Parenting Behaviors Among Depressed Mothers in the Child Welfare System

Background and Purpose: The purpose of this study was to analyze a nationally representative sample of children and families referred to CPS agencies, the National Survey of Child and Adolescent Wellbeing, to examine the association between maternal depression and parenting practices over 36-months following such referrals. Three hypotheses were tested: (1) depressed mothers are more likely to demonstrate harsh parenting than non-depressed mothers; (2) depressed mothers are more likely to demonstrate neglectful parenting than non-depressed mothers, and (3) depressed mothers are more likely to demonstrate emotional maltreatment than non-depressed mothers. The interaction between depression and time was also analyzed for each parenting practice to determine how changes in maternal depression affected changes in parenting behaviors.

Methods: The subset of NSCAW analyzed for this study was 1493 mother-child dyads in which the child was 3-10 years old and remained in-home following the investigation. Harsh parenting, neglect and emotional maltreatment were measured with three sub-scales of the Conflict Tactics Scale – Parent to Child version; maternal depression was measured with the Composite International Diagnostic Interview-Short Form. Chi-square tests were used to analyze the bivariate relationship between maternal depression and the outcome variables. Longitudinal logistic regression models were built to analyze associations and interactions between dependent and independent variables. Generalized estimating equations were used.

Results: The proportion of women reporting depression remained consistent over the study window; however, only 4% of mothers reported depression at all of the follow-up time points. A higher proportion of depressed mothers self-reported neglectful and emotionally abusive parenting practices than non-depressed mothers. In fact, over half of depressed mothers (53%) reported using neglectful parenting behaviors, while only 29% on non-depressed mothers reported using these parenting practices (p < .001). Nearly three-quarters (73%) of depressed mothers self-reported emotional maltreatment compared to 57% of non-depressed mothers (p < .001). No statistically significant difference was found between depression and self-reported harsh parenting. Findings were consistent in the multivariate analysis: a relationship between depression and parenting practices was found for emotional maltreatment and neglect, but not for harsh parenting. In the neglect model, depressed mothers were 1.8 times more likely to self-report neglectful parenting than non-depressed mothers. The odds of self-reporting emotional maltreatment was also 1.8, with this being more likely among depressed mothers than non-depressed mothers. Additionally, emotional maltreatment also increased the odds of mothers engaging in harsh parenting. Change in depression status across the study window was associated with changes in emotional maltreatment.

Conclusions and Implications: Depression among this vulnerable population remained much higher than the national average across time points and was associated with increased risk of emotional maltreatment and neglect over 36-months. Of particular concern is that self-reported emotional maltreatment remained very high across all time points; indicating that these vulnerable children are at ongoing risk of verbal and psychological assaults, which can have long term adverse effects. Implications of this work are the need for:(1) effective mental health services for mothers entering the child welfare system, and (2) parent training to specifically address positive parenting.