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Maternal Psychopathology and Infant Development at 18 Months: The Impact of Maternal Personality Disorder and Depression

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Objective

No previous longitudinal study has examined the impact of comorbid maternal personality disorder (PD) and depression on child development. We set out to examine whether maternal PD and depression assessed at 2 months post partum would be independently associated with adverse developmental outcomes at 18 months of age.

Method

Women were recruited into the study shortly after delivery and screened for depression and PD. Those meeting criteria for depression, PD, or both conditions, were selected for assessment at 2 months post partum, together with a comparison group with neither condition (total sample, N = 200). Assessments of cognitive, social and emotional development were conducted with their children at 18 months of age.

Results

Maternal postpartum depression and PD were both associated with higher levels of dysregulated infant behavior. There was a significant interaction between depression and PD in the model of dysregulated behavior and the detrimental effects of maternal depression and PD were evident only among mothers with both conditions. Maternal depression was independently associated with impaired infant cognitive scores and higher levels of internalizing behavior.

Conclusions

Future studies of the effects of maternal depression should also take into account the effects of comorbid maternal PD. Health professionals need to be aware of the possible co-occurrence of PD among mothers presenting with postnatal depression and that mothers with these co-occurring disorders are likely to require greater support.

Section snippets

Method

Ethical approval was granted by the Institute of Psychiatry and South London and Maudsley NHS Trust Ethical Committee (Research).

Characteristics of Mothers at Time 1

Table 1 shows the socio-demographic and diagnostic characteristics of the sample at Time 1.

Compared with women without depression, women with depression were more likely to be from a non-white ethnic group (p = .04) and from a non-professional occupational group (p = .004). Women with PD were more likely to be single than women without PD (p = .03), but there were no other socio-demographic differences between women with and without PD. Around a third of women with a PD met criteria for a

Discussion

In this study, we examined the impact of maternal depression and PD at 2 months postpartum on key domains of child development at 18 months of age. We detected a significant interaction between depression and PD and dysregulated infant behavior, as assessed by maternal report. Among depressed mothers, the increased risk of dysregulated infant behavior, only occurred in mothers who also had comorbid PD. Equally, among mothers with PD, the increased risk of dysregulated infant behavior only

References (47)

  • Chronicity of maternal depressive symptoms, maternal sensitivty and child functioning at 36 months

    Dev Psychol

    (2009)
  • S.L. Grace et al.

    The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature

    Arch Womens Ment Health

    (2003)
  • P.A. Brennan et al.

    Chronicity, severity, and timing of maternal depressive symptoms: relationships with child outcomes at age 5

    Dev Psychol

    (2000)
  • T. Trapolini et al.

    The effect of maternal depression and marital adjustment on young children's internalizing and externalizing behaviour problems

    Child Care Health Dev

    (2007)
  • B. Cassidy et al.

    Psychopathology in adolescent mothers and its effects on mother-infant interactions: a pilot study

    Can J Psychiatry

    (1996)
  • L.E. Crandell et al.

    ‘Still-face' interactions between mothers with borderline personality disorder and their 2-month-old infants

    Br J Psychiatry

    (2003)
  • L. Newman et al.

    Mothers with borderline personality disorder, mother-infant interaction and parenting perceptions: preliminary findings

    Aust NZ J Psychiatry

    (2007)
  • R. Hobson et al.

    How mothers with borderline personality disorder relate to their year-old infants

    Br J Psychiatry

    (2009)
  • R.P. Hobson et al.

    Personal relatedness and attachment in infants of mothers with borderline personality disorder

    Dev Psychopathol

    (2005)
  • J.R.Z. Abela et al.

    The impact of parental borderline personality disorder on vulnerability to depression in children of affectively ill parents

    J Pers Disord

    (2005)
  • M. Rutter et al.

    Parental psychiatric disorder: effects on children

    Psychol Med

    (1984)
  • J. Kim-Cohen et al.

    Maternal depression and children's antisocial behavior: nature and nurture effects

    Arch Gen Psychiatry

    (2005)
  • J. Kim-Cohen et al.

    The caregiving environments provided to children by depressed mothers with or without an antisocial history

    Am J Psychiatry

    (2006)
  • Cited by (0)

    The study was funded by the Foundation for the Study of Infant Deaths, U.K. and the Nuffield Foundation, U.K.

    We are grateful to the mothers and children who took part in the study and to staff at Kings College Hospital for facilitating participant recruitment. We thank Laura Jones of Kings College London for assistance with recruitment and screening, Avshalom Caspi of Kings College London for his support and encouragement, and Michael Dewey of Kings College London for statistical advice.

    Disclosure: Drs. Pariante, Marks, Davies, Schacht, and Moran, and Ms. Conroy, and Ms. Farrelly report no biomedical financial interests or potential conflicts of interest.

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