Patricia A. Brennan

Chronicity, Severity, and Timing of Maternal Depressive Symptoms: Relationships with Child Outcomes at Age 5.

The relationships between severity, chronicity, and timing of maternal depressive symptoms and child outcomes were examined in a cohort of 4,953 children. Mothers provided self-reports of depressive symptoms during pregnancy, immediately postpartum, and when the child was 6 months old and 5 years old. At the age 5 follow-up, mothers reported on childrens behavior and children completed a receptive vocabulary test. Results suggest that both the severity and the chronicity of maternal depressive symptoms are related to more behavior problems and lower vocabulary scores in children. The interaction of severity and chronicity of maternal depressive symptoms was significantly related to higher levels of child behavior problems. Timing of maternal symptoms was not significantly related to child vocabulary scores, but more recent reports of maternal depressive symptoms were associated with higher rates of child behavior problems.

Maternal Depression, Parent–Child Relationships, and Resilient Outcomes in Adolescence

OBJECTIVE To examine the relationship between maternal depression, parent-child relations, and resilient outcomes in the context of risk in a cross-sectional study of 816 15-year-olds in Australia. METHOD Resilient outcomes were defined as the following: no current Axis I diagnosis, no history of depressive disorder diagnoses, no current internalizing problems, and no indication of current social functioning difficulties. Parent-child relationship qualities were measured using the Five-Minute Speech Sample, the Childrens Report of Parent Behavior Inventory, and a child report questionnaire concerning perceived maternal warmth and hostility. The role of the fathers psychiatric status in resilient outcomes was also assessed. RESULTS Results revealed that low levels of parental psychological control, high levels of maternal warmth, and low levels of maternal overinvolvement all interacted with maternal depression to predict resilient outcomes in youth. CONCLUSIONS Targeting maternal and paternal parenting qualities may be a useful method of increasing the likelihood of resilient outcomes in children of depressed mothers.

Depressed Adolescents of Depressed and Nondepressed Mothers: Tests of an Interpersonal Impairment Hypothesis

Two groups of depressed youngsters were compared. From an interpersonal perspective, it was hypothesized that depressed adolescents of depressed mothers would have significantly more interpersonal dysfunction than depressed youngsters of nondepressed mothers. In a large community sample of youth and their families, 65 depressed offspring of women with histories of a major depressive episode or dysthymia were compared with 45 depressed offspring of never-depressed women. As predicted, after controlling for current symptoms and family social status variables, depressed offspring of depressed mothers displayed significantly more negative interpersonal behaviors and cognitions compared with depressed offspring of nondepressed mothers, but they did not differ on academic performance. Implications concerning mechanisms, course, and consequences of different forms of adolescent depression are presented.

Maternal depression and infant cortisol: influences of timing, comorbidity and treatment

BACKGROUND The current study examines the relationship between maternal depression and infant cortisol concentrations. The potential roles of comorbid maternal anxiety disorders, timing of maternal depression, and maternal treatment with psychotropic medications during pregnancy are addressed. METHODS Women with 6-month-old infants (105 boys and 84 girls) participated in a laboratory paradigm that included infant saliva collection at six points, noise burst and arm restraint stressor tasks, and a diagnostic interview of the mother. RESULTS Lifetime history of maternal depression was associated with increased baseline and mean (average) infant cortisol levels. Comorbidity with anxiety disorder was related to infant cortisol reactivity. Peripartum (prepartum and/or postpartum) maternal depression, rather than a pre-pregnancy history of disorder, was associated with higher infant cortisol reactivity. Prenatal and postnatal exposure to maternal disorder had similar effects, but prenatal maternal psychotropic medication treatment appeared to attenuate infant cortisol increases associated with prenatal maternal disorder exposure. CONCLUSIONS These data suggest that exposure to maternal depression and anxiety during pregnancy and the postpartum period may increase infant salivary cortisol. This maternal depression-infant cortisol association is independent of the effects of delivery complications, and appears to be modulated by prenatal maternal psychotropic treatment.

Impact of Antenatal and Postpartum Maternal Mental Illness: How are the Children?

Prospective studies that begin during pregnancy and follow the mothers and children into adolescence have shown that maternal mental illness during the antenatal and postpartum period can have long-lasting negative consequences on the developing child. The findings from these prospective studies and a discussion of the consistencies and inconsistencies in the current literature are presented. The effects of maternal anxiety and depression during the perinatal period on cognitive, behavioral, and psychologic development from infancy through adolescence are examined.

Interpersonal dysfunction in depressed women: impairments independent of depressive symptoms

BACKGROUND The study explored the generality of interpersonal impairments in depressed women and examined the extent of their independence of current depressive episodes or symptoms. METHODS 812 community women who were formerly depressed, currently depressed, or never depressed were compared on a variety of indices of interpersonal behavior and beliefs. Information was also obtained from their spouses, adolescent children, and raters. Current depressive mood and sociodemographic factors that might affect social functioning were controlled. RESULTS Consistent with the hypotheses that interpersonal difficulties are not just consequences of depressive symptoms, formerly but not currently depressed women were significantly more impaired than never-depressed women on nearly all measures. They were less likely to be stably married, had poorer marital satisfaction, reported more spouse coercion and physical injury, had more problematic relationships with their child, friends, and extended family, reported more stressful life events with interpersonal and conflict content, and were more insecure in their beliefs about other people. Their spouses and boyfriends also reported more problems, and were themselves more likely to have diagnosable disorders. However, the groups did not differ in their childrens perceptions of maternal warmth or hostility. LIMITATIONS The cross-sectional design precluded conclusions about the causal direction of the relationship between interpersonal impairment and depressive disorder. Since clinical depression is more often than not followed by subthreshold symptoms that are not captured by standard diagnostic instruments, such symptoms are not easily discernable from preceding or co-existing interpersonal problems. Only women were studied. CONCLUSIONS Interpersonal impairment is a stable feature of depression, a significant challenge to treatment, and may reflect underlying vulnerability to the onset, and recurrence, of depressive experiences.

Chronic and acute stress and the prediction of major depression in women.

Background: This study explored the relatively neglected role of chronic stress in major depression, examining the independent contributions of co‐occurring chronic and acute stress to depression, whether chronic stress predicts acute life events, and whether the two types of stress interact such that greater chronic stress confers greater sensitivity—or resistance—to the depressive effects of acute stressors. Methods: From a sample of 816 community women, those who had a major depression onset in the past 9 months and those without major depressive episodes (MDE) onset and with no history of current or recent dysthymic disorder were compared on interview‐based measures of antecedent acute and chronic stress. Chronic stress interviews rated objective stress in multiple everyday role domains, and acute stress was evaluated with contextual threat interviews. Results: MDE onset was significantly associated with both chronic and acute stress; chronic stress was also associated with the occurrence of acute events, and there was a trend suggesting that increased acute stress is more strongly associated with depression in those with high versus low chronic stress. Conclusions: Results suggest the importance of including assessment of chronic stress in fully understanding the extent and mechanisms of stress–depression relationships. Depression and Anxiety, 2009. Published 2009 Wiley‐Liss, Inc.

Early childhood adversity and adolescent depression: the mediating role of continued stress

BACKGROUND While various conceptualizations of the link between childhood adversity and later depression have been offered, most have not accounted for the possibility that early adversity predicts continuing stress proximal to depression onset. Thus, the present study tested the possible mediating role of recent stress in the association between early adversity and depression in late adolescence. METHOD Study questions were examined in a longitudinal community sample of 705 youth who were contemporaneously assessed for early adversity exposure prior to age 5 years, chronic and episodic stress at age 15 years, and major depression prior to age 15 years and between 15 and 20 years. RESULTS Total youth stress burden at age 15 years mediated the effect of early adversity on depression between ages 15 and 20 years, and none of the observed relationships were moderated by onset of depression prior to age 15 years. CONCLUSIONS These findings suggest that continued stress exposure proximal to depression onset largely accounts for the association between early adversity and depression in late adolescence. Intervention should thus focus on disrupting the continuity of stressful conditions across childhood and adolescence. Future studies of the neurobiological and psychosocial mechanisms of the link between early experiences and depression should explore whether the effects of early experiences are independent of continuing adversity proximal to depressive onset.

Interpersonal Impairment and the Prediction of Depressive Symptoms in Adolescent Children of Depressed and Nondepressed Mothers

OBJECTIVE Different pathways to youth depression should be explored. Based on an interpersonal impairment perspective on depression, the currently depressed children of depressed mothers were hypothesized to differ in predictors of their depression compared with depressed children of nondepressed mothers. Chronic social difficulties were expected to be more predictive of depressive symptoms in offspring of depressed women, while recent stressful life events were expected to predict depression in offspring of never-depressed women. METHOD A community sample of 812 fifteen-year-old children of depressed and nondepressed women was studied in Queensland, Australia, between 1996 and 1999; chronic and episodic stress in the past 6 to 12 months were examined in relation to current depressive disorders. RESULTS Depressive states in children of depressed mothers were more associated with chronic interpersonal difficulties than were the depressions of children of nondepressed women, and the latter group had greater increases in depression level associated with episodic stressors than did children of depressed women. CONCLUSIONS The results may reflect greater depression reactivity to chronic social difficulties among offspring of depressed mothers. Depressive experiences may have different predictors in subgroups of depressed youths and imply potentially different courses and needs for treatment.

Integrating biological and social processes in relation to early-onset persistent aggression in boys and girls.

This study examined the relationship between biological and social risk factors and aggressive behavior patterns in an Australian high-risk sample of 370 adolescents. Perinatal, temperamental, familial, sociodemographic, and behavioral data were collected during interviews completed during pregnancy. immediately postpartum, and when the children were 6 months old and 5, 14, and 15 years old. Youths were given tests of verbal and neuropsychological functioning at the age 5 and age 15 follow-ups. Youths were divided into early-onset persistent aggression, adolescent-onset aggression, and nonaggressive behavior groups. Results revealed that the interaction of biological and social risk factors was significantly related to early-onset persistent aggression. Gender and developmental phase of measurement moderated the relationship between biosocial risks and the outcomes of early-onset persistent aggression and adolescent-onset aggression.