Longitudinal study of the impact of postpartum depression on children's behavior to 8 years of age

1
Longitudinal study of the impact of postpartum
depression on children's behavior to 8 years of
age

• N. Letourneau and J. D. Willms
• Canadian Research Institute for Social Policy

2
Acknowledgements

• Cindy-Lee Dennis
• Cara Fedick
• Kathleen Hegadoren
• Miriam Stewart
• Social Sciences and Humanities Research Council,
  Initiative on the New Economy

3
Depressed mothers often

• have impaired maternal-infant interactions and
  negative perceptions of normal infant behavior
• less likely to pick up on their infants cues
  resulting in less positive feedback and a
  decreased likelihood of meeting their infants
  needs

4
Depressed mothers often

• less sensitive and appropriate in their
  interactions with their children, and more
  negative in their play
• speak more slowly and less often
• less emotionally expressive and responsive
• less affectionate and more anxious

5

• Disturbances in mother-child interactions are
  observed at one year postpartum, even when
  mothers are no longer depressed.

6
Infants more often

• abused or neglected
• diagnosed with failure to thrive
• hospitalized for poor health

7

• Two meta-analyses suggest that PPD has a
  significant effect on infants cognitive and
  social development.

8
3 to 7 month old infants

• are more tense, less content
• show fewer positive facial expressions, more
  negative expressions and protest behavior
• more drowsy, fussy, withdrawn, disruptive,
  avoidant, and disengaged in maternal-infant
  interactions and in toy play.

9
19 month old infants

• show less sharing, concentration, and sociability
  to strangers, and a lower overall rate of
  interaction
• less responsive and interactive and show
  decreased positive affect
• show more insecure (avoidant) attachment.

10
3- 5 year old children

• are more difficult
• respond in negative manner to friendly approaches
  by other children
• boys most likely to show behaviour problems

11
Long-term effects

• Parental mental health problems can compromise 12
  year-old childrens behavioral adjustment.
• Children of mothers who experienced PPD are two
  to five times more likely to develop long-term
  behavioral problems.

12
Boys and girls

• Boys of depressed mothers tend to display more
  externalizing behaviors including aggression and
  hyperactivity characterized by antisocial,
  active, and distractible behaviors
• Girls of depressed mothers tend to display more
  internalizing behaviors such as anxiety and
  withdrawal

13
Theory

• PPD disrupts maternal behavior and infant
  interactions and engagements with the mother, and
  as a consequence, impairs infant health and
  developmental outcomes.

14
Theory
15
Research Question

• Compared to mothers who are not depressed after
  childbirth, what is the impact of maternal
  depression on childrens anxiety, hyperactivity,
  aggression and prosocial behaviors over time?

16
Do factors such as parenting, social support,
SES, and child gender affect this impact?
17
Where did we get our data?

• National Longitudinal Survey of Children and
  Youth (NLSCY)
• Launched in 1994 by Statistics Canada to track
  the development, health, and well-being of a
  nationally-representative sample of children in
  Canada over time.
• Four cycles of NLSCY data were used
• Cycle 1 (1994-95), Cycle 2 (1996-97), Cycle 3
  (1998-99) and Cycle 4 (2000-01).

18
How many families?

• Four cycles of NLSCY data were used
• Cycle 1 (1994-95), Cycle 2 (1996-97), Cycle 3
  (1998-99) Cycle 4 (2000-01).
• 3533 mothers and children were in our sample
• 691 mothers were depressed when their infants
  were less than 2 years of age.

19
Behaviour Measures

• Anxiety
• Hyperactivity
• Aggression
• Prosocial
• 1 Never or not true, 2 Somewhat or sometimes
  true, and 3 often or very true
• Higher scores show increased presence of behavior
  in the child.

20
Method

• Hierarchical linear modelling
• Allows analysis of growth trajectories

21
(No Transcript)
22
(No Transcript)
23
(No Transcript)
24
Findings
25
Then we added the other variables

• Parenting
• Positive discipline
• Warm and nurturing
• Consistent
• Social Support
• SES
• Single Parent
• Gender

26
What happened?

• The effects of postpartum depression were
  diminished

27
Anxiety

• Positive discipline and consistent parenting
  lowered the level of anxiety at 2 years of age.
• Being in a single parent household raised the
  initial level of anxiety in 2-year-old children.

28
Hyperactivity

• Positive discipline, warm and nurturing parenting
  and SES all decrease initial levels of
  hyperactivity in two year olds.
• Female children have lower levels of
  hyperactivity than males at age two.

29
Aggression

• Initial Aggression scores are lower for 2 year
  old children who experience positive discipline
  and warm and nurturing parenting

30
Discussion

• Exposure to maternal depression in infancy
  appears to affect childrens behavior at two
  years of age and these effects may persist to
  eight years of age and beyond.
• However, parenting characteristics may have a
  greater impact on childrens anxiety,
  hyperactivity, aggression, and prosocial
  behaviours.

31
Intervention

• Needs to start early
• Should target parenting behaviours
• Should be offered to all parents, regardless of
  depression

32
Thank you