of depressive symptoms were 2 to 3 times more likely to report recently feeling helpless or frightened and upset by the child’s asthma. For families dealing with asthma, the role of maternal depression in disease control has been shown to be mediated by the child’s psychological problems as well (Lim, Wood, and Miller, 2008). Findings on depression being associated with parents’ greater hostility and lower warmth/nurturance have also been replicated in low-income African American mothers of children with asthma (Celano et al., 2008), with implications for problems in parents’ management of these children’s persistent health care needs.

Maternal depression and related parenting issues play a role not only in the management but also in the development of asthma. Parenting difficulties early in life, subsequent child psychosocial problems, and immunoglobulin E levels at age 6 were significant predictors of asthma at ages 6–8 years in a longitudinal cohort at high risk for asthma (Klinnert et al., 2001). Maternal depressive symptoms measured at age 6 were strongly correlated with key predictors, parenting, and child psychosocial problems. In a recent large birth cohort study, children with continued exposure over the first 7 years of life to mothers under treatment for depression and anxiety had higher incidence of asthma (odds ratio = 1.25) after controlling for asthma risk factors (Kozyrskyj et al., 2008). These effects were greater in high-income than low-income households.

Only recently have studies been published that examine more closely the interface between maternal mental health, parenting, child behavior, and chronic disease management. These asthma studies illustrate how maternal depression might play a role in adverse outcomes for childhood chronic physical health conditions when psychosocial factors influence the disease process and the diseases require careful parental attention to care management regimes and monitoring.

Other health consequences may occur because of changes in the family environment associated with maternal depression. Mothers of young children with depression are more likely to be smokers (Whitaker, Orzol, and Kahn, 2006), thus exposing children to secondhand smoke that is associated with more respiratory problems (Neuspiel et al., 1989). In a longitudinal study of depressed parents, more respiratory illness was reported in children during middle childhood (Goodwin et al., 2007). Among preschoolers, the children watching the most television were predicted by two factors, maternal depression and maternal overweight status (Burdette et al., 2003). Excessive television viewing in young children has implications for obesity and behavior. Other preventive health parenting practices that may limit optimal health and prevention of disease in children are discussed in the earlier section on parenting practices.



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