. "4 Associations Between Depression in Parents and Parenting, Child Health, and Child Psychological Functioning." Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press, 2009.
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Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention
velopmental processes associated with later hypothalamic-pituitary-adrenal (HPA) axis functioning, potentially resulting in dysregulated stress response systems that have been identified as vulnerabilities to depression (Heim, Plotsky, and Nemeroff, 2004; Kammerer, Taylor, and Glover, 2006).
As with the limitations associated with knowledge of moderators and mediators, the literature is also limited in its ability to draw conclusions from a developmental perspective. Most of the outcomes studied are cross-sectional (both the parent’s depression and the child’s functioning were studied at the same time) rather than longitudinal (studying the parent’s depression and the child’s functioning at two or more times to see if changes in depression over time, such as increases in depressive symptom levels, account for changes in child functioning, such as the emergence of psychological problems). Thus most knowledge is about specific outcomes associated with concurrent depression in mothers at specific child ages (e.g., 4-year-old children of mothers who are depressed at that time). We know less about the course of outcomes over time for children exposed at particular times, taking into account the child’s age when first exposed to depression in the parent (including potentially prenatally) and the chronicity and patterns of recurrence of the parent’s depression. The latter question is complicated by depression being recurrent and the possibility that correlates of depression that matter for children (especially stressors and parenting qualities) may or may not vary with the course of illness (being in episode or in recovery). It is also important to consider the transactional nature of child rearing, in that both parental depression and child functioning continue to influence each other in an ongoing, cyclical manner throughout development (Elgar et al., 2004; Sameroff, 1975). In this review, we present a summary of what is known not only from the cross-sectional studies but also from the longitudinal studies and from studies that include pregnancy measures of depression.
A further limitation of the literature is that the vast majority of studies of parental depression are on depression in mothers rather than fathers. Nonetheless, we reviewed the scant literature on depression in fathers. We also report on the Connell and Goodman (2002) meta-analysis in which we found that, although depression in both mothers and fathers has been shown to affect children’s psychological functioning, both internalizing and externalizing problems in children are more strongly associated with depression in mothers than with depression in fathers.
For some children, the primary caregiver is the grandmother. Thus it is relevant to understand the prevalence of depression in grandmothers or grandfathers who care for their grandchildren, the effect of depression in grandparents on their grandchildren, moderators of those associations, and the role of parenting qualities and other mediators in those associations. The committee found very few studies addressing these points. Findings on