Caregivers' depressive symptoms and parent-report of child executive function among young children in Uganda

Abstract

Maternal mental health (particularly depression) may influence how they report on their child’s behavior. Few research studies have focused on Sub-Saharan countries where pediatric HIV concentrates and impacts child neuropsychological development and caregiver mental health. We investigated the associations between caregivers’ depressive symptoms and neuropsychological outcomes in HIV-infected (n=118) and HIV-exposed (n=164) Ugandan children aged 2–5 years. We compared performance-based tests of development (Mullen Scales of Early Learning, Color Object Association Test), to a caregiver report of executive function (Behavior Rating Inventory of Executive Function, BRIEF). Caregivers were assessed with Hopkins Symptom Checklist-25 depression subscale. The associations between all BRIEF indices and caregiver’s depression symptoms were differential according to child’s HIV status. Caregivers with greater depressive symptoms reported their HIV-infected children as having more behavioral problems related to executive functioning. Assessment of behavior of HIV-infected children should incorporate a variety of sources of information and screening of caregiver mental health.

Low risk of neurodevelopmental impairment among perinatally acquired HIV‐infected preschool children who received early antiretroviral treatment in Thailand

“…. No association was found between caregiver depression and developmental outcomes in our study, although such associations have been observed in earlier studies .…”

Toxic Stress and Quality of Life in Early School‐Aged Ugandan Children With and Without Perinatal Human Immunodeficiency Virus Infection

“…We demonstrate that PHIV status itself was associated with poor child-wellbeing only in caregiving environments characterized by high levels of caregiver stress. This observation confirms the benefit of effective HIV care for PHIV but also highlights opportunities for adjunct interventions to sustain the benefit of excellent HIV care by enhancing the capacity of HIV-affected households to cope with psychosocial adversity including caregiver depression (Familiar et al, 2016) related to their HIV-affected status. On the one hand, PHIV were similar to uninfected children in most QOL measures, with possible higher general vitality than uninfected peers, but only in low caregiver stress environments.…”

Parenting self‐efficacy in the context of poverty and HIV in Eastern Uganda: A qualitative study

“…In Uganda, the prevalence of HIV was 7.6% among women ages 15 to 64 in 2017 (PHIA Project, ). Adverse effects of caregiver mental health problems on parenting, child health, and caregiver reporting of child development outcomes have been described among female HIV‐affected Ugandan caregivers (i.e., a child's primary caregiver who may or may not be the biological parent) (Familiar, Murray, et al., ; Familiar, Nakasujja, et al., ; Murray et al., ). Parenting self‐efficacy, which also affects parent–child interaction, has received far less attention.…”