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Developmental cascade effects of interpersonal psychotherapy for depressed mothers: Longitudinal associations with toddler attachment, temperament, and maternal parenting efficacy

  • Elizabeth D. Handley (a1), Louisa C. Michl-Petzing (a1), Fred A. Rogosch (a1), Dante Cicchetti (a1) (a2) and Sheree L. Toth (a1)...
Abstract
Abstract

Using a developmental cascades framework, the current study investigated whether treating maternal depression via interpersonal psychotherapy (IPT) may lead to more widespread positive adaptation for offspring and mothers including benefits to toddler attachment and temperament, and maternal parenting self-efficacy. The participants (N = 125 motherchild dyads; mean mother age at baseline = 25.43 years; 54.4% of mothers were African American; mean offspring age at baseline = 13.23 months) were from a randomized controlled trial of IPT for a sample of racially and ethnically diverse, socioeconomically disadvantaged mothers of infants. Mothers were randomized to IPT (n = 97) or an enhanced community standard control group (n = 28). The results of complier average causal effect modeling showed that engagement with IPT led to significant decreases in maternal depressive symptoms at posttreatment. Moreover, reductions in maternal depression posttreatment were associated with less toddler disorganized attachment characteristics, more adaptive maternal perceptions of toddler temperament, and improved maternal parenting efficacy 8 months following the completion of treatment. Our findings contribute to the emerging literature documenting the potential benefits to children of successfully treating maternal depression. Alleviating maternal depression appears to initiate a cascade of positive adaptation among both mothers and offspring, which may alter the well-documented risk trajectory for offspring of depressed mothers.

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Corresponding author
Address correspondence and reprint requests to: Elizabeth D. Handley, Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY 14608; E-mail: elizabeth_handley@urmc.rochester.edu.
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We are grateful to the National Institute of Mental Health (MH067792, Principal Investigators D.C. and S.L.T.) for support of this work.

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References
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AinsworthM. D. S., BleharM. C., WatersE., & WallS. (1978). Patterns of attachment: A psychological study of the Strange Situation. Hillsdale, NJ: Erlbaum.
AlegriaM., ChatterjiP., WellsK., CaoZ., ChenC. N., TakeuchiD., … MengX. L. (2008). Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatric Services, 59, 12641272.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders: DSM- IV (4th ed). Washington, DC: Author.
AndradeL., Caraveo-AnduagaJ. J., BerglundP., BijlR. V., GraafR. D., VolleberghW., … WittchenH. (2003). The epidemiology of major depressive episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. International Journal of Methods in Psychiatric Research, 12, 321.
ArdeltM., & EcclesJ. S. (2001). Effects of mothers’ parental efficacy beliefs and promotive parenting strategies on inner-city youth. Journal of Family Issues, 22, 944972.
AtkinsonL., PagliaA., CoolbearJ., NiccolsA., ParkerK. C., & GugerS. (2000). Attachment security: A meta-analysis of maternal mental health correlates. Clinical Psychology Review, 20, 10191040.
BagbyR. M., RyderA. G., SchullerD. R., & MarshallM. B. (2004). The Hamilton Depression Rating Scale: Has the gold standard become a lead weight? American Journal of Psychiatry, 161, 21632177.
BeardsleeW. R., VersageE. M., & GladstoneT. R. (1998). Children of affectively ill parents: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 11341141.
BeckA. T., SteerR. A., & BrownG. K. (1996). Manual for the BDI-II. San Antonio, TX: Psychological Corporation.
BijttebierP., & RoeyersH. (2009). Temperament and vulnerability to psychopathology: Introduction to the Special Section. Journal of Abnormal Child Psychology, 37, 305308.
CampbellS. B., Morgan-LopezA. A., CoxM. J., & McLoydV. C. (2009). A latent class analysis of maternal depressive symptoms over 12 years and offspring adjustment in adolescence. Journal of Abnormal Psychology, 118, 479493.
CarlsonE. A. (1998). A prospective longitudinal study of attachment disorganization/disorientation. Child Development, 69, 11071128.
CarterA. S., Garrity-RokousF. E., Chazan-CohenR., LittleC., & Briggs-GowanM. J. (2001). Maternal depression and comorbidity: Predicting early parenting, attachment security, and toddler social-emotional problems and competencies. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 1826.
CicchettiD., RogoschF. A., & TothS. L. (1998). Maternal depressive disorder and contextual risk: Contributions to the development of attachment insecurity and behavior problems in toddlerhood. Development and Psychopathology, 10, 283300.
CicchettiD., & TothS. L. (1995). Developmental psychopathology and disorders of affect. In Cicchetti D. & Cohen D. J. (Eds.), Developmental psychology: Risk, disorder, and adaptation (Vol. 2, pp. 369420). New York: Wiley.
CicchettiD., & TothS. L. (1997). Transactional ecological systems in developmental psychopathology. In Luthar S. S., Burack J. A., Cicchetti D., & Weisz J. R. (Eds.), Developmental psychopathology: Perspectives on adjustment, risk and disorder (pp. 317349). New York: Cambridge University Press.
CicchettiD., & TothS. L. (1998). The development of depression in children and adolescents. American Psychologist, 53, 221241.
CohenJ. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New York: Academic Press.
ConnellA. M. (2009). Employing complier average causal effect analytic methods to examine effects of randomized encouragement trials. American Journal of Drug and Alcohol Abuse, 35, 253259.
ConnellA. M., & GoodmanS. H. (2002). The association between psychopathology in fathers versus mothers and children's internalizing and externalizing behavior problems: A meta-analysis. Psychological Bulletin, 128, 746773.
CuijpersP., WeitzE., KaryotakiE., GarberJ., & AnderssonG. (2015). The effects of psychological treatment of maternal depression on children and parental functioning: A meta-analysis. European Child & Adolescent Psychiatry, 24, 237245.
CummingsE. M., & CicchettiD. (1990). Towards a transactional model of relations between attachment and depression. In Greenberg M., Cicchetti D., & Cummings E. M. (Eds.), Attachment in the preschool year: Theory, research, and intervention (pp. 339372). Chicago: University of Chicago Press.
CummingsE. M., & DaviesP. T. (1994). Maternal depression and child development. Journal of Child Psychology and Psychiatry, 35, 73122.
CummingsE. M., KellerP. S., & DaviesP. T. (2005). Towards a family process model of maternal and paternal depressive symptoms: Exploring multiple relations with child and family functioning. Journal of Child Psychology and Psychiatry, 46, 479489.
De PauwS. S., & MervieldeI. (2010). Temperament, personality and developmental psychopathology: A review based on the conceptual dimensions underlying childhood traits. Child Psychiatry & Human Development, 41, 313329.
DowneyG., & CoyneJ. C. (1990). Children of depressed parents: An integrative review. Psychological Bulletin, 108, 5076.
DozoisD. J. A., DobsonK. S., & AhnbergJ. L. (1998). A psychometric evaluation of the Beck Depression Inventory—II. Psychological Assessment, 10, 8389.
EisenbergN., ValienteC., SpinradT. L., CumberlandA., LiewJ., ReiserM., … LosoyaS. H. (2009). Longitudinal relations of children's effortful control, impulsivity, and negative emotionality to their externalizing, internalizing, and co-occurring behavior problems. Developmental Psychology, 45, 9881008.
ElkinI., SheaM. T., WatkinsJ. T., ImberS. D., SotskyS. M., CollinsJ. F., … ParloffM. B. (1989). National Institute of Mental Health treatment of depression collaborative research program: General effectiveness of treatments. Archives of General Psychiatry, 46, 971982.
FagotB. I., & KavanaghK. (1993). Parenting during the second year: Effects of children's age, sex, and attachment classification. Child Development, 64, 258271.
FearonR. P., Bakermans-KranenburgM. J., van IJzendoornM. H., LapsleyA. M., & RoismanG. I. (2010). The significant of insecure attachment and disorganization in the development of children's externalizing behavior: A meta-analytic study. Child Development, 81, 435456.
FormanD. R., O'HaraM. W., StuartS., GormanL. L., LarsenK. E., & CoyK. C. (2007). Effective treatment for postpartum depression is not sufficient to improve the developing mother–child relationship. Development and Psychopathology, 19, 585602.
GarberJ., CieslaJ. A., McCauleyE., DiamondG., & SchloredtK. A. (2011). Remission of depression in parents: Links to healthy functioning in their children. Child Development, 82, 226243.
GarberJ., ClarkeG. N., WeersingV. R., BeardsleeW. R., BrentD. A., GladstoneT. R., … IyengarS. (2009). Prevention of depression in at-risk adolescents: A randomized controlled trial. Journal of the American Medical Association, 301, 22152224.
GelfandD. M., & TetiD. M. (1990). The effects of maternal depression on children. Clinical Psychology Review, 10, 329353.
GoldsmithH. H. (1996). Studying temperament via construction of the Toddler Behavior Assessment Questionnaire. Child Development, 67, 218235.
GoodmanS. H., & GotlibI. H. (1999). Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission. Psychological Review, 106, 458490.
GoodmanS. H., & GotlibI. H. (2002). Children of depressed parents: Alternative pathways to risk for psychopathology. Washington, DC: American Psychological Association.
GoodmanS. H., RouseM. H., ConnellA. M., BrothM. R., HallC. M., & HeywardD. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review, 14, 127.
GravenerJ. A., RogoschF. A., OshriA., NarayanA. J., CicchettiD., & TothS. L. (2012). The relations among maternal depressive disorder, maternal expressed emotion, and toddler behavior problems and attachment. Journal of Abnormal Child Psychology, 40, 803813.
GrohA. M., RoismanG. I., van IJzendoornM. H., Bakermans-KranenburgM. J., & FearonR. (2012). The significant of insecure and disorganized attachment for children's internalizing symptoms: A meta-analytic study. Child Development, 83, 591610.
GunlicksM. L., & WeissmanM. M. (2008). Change in child psychopathology with improvement in parental depression: A systematic review. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 379389.
HasinD. S., GoodwinR. D., StinsonF. S., & GrantB. F. (2005). Epidemiology of major depressive disorder: Results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Archives of General Psychiatry, 62, 10971106.
HayesL. J., GoodmanS. H., & CarlsonE. (2013). Maternal antenatal depression and infant disorganized attachment at 12 months. Attachment & Human Development, 15, 133153.
HeneghanA. M., SilverE. J., BaumanL. J., WestbrookL. E., & SteinR. E. (1998). Depressive symptoms in inner-city mothers of young children: Who is at risk? Pediatrics, 102, 13941400.
HoffmanC., CrnicK. A., & BakerJ. K. (2006). Maternal depression and parenting: Implications for children's emergent emotion regulation and behavioral functioning. Parenting: Science and Practice, 6, 271295.
HollonS. D., & PonniahK. (2010). A review of empirically supported psychological therapies for mood disorders in adults. Depression and Anxiety, 27, 891932.
IzzoC., WeissL., ShanahanT., & Rodriguez-BrownF. (2000). Parental self-efficacy and social support as predictors of parenting practices and children's socioemotional adjustment in Mexican immigrant families. Journal of Prevention & Intervention in the Community, 20, 197213.
JacobvitzD., & HazenN. (1999). Developmental pathways from infant disorganization to childhood peer relationships. In Solomon J. & George C. (Eds.), Attachment disorganization (pp. 127159). New York: Guilford Press.
JoB. (2002). Estimation of intervention effects with noncompliance: Alternative model specifications. Journal of Educational and Behavioral Statistics, 27, 385409.
JoB. (2008a). Causal inference in randomized experiments with mediational processes. Psychological Methods, 13, 314336.
JoB. (2008b). Bias mechanisms in intention-to-treat analysis with data subject to treatment noncompliance and missing outcomes. Journal of Educational and Behavioral Statistics, 33, 158185.
JonesT. L., & PrinzR. J. (2005). Potential roles of parental self-efficacy in parent and child adjustment: A review. Clinical Psychology Review, 25, 341363.
KesslerR. C. (2003). Epidemiology of women and depression. Journal of Affective Disorders, 74, 513.
KesslerR. C., BerglundP., DemlerO., JinR., KoretzD., MerikangasK. R., … WangP. S. (2003). The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association, 289, 30953105.
KesslerR. C., McGonagleK. A., SwartzM., BlazerD. G., & NelsonC. B. (1993). Sex and depression in the National Comorbidity Survey: I. Lifetime prevalence, chronicity and recurrence. Journal of Affective Disorders, 29, 8596.
KlermanG. L., WeissmanM. M., RounsavilleB. J., & ChevronE. S. (1984). Interpersonal psychotherapy of depression. New York: Basic Books.
KohlhoffJ., & BarnettB. (2013). Parenting self-efficacy: Links with maternal depression, infant behaviour and adult attachment. Early Human Development, 89, 249256.
KrupnickJ. L., GreenB. L., StocktonP., MirandaJ., KrauseE., & MeteM. (2008). Group interpersonal psychotherapy for low-income women with posttraumatic stress disorder. Psychotherapy Research, 18, 497507.
LiebR., IsenseeB., HöflerM., PfisterH., & WittchenH. U. (2002). Parental major depression and the risk of depression and other mental disorders in offspring: A prospective-longitudinal community study. Archives of General Psychiatry, 59, 365374.
LittleR. J., & YauL. H. (1998). Statistical techniques for analyzing data from prevention trials: Treatment of no-shows using Rubin's causal model. Psychological Methods, 3, 147159.
LovejoyM. C., GraczykP. A., O'HareE., & NeumanG. (2000). Maternal depression and parenting behavior: A meta-analytic review. Clinical Psychology Review, 20, 561592.
Lyons-RuthK., ConnellD. B., GrunebaumH. U., & BoteinS. (1990). Infants at social risk: Maternal depression and family support services as mediators of infant development and security of attachment. Child Development, 61, 8598.
MacDonaldH. Z., BeeghlyM., Grant-KnightW., AugustynM., WoodsR. W., CabralH., … FrankD. A. (2008). Longitudinal association between infant disorganized attachment and childhood posttraumatic stress symptoms. Development and Psychopathology, 20, 493508.
MainM., & SolomonJ. (1990). Procedures for identifying infants as disorganized/disoriented during the Ainsworth Strange Situation. In Greenberg M. T., Cicchetti D., & Cummings E. M. (Eds.), Attachment in the preschool years: Theory, research, and intervention. Chicago: University of Chicago Press.
MartinsC., & GaffanE. A. (2000). Effects of early maternal depression on patterns of infant–mother attachment: A meta-analytic investigation. Journal of Child Psychology and Psychiatry, 41, 737746.
MastenA. S., & CicchettiD. (2010). Developmental cascades. Development and Psychopathology, 22, 491495.
McConleyR. L., MrugS., GillilandM. J., LowryR., ElliottM. N., SchusterM. A., … FranklinF. A. (2011). Mediators of maternal depression and family structure on child BMI: Parenting quality and risk factors for child overweight. Obesity, 19, 345352.
McGrathJ. M., RecordsK., & RiceM. (2008). Maternal depression and infant temperament characteristics. Infant Behavior and Development, 31, 7180.
MichlL. C., HandleyE. D., RogoschF., CicchettiD., & TothS. L. (2015). Self-criticism as a mechanism linking childhood maltreatment and maternal efficacy beliefs in low-income mothers with and without depression. Child Maltreatment, 20, 291300.
MorrisD. W., RushA. J., JainS., FavaM., WisniewskiS. R., BalasubramaniG. K., … TrivediM. H. (2007). Diurnal mood variation in outpatients with major depressive disorder: Implications for DSM-V from an analysis of the Sequenced Treatment Alternatives to Relieve Depression Study data. Journal of Clinical Psychiatry, 68, 1478.
MulcahyR., ReayR. E., WilkinsonR. B., & OwenC. (2010). A randomised control trial for the effectiveness of group interpersonal psychotherapy for postnatal depression. Archives of Women's Mental Health, 13, 125139.
MurisP., & OllendickT. H. (2005). The role of temperament in the etiology of child psychopathology. Clinical Child and Family Psychology Review, 8, 271289.
MurrayL. (1992). The impact of postnatal depression on infant development. Journal of Child Psychology and Psychiatry, 33, 543561.
MuthénL. K., & MuthénB. O. (1998–2013). Mplus user's guide (6th ed). Los Angeles: Author.
NiggJ. T. (2006). Temperament and developmental psychopathology. Journal of Child Psychology and Psychiatry, 47, 395422.
PattersonG. R., ForgatchM. S., & DeGarmoD. S. (2010). Cascading effects following intervention. Development and Psychopathology, 22, 949970.
Pauli-PottU., MertesackerB., BadeU., BauerC., & BeckmannD. (2000). Contexts of relations of infant negative emotionality to caregiver's reactivity/sensitivity. Infant Behavior and Development, 23, 2339.
Pauli-PottU., MertesackerB., BadeU., HaverkockA., & BeckmannD. (2003). Parental perceptions and infant temperament development. Infant Behavior and Development, 26, 2748.
PeltzJ. S., RoggeR. D., RogoschF. A., CicchettiD., & TothS. L. (2015). The benefits of child-parent psychotherapy to marital satisfaction. Families, Systems, & Health, 33, 372382.
PersonsJ. B., ThaseM. E., & Crits-ChristophP. (1996). The role of psychotherapy in the treatment of depression: Review of two practice guidelines. Archives of General Psychiatry, 53, 283290.
RadloffL. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401.
RobinsL. N., CottlerL., BucholzK., & ComptonW. (1995). Diagnostic Interview Schedule for DSM-IV. St. Louis, MO: Washington University.
RobinsL. N., HelzerJ. E., CroughanJ., & RatcliffK. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule: Its history, characteristics, and validity. Archives of General Psychiatry, 38, 381389.
RobinsL. N., HelzerJ. E., RatcliffK. S, & SeyfriedW. (1982). Validity of the Diagnostic Interview Schedule, Version II: DSM-III diagnoses. Psychological Medicine, 12, 855870.
RothbartM. K. (1981). Measurement of temperament in infancy. Child Development, 52, 569578.
RothbartM. K., & PosnerM. I. (2006). Temperament, attention, and developmental psychopathology. In Cicchetti D. & Cohen D. J. (Eds.), Developmental psychopathology: Vol. 2. Developmental neuroscience (2nd ed., pp. 465501). Hoboken, NJ: Wiley.
SchaferJ. L., & GrahamJ. W. (2002). Missing data: Our view of the state of the art. Psychological Methods, 7, 147177.
ShawD. S., ConnellA., DishionT. J., WilsonM. N., & GardnerF. (2009). Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior. Development and Psychopathology, 21, 417439.
SiefertK., BowmanP. J., HeflinC. M., DanzigerS., & WilliamsD. R. (2000). Social and environmental predictors of maternal depression in current and recent welfare recipients. American Journal of Orthopsychiatry, 70, 510522.
StorchE. A., RobertiJ. W., & RothD. A. (2004). Factor structure, concurrent validity, and internal consistency of the Beck Depression Inventory—Second Edition in a sample of college students. Depression and Anxiety, 19, 187189.
StuartS., & RobertsonM. (2003). Interpersonal psychotherapy. London: Edward Arnold.
SwartzH. A., FrankE., ZuckoffA., CyranowskiJ. M., HouckP. R., ChengY., … ShearM. K. (2008). Brief interpersonal psychotherapy for depressed mothers whose children are receiving psychiatric treatment. American Journal of Psychiatry, 165, 11551162.
TalbotN. L., ConwellY., O'HaraM. W., StuartS., WardE. A., GambleS. A., … TuX. (2005). Interpersonal psychotherapy for depressed women with sexual abuse histories: A pilot study in a community mental health center. Journal of Nervous and Mental Disease, 193, 847850.
TetiD. M., & GelfandD. M. (1991). Behavioral competence among mothers of infants in the first year: The mediational role of maternal self-efficacy. Child Development, 62, 918929.
TetiD. M., GelfandD. M., MessingerD. S., & IsabellaR. (1995). Maternal depression and the quality of early attachment: An examination of infants, preschoolers, and their mothers. Developmental Psychology, 31, 364376.
TothS. L., RogoschF. A., ManlyJ. T., & CicchettiD. (2006). The efficacy of toddler-parent psychotherapy to reorganize attachment in the young offspring of mothers with major depressive disorder: A randomized preventive trial. Journal of Consulting and Clinical Psychology, 74, 10061016.
TothS. L., RogoschF. A., OshriA., Gravener-DavisJ., SturmR., & Morgan-LopezA. A. (2013). The efficacy of interpersonal psychotherapy for depression among economically disadvantaged mothers. Development and Psychopathology, 25(4, Pt. 1), 10651078.
TothS. L., RogoschF. A., Sturge-AppleM., & CicchettiD. (2009). Maternal depression, children's attachment security, and representational development: An organizational perspective. Child Development, 80, 192208.
TurneyK. (2011). Labored love: Examining the link between maternal depression and parenting behaviors. Social Science Research, 40, 399415.
van IJzendoornM. H., SchuengelC., & Bakermans-KranenburgM. J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology, 11, 225250.
VerdeliH., FerroT., WickramaratneP., GreenwaldS., BlancoC., & WeissmanM. M. (2004). Treatment of depressed mothers of depressed children: Pilot study of feasibility. Depression and Anxiety, 19, 5158.
WeissmanM. M., MarkowitzJ. C., & KlermanG. L. (2000). Comprehensive guide to interpersonal psychotherapy. New York: Basic Books.
WeissmanM. M., PilowskyD. J., WickramaratneP. J., TalatiA., WisniewskiS. R., FavaM., … RushJ. (2006). Remissions in maternal depression and child psychopathology: A STAR* D-child report. Journal of the American Medical Association, 295, 13891398.
WeissmanM. M., WickramaratneP., NomuraY., WarnerV., PilowskyD., & VerdeliH. (2006). Offspring of depressed parents: 20 years later. American Journal of Psychiatry, 163, 10011008.
WeissmanM. M., WickramaratneP., PilowskyD. J., PohE., HernandezM., BattenL. A., … BlierP. (2014). The effects on children of depressed mothers’ remission and relapse over 9 months. Psychological Medicine, 44, 28112824.
WickramaratneP., GameroffM. J., PilowskyD. J., HughesC. W., GarberJ., MalloyE., … FavaM. (2011). Children of depressed mothers 1 year after remission of maternal depression: Findings from the STAR* D-Child study. American Journal of Psychiatry, 168, 593602.
YuanK. H., & BentlerP. M. (2000). Three likelihood-based methods for mean and covariance structure analysis with nonnormal missing data. Sociological Methodology, 30, 165200.
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