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Abstract

Aim: The aim of the study was to examine the effects of maternal depression during the postpartum period (t1) on the later behavior problems of toddlers (t3), specifically the underlying effects of paternal psychopathology during toddlers' lives and maternal parenting behavior observed during mother child interaction (t2).

Methodology:  A longitudinal study of 101 mothers with their toddlers was carried out. Out of the total sample selected, 50 respondents had experienced an episode of Major Depressive Disorder (MDD) during the first 18 months of their toddlers' lives

Results: There was a significant association between maternal depression at t1 with toddlers' internalizing and externalizing behavior problems only in the presence of paternal psychopathology. As postulated, maternal negativity at t2 interceded the relationship between maternal depression at t1 and toddlers' externalizing behavior problems at t3.

Discussions and Conclusions: Results were consistent with postulations that severe outcomes in children exposed to maternal depression are also dependent upon the presence or absence of paternal psychopathology.  As foreseen, the effects of maternal depression on toddlers' behavior problems on spouses were moderated by paternal psychopathology. According to the study, psychopathology in fathers is a risk factor for toddlers' internalizing problems when mothers have either a history of or current depressive symptoms and externalizing behavior problems when mothers have been previously depressed. In conclusion, negative maternal response interceded the effects of current maternal depression on toddlers' behavior problems. Toddlers who experienced both maternal depression and paternal psychopathology in their lives had the highest scores of behavior problems.

Recommendations: Findings suggest the importance of probing other risks in the family context associated with maternal depression. These results also recommends for examining maternal negativity in the context of mother to child interactions and paternal psychopathology as respective intermediaries and moderators of adjustment of young children with motherly depression. To decrease toddlers' risk for later behavioral problems, the study also support the use of early psychosocial clinical interventions that target negative interaction styles in mothers who have experienced a postpartum depression

Objective of the study

The main objective of the study was to examine the relations among maternal depression, paternal psychopathology, and maternal parenting in the context of mother child interactions on toddlers' externalizing and internalizing behavior problems. In this study the indices for maternal parenting used included negativity, low warmth, and negative feedback. The objective was achieved by answering the following research questions: (i) Does paternal psychopathology moderate the relationship between maternal depression and toddlers' behavior problems? and

(ii) Does Negative maternal parenting mediate associations between maternal depression and toddlers' behavior problems?

Hypotheses

It was postulated that: (i) Paternal psychopathology moderated the relationship between maternal depression and toddlers' behavior problems and (ii) Negative maternal parenting mediated associations between maternal depression and toddlers' behavior problems

Significance of the study

To contribute on the social development literature related to maternal depression

Limitations of the Study

According to Chilcoat and Breslau (2004), indices of maternal depression obtained from maternal report increases the single reporter bias (used in this study), instead of using data from multiple informants particularly depressed mothers. Also generalization of research findings may overestimate the negative affects of maternal depression on later toddlers' externalizing and internalizing problems since majority of mothers described in this article evidenced depressive symptoms so severe that they sought psychiatric treatment of which the larger population of depressed mothers typically does not seek psychiatric treatment

Literature review

Maternal depression

Hey et al (2001), reveal that early exposure to maternal depression has been hypothesized to interfere with children's normative developmental processes and several studies indicate that early exposure to maternal depression has lingering detrimental effects on children's functioning

Studies that do not find main effects for the impact of maternal depression on child outcomes may be related to the limited examination of family risk factors that co-occur with maternal depression and increase prediction of which children exposed to maternal depression are most at-risk. Specifically, maternal depression may be more likely to be associated with young children's maladjustment in the presence of paternal psychopathology and negative maternal interaction styles.

Cohen and Campbel (2004) found that maternal depression, in the absence of other risk factors, did not predict poor infant responsiveness or insecure attachment in infants. Similarly in a study dubbed maternal depression and toddler attachment, by Cummings et al.( 1990), there are no differences in rates of infant attachment insecurity between depressed and non depressed mothers, although higher rates of insecure attachment were evident in the children of mothers with bipolar disorder. Seifer et al (1996), further reiterates that toddlers with depressed mothers did not differ from controls in their attachment security and social competence.

A meta-analysis of studies on the effects of early maternal depression on infant attachment by Martins and Gaffan (2000), suggest that maternal depression, as a single risk factor, may not always predict child maladjustment early in development.

Cornish et al (2006), suggest that chronic exposure to maternal depression is more strongly associated with increased maternal parenting stress. Consequently, the assessment of various indices of maternal depression may provide answers regarding what types of maternal depression confer the greatest risk to children.

Paternal psychopathology

Jaffee et al (2003), remarks that the combined risk of both maternal depression and paternal psychopathology is critical for children already at risk for maladjustment. According to Dierker et al (1999), paternal psychopathology boosts children's genetic vulnerability for developing psychiatric disorders, worsens stress between family members, and reduces cohesion in the family environments in which these children are socialized

Kane and Garber (2004), suggest that young children of depressed mothers are more likely to have fathers with a psychological disturbance. Paternal psychopathology has been associated with high levels of behavior problems and maladjustment in children and adolescents. Hossain reiterates that mental disorders in fathers may modify the degree of risk children experience, where as involvement with healthy fathers may promote resilience in children with depressed mothers and may buffer children from negative effects of maternal depression

Weissman (1984), supports the rationale of considering paternal psychopathology as a moderator, rather than mediator, in his empirical studies indicating that school-aged children with two depressed parents are at significantly greater risk for disorder than are school aged children with one depressed parent

Mother Child interaction

A study by Cummings and Dedham (2002), found that depressed mothers demonstrate high levels of negative affect and critical feedback and low levels of sensitivity and warmth in interactions with their young children. According to Kochanska (1997), positive communication styles and maternal warmth observed in mother child interactions have been associated with pro-social behavior and positive self-concept development in children.

Conversely Riniti (1994), argues that negative affectivity and communication styles observed in mothers have been associated with negative self-concept and high levels of externalizing and internalizing behavior in children. Goodman and Gotlib (1993), proposed that parenting interactions arbitrate the effects of maternal depression on children's social and emotional development. Maternal negativity, low levels of maternal warmth, and negative communication styles may be mechanisms through which parenting interactions of depressed mothers increase their children's risk for behavior and emotional problems.

Nevertheless, Rogosch and Toth (2000), in their work remarks that only a few empirical studies have demonstrated negative maternal parenting mediating the relationship between maternal depression and maladjustment in young children

Methodology

A longitudinal study of 101 mothers with their toddlers was carried. Out of the total sample selected, 50 respondents had experienced an episode of Major Depressive Disorder (MDD) during the first 18 months of their toddlers' lives. The sample selected for the study of the effects of maternal depression on toddlers' self-efficacy was relatively homogeneous, composed of mostly intact, middleclass families, which allowed for isolating the influence of maternal depression from other high-risk factors associated with poor child outcomes.

The majority of mothers composing the depressed group were recruited from a regional psychiatric hospital. The majority of mothers in the non depressed control group were recruited from a large urban obstetrics hospital. All mothers in the depressed group met Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) by American Psychiatric Association.

Maternal depression status: Maternal psychiatric history was assessed using the SCID-IV by First et al. The SCID-IV yields a categorical diagnostic status of (a) absent, (b) sub threshold, and (c) threshold for mood disorders, anxiety disorders, psychotic disorders, substance abuse disorders, eating disorders, and adjustment disorders.

At t1, three indicative groups were definite: (a) never depressed group, mothers with no history of MDD and no current depressive symptoms (b) past MDD group, mothers who experienced a depressive episode in the first 18 months of their toddlers' lives but were not currently depressed and (c) current MDD group, mothers who experienced an episode of depression in the first 18 months of their toddlers' lives and were currently experiencing a sub threshold or threshold depression

Paternal psychopathology: The Family Informant Schedule and Criteria for DSM-IV, an interview derived from the Family History-Research Diagnostic Criteria by Endicott et al., was used to assess fathers' psychiatric history at t3.

Mother Child interactions: Maternal parenting behavior was assessed through video recording interaction with at t1 t2 and t3 Mothers and toddlers were presented with an attractive but challenging toy. Mothers were prompted to help toddlers complete the task. Mothers interacted with their toddlers for 5 min. Maternal Negativity and Maternal Warmth were coded on separate 4-point scales, with higher scores indicating higher levels of negativity or warmth.

Maternal Negativity was defined as any behaviors displaying maternal hostility, rejection, and/or unresponsiveness. Maternal Warmth was defined as behaviors that imply acceptance and sensitivity toward toddlers.

Discussions of results, Conclusions and Recommendations

Three sets of multiple regression analyses were conducted to examine Maternal Negativity, Maternal Warmth, and maternal Negative Feedback as mediators of the relationship between mothers' depression at t1 and toddlers' Externalizing behavior problems at t3. Another set of three multiple regression analyses tested each of these proposed mediators on the relationship between maternal depression at t1 and toddlers' Internalizing behavior problems at t3. Because there were significant associations between t1 and t2 indices of Maternal Negativity and

Maternal Warmth and between t1 and t3 indices of Maternal Negative Feedback t1 indices of mother child interaction variables were included as covariates in these multiple regression analyses. Separate multiple regression analyses examined paternal psychopathology as a moderator of mother's depression on toddlers' Externalizing and Internalizing behavior problems.

Results show:

  1. Adverse outcomes in children exposed to maternal depression are also dependent upon the presence or absence of paternal psychopathology
  2. Mothers who experienced depression in their toddlers' lives were more likely to have spouses/partners, who also experienced psychopathology in their toddlers' lives,
  3. As predicted, paternal psychopathology moderated the effects of maternal depression on toddlers' behavior problems:  Toddlers were more likely to have higher rates of behavior problems in the case where fathers have met criteria for a psychiatric illness and mothers have a history of depression at some point since the toddlers' birth.
  4. The presence of psychopathology in fathers as a risk factor for toddlers' externalizing behavior problems when mothers have been previously depressed, and for toddlers internalizing problems when mothers have either a history of or current depressive symptoms.

In conclusion, Toddlers who experienced both maternal depression and paternal psychopathology in their lives had the highest scores of behavior problems.  These findings suggest the importance of investigating other risks associated with maternal depression, particularly those in the family context. They also argue for examining maternal negativity in the context of mother-child interactions and paternal psychopathology as respective mediators and moderators of maladjustment of young children who have experienced maternal depression.

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