No abstract

OBJECTIVE: To test, with a sample of adolescent mothers (16–20 at childbirth) and their first-born infants/toddlers (average age 1 year), whether the impact of a home visiting (HV) child maltreatment prevention program was moderated by maternal depression. METHODS: The study design was a randomized controlled trial of Healthy Families Massachusetts, a statewide child maltreatment prevention program. A total of 707 first-time mothers were randomly assigned to the HV or control group. The HV group received visits from paraprofessional home visitors. Mothers in the control group were referred to other service providers. The outcome variable consisted of state Child Protective Services reports of child abuse and neglect (mother or other person as perpetrator). Maternal depression was assessed by maternal report (Center for Epidemiologic Studies-Depression questionnaire). RESULTS: A considerable proportion of families had child maltreatment reports (30% of sample) and maternal depression (38% had clinically significant symptoms). Most maltreatment was neglect. Among control group mothers, reports of maltreatment did not vary according to depressive symptoms. For HV mothers, probability of reports varied with levels of depressive symptoms. Nonsymptomatic HV mothers were less likely to have a child who was reported for maltreatment compared with HV mothers who endorsed clinical levels of depressive symptoms. CONCLUSIONS: The prevalence of maternal depressive symptoms in this sample, and the link between depression and child maltreatment prevention program effectiveness, suggest that home visitors be alert to maternal depression. Programs also should be aware of possible surveillance effects related to maternal depression.

The negative consequences of maternal depression are a major public health concern, both for mothers and for their children. Despite the high prevalence of depression among adolescent mothers, little is known about the patterns of adolescent mothers' depression in the early parenting years. The present study examined mothers' depression during the first 2 years following childbirth in a sample of 428 young mothers (20 or younger at first childbirth) who were participants in a randomized controlled trial of a home visiting parenting support program. Depressive symptoms were assessed using the self-reported Center for Epidemiological Studies Depression Scale (CES-D). Mothers were classified into groups based on whether their depressive symptoms were below or above the cutoff for clinically significant symptomatology. Depression groups (stable nondepressed, stable depressed, remitted depression) were associated with variations in mothers' satisfaction with support from the baby's father and enrollment in the home visiting program. Maternal depression was more likely to remit when mothers were satisfied with father support; assignment to the home visiting program was associated with mothers remaining mentally healthy. Results have clinical and policy implications for prevention and intervention programs.

Intimate partner violence (IPV) is prevalent in families with young children and challenges their healthy development. This study examined characteristics of IPV (e.g., mother- vs. partner-perpetrated, types and severity) and investigated potential effects of IPV on toddlers' behavioral regulation in a sample of families at risk for IPV. We also examined whether maternal depression and child-rearing attitudes and behavior would moderate IPV-child behavior links. These questions were addressed in a sample ( N = 400) of first-time adolescent mothers and their toddlers (1-2 years of age). Families were visited in their homes; data were collected via maternal report and observations. Partner- and self-perpetrated IPV was assessed using the Conflict Tactics Scale questionnaire; child behavior regulation was measured using the Brief Infant-Toddler Social and Emotional Assessment questionnaire. Approximately 80% of families experienced psychological aggression; almost one third reported physical assault in the past year. Both physical and psychological IPV were associated with greater toddler behavior problems. Neither maternal depression, mothers' attitudes about corporal punishment, nor nonhostile interaction moderated IPV-behavior problem links, though mothers' reports of maltreating behavior did. Among children whose mothers did not use corporal punishment/physical violence, IPV did not differentially affect behavior problems. Children whose mothers used corporal punishment/physical violence with them showed behavior problems in the context of IPV (severe psychological aggression). Results underscore the importance of exposure to IPV during the first year of life, and the prevalence of IPV perpetrated by both mothers and their partners in families with adolescent mothers.