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Journal of Youth and Adolescence

, Volume 37, Issue 8, pp 906–916 | Cite as

Course and Severity of Maternal Depression: Associations with Family Functioning and Child Adjustment

  • Cynthia Ewell Foster
  • Melissa C. Webster
  • Myrna M. Weissman
  • Daniel J. Pilowsky
  • Priya J. Wickramaratne
  • A. John Rush
  • Carroll W. Hughes
  • Judy Garber
  • Erin Malloy
  • Gabrielle Cerda
  • Susan G. Kornstein
  • Jonathan E. Alpert
  • Stephen R. Wisniewski
  • Madhukar H. Trivedi
  • Maurizio Fava
  • Cheryl A. KingEmail author
Original Paper

Abstract

Number of lifetime episodes, duration of current episode, and severity of maternal depression were investigated in relation to family functioning and child adjustment. Participants were the 151 mother–child pairs in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) child multi-site study. Mothers were diagnosed with Major Depressive Disorder; children (80 males and 71 females) ranged in age from 7 to 17 years. Measures of child adjustment included psychiatric diagnoses, internalizing and externalizing symptoms, and functional impairment. Measures of family functioning included family cohesion, expressiveness, conflict, organization, and household control; parenting measures assessed maternal acceptance and psychological control. Children of mothers with longer current depressive episodes were more likely to have internalizing and externalizing symptoms, with this association being moderated by child gender. Mothers with more lifetime depressive episodes were less likely to use appropriate control in their homes.

Keywords

Maternal depression Family functioning Child adjustment Gender 

Notes

Acknowledgments

We are grateful to the seven participating STAR-D Regional Centers: Massachusetts General Hospital, Boston, MA, Primary Investigator: Andrew Nierenberg, MD; University of California, San Diego, CA, Primary Investigator: Sid Zisook, MD; University of Michigan, Ann Arbor, MI, Primary Investigator: Elizabeth Young, MD; University of North Carolina, Chapel Hill, NC, Primary Investigator: Bradley Gaynes, MD, MPH; University of Texas Southwestern Medical Center, Dallas, TX, Primary Investigator: Mustafa Husain, MD; Vanderbilt University, Nashville, TN, Primary Investigator: Steven Hollon, Ph.D.; and Virginia Commonwealth University, Richmond, VA, Co-Principal Investigator: A. Bela Sood, MD. We are also grateful to Ardesheer Talati, Ph.D., Charlene Bryan, MA, Kenneth Guire, MA, and Joe Kazemi, MA for their assistance with analyses and comments on earlier versions of this manuscript. This study was supported by NIMH grant no. R01MH063852 (M. M. Weissman, PI) and by an NIMH contract (no. N01 MH90003) (A. John Rush, PI). Dr. Garber was supported in part by an Independent Scientist Award during completion of this work (K02 MH66249).

References

  1. Achenbach, T. (1991). Manual for the CBCL 4-18, 1991 Profile. Burlington, VT: University of Vermont. Department of Psychiatry.Google Scholar
  2. Allgood-Merten, B., Lewinsohn, P. M., & Hops, H. (1990). Sex differences and adolescent depression. Journal of Abnormal Psychology, 99, 55–63.PubMedCrossRefGoogle Scholar
  3. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategies, and statistical considerations. Journal of Personality and Social Psychology, 61, 1173–1182.CrossRefGoogle Scholar
  4. Billings, A. G., & Moos, R. H. (1983). Comparisons of children of depressed and non-depressed parents: A social-environmental perspective. Journal of Abnormal Child Psychology, 11, 463–486.PubMedCrossRefGoogle Scholar
  5. Brennan, P., Hammen, C., Andersen, M., Bor, W., Najman, J., & Williams, G. (2000). Chronicity, severity, and timing of maternal depressive symptoms: Relationships with child outcomes at age 5. Developmental Psychology, 36, 759–766.PubMedCrossRefGoogle Scholar
  6. Burt, K. B., Van Dulmen, M. H. M., Carlivati, J., Egeland, B., Sroufe, L. A., Forman, D. R., Appleyard, K., & Carlson, E. A. (2005). Mediating links between maternal depression and offspring psychopathology: The importance of independent data. Journal of Child Psychology and Psychiatry, 46, 490–499.PubMedCrossRefGoogle Scholar
  7. Campbell, S. B., Cohn, J. F., & Meyers, T. A. (1995). Depression in first-time mothers: Mother-infant interaction and depression chronicity. Developmental Psychology, 31, 349–357.CrossRefGoogle Scholar
  8. Cummings, E. M., Keller, P. S., & Davies, P. T. (2005). Towards a family process model of maternal and paternal depressive symptoms: Exploring multiple relations with child and family functions. Journal of Child Psychology and Psychiatry, 46, 479–489.PubMedCrossRefGoogle Scholar
  9. Davies, P., & Windle, M. (1997). Gender-specific pathways between maternal depressive symptoms, family discord, and adolescent adjustment. Developmental Psychology, 33, 657–668.PubMedCrossRefGoogle Scholar
  10. Essex, M. J., Klein, M. H., Cho, E., & Kraemer, H. C. (2003). Exposure to maternal depression and marital conflict: Gender differences in children’s later mental health symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 728–737.PubMedCrossRefGoogle Scholar
  11. Fergusson, D. M., Horwood, L. J., & Lynskey, M. T. (1995). Maternal depressive symptoms and depressive symptoms in adolescents. Journal of Child Psychology and Psychiatry, 36, 1161–1178.PubMedCrossRefGoogle Scholar
  12. Forman, D. R., O’Hara, M. W., Stuart, S., Gorman, L. L., Larsen, K. E., & Coy, K. C. (2007). Effective treatment for postpartum depression is not sufficient to improve the developing mother–child relationship. Development and Psychopathology, 19, 585–602.PubMedCrossRefGoogle Scholar
  13. Frankel, K. A., & Harmon, R. J. (1996). Depressed mothers: They don’t always looks as bad as they feel. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 289–298.PubMedCrossRefGoogle Scholar
  14. Goodman, S. H., & Gotlib, I. H. (1999). Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission. Psychological Review, 106, 458–490.PubMedCrossRefGoogle Scholar
  15. Goodman S. H., & Gotlib I. H. (Eds). (2002). Children of depressed parents: Mechanisms of risk and implications for treatment. Washington, DC: APA.Google Scholar
  16. Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–296.PubMedGoogle Scholar
  17. Hammen, C., & Brennan, P. A. (2003). Severity, chronicity, and timing of maternal depression and risk for adolescent offspring diagnoses in a community sample. Archives of General Psychiatry, 60, 253–258.PubMedCrossRefGoogle Scholar
  18. Hammen, C., Burge, D., Burney, E., & Adrian, C. (1990). Longitudinal study of diagnoses in children of women with unipolar and bipolar affective disorder. Archives of General Psychiatry, 47, 1112–1117.PubMedGoogle Scholar
  19. Holahan, C. J., & Moos, R. H. (1982). Social support and adjustment: Predictive benefits of social climate indices. American Journal of Community Psychology, 10, 403–415.PubMedCrossRefGoogle Scholar
  20. Hops, H. (1992). Parental depression and child behaviour problems: Implications for behavioural family intervention. Behaviour Change, 9, 126–138.Google Scholar
  21. John, K., Gammon, G. D., Prusoff, B. A., & Warner, V. (1987). The social adjustment inventory for children and adolescents (SAICA): Testing of a new semi-structured interview. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 898–911.PubMedCrossRefGoogle Scholar
  22. Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988.PubMedCrossRefGoogle Scholar
  23. Kessler, R. C., Nelson, C. B., McKinagle, K. A., Edlund, M. J., Frank, R. G., & Leaf, P. J. (1996). The epidemiology of co-occurring addictive and mental disorders: Implications for prevention and service utilization. American Journal of Orthopsychiatry, 66, 17–31.PubMedCrossRefGoogle Scholar
  24. King, C., Segal, H., Naylor, M., & Evans, T. (1993). Family functioning and suicidal behavior in adolescent inpatients with mood disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 1198–1206.PubMedCrossRefGoogle Scholar
  25. Kochanska, G., Kucynski, L., Radke-Yarrow, M., & Welsh, J. D. (1987). Resolutions of control episodes between well and affectively ill mothers and their young child. Journal of Abnormal Child Psychology, 15, 441–456.PubMedCrossRefGoogle Scholar
  26. Lovejoy, M. C., Graczyk, P. A., O’Hare, E., & Neuman, G. (2000). Maternal depression and parenting: A meta-analytic review. Clinical Psychology Review, 20, 561–592.PubMedCrossRefGoogle Scholar
  27. Montemayor, R. (1983). Parents and adolescents in conflict: All the families some of the time and some families most of the time. Journal of Early Adolescence, 3, 83–103.CrossRefGoogle Scholar
  28. Moos, R. H., & Moos, B. S. (1986, 1994). Family environment scale manual (2nd and 3rd ed.). Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  29. Najman, J. M., Williams, G. M., Nikles, J., Spence, S., Bor, W., O’Callaghan, M., LeBrocque, R., & Andersen, M. J. (2000). Mothers’ mental illness and child behavior problems: Cause-effect association or observation bias? Journal of the American Academy of Child and Adolescent Psychiatry, 39, 592–602.PubMedCrossRefGoogle Scholar
  30. Nolen-Hoeksema, S., & Girgus, J. S. (1994). The emergence of gender differences in depression during adolescence. Psychological Bulletin, 115, 424–443.PubMedCrossRefGoogle Scholar
  31. Offord, D., Boyle, M., & Racine, Y. (1991). Ontario child health study: Correlates of disorder. In S. Chess, & M. Hertzig (Eds.), Annual progress in child psychiatry and child development. Philadelphia: Bruner/Mazel.Google Scholar
  32. Pilowsky, D. J., Wickramaratne, P., Rush, A. J., Hughes, C. W., Garber, J., Malloy, E., et al. (2006). Children of currently depressed mothers: A STAR*D ancillary study. Journal of Clinical Psychiatry, 67, 126–136.PubMedCrossRefGoogle Scholar
  33. Richters, J. E. (1992). Depressed mothers as informants about their children: A critical review of the evidence for distortion. Psychological Bulletin, 112, 485–499.CrossRefGoogle Scholar
  34. Rush, A. J., Fava, M., Wisniewski, S. R., Lavori, P. W., Trivedi, M. H., Sackheim, H. A., et al. (2004). Sequenced treatment alternatives to relieve depression (STARD*D): Rationale and design. Controlled Clinical Trials, 25, 119–142.PubMedCrossRefGoogle Scholar
  35. Rush, A. J., Trivedi, M. H., Ibrahim, H. M., Carmody, T. J., Arnow, B., Klein, D. N., et al. (2003). The 16-item quick inventory of depressive symptomatology (QIDS, clinician rating (QIDS-C), and self-report (QIDS-SR): A psychometric evaluation in patients with chronic major depression. Biological Psychiatry, 54, 573–583.PubMedCrossRefGoogle Scholar
  36. Sagrestano, L. M., Paikoff, R. L., Holmbeck, G. N., & Fendrick, M. (2003). A longitudinal examination of familial risk factors for depression among inner-city African American adolescents. Journal of Family Psychology, 17, 108–120.PubMedCrossRefGoogle Scholar
  37. Schludermann, E. H., & Schludermann, S. M. (1988). Children’s Report on Parent Behavior (CRPBI-108, CRPBI-30) for older children and adolescents (Tech. Rep.). Winnipeg, MB, Canada: University of Manitoba, Department of Psychology.Google Scholar
  38. Sheeber, L., Davis, B., & Hops, H. (2002). Gender-specific vulnerability to depression in children of depressed mothers. In S. H. Goodman, & I. H. Gotlib (Eds.), Children of depressed parents: Mechanisms of risk and implications for treatment. Washington, DC: APA.Google Scholar
  39. Trivedi, M. H., Rush, J. A., Wisniewski, S. R., Nierenberg, A., Warden, D., Ritz, L., et al. (2006). Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: Implications for clinical practice. American Journal of Psychiatry, 163, 28–41.PubMedCrossRefGoogle Scholar
  40. Weissman, M. M., & Jensen, P. (2002). What research suggests for depressed women with children. Journal of Clinical Psychiatry, 63, 641–647.PubMedGoogle Scholar
  41. Weissman, M. M., Pilowsky, D. J., Wickramaratne, P. J., Talati, A., Wisniewski, S. R., Fava, M., et al. (2006). Remissions in maternal depression and child psychopathology: A STAR*D-child report. JAMA, 295, 1389–1398.PubMedCrossRefGoogle Scholar
  42. Weissman, M. M., Wickramaratne, P., Nomura, Y., Warner, V., Pilowsky, D., & Verdeli, H. (2006). Offspring of depressed parents: 20 years later. The American Journal of Psychiatry, 163, 1001–1008.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Cynthia Ewell Foster
    • 1
  • Melissa C. Webster
    • 1
  • Myrna M. Weissman
    • 2
  • Daniel J. Pilowsky
    • 2
  • Priya J. Wickramaratne
    • 2
  • A. John Rush
    • 3
  • Carroll W. Hughes
    • 3
  • Judy Garber
    • 4
  • Erin Malloy
    • 5
  • Gabrielle Cerda
    • 6
  • Susan G. Kornstein
    • 7
  • Jonathan E. Alpert
    • 8
  • Stephen R. Wisniewski
    • 9
  • Madhukar H. Trivedi
    • 3
  • Maurizio Fava
    • 8
  • Cheryl A. King
    • 1
    Email author
  1. 1.Department of PsychiatryUniversity of MichiganAnn ArborUSA
  2. 2.Columbia University and the New York State Psychiatric InstituteNew YorkUSA
  3. 3.University of Texas Southwestern Medical CenterDallasUSA
  4. 4.Vanderbilt UniversityNashvilleUSA
  5. 5.University of North CarolinaChapel HillUSA
  6. 6.University of CaliforniaSan DiegoUSA
  7. 7.Virginia Commonwealth UniversityRichmondUSA
  8. 8.Harvard UniversityCambridgeUSA
  9. 9.University of PittsburghPittsburghUSA

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