Depression and parenting: the need for improved intervention models

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Highlights

  • Parental depression is associated with a variety of indicators of poorer quality parenting.

  • The established impact on parenting includes increased stress, negative behaviors and potentially a reduction in the quality of the parent–child relationship.

  • Child developmental outcomes follow from both depression, parenting and their interaction.

  • Current treatments of depression have not yet been shown to reduce the impact of parental depression on parenting or child outcomes.

The impact of maternal depression on parenting is well established and there is a clear interaction between maternal depression and parenting that is predictive of child outcomes. The research on paternal depression is more limited but suggests the father’s mental health may be an independent risk factor for both parenting and child outcomes. There is insufficient evidence that treatment of depression alone – be it through pharmacological or psychological interventions – is able to substantially reduce the impact of depression on child outcomes. The evidence of interventions aimed at parenting and/or child outcomes in the context of depression is limited and the findings that are available are mixed.

Section snippets

Background

Parental depression has emerged as one of the most significant risk factors for child mental health and emotional wellbeing. While effects of parental depression on children are not inevitable [1] parental depression remains one of the most important modifiable factors in the transmission of mental disorder from one generation to the next.

The relationship between depression in both mothers and fathers, its impact on parenting and child outcomes is complex and remains to be fully elucidated.

From pregnancy to early childhood

Maternal depression in pregnancy and following childbirth is one of the most common problems faced by women [4, 5]. Initially research focused on effects of postnatal depression (PND) on parenting and child outcomes. For example, a 22-years longitudinal study of the effects of PND led by Murray and Cooper has continued to find independent effects from exposure to maternal PND on outcomes across adolescence and well into adulthood including altered stress reactivity in young adults [6]. A

Effects of paternal depression on child outcomes

The available research on the effects of paternal depression on parenting and child outcomes is more limited than maternal depression. Two recent meta-analyses have examined the role of paternal depression on parenting behavior and on child outcomes, respectively [3, 26•]. Both have shown significant effects although the number of studies available was small. One interesting outcome of these reviews was that the impact of paternal depression was greater when a younger child was exposed.

A

The role of treatment of depression

This literature shows effects of parental depression from infancy to adolescence [29, 30, 31, 32]. Chronicity, severity, trajectory and current symptoms of depression all predict parenting behaviors and child outcomes. An interesting aspect of this literature is to consider whether the treatment of parental depression can also improve either parenting or child outcomes.

While there is a plethora of evidence supporting the psychological treatment of depression, the effects of such treatment on

Pathways from depression to parenting

The relationship between parental depression and parenting includes understanding effects on child outcomes. Key moderators between parental mental health and child mental health clearly will include genetics as well as other important developmental influences. However, it is also clear that mediating factors such as adverse parental relationship including domestic violence and parenting practices influenced by depression will also be important for understanding parental depression and child

Conclusion

Parenting can be one of the most enriching of human experiences and contributes to lifelong wellbeing for offspring. Parental depression has consistently been associated with an adverse impact on the experience of parenting, parenting behaviors, and the quality of the parent–child relationship with implications also for child development. It is therefore apparent that investing in understanding the inter-relationship between parental depression, parenting and child outcomes will be crucial to

Conflict of interest statement

MG has previously received honorarium for speaking from Lundbeck. The other author declares that they have no competing interests. The writing of this paper received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

References and recommended reading

Papers of particular interest, published within the period of review, have been highlighted as:

  • • of special interest

  • •• of outstanding interest

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