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

Data on the relation between marital turmoil (ie, discord and divorce) and behavior problems in children are reviewed It is concluded that a relation between the two domains docs exist Several parameters of this relation are outlined, including type of marital turmoil, form of the child's behavioral response, sex differences, age effects, parental buffering, and effects of parental psychopathology Conclusions drawn from this review are used to evaluate several broad etiological hypotheses about the effect of marital turmoil on children, and implications for the treatment of behavior problems in children from these families are discussed Finally, interpretative and methodological refinements are suggested for future research

Interparental conflict and the children of discord and divorce.

Research on the prevalence, course, and correlates of behavior problems in preschool children was examined. Prospective epidemiological studies and follow-up studies of clinical/high risk samples indicate that serious externalizing problems identified early often persist. Negative, inconsistent parental behavior and high levels of family adversity are associated with the emergence of problems in early childhood and predict their persistence to school age. Studies are examined from a developmental perspective and integrated with research on optimal parent-child relationships. The severity of initial problems and family context are related to different developmental outcomes.

Behavior Problems in Preschool Children: A Review of Recent Research

Maternal Depression and Child Development

Using a random sample of first-time mothers from an inner London borough, the relationship was examined between maternal depression and child behaviour problems at various stages after the birth of the child. Child problems at 14 months were unrelated to present or past maternal depression. Child problems at 27 and 42 months were related in an interactive way with present and past depression. There was little indication of behaviour problems preceding maternal depression. An examination of possible confounding factors in these relationships was also attempted.

A longitudinal study of maternal depression and child behaviour problems

SUMMARY

An epidemiological study of psychiatric disorder among 10 to 11-year-old children in two communities showed a strong association in boys between antisocial disorder and a history of a short period in foster-care or in a Children's Home. This association was much less evident in girls. At the time of study, years after the period “in care”, most of the children were living in large families characterised by parental discord. It is suggested that it is this long-term family disturbance which leads to the antisocial disorder rather than the short-period of care per se. The reason for the sex difference in susceptibility to family discord requires further study. The findings also suggest the need for preventive treatment for families seeking short-term placement “in care”.

Children who have been "in care"--an epidemiological study

The social, behavioural, and school adjustment of 41 9-year-old children in long-term residential group care in Greece was compared with that of children of the same sex and age brought up in two-parent families. Observational, interview, and questionnaire measures were employed. Observations in school classrooms showed that compared with their classmates, the group care children were more inattentive, participated less often in the classroom activities, were more likely to be passive, and tended to be involved in alternative and nonproductive activities. In the playground, they rarely interacted with non-institutional children. On both parent and teacher scales the group care children showed significantly more overall disturbance. The boys showed poor task involvement in the classroom and more emotional difficulties, conduct problems, and hyperactivity, whereas the between-group differences for girls were statistically significant only for emotional disturbance and poor task involvement in the classroom. Both boys and girls in long-term residential care showed less harmonious, confiding relationships with peers than those reared in families, and were more affection-seeking with teachers.

A comparative study of Greek children in long-term residential group care and in two-parent families: I. Social, emotional, and behavioural differences.

Forty-one children reared in group care were compared with 41 age- and sex-matched family care children according to interview, questionnaire, and observation measures of behavioural and scholastic functioning. Individual differences in outcome within the group care sample were examined in relation to a range of possible risk/protective indicators. The strongest predictor of outcome proved to be the reason for admission into residential care, with the implication that the outcome was best for children who had experienced stable, harmonious family relationships in their early years. The risk and protective effects applied to both the children's behaviour and scholastic attainments but, although the two were intercorrelated, neither accounted for the other. All subgroups of children in institutional care failed to show a lack of confiding peer relationships, with the pattern of findings suggesting that this stemmed from some aspect of experiences (possibly involving peer relationships) during residential care, as well as from discontinuity in caregiving during the early years.

A Comparative Study of Greek Children in Long-term Residential Group Care and in Two-parent Families: II. Possible Mediating Mechanisms

Summary
This paper reports a longitudinal study of behavioural symptoms in 3, 4 and 5 yr old children. The sample consisted of 50 boys and 50 girls living in a working-class area in Inner London, and information was obtained on maternal health and adjustment to school in addition to the expression of behavioural symptoms at home. The results indicate that while maternal health and behaviour disturbance in the home correlate positively together, with the exception of two symptoms there was no relation at all between behaviour at home and adjustment to school. These results are considered to have implications for the prognostic value of behavioural symptoms as well as for the treatment of young children.

Stephen Wolkind

Papers

A longitudinal study of maternal depression and child behaviour problems

Children who have been "in care"--an epidemiological study

A comparative study of Greek children in long-term residential group care and in two-parent families: I. Social, emotional, and behavioural differences.

A Comparative Study of Greek Children in Long-term Residential Group Care and in Two-parent Families: II. Possible Mediating Mechanisms

Symptoms of behaviour disturbance and adjustment to school