The connection between maternal depression, parenting, and child externalizing disorders

Maternal depression has been found to be a risk factor in the development of child psychopathology (Burke, 2003) and more specifically, in the development of child externalizing disorders (Brennan et al., 2000; Hay et al., 2003; Kim-Cohen et al., 2005). The relation between maternal depression and poor parenting has also been identified in a number of contexts (Lovejoy et al., 2000; Shay & Knutson, 2008), as has the relation between poor parenting and child externalizing disorders (Morrell & Murray, 2003; Pevalin et al., 2003). Because maternal depression confers risk on parenting and child outcome, this study was an attempt to reveal the specifics of how maternal depression relates to the development of child externalizing disorders. The proposed model purports that maternal depression, mediated by trait irritability, which then leads to harsh discipline, will result in the development of Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), but not Attention Deficit Hyperactivity Disorder (ADHD). The model also purports that maternal depression, mediated by poor supervision will be associated with care neglect, as found in Knutson et al. (2005), leading to the development of ODD and CD, but not ADHD. Furthermore, it is proposed that child ADHD will not follow either the maternal depression--irritability--poor parenting pattern or maternal depression--supervisory neglect--care neglect pattern.

One-hundred thirty four economically disadvantaged mothers who were enrolled in a study of parenting were assessed for depression using both dimensional and categorical measures of current and lifetime depression. Parenting was assessed using a variety of measures which assessed supervisory neglect, care and environmental neglect, and harsh discipline. Maternal irritability not specific to discipline was assessed using the Spielberger Trait Anger Expression Inventory (Spielberger, Johnson, Russell, Crane, Jacobs, & Wordent, 1985). Child externalizing disorders were evaluated based on parent and teacher report as ADHD and a combined ODD/CD construct.

As hypothesized, child externalizing disorders were related to maternal depression. The findings of the current study indicate that the relation is not direct and that maternal depression, mediated by trait irritability, leads to poor parenting characterized by inconsistent discipline, and that this poor parenting leads to the development of child ODD and CD. Moreover, whether the index of maternal depression was based on current dimensional data or lifetime history of maternal depression, the results of the analyses supported the hypothesized relation between maternal depression and child ODD/CD. However, an unexpected direct relation between current maternal depression and child ADHD was found, whereas a lifetime history of maternal depression was unrelated to child ADHD. Nonetheless, the relation between maternal depression and child ADHD did not follow the same pattern as the relation between maternal depression and child ODD/CD. Findings suggest that maternal irritability and inconsistent parenting are central to the putative link between maternal depression and child ODD/CD and that depressed mothers should be treated in an effort to reduce the risk for development of child ODD and CD.