Perinatal Depression and Children's Developmental Outcomes at 2 and 3 Years Postpartum
Citation:
Nix, Laura, Perinatal Depression and Children's Developmental Outcomes at 2 and 3 Years Postpartum, Trinity College Dublin.School of Medicine, 2022Download Item:
Abstract:
Depression is the most common perinatal psychiatric disorder and has been associated with a range of adverse outcomes for children, parents and overall family functioning. The current thesis sought to build on existing research by adopting a family systems perspective to examine the impact of perinatal depression and parenting behaviours on children's social-emotional, cognitive, language and adaptive behavioural outcomes at 2 and 3 years. According to the 'Developmental Origins of Health and Disease' (DOHaD) hypothesis (Barker, 1990, 2007), the antenatal period represents a critical period for the origins of later developmental outcomes. One mechanism that is posited to underlie the intrauterine influence on children's subsequent mental health is the activity of the hypothalamic-pituitary-adrenal (HPA) axis, which undergoes significant change throughout pregnancy. The data included in the current analyses were collected at the fifth and sixth timepoints of a prospective longitudinal study, which followed participants from pregnancy through to 3 years postpartum. Women were recruited during their second or third trimester of a singleton pregnancy, and stratified into three participant groups: 1. Depressed (those with a clinical diagnosis of Major Depressive Disorder [MDD]); 2. History of Depression (those who were currently euthymic with a previous MDD episode); 3. Control (no history of psychiatric disorders). At the 2- and 3-year timepoints, mothers, fathers and their children were invited to participate in follow-up appointments based in the Trinity College Infant and Child Research Laboratory. Parental depression severity was evaluated using the Hamilton Depression Rating Scale (HAM-D), children's developmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development, 3rd Edition (BSID-III), parents' and children's HPA axis activity was measured using salivary cortisol samples, and parent-child play interactions were analysed in dyadic and triadic contexts. No direct associations between parents' depression scores and children's social- emotional, cognitive or language development were observed. When the current study examined parents' and children's HPA axis activity for markers of dysregulation associated with depression, no significant group differences were observed. However, maternal cortisol was significantly associated with children's language outcomes. The relationships between parental depression and coparenting and parenting quality were also examined, and no negative associations were observed among mothers. However, there was evidence of a cross-over effect, wherein the vocal responsiveness of mothers and fathers was negatively associated with their partners' depression scores. The conversational balance exhibited during parent-child play interactions was positively associated with parental depression scores, as well as with children's cognitive and language scores, providing further evidence to suggest that the developmental outcomes of children in the current study were not adversely impacted by their exposure to depression. While findings based on small samples must be interpreted with great caution, the current study presents a detailed examination of parent-child interaction in the context of perinatal depression and provides avenues for future research.
Description:
APPROVED
Author: Nix, Laura
Advisor:
O'Keane, VeronicaNixon, Elizabeth
Publisher:
Trinity College Dublin. School of Medicine. Discipline of PsychiatryType of material:
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