Prospective investigation of postpartum depression: Factors involved in onset and recovery.

We examined the role of a number of psychosocial variables in the onset of postpartum depression and in recovery from depression that occurs during pregnancy. Women (N?=?730) were recruited during pregnancy and were followed through 1 mo postpartum. They were assessed on demographic variables and on measures of depressive symptomatology and diagnostic status, perceived stress, marital satisfaction, perceptions of their own parents, dysfunctional cognitions, and coping style. Onset of depression in the postpartum was predicted by the levels during pregnancy of depressive symptomatology and perceived maternal and paternal care during childhood. In contrast, recovery in the postpartum from depression during pregnancy was not predicted by the variables examined in this study. These results are discussed with reference to previous investigations that have examined depression that occurs outside the context of childbirth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal depressive symptomatology over the transition to parenthood: Assessing the influence of marital satisfaction and marital sex role traditionalism.

This longitudinal study examined the importance of the marital context in predicting maternal depressive symptomatology, as assessed with marital satisfaction and the endorsement of traditional sex role beliefs about the marriage, in 142 first-time mothers and their husbands or partners. Data were collected during pregnancy and at 6 weeks and 9 months infant age. Maternal and paternal reports about the marriage were assessed, and analyses were done on the way in which marital context scores interacted with earlier and concurrent levels of maternal depressive symptomatology. A hierarchical multiple regression analysis revealed that the final model explained 57% of the variance; marital context contributed 18% of the variance beyond that of earlier symptom levels in predicting mothers' depressive symptoms 9 months after the birth of the first child. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive information processing among nonclinic, nonreferred college students.

A. T. Beck's (1972, 1974) cognitive theory of depression provided the conceptual framework for examining the depressive information processing of nonclinic, nonreferred college students. Specifically, the students' processing of personal information, as assessed by both the self-referent incidental recall and the personal hypothesis testing tasks, was examined as a function of their current states of depressive symptomatology, as well as cognitive vulnerability to depression. The results of canonical correlation analyses revealed that the students' experience of greater levels of depressive symptomatology was significantly related to their negative processing of personal information, in support of Beck's theory. The students' cognitive vulnerability status was found to have less of an effect on their personal information processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reciprocal models of child behavior and depressive symptoms in mothers and fathers in a sample of children at risk for early conduct problems.

Although much has been written about transactional models in the study of parenting practices, relatively few researchers have used this approach to examine how child behavior might be related to parental well-being. This study used latent growth curve modeling to test transactional models of age 2 child noncompliance, parental depressive symptoms, and age 4 internalizing and externalizing behaviors using a subsample of families in the Early Steps Multisite Study. In unconditional models, maternal depressive symptoms showed a linear decrease from child ages 2 to 4, whereas paternal depression did not show significant change. Observed child noncompliance at age 2 showed significant associations with concurrent reports of maternal depressive symptoms and trend-level associations with paternal depressive symptoms. For both parents, higher levels of initial depressive symptoms were related to increased age 4 child internalizing behaviors. The findings provide support for reciprocal process models of parental depression and child behavior, and this study is one of the first to present empirical evidence that fathers' depressive symptoms have bidirectional associations with their children's behavior in early childhood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The developmental origins of cognitive vulnerability to depression: Temperament, parenting, and negative life events in childhood as contributors to negative cognitive style.

Cognitive models of depression have been well supported with adults, but the developmental origins of cognitive vulnerability are not well understood. The authors hypothesized that temperament, parenting, and negative life events in childhood would contribute to the development of cognitive style, with withdrawal negativity and negative parental feedback moderating the effects of negative life events to predict more depressogenic cognitive styles. These constructs were assessed in 289 children and their parents followed longitudinally from infancy to 5th grade; a subsample (n = 120) also participated in a behavioral task in which maternal feedback to child failure was observed. Results indicated that greater withdrawal negativity in interaction with negative life events was associated with more negative cognitive styles. Self-reported maternal anger expression and observed negative maternal feedback to child's failure significantly interacted with child's negative events to predict greater cognitive vulnerability. There was little evidence of paternal parenting predicting child negative cognitive style. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual differences in trajectories of emotion regulation processes: The effects of maternal depressive symptomatology and children's physiological regulation.

Trajectories of emotion regulation processes were examined in a community sample of 269 children across the ages of 4 to 7 using hierarchical linear modeling. Maternal depressive symptomatology (Symptom Checklist-90) and children's physiological reactivity (respiratory sinus arrhythmia [RSA]) and vagal regulation (ΔRSA) were explored as predictors of individual differences in trajectories of emotion regulation and negativity (mother-reported Emotion Regulation Checklist; A. M. Shields & D. Cicchetti, 1997). In addition, the authors explored whether children's physiological regulation would moderate the effect of maternal depressive symptomatology on children's emotion regulation trajectories. Results indicated that over time, emotion regulation increased whereas negativity decreased, though considerable individual variability in the pattern of change was observed. Greater maternal depressive symptomatology was associated with less steep emotion regulation trajectories. There was a significant Maternal Depressive Symptomatology × Baseline RSA × Age interaction predicting emotion regulation trajectories. Overall, it appears that the development of emotion regulation over time is compromised when mothers report greater depressive symptomatology. There is also evidence that children's capacity for physiological regulation can buffer some of the adverse consequences associated with maternal depressive symptomatology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptomatology in new mothers: A stress and coping perspective.

The aim of the present research was to test the utility of a stress-coping model of postpartum depression. Data were collected during the last trimester of pregnancy (n?=?197) and twice after the birth (4 weeks, n?=?180, and approximately 5 months, n?=?163). Coping resources and depressive symptomatology were assessed at Time 1, stress and coping were assessed at Time 2, and depressive symptomatology and partner ratings of coping effectiveness were assessed at Times 2 and 3. After control of the effects of initial depression, there was evidence of significant effects of levels of stress and coping responses on the Time 2 and Time 3 outcome measures. There was also some evidence linking coping resources (particularly self-esteem and family support) to postpartum depressive symptomatology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Le r?le des interactions mère-enfant et de la dépression maternelle à l'age préscolaire dans la prédiction de l'attachement de l'enfant à l'age scolaire.

Examined the contribution of mother–child partnership and maternal depression during the preschool period to the prediction of the child's attachment classification at early school-age in 91 French-Canadian children. Mother–child interactions were observed during a collaborative task using a scale measuring synchronized and reciprocal social-affective exchanges in the mother-child partnership (age 3–5 yrs). Maternal depression was assessed during the same lab visit using the Beck Depression Inventory. At a second lab visit (age 5–7 yrs), attachment classifications were assigned on the basis of reunion behaviour. A discriminant function analysis showed that reciprocal mother–child partnerships in the absence of maternal depressive symptom predicted security of attachment two years later, whereas failed reciprocity in the presence of maternal depressive symptoms predicted both insecure disorganized and ambivalent attachment. Quality of prediction is high for secure, ambivalent and disorganized children, although ambivalent and disorganized children cannot be distinguished from each other. Results support the importance of mother–child interactions and maternal depression as preschool variables associated with security and insecurity of attachment at early school-age. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting Behaviors and the Occurrence and Co-Occurrence of Depressive Symptoms and Conduct Problems Among African American Children.

The occurrence and co-occurrence of depressive symptoms and conduct problems were examined in the context of parenting behaviors in a community-based sample of 897 African American children and their primary caregivers using a multi-informant, longitudinal design. Parenting behaviors and clinical symptoms were assessed in 2 waves, when the children averaged 10.5 and 12.3 years of age. Parenting behaviors differed significantly according to a child's symptomatology; (a) that is, when a child exhibited no depressive or conduct problems, (b) depressive problems only, (c) conduct problems only, or (d) co-occurring depressive and conduct problems. When parenting behaviors were examined according to changes in children's symptom levels, children whose symptoms increased over time reported increases in hostility and harsh-inconsistent parenting and decreases in warmth and nurturant-involved parenting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An investigation of the object relations theory of depression.

The current study investigated a particular aspect shared by a number of theories of depression under the common heading of object relations theory (ORT), namely that depression is associated with a continuing pattern of poor attachment that is laid out in childhood and continues into adulthood. The study examined the relationship between attachment (both parental and peer) and depressive symptoms in young adults (N = 85) of Northern Ireland. Results provided support for the continuity of perceptions of attachment styles across the life span and revealed that perceptions of early attachment experiences, as well as continuing peer attachment styles, appeared to be predictive of current depressive symptoms. More specifically, the analyses revealed a statistically significant positive correlation between perceived quality of current peer attachment and symptoms of depression, as well as a statistically significant negative correlation between self-reported childhood maternal care and symptoms of depression. However, other self-reported measures of childhood attachment were not found to be significant predictors of depressive symptoms (i.e., paternal care, maternal overprotection, paternal overprotection). Taken together, the findings lend some support for this important element of a number of object relations theories, as they pertain to depression. Further empirical research is indicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of depressive symptom trajectories in mothers of preterm or low birth weight infants.

Predictors of maternal depression trajectories were examined longitudinally in families with an infant born preterm or at a low birth weight. A total of 181 mother–infant dyads enrolled in the study before the infant’s neonatal intensive care unit (NICU) discharge. Maternal depressive symptoms were assessed at 5 timepoints, and contextual variables and infant risks were assessed at NICU discharge. Hierarchical linear models revealed that mothers who experienced more risk factors reported more depressive symptoms just before their infant’s NICU discharge and showed less decline in depressive symptoms in the months immediately following the child’s birth. Although cumulative risks predicted depression trajectories, this effect appeared driven by maternal and family sociodemographic risks rather than infant risks. Addition of family support as a covariate in the multilevel models with a subsample of families revealed that social support and depression covaried across time. However, most of the findings regarding the association between risk and depression remained consistent, whereas the effects of maternal race and multiple birth were slightly attenuated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stable maternal cohabitation, couple relationship quality, and characteristics of the home environment in the child's first two years.

Data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development was used to address how cohabitation of unmarried 2-biological-parent families is associated with characteristics of young children's family environment using longitudinal assessments of maternal depression and observed parenting sensitivity collected across the child's first 2 years and mothers' reports of couple relationship conflict and ambivalence. We compared 43 cohabiting 2-biological-parent families and 877 married 2-biological-parent families, all of whom had stable relationships over the child's first 2 years. Demographic factors of lower parental education, non-White race/ethnicity, and low income characterized the cohabiting parents, in comparison with married parents. After controlling for these demographic differences, we found that stably cohabiting mothers reported more depressive symptoms and were less sensitive with their child than were married mothers. Cohabiting couple relationships were characterized by more ambivalence and conflict, each of which partially mediated associations of cohabitation with maternal depression and parenting sensitivity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal depression, paternal psychopathology, and adolescent diagnostic outcomes.

The authors examined the relationship between maternal depression, paternal psychopathology, and adolescent diagnostic outcomes in a community sample of 522 Australian families. They also examined whether chronic family stress, father's expressed emotion, and parents' marital satisfaction mediated the relationship between parental psychopathology and adolescent outcomes. Mother's education, child's gender, and family income were covaried in all analyses. Results revealed that maternal depression and paternal depression had an additive effect on youth externalizing disorders. In addition, maternal depression interacted with both paternal depression and paternal substance abuse in predicting youth depression but not youth nondepressive disorders. Chronic family stress and father's expressed emotion appeared to mediate the relationship between parental psychopathology and youth depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-disgust mediates the relationship between dysfunctional cognitions and depressive symptomatology.

Disgust has been linked to several psychopathologies, although a role in depression has been questioned. However, it has recently been proposed that rather than general disgust sensitivity, disgust directed toward the self (self-disgust) may influence the development of depression, providing a causal link between dysfunctional cognitions and depressive symptomatology. This possibility was examined by developing a scale to measure self-disgust (the Self-Disgust Scale; SDS) and then using mediator analysis to determine if self-disgust was able to explain the relationship between dysfunctional cognitions (measured with the use of the Dysfunctional Attitudes Scale) and depressive symptomatology (measured with the use of the Beck Depression Inventory and the Depression, Anxiety and Stress Scale). The developed SDS was found to exhibit a high level of internal consistency, test-retest reliability, and concurrent validity. Principal-components analysis revealed two factors to underlie responses to SDS items: the 'Disgusting self,' concerned with enduring, context independent aspects of the self, and 'Disgusting ways,' concerned with behavior. Self-disgust was found to mediate the relationship between dysfunctional cognitions and depressive symptomatology, demonstrating for the first time that self-disgust plays a role in depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental trajectories of adolescents' depressive symptoms: Predictors of change.

in a sample of 240 adolescents assessed annually in Grades 6 through 11, the developmental trajectories of their depressive symptoms were examined using latent factor growth modeling. Growth in mother-reported adolest.ent depressive symptoms was quadratic; growth in adolescent-reported symptoms was linear. In the model with gender and maternal depression, girls reported a greater increase in depressive symptoms over time than boys, and adolescents of mothers with histories of mood disorders had higher initial levels of depressive symptoms than offspring of never-depressed mothers. After gender and maternal depression were controlled, initial levels of negative attributions and stressors significantly predicted initial levels of adolescent- and mother-reported depressive symptoms. Attributional styles that were increasingly negative across time were associated with significantly higher initial levels (mother reported) and increasing growth (adolescent reported) of depressive symptoms. Reciprocal models in which development of depressive symptoms predicted the development of attributions and stress also were examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tightly linked systems: Reciprocal relations between maternal depressive symptoms and maternal reports of adolescent externalizing behavior.

The frequently observed link between maternal depressive symptoms and heightened maternal reporting of adolescent externalizing behavior was examined from an integrative, systems perspective using a community sample of 180 adolescents, their mothers, fathers, and close peers, assessed twice over a 3-year period. Consistent with this perspective, the maternal depression–adolescent externalizing link was found to reflect not simply maternal reporting biases, but heightened maternal sensitivity to independently observable teen misbehavior as well as long-term, predictive links between maternal symptoms and teen behavior. Maternal depressive symptoms predicted relative increases over time in teen externalizing behavior. Child effects were also found, however, in which teen externalizing behavior predicted future relative increases in maternal depressive symptoms. Findings are interpreted as revealing a tightly linked behavioral-affective system in families with mothers experiencing depressive symptoms and teens engaged in externalizing behavior and further suggest that research on depressive symptoms in women with adolescent offspring should now consider offspring externalizing behaviors as a significant risk factor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vulnerability to postpartum depression: A prospective multivariate study.

A sample of 115 primiparous women was assessed during pregnancy and the postpartum to identify the predictors and correlates of postpartum depression. The variables considered were marital adjustment, attributional style, life stress, maternal expectations for and perceptions of infant behavior, and blues symptoms. The data obtained at each assessment were submitted to principal-components analyses to identify variable clusters or constructs, which were used to predict both depressive symptom levels and a diagnosis of depression. Concurrently, symptoms and diagnosis were related to mothers' perceptions of their infants as temperamentally difficult. Prospectively, depressive symptomatology was predicted by low marital adjustment and depressed mood during pregnancy, optimistic expectations for infants, prepartum life stress, and early postpartum symptoms of anxiety and cognitive impairment. Although diagnostic status was related to a subset of these variables, results indicate that depressive symptom levels and diagnosis are not synonymous measures of the construct "postpartum depression." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive vulnerability in parents and their 5-year-old child's temperament: A family system perspective.

The actor-partner interdependence model was used to test whether one parent's depressive vulnerability (self-criticism and dependency) was associated with the same parent's own (an intraparental association) and the other parent's (a cross-parental association) ratings of their 5-year-old child's temperament (536 parents, 268 dyads). The more vulnerable the parents were, the more the children showed negative affectivity and lack of effortful control. Significant interactions with the parent's gender and between the spouses' depressive vulnerabilities were found, highlighting the fact that child outcomes are dependent on family processes. All associations were independent of maternal and paternal depressive symptoms. The influence of personality-based depressive traits on child temperamental outcomes and effective parenting is discussed with reference to between-dyad family dynamics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Father Involvement Moderates the Effect of Maternal Depression During a Child's Infancy on Child Behavior Problems in Kindergarten.

This research investigated whether father involvement in infancy may reduce or exacerbate the well-established adverse effect of maternal depression during a child's infancy on behavior problems in childhood. In a community sample (N = 350), the authors found that fathers' self-reported parenting styles interacted with the amount of time fathers spent caring for their infants to moderate the longitudinal effect of maternal depression during the child's infancy on children's internalizing, but not externalizing, behaviors. Low to medium amounts of high-warmth father involvement and high amounts of medium- or high-control father involvement at this time were associated with lower child internalizing behaviors. Paternal depression during a child's infancy exacerbated the effect of maternal depression, but this moderating effect was limited to depressed fathers spending medium to high amounts of time caring for their infants. Results emphasize the moderating role fathers may play in reducing or exacerbating the adverse long-term effects of maternal depression during a child's infancy on later child behavior problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health-related quality of life in head and neck cancer survivors: Impact of pretreatment depressive symptoms.

Objective: Symptoms of depression are common in those with cancer. The authors investigated whether depressive symptoms assessed before the initiation of cancer treatment predicted diminished health-related quality of life (HRQOL) at follow-up. Design: As part of a large, prospective study of oncologic outcomes, 306 patients with head and neck cancer (HNC) were assessed on several clinical and psychosocial characteristics during a pretreatment clinic visit and then at 3- and 12-month follow-up appointments. Main Outcome Measures: Depressive symptomatology was assessed with the Beck Depression Inventory and HNC-specific HRQOL (main outcome measure) was assessed with the Head and Neck Cancer Inventory. Results: Controlling for age, gender, marital status, cancer site, stage of disease, alcohol and tobacco use, comorbidity status, and pretreatment HRQOL, simultaneous multiple regression analyses revealed that depressive symptoms present at study enrollment, before the initiation of cancer treatment, significantly predicted lower HRQOL at 3- and 12-month follow-up assessments across the 4 HNC-specific domains of speech, eating, aesthetics, and social disruption (all ps ≤ .01). Conclusion: Results suggest that depressive symptomatology present near the time of diagnosis can have a significant, deleterious impact on HRQOL over time in HNC survivors. Thus, it may be useful to assess depression at diagnosis to identify individuals at greater risk for poor HRQOL outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)