stressors. For example, Adrian and Hammen (1993) found that children of depressed mothers were exposed to stressful events in their families because of increased interpersonal conflict associated with the parent’s depression, and that family stress was also (along with depression in the mothers) an important predictor of both internalizing and externalizing problems in children.

Stress clearly needs to be an integral part of a model of associations between depression in parents, parenting, and outcomes in children. As an example of the essential role of stress, Jones, Forehand, and Beach (2000) studied the role of maternal depressive symptoms and family relationship stress in a community sample. Mothers’ initial depressive symptoms generated perceived stress in both marital and mother-adolescent relationships a year later. In turn, mother-reported family relationship stress exacerbated her depressive symptoms. Mother-reported stressful family interactions also contributed to higher levels of depressive symptoms in both adolescent girls and boys. Although no evidence of a family stress generation process for fathers was found, father-reported family relationship stress was associated with greater adolescent depressive symptoms.

Beyond social support and stress, other moderators, which may increase or decrease the degree of association between depression and parenting, are the level of depression symptom severity, being in or out of a depressive episode, and level of impairment. There is evidence that problematic parenting behaviors persist, as depressed individuals continue to experience interpersonal impairment when not in a depressive episode (Hammen, 2003). However, more research is needed to determine how parenting qualities change in relation to exacerbation or improvement in depression symptoms.

Depression in women who became mothers as teenagers is also a concern, with teenage parenting considered a moderator of associations between depression in parents and adverse outcomes in children. The subset of children of depressed mothers whose mothers gave birth as teenagers may be worse off than other children of depressed mothers. Being a teenage mother is an independent risk factor for depression and also for adverse outcomes for children, although not all such mothers become depressed and not all of their children develop problems. African American women who become mothers during adolescence are more likely to be depressed than their peers who delay motherhood (Deal and Holt, 1998; Horwitz et al., 1996). Teenagers who become pregnant have been found to engage in more maladaptive parenting behaviors than adult mothers (Garcia-Coll et al., 1986; Hann et al., 1994). They are less likely to be empathic and more likely to value physical punishment than adult mothers (Fox et al., 1987). In our review, we highlight studies that sampled teenage mothers for



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