2002; Dawson et al., 1997). However, depression during pregnancy was measured retrospectively when the mothers were 13–15 months postpartum, and depression was defined to include women who were in partial remission or subthreshold. If this finding is replicated, it suggests the need to examine such mechanisms as genetics and intrauterine factors for the association between maternal depression and frontal brain activity in prenatally exposed infants.
Other potential moderators yield mixed findings. For example, abnormalities in neurobiological or neuroendocrine functioning in infants are sometimes specifically found to be associated with face-to-face interaction with their depressed mothers (Field, 1992) and with harsh parenting in particular (Hertsgaard et al., 1995), but others find them to reflect a more general trait (Dawson et al., 2001).
The ultimate outcome of concern among children of depressed parents is the emergence of elevated levels of behavior problems or diagnosable psychopathology. Many studies show that rates of depression are higher in children with depressed mothers, whether the maternal depression is determined by meeting diagnostic criteria or clinically significant levels of depressive symptom scale scores, relative to a variety of controls (Beardslee et al., 1988; Billings and Moos, 1985; Goodman et al., 1994; Lee and Gotlib, 1989; Malcarne et al., 2000; Orvaschel, Walsh-Allis, and Ye, 1988; Weissman et al., 1984; Welner et al., 1977). Studies with adolescents show the same. Adolescents with depressed parents have been found to have higher rates of depression (Beardslee et al., 1988; Beardslee, Schultz, and Selman, 1987; Hammen et al., 1987; Hirsch, Moos, and Reischl, 1985) as well as higher rates of other disorders (Orvaschel, Walsch-Allis, and Ye, 1988; Weissman et al., 1984) relative to controls. Overall, rates of depression in the school-age and adolescent children of depressed mothers have been reported to be between 20 and 41 percent, in contrast to general population rates of about 2 percent in children ages 12 and younger and 15 to 20 percent in adolescents (Lewinsohn et al., 2000). Higher rates among children of depressed parents are associated with greater severity or impairment of the parent’s depression and with the addition of other risk factors, such as those associated with poverty.
Not only are rates of depression higher, but depression in children of depressed parents, relative to depression in same-age children of non-depressed parents, has an earlier age of onset and longer duration and is associated with greater functional impairment and a higher likelihood of recurrence (Hammen and Brennan, 2003; Hammen et al., 1990; Keller et al., 1986; Warner et al., 1992).