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

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Title: 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  • more drowsy, fussy, withdrawn, disruptive,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
Outcome variable Cycle 2 Age 2 to 4 years Cycle 2 Age 2 to 4 years
Outcome variable Depressed Non-depressed
Anxiety 1.28 (0.275) 1.20 (0.238)
Hyperactivity 1.74 (0.448) 1.62 (0.400)
Aggression 1.49 (0.478) 1.40 (0.428)
Prosocial Behavior 2.12 (0.544) 2.13 (0.524)
22
Outcome variable Cycle 3 Age 4 to 6 years Cycle 3 Age 4 to 6 years
Outcome variable Depressed Non-depressed
Anxiety 1.32 (0.293) 1.25 (0.259)
Hyperactivity 1.74 (0.442) 1.58 (0.399)
Aggression 1.35 (0.390) 1.26 (0.311)
Prosocial Behavior 2.22 (0.407) 2.22 (0.385)
23
Outcome variable Cycle 4 Age 6 to 8 years Cycle 4 Age 6 to 8 years
Outcome variable Depressed Non-depressed
Anxiety 1.38 (0.344) 1.31 (0.301)
Hyperactivity 1.72 (0.480) 1.58 (0.416)
Aggression 1.29 (0.380) 1.23 (0.308)
Prosocial Behavior 2.38 (0.406) 2.41 (0.363)
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
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