This study tested a mediated-moderator model that was developed to explore whether age of entry into a Head Start Program moderated the relationship between maternal depressive symptomology and child cognitive and social outcome. In addition, the mediating role of maternal social support was examined. The study sample included 43 low-income mothers and their pre-school aged children who were enrolled in a large Head Start program in Southwest Virginia. Maternal depressive symptomology was measured using the CES-D and perceived social support was measured using the Perceived Social Support Scale (PSS). Child cognitive data included scores on two working memory tasks and the PPVT. Child social outcomes were assessed using the Social Skills Scale and the Classroom Conduct Scale developed for use with Head Start Populations. Results of the study did not support a moderating role for age of entry to Head Start. Level of maternal education was found to predict both child working memory skill and receptive language ability, and high levels of maternal depressive symptomology were found to predict child social skills. In addition, exploratory analyses were conducted to examine gender differences in the relations between variables when girls and boys were analyzed separately. A significant interaction effect was found for gender and maternal education in predicting preschool receptive language ability. Preliminary data suggests that boys may be more highly impacted by maternal factors than are girls. Policy implications and directions for future research are discussed. / Ph. D.

Maternal depression is a common mental health disorder that can have significant adverse effects on child functioning, including increased rates of child behaviour problems. Adopting a resilience approach highlights that despite the increased risk there is considerable variation in child behaviour development, although mechanisms through which this occurs are not well understood. This thesis investigates positive parenting, harsh parenting, and child inhibitory control as developmentally salient processes that may explain why some children of mothers with depression develop more positive behaviours than others. Analyses were conducted using data from the Early Steps Multisite Study, a longitudinal randomised controlled trial that includes 731 ethnically diverse families from three sites across the United States. Baseline measures were completed at child age 2, with annual follow-up assessments until age 8. These analyses used mother self-reported depressive symptoms, observed measures of parenting, alternate caregiver-reported child inhibitory control, and mother- and teacher-reported child externalising behaviours. Categorical and continuous variables of maternal depression and child behaviour were tested to explore the implications of different analytic approaches, particularly with reference to the concept of resilience. Logistic regression results indicate that child inhibitory control is a robust predictor of developmentally normative behaviours for children of mothers with depression and children in general. Linear regression results support a risk-specific effect of harsh parenting, such that it interacts with maternal depression to predict increased externalising behaviours specifically for children of mothers with depression. Positive parenting appears to predict the behaviour of children in general but not the behaviour of children of mothers with depression. Path analyses indicate that between the ages of 2 and 4, harsh parenting partially mediates the association between maternal depression and child externalising behaviours. Moderated mediation results suggest that children with lower levels of inhibitory control elicit increased harsh parenting behaviours from mothers both with and without depression. Cross-lagged path analyses provide support for reciprocal influence between maternal depression, harsh parenting, and child externalising behaviour, and suggest an impact of maternal depression severity on the establishment of negative patterns of mother-child interactions from age 2. The findings of this thesis support the importance of reducing harsh parenting behaviours particularly for mothers with depression and of improving child self-regulation from an early age. The concept of resilience as a dimensional and potentially reciprocal process is discussed in the context of maternal depression and child behaviour development. Results emphasise that both mother and child are actively involved in influencing processes of resilience. From early childhood, there is a need to support more adaptive patterns of behaviour between mothers with depression and their children in order to increase the likelihood of positive child outcomes over time.

Objectives: The rate and impact of depressive symptoms were examined with two models based on known effects of depression on variables related to diabetes management, parental involvement and diabetes conflict. The proposed models will measure potential effects high maternal depressive symptoms may have on parental monitoring and involvement and diabetes specific conflict and how these variables may in turn relate to poor regimen adherence. Methods: Participants included 225 mothers and young adolescents (aged 11-14) with T1D. Diabetes self-care behaviors were measured with the 24 Hour Recall Interview, parental involvement and monitoring were measured with the Parent Management of Diabetes Scale, and diabetes specific conflict was measured with the Diabetes Family Conflict Scale. Results: A significant portion of mothers (21%) reported clinically elevated levels of depressive symptoms. These high levels of depressive symptoms were related to low levels of parental involvement with diabetes care (r = -.19, p < .01). Depressive symptoms were indirectly related to lower frequency of blood glucose monitoring (C.95 = -.03, -.002), insulin use (C.95 = -.01, -.0007), and meals (C.95 = -.02, -.002) through low levels of parental involvement. Higher levels of depressive symptoms were also related to higher levels of diabetes specific conflict (r = .16, p < .01), however, this relationship did not have a significant indirect effect on frequency of self-care behaviors. Conclusions: A significant portion of mothers in the current sample reported symptoms of depression above the clinical cutoff. Mothers that reported higher levels of depressive symptoms also reported lower levels of parental involvement in management of disease-care behaviors. Low levels of parental involvement mediated a significant relation between depressive symptoms and less frequent disease-care behaviors. Diabetes conflict did not mediate a relation between depressive symptoms and disease-care behaviors. These findings suggest that the reported high levels of maternal depressive symptoms among mothers of children with T1D may interfere with good diabetes management through low parental involvement. Individual treatment for depressive symptoms and interventions targeted at increasing parental involvement without increasing diabetes conflict could help improve regimen adherence.

Conduct disorder is characterized by behaviors that take a large toll on the individuals, families, and communities afflicted. Thus, improving treatment effectiveness should be a high priority. Currently, common intervention programs do not address parental depression, even though it has been linked to adolescent conduct disorder behaviors in some studies. The current study assessed whether the relation between maternal depression and adolescent conduct disorder behaviors is mediated by another factor which has been linked to conduct disorder behaviors, maternal monitoring. Results did not support the hypothesized mediated association, but did show significant individual associations for both maternal depression and maternal monitoring with adolescent conduct disorder behaviors. Secondary analyses showed that adolescent age and household income were significantly related to maternal monitoring and maternal depression, respectively. Findings also suggested that child disclosure may drive the association between maternal monitoring and adolescent conduct disorder behaviors. Implications for intervention are discussed.

Previous research has found that maternal depression is predictive of adolescents’ aggression. The present study examined three mechanisms believed to account for this relation: parenting practices, family functioning, and informant discrepancy. The data for this study are from the Multisite Violence Prevention Project which collected data from a high-risk sample of sixth grade students, parents, and core teachers. A within-subjects analysis of variance examined the association between maternal depression and informant discrepancy. Structural equation modeling compared the relation between maternal depression and adolescents’ aggression as a function of parenting practices and family functioning. Results indicated that maternal depression was related to adolescents’ aggression and moderated the degree of the discrepancy between reports of aggression. Results indicated that the relation between maternal depression and mother-report of adolescents’ aggression was mediated by parenting practices and family functioning, with parenting practices mediating the relation over and beyond family functioning.

A depressão materna é reconhecida como uma adversidade que incide sobre o ambiente familiar, mostrando-se associada a problemas comportamentais em escolares. Verifica-se a demanda por estudos que abordem condições de risco e proteção do ambiente familiar e que avaliem as crianças por múltiplos informantes. Objetivou-se: (a) comparar e correlacionar os recursos e eventos estressores do ambiente familiar de crianças que convivem com a depressão materna e que apresentam problemas de comportamento, com os apresentados por crianças que convivem com mães sem depressão e que não apresentam problemas comportamentais; e (b) comparar e correlacionar os comportamentos das crianças, segundo a avaliação das suas mães e professoras. Adotou-se um delineamento transversal e avaliou-se uma amostra de conveniência composta por 85 díades mães-crianças, distribuídas em: G1 = 26 mães com indicadores de depressão e crianças com problemas comportamentais; G2 = 29 mães sem indicadores de depressão e crianças com problemas comportamentais e G3 = 30 mães sem indicadores de depressão e crianças sem problemas comportamentais. Foram incluídas crianças de ambos os sexos, de sete a 10 anos. Procedeu-se à avaliação primeiramente com as mães, seguida das crianças e professoras. Foram aplicados com as mães, em sessão única, face a face, os instrumentos: Questionário Geral, Questionário sobre a Saúde do Paciente, Inventário de Recursos do Ambiente Familiar, Escala de Eventos Adversos, Escala de Adversidade Crônica e Questionário de Capacidades e Dificuldades (SDQ). As crianças foram avaliadas quanto ao nível intelectual pelo teste Matrizes Progressivas Coloridas de Raven Escala Especial. As professoras responderam ao SDQ - professores, precedido de informações sobre o desempenho escolar das crianças. Os dados obtidos foram codificados de acordo com as proposições técnicas e procedeu-se a análise dos mesmos por procedimentos estatísticos, adotando-se o nível de significância de 5% (p0,05). Quando das comparações entre os grupos verificou-se com diferenças significativas, que: as famílias que convivem com a depressão materna apresentaram mais indicadores de adversidades crônicas; e as crianças com problemas comportamentais, menos recursos e mais adversidades crônicas. As mães identificaram, com significância estatística, mais problemas de comportamento das crianças em relação às professoras; e ainda verificou-se associações entre a depressão materna e os problemas de comportamento dos escolares, na avaliação de mães (r = 0,490) e professoras (r = 0,294) e dos problemas comportamentais com o baixo desempenho escolar. Constatou-se que: (a) as crianças que convivem com a depressão materna apresentaram indicadores de múltiplas condições de risco em seu ambiente familiar, o que pode estar favorecendo os problemas comportamentais, os quais também se associaram a menos recursos; e (b) as mães e professoras divergiram quando das avaliações dos problemas de comportamento das crianças, evidenciando a utilização de diferentes parâmetros de avaliação nos contextos familiar e escolar. Considera-se que tais dados podem instrumentar programas de prevenção no contexto escolar e de intervenção no contexto familiar, com possíveis benefícios para o comportamento das crianças. / Maternal depression is known to be an adversity that affects the family environment and is associated with behavioral problems among schoolchildren. There is a need for studies addressing risk and protective conditions of the family environment assessing children through multiple informants. The objectives were (a) to compare and correlate resources and stressors in the family environment of children who live with maternal depression and present behavioral problems with the resources and the stressors of children whose mothers do not present depression and who do not present behavioral problems; and (b) to compare and correlate the behaviors of children from the perspective of their mothers and teachers. A cross-sectional design was used to assess a convenience sample composed of 85 mother-child pairs distributed between: G1 = 26 mothers with indicators of depression and children with behavioral problems; G2 = 29 mothers without indicators of depression and children with behavioral problems; and G3 = 30 mothers without indicators of depression and children without behavioral problems. Children aged from seven to 10 years old, of both sexes, were included. Assessment was initiated with the mothers, followed by the children and teachers. The following instruments were applied face-to-face to the mothers in a single session: General Questionnaire, Patient Health Questionnaire, Family Environment Resource Inventory, Adverse Events Scale, Chronic Adversity Scale, and The Strengths and Difficulties Questionnaire (SDQ). The childrens intellectual level was assessed using Ravens Progressive Matrices Special Scale. The teachers responded to the SDQ teachers, preceded by information on the childrens school performance. Data were coded according to technical propositions and statistically analyzed adopting a significance level of 5% (p0.05). Comparisons among groups showed the following significant differences: the families facing maternal depression presented more indicators of chronic adversities; and the children with behavioral problems presented fewer resources and more chronic adversities. The mothers identified more behavioral problems in children than teachers. The mothers (r = 0.490) and teachers (r = 0.294) assessments showed associations between maternal depression and childrens behavioral problems and between behavioral problems and poor school performance. We verified that: (a) children living with maternal depression presented multiple risk indicators in their family environment, which may have favored behavioral problems, which were also associated with having fewer resources; and (b) mothers and teachers diverged in regard to their assessments concerning the childrens behavioral problems, showing that different parameters were used in the family and school contexts. These data may support the development of preventive programs in the school context and also interventions for the family context, which may benefit childrens behaviors.

abstract: Rapidly growing research on mothers’ perinatal depression, has demonstrated significant links among mothers’ depressive symptoms during pregnancy and the first year postpartum, their parenting, and multiple aspects of children’s development. This prospective longitudinal study contributes to research on mothers’ perinatal depression by examining the mechanisms by which maternal perinatal depression is associated with children’s adjustment early in development in a sample of 204 Mexican-origin adolescent mothers (Mage at Wave 1 = 16.80, SD = 1.0) and their children (58% boys). I expected that adolescent mothers’ negative parenting behaviors would mediate the associations between mothers’ perinatal depressive symptoms and three child outcomes: internalizing symptoms, externalizing behaviors, and cognitive ability. I further hypothesized that mothers’ perceived social support from their family would modify the extent to which mothers’ perinatal depressive symptoms negatively impact their parenting behaviors and their children’s developmental outcomes. Mothers reported on their own depressive symptoms, their perceived social support from their family and their children’s internalizing and externalizing problems; negative parenting was assessed using observational methods; and children’s cognitive ability was assessed using standardized developmental assessments. In this sample, adolescent mothers’ negative parenting behaviors did not significantly mediate the relations between mothers’ perinatal depression and children’s developmental outcomes. Further, perceived social support did not significantly buffer the effects of mothers’ perinatal depression on mothers’ negative parenting or children’s developmental outcomes. However, in line with hypotheses, results indicated that mothers’ prenatal depression had a wider impact on children’s adjustment outcomes than mothers’ postpartum depression, which appeared more specific to children’s internalizing problems. Discussion focuses on implications for intervention addressing adolescent mothers’ perinatal depression, as well as the need to continue to explore protective factors that have the potential to disrupt the negative intergenerational transmission of risks. / Dissertation/Thesis / Doctoral Dissertation Family and Human Development 2019

Autism Spectrum Disorder (ASD) is a developmental disorder known for deficits in language and social skills. It is often associated with maladaptive behaviors. Studies have indicated that these behaviors in children lead to increased stress, anxiety and depression in mothers. This study examines the effects of parent-implemented Positive Behavior Support (PBS) and behavioral activation (BA) on reducing problem behaviors and increasing maternal wellness. The single subject study was conducted with three mothers (between the ages of 30 and 45) and their three children (between the ages of 5 and 7) with autism spectrum disorder. The results of this study demonstrate that while PBS implementation does reduce problem behaviors, it does not significantly impact maternal well-being. Results indicated that two of the three mothers were able to implement PBS interventions and their children demonstrated significant behavioral improvements. These mothers also engaged in high levels of valued activities both at baseline and during intervention and showed few depression symptoms. The third mother was not able to implement the interventions and her child demonstrated little behavioral progress. This mother showed signs of depression and did not make gains in this area. Further research may want to examine the relationship between behavioral activation and respite care, as well as the role of socioeconomic status.

Bronfenbrenners Process-Person-Context-Time model was used to examine the relationships among the process of negative parenting, the person characteristics of child temperament and early aggressive behaviour and the contexts of family income (in)adequacy and maternal depression from infancy to school entry and their effects on the outcome of aggressive behaviour in boys at school entry. The sample included 361 boys in two-parent families who participated in the Canadian National Longitudinal Survey of Children and Youth (NLSCY). Structural equation modeling was used with a repeated measures longitudinal design. The model explained 43% of the variance in boys aggressive behaviour at school age. The results indicated that, by preschool age, boys and mothers behaviours are well established, and that process, person, and context variables all influence the persistence of boys aggressive behaviour. The strength of the effects of these variables increased with their proximity to the developing child and decreased over time. By school age, concurrent effects were not significant. The addition of the contextual variables resulted in ill-fitting models. Modification indices suggested the ill fit was localized in modeling the persistence of maternal depression, and not in the relationship between maternal depression and the other variables in the model. Modification indices also suggested there may be reciprocal effects between boys aggressive behaviour and both negative parenting and maternal depression, but this was not tested. Future research using a cross-lagged panel design could clarify these relationships. This study contributes to a growing body of research on the development of aggressive behaviour in children and underscores the importance of examining the contribution of the multiple levels of process, person, context, and time to the development of aggressive behaviour. Findings of this study provide evidence that the effects of proximal processes and proximal contexts on the development of boys aggressive behaviour are strongest in infancy and toddlerhood, and their consequences extend through to school entry. Initiating prevention and intervention efforts in early childhood that provide parents-to-be and parents of young children with practical direction in ways to engage in positive and responsive interactions with their children would do more to reduce the development of aggressive behaviour in children than would later interventions aimed at changing entrenched behaviours in both parents and children.

The daughters of women with a history of depression are at heightened risk for a range of mental health problems. The present study investigated emotion regulation, cortisol reactivity to stress, and interpersonal competence as potential indicators of risk in adolescent girls at high versus low risk for depression. Participants were a community sample of 47 girls and their mothers (27 high risk and 20 low risk). Mothers and daughters had been interviewed to assess diagnostic history as part of a previous longitudinal study. In the current study, daughters completed the Trier Social Stress Test for Children (TSST-C) and cortisol samples were collected before and after exposure to this psychosocial stressor. Both mothers and daughters completed self-report questionnaires and daughters were re-assessed using the Depressive Disorders module of the Kiddie Schedule for Affective Disorders and Schizophrenia. High risk mothers were also interviewed to assess the timing and chronicity of their depressive episodes during their daughters’ lifetime. High and low risk girls had equivalent ratings of self-reported stress following the TSST-C, but different physiological responses. Girls at high risk for depression showed a blunted cortisol response to the TSST-C whereas low risk girls showed a normal cortisol response. High risk status for depression predicted a blunted cortisol response to stress, which predicted difficulties with emotion regulation; difficulties with emotion regulation in turn predicted a greater number of self-reported depressive symptoms. These results suggest that maternal depression may act as a stressor that compromises stress-response system functioning in daughters and produces related difficulties with emotion regulation.