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Trajectories of maternal depressive symptoms predict child problem behaviour: The Generation R Study

Published online by Cambridge University Press:  11 April 2012

R. A. M. Cents ,
S. Diamantopoulou ,
J. J. Hudziak ,
V. W. V. Jaddoe ,
A. Hofman ,
F. C. Verhulst ,
M. P. Lambregtse-van den Berg  and
H. Tiemeier
R. A. M. Cents
Affiliation:
The Generation R Study Group, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands
S. Diamantopoulou
Affiliation:
Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands
J. J. Hudziak
Affiliation:
Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands Departments of Psychiatry, Medicine and Paediatrics, University of Vermont, Burlington, USA
V. W. V. Jaddoe
Affiliation:
The Generation R Study Group, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands Department of Epidemiology, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands Department of Paediatrics, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands
A. Hofman
Affiliation:
Department of Epidemiology, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands
F. C. Verhulst
Affiliation:
Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands
M. P. Lambregtse-van den Berg
Affiliation:
Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands Department of Psychiatry, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands
H. Tiemeier*
Affiliation:
Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands Department of Epidemiology, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands Department of Psychiatry, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands
*
*Address for correspondence: Dr H. Tiemeier, Department of Child & Youth Psychiatry, Erasmus MC-University Medical Centre, Rotterdam, PO Box 2060, 3000 CB Rotterdam, The Netherlands. (Email: h.tiemeier@erasmusmc.nl)
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Abstract

Background

It is unclear how the course of maternal depressive symptoms affects child development. We modelled trajectories of maternal depressive symptoms from mid-pregnancy to 3 years after childbirth to better determine their associations with child problem behaviour.

Method

Mother–child dyads (n = 4167) participated in a population-based prospective cohort in The Netherlands. Depressive symptoms were assessed with the Brief Symptom Inventory during pregnancy and at 2, 6 and 36 months postnatally. When children were 3 years old, problem behaviour was assessed with the Child Behaviour Checklist completed by each parent. A group-based modelling technique was used to model trajectories of maternal depressive symptoms and to examine their association with child problem behaviour. The added value of trajectory modelling was determined with successive linear regressions.

Results

We identified four trajectories of maternal depressive symptoms; ‘no’ (34%), ‘low’ (54%), ‘moderate’ (11%) and ‘high’ (1.5%). Child problem behaviour varied as a function of maternal trajectory membership. Whether rated by mother or father, children of mothers assigned to higher trajectories had significantly more problem behaviours than children of mothers assigned to lower trajectories. The model including trajectories had additive predictive value over a model relying only on a summed repeated measure of severity and a predefined chronicity variable.

Conclusions

Depending on their course, maternal depressive symptoms have different effects on child problem behaviour. More information is gained by studying trajectories of symptoms, than only predefined measures of severity and chronicity. Moreover, trajectories can help identifying clinically depressed mothers who are possible candidates for early interventions.

Keywords

Child internalizing and externalizing problemsgroup-based trajectory modellingtrajectories of maternal depressive symptoms
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 1 , January 2013 , pp. 13 - 25
Copyright
Copyright © Cambridge University Press 2012

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