A large body of literature documents the adverse effects of maternal depression on the functioning and development of offspring. Although investigators have identified factors associated with risk for abnormal development and psychopathology in the children, little attention has been paid to the mechanisms explaining the transmission of risk from the mothers to the children. Moreover, no existing model both guides understanding of the various processes' interrelatedness and considers the role of development in explicating the manifestation of risk in the children. This article proposes a developmentally sensitive, integrative model for understanding children's risk in relation to maternal depression. Four mechanisms through which risk might be transmitted are evaluated: (a) heritability of depression; (b) innate dysfunctional neuroregulatory mechanisms; (c) exposure to negative maternal cognitions, behaviors, and affect; and (d) the stressful context of the children's lives. Three factors that might moderate this risk are considered: (a) the father's health and involvement with the child, (b) the course and timing of the mother's depression, and (c) characteristics of the child. Relevant issues are discussed, and promising directions for future research are suggested.

Risk for psychopathology in the children of depressed mothers: a developmental model for understanding mechanisms of transmission.

Although the association between maternal depression and adverse child outcomes is well established, the strength of the association, the breadth or specificity of the outcomes, and the role of moderators are not known This information is essential to inform not only models of risk but also the design of preventive interventions by helping to identify subgroups at greater risk than others and to elucidate potential mechanisms as targets of interventions A meta-analysis of 193 studies was conducted to examine the strength of the association between mothers’ depression and children’s behavioral problems or emotional functioning Maternal depression was significantly related to higher levels of internalizing, externalizing, and general psychopathology and negative affect/behavior and to lower levels of positive affect/behavior, with all associations small in magnitude These associations were significantly moderated by theoretically and methodologically relevant variables, with patterns of moderation found to vary somewhat with each child outcome Results are interpreted in terms of implications for theoretical models that move beyond main effects models in order to more accurately identify which children of depressed mothers are more or less at risk for specific outcomes

/pdf/maternal-depression-and-child-psychopathology-a-meta-2mbyrrledi.pdf

Maternal Depression and Child Psychopathology: A Meta-Analytic Review

Potential roles of parental self-efficacy in parent and child adjustment: a review.

Self-Efficacy and Parenting Quality: Findings and Future Applications

Background: The differential effectiveness of parent training has led researchers to examine a variety of child, parent, and familial variables that may predict treatment response. Studies have identified a diverse set of child, parent psychological/behavioral and demographic variables that are associated with treatment outcome and dropout.

Method:  The parent training literature was examined to isolate child, parent, and family variables that predict response to parent training for child externalizing behavior problems. A literature review was conducted spanning articles published from 1980 to 2004 of indicated prevention (children with symptoms) and treatment (children with diagnosis) studies. Meta-analyses were conducted to determine standardized effect sizes associated with the identified predictors.

Results:  Many of the predictors of treatment response examined in this meta-analysis resulted in moderate standardized effect sizes when study results were subjected to meta-analytic procedures (i.e., low education/occupation, more severe child behavior problems pretreatment, maternal psychopathology). Only low family income resulted in a large standardized effect size. Predictors of drop-out resulted in standardized effect sizes in the small or insubstantial range.

Conclusions:  Response to parent training is often influenced by variables not directly involving the child, with socioeconomic status and maternal mental health being particularly salient factors.

Predictors of parent training efficacy for child externalizing behavior problems--a meta-analytic review.

The purpose of this study was to test a model of maternal self-efficacy during toddlerhood using a longitudinal sequential design. Participants were 126 mothers of 1-year olds (Cohort 1) and 126 mothers of 2-year olds (Cohort 2) who completed questionnaires measuring maternal self-efficacy, depression, and perceived difficult toddler temperament three times over 1 year. Data were analyzed using structural equation modeling and maximum likelihood estimation. Findings support a model whereby (a) the more depressed the mother feels, the more likely she is to rate her toddler's temperament as difficult, (b) the more difficult the child's temperament is perceived to be, the lower the mother's estimates of her parenting self-efficacy, (c) the lower the mother's self-efficacy, the greater her depression, and (d) the more depressed the mother feels at one point in time, the more likely she is to remain depressed 6 months later. Implications of the findings are discussed as they relate to self-efficacy theory and nursing intervention with parents of difficult toddlers.

A longitudinal model of maternal self-efficacy, depression, and difficult temperament during toddlerhood.

The purpose of this study was to examine the relationships among maternal confidence, knowledge of child development, and quality of mother-toddler interactions using self-efficacy (Bandura, 1977, 1989) as the theoretical framework. Using the Toddler Care Questionnaire, 50 mothers of toddlers were asked to estimate their confidence in their ability to parent their toddlers. Mothers also completed the Knowledge of Infant Development Questionnaire and were videotaped in their homes during a structured interaction with their toddlers. Maternal confidence was positively correlated with maternal knowledge of child development and parenting. The relationships among mother's knowledge of child development, maternal confidence, and quality of mother-toddler interactions were examined by a 2 × 3 analysis of variance with quality of interactions as the dependent variable. There were no significant main effects for maternal knowledge or confidence on quality of mother-toddler interactions, but there was a significant interaction effect. That is, the combined effects of maternal knowledge and confidence were related to quality of mother-toddler interactions. These results may explain previous inconsistencies in the literature regarding the significance of maternal confidence for mother-child interactions and are congruent with self-efficacy theory. Implications for interventions are discussed.

Maternal confidence, knowledge, and quality of mother‐toddler interactions: A preliminary study

The purpose of this longitudinal study was to examine the relationship between maternal depression and preschool children's mental health in a community sample. Cohort 1 (n = 97) consisted of mothers and children followed from 2 to 3 years of age. Cohort 2 (n = 97) consisted of mothers and children followed from 3 to 4 years of age. Mothers completed a self-report measure of depression twice during 1 year. The children's day care providers/nursery school teachers completed two instruments measuring the children's social competence and behavior problems at the end of the year. Maternal depression was significantly related to lower social competence and more behavior problems in the children. Although there were no significant mean differences in children's mental health scores by gender, boys of more depressed mothers were more likely to have poorer social competence and more behavior problems than girls. Item analyses suggest that the boys' behaviors may be particularly aversive for depressed mothers, increasing the likelihood that these mothers will respond to and reinforce their sons' difficult behaviors.

A longitudinal study of maternal depression and preschool children's mental health.

A Longitudinal Study of Maternal Depression and Preschool Children??s Mental Health

The purpose of this study was to examine what aspects of the mother-child relationship are measured by the Nursing Child Assessment Teaching Scale (NCATS). A racially heterogeneous sample of 128 mothers completed questionnaires measuring maternal depression, parenting self-efficacy, knowledge of developmental and parenting principles, and perceived difficult toddler temperament. Mothers and children were also videotaped during home visits while completing two teaching tasks that were later scored using NCATS. NCATS Parent subscale scores were significantly related to maternal knowledge and education but unrelated to depression and self-efficacy. Child subscale scores were unrelated to all of the study variables, including perceived difficult temperament. Significant differences were noted among African-American, Hispanic, and white mothers. The findings suggest that the NCATS taps cognitive factors more reliably than affective factors underlying the mother-child relationship and the cognitive factors may be culturally biased.

Barbara Conrad

Papers

A longitudinal model of maternal self-efficacy, depression, and difficult temperament during toddlerhood.

Maternal confidence, knowledge, and quality of mother‐toddler interactions: A preliminary study

A longitudinal study of maternal depression and preschool children's mental health.

A Longitudinal Study of Maternal Depression and Preschool Children??s Mental Health

What does the NCATS (Nursing Child Assessment Teaching Scale) measure