Background There is a body of literature suggesting that postnatal depression – and poor maternal mental health generally – may lead to impaired child mental health, child behaviour and poorer cognitive outcomes. Some studies have also provided data showing significant associations between maternal mental illness and impaired child outcomes. While the available data is suggestive, it is largely derived from cross-sectional studies which do not have a capacity to assess the temporal sequences involved. Little is known about the impact of the severity, timing or chronicity of maternal mental health problems over the child’s life course on child mental health and behaviour. After examining patterns of maternal mental health impairment over the period of child rearing, the impact of maternal mental health impairment on adolescent behaviour problems at fourteen years of age is assessed. Specifically, the role of maternal anxiety, depression and co-occurring anxiety and depression were considered. This study used data from a prospective birth cohort study, with repeated measures of maternal mental health, to determine whether impaired maternal mental health in pregnancy, early childhood or early adolescence impact on the adolescent child’s mental health and behaviour. Material and Methods The Mater University Study of Pregnancy (MUSP) provided the data base for this study. Women were recruited from a large metropolitan hospital in Brisbane, Australia at their first antenatal visit – generally around the middle of the second trimester of pregnancy (on average at eighteen weeks gestation). Additional data was obtained 3-5 days after the birth of the child, six months after the birth of the child, when the child reached five years of age, and again when the study child reached fourteen years of age. During these phases of data collection, detailed information was obtained on the mother’s demographic characteristics, health information and also relating to a range of social factors. Data relating to the child was also derived using maternal reports throughout the study, and also child self-report at the fourteen-year follow up. Maternal anxiety and depression was measured at each phase of the study using the Delusions-Symptoms-States Inventory (DSSI) developed by Bedford & Foulds (1978). Child self-reported mental health and behaviour was assessed using the Child Behaviour Check List.(CBCL) (Achenbach & Edelbrock 1990). Maternal age and family income were included in analyses as potentially confounding factors, and maternal marital change and marital satisfaction were included as potential mediators. The full birth cohort of the MUSP study constituted 7223 mothers and their babies. The subset used in the current study includes 4297 mother and child pairs. This constitutes approximately sixty percent of the original birth cohort. Findings Maternal mental health impairment was analysed in terms of severity of impairment, timing of mental health impairment (during sensitive periods of child development – the antenatal/postnatal period and during later childhood/adolescence), and recurrence of episodes of mental health impairment. Rates of maternal mental health impairment were found to increase in occurrence and severity over the course of child rearing, with recurrence of episodes being a common manifestation of all forms of impairment. It is significant to note the mental health of women in the sample appears to decline as their children grow and develop into adolescents. The increase in maternal mental health impairment experienced as children progress through childhood into adolescence might be indicative of the pressures associated with raising children. This is a notion not previously explored in the literature. Contrary to existing literature, the analyses conducted in this study found that maternal mental health impairment occurring during the antenatal/postnatal period of child development had no independent negative impact on adolescent behavioural outcomes. The longitudinal nature of the data allowed for an assessment of these sensitive periods, whilst controlling for later occurring mental health impairment – a potential confounder not accounted for in many previous studies. Proximal and recurrent exposure to maternal mental health impairment was associated with a significantly increased risk of adolescent mental health and behavioural problems in children at fourteen years of age. Conclusion There is a need to further explore the nature and course of maternal mental health impairment during child rearing. The findings presented here point to the need for support for mothers to improve their mental health during later stages of child rearing – particularly in the period during which their children are adolescents. This period is significant both in terms of increased rates of maternal mental health impairment, and also the negative influences of exposure to maternal mental health impairment in terms of impaired adolescent mental health and behavioural outcomes.
| Identifer | oai:union.ndltd.org:ADTP/254147 |
| Creators | Belinda Lloyd |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
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