problems at ages 11 and 16 (Hay et al., 2001). In the other British study, which sampled from a more middle-income population, postnatal depression exposure was associated with subsequent behavior problems (at age 5) and symptoms of hyperactivity and conduct disorder (at age 8) (Morrell and Murray, 2003). However, later follow-ups revealed that both postnatal depression and later episodes of depression in mothers predicted depression in the children at age 13, although anxiety was best predicted by postpartum exposure alone (Halligan et al., 2007).
Others concluded that postpartum depression does not predict later functioning in children, but that it is later exposures that matter. For example, in a large study of predominantly low-income Australian mothers and their children, mothers’ recent depressive symptoms were associated with their 5-year-old children’s socioemotional problems, whereas their postpartum depression levels were not (Brennan et al., 2000).
Other support for the conclusion that postpartum depression combined with later exposures is what matters for children comes from another British study, in which only postpartum depression that continued was associated with children’s behavior problems at age 15 months (Cornish et al., 2006) and age 4 years as reported by mothers, fathers, and teachers (Trapolini, McMahon, and Ungerer, 2007).
Among studies that did not explicitly examine treatment for depression in the parents, the small longitudinal literature reveals that, for the most part, children’s problems persist despite the mothers’ remission or recovery from depression. Typical of these studies are two that focused on children of preschool age through adolescence. Children of depressed parents continued to be at risk for psychological problems despite reductions in parents’ depressive symptoms (Billings and Moos, 1985; Lee and Gotlib, 1991; Timko et al., 2002). Most of the longitudinal studies of infants and toddlers have drawn similar conclusions, that is, children of the recovered mothers showed fewer disturbances than the children of unrecovered mothers but greater disturbances than the children of control mothers who had never been depressed (Cox et al., 1987; Ghodsian, Zayicek, and Wolkind, 1984). Similarly, in a follow-up of low-income children ages 18 months to 4–6 years, Alpern and Lyons-Ruth (1993) showed that both the group of children whose mothers exceeded the clinical cutoff score on a depression rating scale at both times and the group whose mothers were previously but not currently depressed had more behavior problems than the children with never-depressed mothers.
Maternal depression during the first postpartum year predicted lower cognitive ability at age 4 years regardless of the mother’s depression status