Maternal Depression and Early Childhood Behaviors: The Role of Mother-Daughter Relationships

Maternal depression has been linked to a variety of negative developmental outcomes for children. Using data from Waves I and III of The National Longitudinal Study of Adolescent Health, this study used a three-generational model (child, mother, grandmother) to examine maternal depression as it relates to the quality of the mother-daughter relationship and children’s behaviors. The study found that young women were more likely to report feeling depressed both prior to and following childbirth when they perceived problems in relating with their own mothers. Behavior problems were more prevalent for children who had mothers with more depressive symptoms. Acknowledgments. This research uses data from Add Health, a program project designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris, and was funded by a grant P01HD31921 from the National Institute of Child Health and Human Development with cooperative funding from 17 other agencies. Special acknowledgement is due to Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Persons interested in obtaining data files from Add Health should contact Add Health, Carolina Population Center, 123 W. Franklin Street, Chapel Hill, NC 27516-2524 ([email protected]). To contact the authors of the study, email Dr. Kevin Gross at [email protected] Family Science Review, Volume 15, Issue 1, 2010 © 2010 by the Family Science Association. All rights reserved. Maternal Depression and Early Childhood Behaviors 65 The birth of a child is expected to be one of the most joyous times in a woman's life. Yet, for many women, this life-changing event is accompanied by overwhelming sadness and despair. Postpartum depression, defined as the onset of depression within the first year of childbirth (Centers for Disease Control and Prevention, 2004), may threaten the mother's quality of life and daily functioning as well as her marriage, the mother/child bond, and the behavior and/or development of the baby (Beck, 1995; Campbell & Cohn, 1991; Field, 1995; Gotlib & Whiffen, 1991). An estimated 10-15% of women develop postpartum depression within one year of giving birth (National Institutes of Health, 2005). Data from the Pregnancy Risk Assessment Monitoring System (PRAMS) indicates the actual occurrence may vary widely based on the level of severity, demographic factors, and associated risk factors. In 2000, out of 453,186 women in seven states, 7.1% reported severe postpartum depression and 52% reported low to moderate levels (Centers for Disease Control and Prevention, 2004). Women who report severe postpartum depressions tend to perceive their pregnancy as one of the most difficult times of their lives (Gross, Wells, Radigan-Garcia, & Dietz, 2002). A family systems perspective would suggest that family of origin characteristics, such as the quality of the mother-daughter relationship, might affect maternal depression and that the presence of depressive symptoms would affect not only the mother but other members of the family, including the child. The purpose of this study is to use a multi-generational model (i.e., grandmother, mother, child) to explore predictors of maternal depression and assess the impact of maternal depression on child behaviors. Specifically, we examine maternal depression as it relates to (a) a history of depression, (b) the quality of the mother-daughter relationship (i.e., the relationship between the grandmother and mother), and (c) children’s behaviors. This study has implications for family life education as well as implications for family therapists who may work with women experiencing maternal depression or children whose mothers suffer from depression. A recent meta-analysis of 84 studies revealed 13 significant predictors of postpartum depression: prenatal depression, self esteem, childcare stress, prenatal anxiety, life stress, social support, marital relationship, history of previous depression, infant temperament, maternity blues, marital status, socioeconomic status, and unplanned /unwanted pregnancy (Beck, 2001). A history of depression has been noted as the strongest and most consistent predictor of postpartum depression (Hobfoll, Ritter, Lavin, Hulsizer, & Cameron, 1995; Johnstone, Boyce, Hickey, Morris-Yates, & Harris, 2001). Perceptions of self as mother and perceptions of the child are important in the mother's psychological response to motherhood as well as her interactions with the baby (Ammaniti et al., 1992; Pajulo, Savonlahti, Sourander, Piha, & Helenius, 2004). Women who were raised in emotionally deprived parent-child relationships are vulnerable to past hurts and the disappointment and anxiety of unrealistic expectations in parenting their own children (Lier, Gammeltoft, & Knudsen, 1995). Thus, the mother-daughter relationship may be a significant context for the development of positive perceptions and expectations of motherhood, thereby serving as a protective factor against postpartum and maternal depression. Maternal depression has been related to externalizing and internalizing problems in children from infancy through the school-age years (Civic & Holt, 2000; Field, 1995; Luoma et al., 2001; Luoma et al., 2004; Marchand & Hock, 1998). In a meta-analysis of studies exploring the relationship between maternal depression and attachment, maternal depression was related to less likelihood of secure attachment and greater likelihood of avoidant or disorganized attachment in infants (Martins & Gaffan, 2000). However, the effect of maternal depression on children is Maternal Depression and Early Childhood Behaviors 66 linked to length and persistence of the depression (Civic & Holt, 2000). When postpartum depression ended within six months, infants who were depressed in the early months of life were no longer depressed at one year of age (Field, 1995). Although there is substantial support for a lack of increased risk for postpartum depression, longitudinal studies are needed to determine whether a causal relationship exists (Surkan, Peterson, Hughes, & Gottlieb, 2006). Since mothers are often an important source of social support, this study will explore the relationship between the quality of the mother-daughter relationship and daughter's depression at two points in time during the daughter’s adolescence and during the birth of her first child. We then examine the impact that maternal depression has on child behaviors. Because demographic factors such as financial strain and education have been associated with postpartum depression (Surkan et al., 2006), they also are included in the analyses. The study asks the following research questions: (a) Is the quality of the mother-daughter relationship associated with self-reported depression either as an adolescent and/or as a young mother?; (b) Are young mothers’ self-reports of depression associated with their children’s behaviors?; (c) Is the quality of the mother-daughter relationship associated with children’s behaviors?