful" in relation to their child's anxiety but also gave feedback that they would appreciate some tailoring of programme content to the context of ASD. These pilot findings suggest Cool Little Kids may be helpful for reducing comorbid anxiety in pre-schoolers with ASD. Further research is warranted to develop an ASD-specific adaptation which can be trialled with a larger sample of children with confirmed ASD diagnosis. Trial registration ISRCTN30996662 http://www.isrctn.com/ISRCTN30996662. Autism Res 2018, 11: 1166-1174. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Many children with autism spectrum disorder (ASD) also have anxiety. This pilot study explored acceptability to parents and outcomes for pre-schoolers with ASD of a parenting group programme to prevent anxiety problems. Among the sample of 26 pre-schoolers with ASD, we found reduced anxiety disorders and separation symptoms when their parents had received the intervention, as reported by caregivers in checklists and clinical interviews. Parents gave feedback that the programme was useful but suggested content be adapted to the context of ASD.

Trajectories of maternal depressive symptoms during pregnancy and the first 12 months postpartum and child externalizing and internalizing behavior at three years.

BackgroundMost evidence of the association between maternal depression and children’s development is limited by being cross-sectional. To date, few studies have modelled trajectories of maternal depressive symptoms from pregnancy through the early postpartum years and examined their association with social emotional and behavior functioning in preschool children. The objectives of this study were to: 1) identify distinct groups of women defined by their trajectories of depressive symptoms across four time points from mid-pregnancy to one year postpartum; and 2) examine the associations between these trajectories and child internalizing and externalizing behaviors.MethodsWe analyzed data from the All Our Families (AOF) study, a large, population based pregnancy cohort of mother-child dyads in Alberta, Canada. The AOF study is an ongoing pregnancy cohort study designed to investigate relationships between the prenatal and early life period and outcomes for children and mothers. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Children’s behavioral functioning at age 3 was assessed using the Behavior Scales developed for the Canadian National Longitudinal Survey of Children and Youth. Longitudinal latent class analysis was conducted to identify trajectories of women’s depressive symptoms across four time points from pregnancy to 1 year postpartum. We used multivariable logistic regression to assess the relationship between trajectories of maternal depressive symptoms and children’s behavior, while adjusting for other significant maternal, child and psychosocial factors.Results1983 participants met eligibility criteria. We identified four distinct trajectories of maternal depressive symptoms: low level (64.7%); early postpartum (10.9%); subclinical (18.8%); and persistent high (5.6%). In multivariable models, the proportion of children with elevated behavior symptoms was highest for children whose mothers had persistent high depressive symptoms, followed by mothers with moderate symptoms (early postpartum and subclinical trajectories) and lowest for minimal symptoms. After accounting for demographic, child and psychosocial factors, the relationships between depression trajectories and child hyperactivity/inattention, physical aggression (subclinical trajectory only) and separation anxiety symptoms remained significant.ConclusionThese findings suggest both externalizing and internalizing children’s behaviors are associated with prolonged maternal depressive symptoms. There is a good case for the need to move beyond overly simplistic clinical cutoff approaches of depressed/not depressed in screening for perinatal depression. Women with elevated depressive symptoms at clinical and subclinical levels need to be identified, provided with evidence-based treatment, and monitored with repeat screening to improve maternal mental health outcomes and reduce the risk of associated negative outcomes on children’s early social-emotional and behavior development.