• Parental functioning, prenatal exposure to stress and anxiety, genetic influences, and stressful environments appear to play a role in the development of adverse outcomes in children.

This chapter reviews what is known about the associations among depression in parents and parenting, child health, and child functioning, based on the large number of epidemiological and clinical studies that have documented these associations. Throughout our work, the committee recognized that depression exists in a broader context of comorbidities, correlates, and contexts. In addition, there has been a growing body of research that suggests that parenting styles and processes are not necessarily universal and may differ and have differential impact on children’s behavior based on culture and ethnic group variations (Deater-Deckard et al., 1996). Thus, the literature was approached with a caution against interpreting outcomes as owing solely to the depression in the parent as a single risk factor. With this in mind, the committee’s task was to review the literature that focused on (1) direct association between depression in parents and parenting, child health, and child functioning; (2) conditions that may make the association stronger or weaker (i.e., moderators); and (3) mechanisms or intermediate steps (i.e., mediators) through which depression in the parent becomes associated with parenting or with outcomes in children. Although a review of the effects of parents’ depression on the family (e.g., marital conflict) is not within the study scope, such effects are integrated into the literature summaries when findings bear on moderation (e.g., when maternal depression is more strongly associated with adverse child outcomes in the presence of high marital conflict rather than low marital conflict) or mediation (e.g., when maternal depression is associated with an increase in marital conflict, which is then associated with adverse child outcomes).

Skills in parenting are key to facilitating healthy development in children. Qualities of parenting that have been found to be related to healthy development vary by age of the child. They range from the sensitive, responsive caregiving especially needed by infants to the monitoring that is particularly needed by adolescents. Important aspects of effective parenting across development include providing age-appropriate levels of warmth and structure to help children feel safe and to help regulate their emotions (e.g., Cole, Martin, and Dennis, 2004). Children also are dependent on their parents to facilitate their education and to obtain their medical care.