مسیر نقطه ضعف: توضیح رابطه بین افسردگی مادر و مشکلات رفتاری کودکان

Abstract A large body of literature documents that children of depressed mothers have impaired cognitive, behavioral, and health outcomes throughout the life course, though much less is known about the mechanisms linking maternal depression to children’s outcomes. In this paper, I use data from the Fragile Families and Child Wellbeing Study to estimate and explain the consequences of maternal depression for 5-year-old children’s internalizing and externalizing problem behaviors. Ordinary least squared (OLS) regression models and propensity score models show that children exposed to both chronic and intermittent maternal depression have more problem behaviors than their counterparts with never depressed mothers. Results also show that economic resources and maternal parenting behaviors mediate much of the association between maternal depression and children’s problem behaviors, but that relationships with romantic partners and social support do little to explain this association. This research extends past literature by illuminating some mechanisms through which maternal depression matters for children; by utilizing longitudinal measures of depression; by employing rigorous statistical techniques to lend confidence to the findings; and by using a large, diverse, and non-clinical sample of children most susceptible to maternal depression. Given that early childhood problem behaviors lay a crucial foundation for short- and long-term life trajectories, the social consequences of maternal depression may be far-reaching.

Introduction A substantial literature addresses inequalities in the social and emotional wellbeing of young children, as well as explanations for these inequalities and the consequential, long-term effects of divergent outcomes. Internalizing problem behaviors (such as feeling lonely or nervous) and externalizing problem behaviors (such as destroying things or fighting) are perhaps the most commonly studied indicators of social and emotional wellbeing in early childhood. Impaired behaviors during early childhood may place children on trajectories to experience disadvantages throughout the life course (Caspi et al., 1989, Crosnoe and Elder, 2004, Entwisle et al., 2005, McLeod and Fettes, 2007 and McLeod and Kaiser, 2004; though see Duncan et al., 2007). Children’s internalizing and externalizing problem behaviors are not randomly distributed across the population but are instead influenced by a host of individual- and family-level characteristics such as race (Lee and Burkam, 2002), socioeconomic status (Duncan and Brooks-Gunn, 1997), and family instability (Fomby and Cherlin, 2007). One predictor of children’s problem behaviors that has received relatively less attention in the literature is maternal depression. Major depressive disorder is one of the most common, chronic, and debilitating mental health disorders, affecting more than 13 million individuals – many of them parents – in the United States annually (Kessler et al., 2003). There are compelling conceptual reasons that may explain why maternal depression is associated with young children’s problem behaviors. Depression – which is characterized by symptoms including fatigue, difficulty concentrating, and losing interest in daily activities – is a leading cause of role impairment that may compromise a mother’s ability to provide her child necessary developmental resources. The social consequences of depression are far-reaching, with sufferers reporting being unable to carry out usual activities for nearly 30 days each year (Kessler et al., 2003 and Merikangas et al., 2007). Depression may increase economic insecurity (Frank and Koss, 2005 and Marcotte and Wilcox-Gok, 2001), impair a mother’s ability to parent effectively or consistently (Lovejoy et al., 2000 and Marmorstein et al., 2004), and facilitate withdrawn or negative interactions in romantic partnerships and other social relationships (Coyne, 1976 and Kim and McKenry, 2002), all of which are independently and robustly associated with child wellbeing. Maternal depression may be especially detrimental to young children, as young children are dependent on their parents, have little exposure to social settings outside the home, and may be less equipped to cope with stressors. Indeed, existing research finds maternal depression is associated with impaired cognitive, behavioral, and health outcomes from infancy through adulthood (Augustine and Crosnoe, 2010, Downey and Coyne, 1990, Goodman and Gotlib, 2002, Hammen et al., 2008, Kiernan and Carmen Huerta, 2008 and Weissman et al., 2006). Though this research suggests maternal depression has important, negative, and long-lasting consequences for children, there are several opportunities to advance our understanding of this relationship, not the least of which is understanding the pathways linking maternal depression to children’s outcomes. Theoretical perspectives suggest several potential mechanisms through which maternal depression renders children vulnerable and researchers agree about the importance of understanding these pathways (Downey and Coyne, 1990, Goodman and Gotlib, 2002, Gunlicks and Weissman, 2008, Hammen and Brennan, 2003 and Turney, 2011a), but relatively little research has comprehensively explored these mechanisms. Thus, in this paper, I broaden our understanding of the consequences of depression by investigating the relationship between maternal depression and 5-year-old children’s internalizing and externalizing problem behaviors. I use data from the Fragile Families and Child Wellbeing Study, a survey of nearly 5000 mostly unmarried couples who had children between 1998 and 2000, which provides an exceptional empirical lens to understand this relationship. These data include a large, diverse sample of children arguably most at risk of exposure to maternal depression and to problem behaviors; feature a longitudinal design that includes established measures of depression and problems behaviors; and contain unusually rich information about family functioning and other previously unobserved information (e.g., depression in the child’s maternal and paternal grandparents, co-parenting among the child’s mother and father). Given that substantial numbers of children are exposed to maternal depression, the unequal distribution of maternal depression, and the importance of early childhood behaviors for life course trajectories, disentangling the consequences of maternal depression for children adds a new dimension to our understanding of social inequalities.

7. Conclusions Overall, results suggest maternal depression has important implications for child wellbeing. Children exposed to maternal depression early in the life course, especially those exposed to depression across multiple years, are more likely than their counterparts to have internalizing and externalizing problem behaviors when they are 5 years old. Much of the independent consequences of depression for children, though, stem not directly from depression but instead from other social consequences of depression. These findings extend prior research on the consequences of maternal depression for children by using a large, non-clinical sample; by utilizing longitudinal measures of maternal depression; by employing rigorous statistical techniques to lend confidence to the findings; and, most importantly, by elucidating mechanisms through which depression matters for children. Given the importance of early childhood behavioral problems predicting short- and life-term trajectories, these findings may have implications for the intergenerational transmission of inequality.