How does parental depression influence child behaviour outcomes? A large adoption study supports the mediating role of overreactive parenting.

This week on the blog, Daniel [EDIT Lab PhD student] summarises the findings of a recently published study by Taraban et al. investigating the influence of parental depression on the development of behaviour problems in children through its effect on parenting.

 


Parenting can be stressful, so it comes as no surprise that around 20-40% of mothers and slightly fewer fathers experience depression during the first year of their child’s life1. Some will already have had depression before their child’s birth, and unfortunately, many go on suffering symptoms for years after. It is well-established that children of depressed parents are at higher risk of developing various mental health problems, but we still don’t know exactly why this is2. There is a substantial body of evidence showing that depressed parents have an impaired ability to be attentive and responsive to their children, and tend to be more irritable and hostile during parent-child interactions3.

We aren’t yet sure why children of depressed parents are at higher risk for developing mental health problems.

However, we can’t be sure that these factors themselves drive later changes in children’s mental health. An alternative explanation could be that genetic factors that increase parents’ risk of depression are passed on to their child, affecting their later risk of developing depression and other mental health problems. This is called a passive gene-environment correlation, because in biological families, the child’s rearing environment and their genes are provided by the same individuals, their parents. To really understand how parenting and parent mental health affect child development, we have to find ways to measure the complex interplay of genes and environments within families. A great way of doing this is to study children who were adopted at or shortly after birth. This gives us a lot more confidence about what drives children’s development, because birth parents only provide genes and prenatal environments (conditions in the womb), while adoptive parents only provide postnatal environments (parenting and other family factors).

“To really understand how parenting and parent mental health affect child development, we have to find ways to measure the complex interplay of genes and environments within families.”

A recent study used the adoption design to explore the relationship between parental depression, overreactive parenting and child externalising problems in 519 adoptive families4. Overreactive parenting included self-reported irritable, mean or angry responses to child challenges or misbehaviour, while child externalising problems included combined parent reports of children’s behavioural problems, such as destroying others’ things, attacking people and getting into fights.

Taraban et al. found that parental depression may lead to overreactive parenting, which itself leads to childhood behavioural problems.

The study found that for mothers and fathers, parental symptoms of depression when children were aged 9 months predicted overreactive parenting at 18 months. In mothers but not fathers, this went on to predict child externalising problems at 27 months. Depression itself had no influence on child externalising when accounting for the effects of overreactive parenting. Furthermore, birth mother mental health problems didn’t explain these relationships, suggesting that children weren’t just developing externalising problems due to inherited genetic risk.

“Depression itself had no influence on child externalising when accounting for the effects of overreactive parenting”

The study also looked at social support, an important protective factor for mental health5. Both parents’ satisfaction with their social support was associated with lower levels of depression, overreactive parenting, and later child externalising problems. However, it didn’t affect the relationship between mothers’ depression, overreactive parenting and child externalising. This doesn’t mean social support made no difference – it just means that mothers’ overreactive parenting predicted later child externalising problems regardless of how satisfied they were with their social support.

Implications for parenting

How do we make sense of these results? The most resounding finding was that mothers’ overreactive parenting, rather than depression itself, consistently predicted later child externalising problems. Importantly, while fathers’ overreactive parenting didn’t predict child externalising, it could still have influenced other child outcomes that weren’t measured in this study. Though results on social support were mixed, the emerging picture was that social support is important in predicting parents’ mental health and its longer-term consequences for parenting.

“The most resounding finding was that mothers’ overreactive parenting, rather than depression itself, consistently predicted later child externalising problems.”

The study had several limitations. For example, the authors noted that findings may have been explained by depressed parents over-reporting their overreactive parenting as well as their children’s externalising problems. They suggested that observational measures of parenting and child externalising could be used to address this in future studies. Another issue is that findings from adoptive families can’t necessarily be generalised to regular families. Adoptive parents tend to be older and have higher incomes, as was the case in this study, so we can’t be sure that the same relationships would be seen in higher-risk or lower-income families. Another limitation was that birth father mental health problems weren’t measured, so children’s outcomes may have been explained by unmeasured genetic factors inherited from fathers.

Despite its limitations, the study does provide insight into how parent mental health can influence child outcomes through its impact on specific parenting behaviours. The findings could have important implications for screening and targeted interventions for parents whose mental health problems may impact on their parenting and the long-term health of their child.

 

For more information on Depression see our previous post on the blog: D for Depression

References

  1. Field T. Postpartum Depression Effects on Early Interactions, Parenting, and Safety Practices: A Review. Infant Behav Dev 2010;33(1):1. doi: 10.1016/j.infbeh.2009.10.005
  2. Goodman SH, Rouse MH, Connell AM, et al. Maternal depression and child psychopathology: A meta-analytic review. Clinical child and family psychology review 2011;14(1):1-27.
  3. Lovejoy MC, Graczyk PA, O’Hare E, et al. Maternal depression and parenting behavior: a meta-analytic review. Clin Psychol Rev 2000;20(5):561-92. [published Online First: 2000/06/22]
  4. Taraban L, Shaw DS, Leve LD, et al. Parental Depression, Overreactive Parenting, and Early Childhood Externalizing Problems: Moderation by Social Support. Child Dev;0(0) doi: doi:10.1111/cdev.13027
  5. Ozbay F, Johnson DC, Dimoulas E, et al. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont) 2007;4(5):35.