Depressive Symptoms and Compromised Parenting in Low-Income Mothers of Infants and Toddlers: Distal and Proximal Risks

Abstract

Low-income mothers develop depressive symptoms at higher rates than the general population, adding to the existing risk that economic hardship places on their infants and toddlers. Emphasizing a few key intervention targets, an approach that is especially relevant to mothers when depressive symptoms compromise their energy and concentration, can improve interventions with populations facing adversity. The goal of this study was to identify contextual risk factors that significantly contributed to depressive symptoms and that, in combination with depressive symptoms, were associated with compromised parenting. Using baseline data from 251 ethnically diverse mothers from six Early Head Start programs in the Northeastern and Southeastern US, who were recruited for a clinical trial of an in-home intervention, Belsky's ecological framework of distal to proximal levels of influence was used to organize risk factors for depressive symptoms in hierarchical regression models. Under stress, mothers of toddlers reported more severe depressive symptoms than mothers of infants, supporting the need for depressive symptom screening and monitoring past the immediate postpartum period. Multivariate models revealed intervention targets that can focus depression prevention and intervention efforts, including helping mothers reduce chronic day-to-day stressors and conflicts with significant others, and to effectively handle challenging toddler behaviors, especially in the face of regional disciplinary norms. Presence of a live-in partner was linked to more effective parenting, regardless of participants' depressive symptom severity.

Longitudinal network structure of depression symptoms and self-efficacy in low-income mothers

“…This is a secondary analysis of combined data from two randomized clinical trials (RCTs) conducted from 2003–2010 in low-income communities in North Carolina and New York [ 28 – 30 ]. The RCTs were focused on decreasing maternal depression symptoms through an interpersonal psychotherapy/parent enhancement intervention, and the control group received either usual care or an equal attention, health education condition; both groups received parenting guidance and wrap around services as part of federal Early Head Start programming; further details about the parent RCT designs and findings can be found elsewhere [ 28 – 30 ]. In the parent RCTs the total sum-score of the Center for Epidemiological Studies Depression scale (CES-D) was used as a measure of change in depression severity.…”

Maternal and Child Characteristics Associated With Mother–Child Interaction in One‐Year‐Olds

“…Mothers’ interactions with their spouses or partners may serve as a model for interacting with and forming a positive, warm, supportive relationship with their children. Beeber et al () reported that being married or having a live‐in partner was linked to mothers’ providing developmental stimulation and more effective parenting.…”

The intersection of extreme poverty and familial mental health in the United States

“…Within this group, 1.5 million families live in extreme or deep poverty, a category alternately defined as living on $2.00 or less per day, per family member (Ekono, Jiang, & Smith, 2016; Quiggin & Mahadevan, 2010; Sachs, 2007), at 50% below the federal poverty level (Beeber et al, 2014), or in a neighborhood where 40% or more of residents live below the federal poverty level (Ludwig et al, 2012). …”