. "2 Approach to Research and Its Evaluation." 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
any particular point in time of studying these families. We also recognized the importance, and the challenge, of understanding any child’s history of exposure to depression in a parent. We expected that the age of the children at the times the parent was depressed would influence the particular risks to their development, the resiliencies that they would be able to bring to bear, the mechanisms by which those risks might be transmitted, the challenges to parenting with depression, the approach to screening for depression, and the nature of the preventive or other intervention that might be found to be effective. Although we reviewed literature that suggests reasons to be concerned and to intervene regardless of the children’s ages, we also noted a compelling case for the youngest children. Most important was the understanding that development needs to be taken into account.
A Developmental Psychopathology Perspective
We were also guided by a developmental psychopathology perspective, which conceptualizes risk for the development of psychopathology in terms of processes that extend through time and are considered in the context of normal developmental processes (Cicchetti and Schneider-Rosen, 1984; Sroufe and Rutter, 1984). Understanding the mechanisms of risk in children of depressed parents requires understanding the processes underlying individual patterns of adaptation and the consequences of the individual patterns for the development of depression or other problems. Early in their developmental pathways, children of depressed mothers may develop vulnerabilities for depression, which, in turn, increase the likelihood of developing depression. Given the stage-salient needs of infants, of particular concern have been limits on depressed mothers’ abilities to provide the sensitive, responsive care needed for the development of healthy attachment relationships (Egeland and Farber, 1984) and emotional self-regulation (Tronick and Gianino, 1986). We recognized the value of knowledge of children’s potential vulnerabilities and developmental needs to inform screening, prevention, treatment, and policy.
Depression and Parenting Children Across Development
Even when one takes a developmental perspective, it is often ignored that, among women with depression, it occurs during pregnancy with at least as high a rate as in the postpartum period (Evans et al., 2001). Antenatal depression may be an early life stress that alters fetal development of stress-related biological systems (especially hypothalamic-pituitary-adrenal functioning), retards fetal growth, constricts the length of gestation, and increases risk of obstetrical complications (Van den Bergh et al., 2005). Concerns about the fetus suggest potential long-term implications for the