Research That Matters (January 17 - 20, 2008)

Purpose. The transition to parenthood is a stressful experience for many women and may be especially stressful for young mothers (e.g., Troutman & Cutrona, 1990). Depressive symptoms are common during pregnancy and the first year postpartum. Of concern is how maternal depression may impact the developing mother/child relationships (e.g., Teti, 1991).

Methods. 208 African-American women between the ages of 14 and 21 (mean 18.3 years) were interviewed during the second trimester of pregnancy and when their infants were four and twelve months old. Mothers were recruited through prenatal clinics of an urban teaching hospital. Most were unmarried and giving birth for the first time.

Adolescents were administered the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977) to assess depressive symptoms at each of the longitudinal time points.

A multi-method, multi-dimensional approach was used to assess parenting and the parent-child relationship. At 4 and 12 months, the Parenting Stress Index (PSI; Abidin, 1983) assessed mothers' feelings of stress related to her relationship with the child and related to child difficult behavior. At 4 months only, the Adult Adolescent Parenting Inventory (AAPI; Bavolek, 1984) assessed beliefs about appropriate parenting. Videotapes of mother-infant interaction at 4 and 12 months were coded for maternal sensitive responsive behavior and maternal teaching behavior using the Parent-Child Observation Guide (PCOG; Bernstein, Percansky, & Hans, 1987).

Results. Mean CES-D scores were 16.0 (SD=8.7) prenatally, 11.8 (SD=9.2) at four months postpartum, and 11.0 (SD=9.1) at twelve months postpartum. 45% of the women had CES-D scores above the clinical level (>16) during pregnancy, with fewer having elevated scores at four months (24%) and twelve months (22%) postpartum.

At both four and twelve months, maternal depression was associated with maternal reports of child difficult behavior and stressful parent-child relationships (PSI) (correlations ranging between .31 and .37). Depressed mothers were especially likely to endorse items stating “Most times I feel that my child does not like me,” “Sometimes my child does things just to be mean,” and “I expected to have closer and warmer feelings for my child.” Maternal depression was also associated with mothers having inappropriate developmental expectations for their infants (r=.19) (AAPI). Maternal sensitive responsiveness was associated with parenting stress (r=-.14 at 4 months and -.14 at 12 months) and inappropriate developmental expectations (r=.15 at 4 months). Thus although maternal depression was not directly associated with parenting behavior observed on the videotapes, depression was associated with parenting stress and inappropriate developmental expectations that in turn were related to lack of sensitive responsive parenting.

Conclusions and Implications. Findings suggest that young mothers experiencing depressive symptoms may benefit from psycho-educational or social-support interventions that focus on providing information about normal infant development and normal challenges associated with parenting an infant. Moreover, young mothers may benefit from infant mental health interventions focusing on cognitive intervention strategies such as making appropriate attributions about infants, reframing and normalizing infant behavior.