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Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior

  • Daniel S. Shaw (a1), Arin Connell (a2), Thomas J. Dishion (a3), Melvin N. Wilson (a4) and Frances Gardner (a5)...

Maternal depression has been consistently linked to the development of child problem behavior, particularly in early childhood, but few studies have examined whether reductions in maternal depression serve as a mediator in relation to changes associated with a family-based intervention. The current study addressed this issue with a sample of 731 families receiving services from a national food supplement and nutrition program. Families with toddlers between ages 2 and 3 were screened and then randomized to a brief family intervention, the Family Check-Up, which included linked interventions that were tailored and adapted to the families needs. Follow-up intervention services were provided at age 3 and follow-up of child outcomes occurred at ages 3 and 4. Latent growth models revealed intervention effects for early externalizing and internalizing problems from 2 to 4, and reductions in maternal depression from ages 2 to 3. In addition, reductions in maternal depression mediated improvements in both child externalizing and internalizing problem behavior after accounting for the potential mediating effects of improvements in positive parenting. The results are discussed with respect to targeting maternal depression in future intervention studies aimed at improving early child problem behavior.

Corresponding author
Address correspondence and reprint requests to: Daniel S. Shaw, Department of Psychology, University of Pittsburgh, 210 South Bouquet Street, 4101 Sennott Square, Pittsburgh, PA 15260-0001; E-mail:
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Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA preschool forms and profiles. Burlington, VT: University of Vermont, Department of Psychiatry.
Aguilar, B., Sroufe, L. A., Egeland, B., & Carlson, E. (2000). Distinguishing the life-course-persistent and adolescent-limited antisocial behavior types: From birth to 16 years. Development and Psychopathology, 12, 109132.
Baydar, N., Reid, M. J., & Webster-Stratton, C. (2003). The role of mental health factors and program engagement in the effectiveness of a preventive parenting program for Head Start mothers. Child Development, 74, 14331453.
Barlow, J., Coren, E., & Stewart-Brown, S. S. B. (2003). Parent-training programmes for improving maternal psychosocial health. Cochrane Database of Systematic Reviews, 4, CD002020.
Beardslee, W. R., Versage, E. M., & Gladstone, T. G. (1998). Children of affectively ill parents: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 11341141.
Belsky, J. (1984). The determinants of parenting: A process model. Child Development, 55, 8396.
Brinkmeyer, M. Y., & Eyberg, S. M. (2003). Parent–child interaction therapy for oppositional children. In Kazdin, A. & Weisz, J. (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 204223). New York: Guilford Press.
Caldwell, B. M., & Bradley, R. H. (1978). Manual for the Home Observation for Measurement of the Environment. Little Rock, AR: University of Arkansas.
Campbell, S. B., Brownell, C. A., Hungerford, A., Spieker, S., Mohan, R., & Blessing, J. S. (2004). The course of maternal depressive symptoms and maternal sensitivity as predictors of attachment security at 36 months. Development and Psychopathology, 16, 231252.
Campbell, S. B., Pierce, E. W., Moore, G., Marakovitz, S., Newby, K. (1996). Boys' externalizing problems at elementary school: Pathways from early behavior problems, maternal control, and family stress. Development and Psychopathology, 8, 701720.
Collins, L., Schafer, J., & Kam, C.-M. (2001). A comparison of inclusive and restrictive strategies in modern missing data procedures. Psychological Methods, 6, 330351.
Conger, R. D., Patterson, G. R., & Ge, X. (1995). It takes two to replicate: A mediational model for the impact of parents' stress on adolescent adjustment. Child Development, 66, 8097.
Connell, A., Dishion, T., & Deater-Deckard, K. (2006). Variable- and person-centered approaches to the analysis of early adolescent substance use: Linking peer, family, and intervention effects with developmental trajectories. Merrill–Palmer Quarterly, 52, 421448.
Connell, A., Bullock, B. M., Dishion, T. J., Shaw, D., Wilson, M., & Gardner, F. (2008). Family intervention effects on co-occurring behavior and emotional problems in early childhood: A latent transition analysis approach. Journal of Abnormal Child Psychology, 36, 12111225.
Connell, A., & Goodman, S. (2002). The association between child internalizing and externalizing behavior problems and psychopathology in mothers versus fathers: A meta-analysis. Psychological Bulletin, 128, 746773.
Cummings, E. M., & Davies, P. T. (1994). Maternal depression and child development. Journal of Child Psychology and Psychiatry, 35, 73112.
Cummings, E. M., Keller, P. S., & Davies, P. 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.
Cutrona, C. E., & Trouman, B. R. (1986). Social support, infant temperament, and parenting self-efficacy: A mediational model of postpartum depression. Child Development, 57, 15071518.
DeGarmo, D. S., Patterson, G. R., & Forgatch, M. S. (2004). Why do parent training intervention outcomes maintain or wane over time? Prevention Science, 5, 7389.
DelBello, M. P., & Geller, B. (2001). Review of studies of child and adolescent offspring of bipolar parents. Bipolar Disorders, 3, 325334.
Dishion, T. J., & Kavanagh, K. (2003). Intervening in adolescent problem behavior: A family-centered approach. New York: Guilford Press.
Dishion, T. J., Kavanagh, K., Schneiger, A., Nelson, S. E., & Kaufman, N. (2002). Preventing early adolescent substance use: A family-centered strategy for the public middle-school ecology. Prevention Science, 3, 191201.
Dishion, T. J., Shaw, D. S., Connell, A., Wilson, M., Gardner, F., & Weaver, C. (2008). The Family Check Up with high-risk families with toddlers: Outcomes on positive parenting and early problem behavior. Child Development, 79, 13951414.
Elgar, F. J., McGrath, P. J., Waschbusch, D. A., Stewart, S. H., & Curtis, L. J. (2004). Mutual influences on maternal depression and child adjustment problems. Clinical Psychology Review, 24, 441459.
Enders, C. (2001). The impact of nonnormality on full information maximum-likelihood estimation for structural equation models with missing data. Psychological Methods, 6, 352370.
Fagot, B., & Kavanaugh, K. (1993). Parenting during the second year: Effects of children's age, sex, and attachment classification. Child Development, 64, 258271.
Farmer, A., McGuffin, P., & Williams, J. (2002). Measuring psychopathology. Oxford: Oxford University Press.
Fergusson, D. M., Lynskey, M. T., & Horwood, L. J. (1993). The effect of maternal depression on maternal ratings of child behavior. Journal of Abnormal Child Psychology, 21, 245269.
Field, T., Healy, B., Goldstein, S., Perry, S., Bendell, D., Shanberg, S., et al. (1988). Infants of depressed mothers show “depressed” behaviour even with non-depressed adults. Child Development, 59, 15691579.
Forgatch, M. S., Patterson, G. R., & DeGarmo, D. S. (2005). Evaluating fidelity: Predictive validity for a measure of competent adherence to the Oregon Model of Parent Management Training. Behavior Therapy, 36, 313.
Gardner, F., Shaw, D., Dishion, T., Burton, J., & Supplee, L. (2007). Randomized trial of a family-centered approach to preventing conduct problems: Linking changes in proactive parenting to boys' disruptive behavior in early childhood. Journal of Family Psychology, 21, 398406.
Gardner, F., Sonuga-Barke, E., & Sayal, K. (1999). Parents anticipating misbehavior: An observational study of strategies parents use to prevent conflict with behavior problem children. Journal of Child Psychology and Psychiatry, 40, 11851196.
Gelfand, D. M., & Teti, D. M. (1990). The effects of maternal depression on children. Clinical Psychology Review, 10, 320354.
Goodman, S. H., & Brumley, H. E. (1990). Schizophrenic and depressed mothers: Relational deficits in parenting. Developmental Psychology, 26, 3139.
Goodman, S. J., & Gotlib, I. H. (1999). Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission. Psychological Review, 106, 458490.
Gross, H. E., Shaw, D. S., & Moilanen, K. (2009). Reciprocal associations between boys' externalizing problems and mothers' depressive symptoms. Manuscript submitted for publication.
Haines, M. M., McMunn, A., Nazroo, J. Y., & Kelly, Y. J. (2002). Social and demographic predictors of parental consultation for child psychological difficulties. Journal of Public Health Medicine, 24, 276284.
Hay, D. F., Pawlby, S., Angold, A., Harold, G. T., & Sharp, D. (2003). Pathways to violence in the children of mothers who were depressed postpartum. Developmental Psychology, 39, 10831094.
Jabson, J. M., Dishion, T. J., Gardner, F. E. M., & Burton, J. (2004). Relationship Process Code V-2.0 training manual: A system for coding relationship interactions. Unpublished manuscript, University of Oregon, Child and Family Center.
Lapalme, M., Hodgins, S., & LaRoche, C. (1997). Children of parents with bipolar disorder: A metaanalysis of risk for mental disorders. Canadian Journal of Psychiatry, 42, 623631.
Leve, L. D., Kim, H. K., & Pears, K. C. (2005). Childhood temperament and family environment as predictors of internalizing and externalizing trajectories from ages 5 to 17. Journal of Abnormal Child Psychology, 33, 505520.
Lunkenheimer, E. S., Skuban, E. M., Dishion, T. J., Connell, A. M., Shaw, D. S., Gardner, F., et al. (2007). Collateral benefits of the Family Check-Up on early childhood school readiness: Indirect effects of parents' positive behavior support. Unpublished manuscript, University of Oregon.
Kraemer, H., Wilson, T., Fairburn, C., & Agras, W. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry 59, 877883.
Marchand, J. F., Hock, E., & Widaman, K. (2002). Mutual relations between mothers' depressive symptoms and hostile-controlling behavior and young children's externalizing and internalizing behavior problems. Parenting: Science and Practice, 2, 335353.
MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods, 7, 83104.
MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivariate Behavioral Research, 39, 99128.
Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press.
Moffitt, T. E., Caspi, A., Dickson, N., Silva, P., & Stanton, W. (1996). Childhood-onset versus adolescent-onset antisocial conduct problems in males: Natural history from ages 3 to 18 years. Development and Psychopathology, 8, 399424.
Murray, L., Fiori-Cowley, A., Hooper, R., & Cooper, P. J. (1996). The impact of postnatal depression and associated adversity on early mother infant interactions and later infant outcome. Child Development, 67, 25122516.
Muthén, L., & Muthén, B. (2004). Mplus user's guide (3rd ed.). Los Angeles: Author.
Olds, D. (2002). Prenatal and infancy home visiting by nurses: From randomized trials to community replication. Prevention Science, 3, 153172.
Patterson, G. R. (1980). Mothers: The unacknowledged victims. Monographs of the Society for Research in Child Development, 45(5, Serial No. 186).
Patterson, G. R., DeGarmo, D. S., & Forgatch, M. S. (2004). Systematic changes in families following prevention trials. Journal of Abnormal Child Psychology, 32, 621633.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401.
Robinson, E. A., Eyberg, S. M., & Ross, A. W. (1980). The standardization of an inventory of child conduct problem behaviors. Journal of Clinical Child Psychology, 9, 2228.
Rutter, M. (2005). Environmentally mediated risks for psychopathology: Research strategies and findings. Journal of American Academy of Child & Adolescent Psychiatry, 44, 318.
Schafer, J., & Graham, J. (2002). Missing data: Our view of the state of the art. Psychological Methods, 7, 147177.
Schlatter, A., Gill, A., Adelman, B., Curby, M., Wilson, M., & Shaw, D. S. (June, 2005). Preventative interventions in diverse populations and settings: Issues in engaging ethnically diverse low-income families in rural and urban settings. Paper presented at the annual meeting of the Society for Prevention Research, Washington DC.
Sharp, D., Hay, D., Pawlby, S., Schmucher, G., Allen, H., & Kumar, R. (1995). The impact of postnatal depression on boys' intellectual development. Journal of Child Psychology and Psychiatry, 36, 13151337.
Shaw, D. S., & Bell, R. Q. (1993). Developmental theories of parental contributors to antisocial behavior. Journal of Abnormal Child Psychology, 21, 493518.
Shaw, D. S., Bell, R. Q., & Gilliom, M. (2000). A truly early starter model of antisocial behavior revisited. Clinical Child and Family Psychology Review, 3, 155172.
Shaw, D. S., Dishion, T. J., Supplee, L., Gardner, F., & Arnds, K. (2006). A family-centered approach to the prevention of early-onset antisocial behavior: Two-year effects of the Family Check-Up in early childhood. Journal of Consulting and Clinical Psychology, 74, 19.
Shaw, D. S., Gilliom, M., Ingoldsby, E. M., & Nagin, D. (2003). Trajectories leading to school-age conduct problems. Developmental Psychology, 39, 189200.
Shaw, D. S., & Gross, H. (2008). Early childhood and the development of delinquency: What we have learned from recent longitudinal research. In Lieberman, A. (Ed.), The long view of crime: A synthesis of longitudinal research (pp. 79127). New York: Springer.
Shaw, D. S., Keenan, K., & Vondra, J. I. (1994). The developmental precursors of antisocial behavior: Ages 1–3. Developmental Psychology, 30, 355364.
Shaw, D. S., Vondra, J. I., Dowdell Hommerding, K., Keenan, & Dunn, M. (1994). Chronic family adversity and early child behavior problems: A longitudinal study of low income families. Journal of Child Psychology and Psychiatry 35, 11091122.
Shaw, D. S., Winslow, E. B., Owens, E. B., & Hood, N. (1998). Young children's adjustment to chronic family adversity: A longitudinal study of low-income families. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 545553.
Sinclair, D. A., & Murray, L. (1998). Effects of postnatal depression on children's adjustment in school. British Journal of Psychiatry, 172, 5863.
Webster-Stratton, C. (1985). Comparisons of behavior transactions between conduct-disordered children and their mothers in the clinic and at home. Journal of Abnormal Child Psychology, 13, 169183.
Webster-Stratton, C., & Reid, M. J. (2003). The incredible years parents, teachers, and children training series: A multifaceted treatment approach for young children with conduct problems. In Kazdin, A. & Weisz, J. (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 224240). New York: Guilford Press.
Whiffen, V. E., & Gotlib, I. H. (1989). Infants of postpartum depressed mothers: Temperament and cognitive status. Journal of Abnormal Psychology, 98, 274279.
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