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![The hypothesized moderated mediation analysis in latent growth curve modeling with child gender as a categorical moderator (multi-group). Note: Latent structures omitted for simplicity; Solid lines are direct effects and dashed lines are indirect effects; X = independent variable: maternal depression, age one; M = mediator variable: harsh parenting (M 1 = intercept, age one; M 2 = slope [linear growth], age one to age three); Y = dependent variable: children's dysregulated internal representations (latent factor), age five.](profile/Tiffany-Martoccio/publication/284729685/figure/fig1/AS:614008281370629@1523402390310/The-hypothesized-moderated-mediation-analysis-in-latent-growth-curve-modeling-with-child.png)
The hypothesized moderated mediation analysis in latent growth curve modeling with child gender as a categorical moderator (multi-group). Note: Latent structures omitted for simplicity; Solid lines are direct effects and dashed lines are indirect effects; X = independent variable: maternal depression, age one; M = mediator variable: harsh parenting (M 1 = intercept, age one; M 2 = slope [linear growth], age one to age three); Y = dependent variable: children's dysregulated internal representations (latent factor), age five.
Source publication
There is some evidence linking maternal depression, harsh parenting, and children's internal representations of attachment, yet, longitudinal examinations of these relationships and differences in the developmental pathways between boys and girls are lacking. Moderated mediation growth curves were employed to examine harsh parenting as a mechanism...
Context in source publication
Context 1
... the gaps in the current literature, this study was designed to longitudinally test whether harsh parenting (M) mediates the association between early-occurring maternal depression (X) and children's dysregulated internal representations (Y) and the moder- ating impact of gender (W) (see Figure 1). A moderated mediation approach determined whether different levels of the moderator identify distinct mediated relationships. In order to examine the hypothesized developmental model strongly embedded within attachment theory and research, we employed a moderated mediation analysis in a latent growth curve framework. Longitudinal data are necessary to make causal infer- ences regarding mediation. In particular, latent growth curve modeling provide for the testing effects of prior change on later change to determine mediation chains across multiple waves of data (MacKinnon, Fairchild, & Fritz, 2007). To provide intensive tests of our developmental process model, we utilized a multi-informant (i.e., observation and maternal report), repeated measure design across three waves of data collection to examine mediation of harsh parenting initial level (intercept) and linear growth (slope). Intercept loadings were set at the initial data wave age one, to estimate possible concurrent effects between early-occurring maternal depression and harsh ...
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Citations
... Outcomes. NSST validity rests on the assumption that children's produced narratives represent some dimension of the child's real-life psychological, emotional, and social functioning and the caregiving environment (Kelly & Bailey, 2021), either directly or mediated by attachment (e.g., Martoccio et al., 2016). The strongest evidence for convergent validity comes from measures of personal and social functioning, including self-evaluations, popularity/leadership, peer relations, and inhibitory control and aggression (at 2 years), as found in Koreans (Shin, 2019), Puerto Ricans (Gullón-Rivera, 2013), Mexicans, Peruvians (Nóblega et al., 2019), and a diverse US sample (Grey & Yates, 2014). ...
Narrative story stem techniques (NSSTs) offer insight into attachment and other representational aspects of preschool to young school aged children’s inner lives. While the method moved into the academic and clinical mainstream some 35 years ago, their applicability to “non-Western” contexts remains little understood. This synthesis comprises 31 NSST studies of samples from parts of Africa, East Asia, Latin America, and the Middle East, and from US and UK ethnocultural minoritized backgrounds. In the reviewed studies, three specific NSSTs dominated, story stems were used most to evaluate attachment, and some were clinically focused. However, there was also a strong cultural focus and over half of samples were socioeconomically disadvantaged. Studies revealed both universal and culturally specific features of NSSTs. Attachment distributions were as expected, given the high clinical risk in pooled samples (49% secure, 19% avoidant, 12% ambivalent, 20% disorganized), including by clinical and socioeconomic risk status. Gender differences were similar to “Western” findings. However, the growing evidence for convergent validity across cultural groups is tempered by low reporting of psychometrics. Narratives may sometimes reflect children’s unintended interpretations of the task and therefore not activate internal representations, or may reflect reality but lack equivalent meaning in coding schemes. We discuss how researchers and clinicians can enhance the validity of NSSTs by considering the role of culture in the sense-making process. Pending further validation work, NSSTs have the added potential to give a voice to young children from underrepresented backgrounds.
... Mothers with depression tend to engage in lower-quality interactions with their young children, characterized by decreased engagement and sensitivity, more irritability, and coercive or harsh discipline [11]. Lower-quality parent-child interactions mediate the association between maternal depression and various deleterious childhood outcomes, including insecure attachment, increased risk of disruptive behavior disorders, and decreased executive functioning [12][13][14]. Mothers facing additional stressors, such as living in poverty, may be at particular risk for persistent depression during their child's life and may be more likely to exhibit negative affect while parenting (e.g., hostility, anger) [11,15]. Maternal depression is estimated to affect a quarter of mothers of young children globally, has deleterious effects on parenting practices, and increases the risk of child MI. ...
Background
Since the onset of the COVID-19 pandemic, the worldwide prevalence of maternal depression has risen sharply; it is now estimated that one quarter of mothers experience clinically significant depression symptoms. Exposure to maternal depression during early childhood increases the risk for the development of childhood mental illness (MI) in offspring, with altered parenting practices mediating the association between maternal depression and child outcomes. Dual-generation interventions, which aim to simultaneously treat parent and child mental health, show promise for improving outcomes for mothers with depression and their young children. The Building Regulation in Dual Generations (BRIDGE) program combines Dialectical Behavior Therapy (DBT) and parenting skills training to concurrently treat maternal depression and improve parenting practices. In pilot within-group studies, BRIDGE has led to large reductions in maternal depression and child MI symptoms. The aim of the current study is to evaluate the efficacy of BRIDGE in reducing maternal depression and child MI symptoms (primary outcomes) as well as parenting stress and harsh parenting (secondary outcomes).
Methods
A three-armed randomized control trial with equal group sizes will be conducted to compare the efficacy of (1) BRIDGE (DBT + parenting skills), (2) DBT skills training, and (3) services-as-usual. Participants (n = 180) will be mothers of 3- to 5-year-old children who report elevated depression symptoms. Those randomized to BRIDGE or DBT skills training will complete a 16-week group therapy intervention. Assessments will be administered at pre-intervention(T1) post-intervention (T2), and 6-month follow-up (T3).
Discussion
Dual-generation programs offer an innovative approach to prevent the intergenerational transmission of mental illness. The current study will add to the evidence base for BRIDGE by comparing it to a stand-alone mental health intervention and a services-as-usual group. These comparisons will provide valuable information on the relative efficacy of including parenting support in a mental health intervention for parents. The results will contribute to our understanding of how maternal depression affects children’s development and how intervening at both a mental health and parenting level may affect child and family outcomes.
Trial registration
Name of registry: Clinical Trials Protocol Registration and Results System; trial registration number: NCT05959538; date of registry: July 24, 2023; available: https://classic.clinicaltrials.gov/ct2/show/NCT05959538
... A putative key social context is arguably the parent-child relationship. Although no study has yet directly explored the relationship between children's subjective experience of exposure to specific parenting practices and their experiences of affiliative reward, children exposed to less sensitive caregiving have been shown to develop dysregulated representations of attachment relationships, of parents and of self (Martoccio et al., 2016;Toth et al., 2009). ...
In explaining the “parenting – callous-unemotional traits – antisocial behavior” axis, recent theoretical advances postulate a critical role for affiliative reward. Existing empirical studies focus on early childhood and the appetitive phase of the reward process (i.e. affiliation-seeking behavior) rather than the consummatory phase (i.e. affective rewards). This study focuses on experienced affiliative reward (i.e. companionship, intimacy, affection, and worth) in relation to parents and best friends in early adolescence. The Alabama Parenting Questionnaire, Network of Relationships Inventory, Inventory of Callous and Unemotional Traits, and Youth Self Report were completed by 1132 12-year-olds and analyzed via structural equation models. In this cross-sectional sample, parent-related affiliative reward mediated the path from perceived parenting practices to callousness and further to aggression and rule-breaking. Parent-related affiliative reward was also related to uncaring traits and further to aggression and rule-breaking. In contrast, friend-related affiliative reward was not a mediator in this theoretical causal chain and largely not related to perceived parenting practices or CU traits. Low parent-related experienced affiliative reward is a mechanism through which corporal punishment, poor monitoring, and low involvement translate into callousness, and therefore to aggression and rule-breaking. Friend-related affiliative reward does not yet play a role in early adolescence.
... 11 Lower-quality parent-child interactions mediate the association between maternal depression and various deleterious childhood outcomes, including insecure attachment, increased risk of disruptive behaviour disorders, and decreased executive functioning. 12,13,14 Mothers facing additional stressors, such as living in poverty, may be at particular risk for persistent depression during their child's life and may be more likely to exhibit negative affect while parenting (e.g., hostility, anger). 15,11 Maternal depression is estimated to affect a quarter of mothers of young children globally, has deleterious effects on parenting practices, and increases the risk of child MI. ...
Background: Since the onset of the COVID-19 pandemic, the worldwide prevalence of maternal depression has risen sharply; it is now estimated that one-quarter of mothers experience clinically significant depression symptoms. Exposure to maternal depression during early childhood increases the risk for the development of childhood mental illness (MI) in offspring, with altered parenting practices mediating the association between maternal depression and child outcomes. Dual-generation interventions, which aim to simultaneously treat parent and child mental health, show promise for improving outcomes for mothers with depression and their young children. The Building Regulation in Dual Generations (BRIDGE) program combines Dialectical Behavior Therapy (DBT) and parenting skills training to concurrently treat maternal depression and improve parenting practices. In pilot within-group studies, BRIDGE has led to large reductions in maternal depression and child MI symptoms. The aim of the current study is to evaluate the efficacy of BRIDGE in reducing maternal depression and child MI symptoms (primary outcomes) as well as parenting stress and harsh parenting (secondary outcomes).
Methods: A three-armed randomized control trial with equal group sizes will be conducted to compare the efficacy of (1) BRIDGE (DBT + parenting skills), (2) DBT skills training, and (3) services-as-usual. Participants (n=180) will be mothers of 3- to 5-year-old children who report elevated depression symptoms. Those randomized to BRIDGE or DBT skills training will complete a 16-week group therapy intervention. Assessments will be administered at pre-intervention(T1) post-intervention (T2), and 6-month follow-up (T3).
Discussion: Dual-generation programs offer an innovative approach to prevent the intergenerational transmission of mental illness. The current study will add to the evidence base for BRIDGE by comparing it to a stand-alone mental health intervention and a services-as-usual group. These comparisons will provide valuable information on the relative efficacy of including parenting support in a mental health intervention for parents. Results will contribute to our understanding of how maternal depression affects children’s development, and how intervening at both a mental health and parenting level may affect child and family outcomes.
Trial registration: Name of registry: Clinical Trials Protocol Registration and Results System; Trial registration number: NCT05959538; Date of registry: July 24, 2023; Available: https://classic.clinicaltrials.gov/ct2/show/NCT05959538
... We found that families with higher scores on composite mental health concerns tended to remain in IMH-HV treatment for longer than those with lower scores. These families are at high risk for negative outcomes, including harsh parenting and child behavior/regulation problems ( Ammerman et al., 2012 ;Martoccio, Brophy-Herb, Maupin, & Robinson, 2016 ;Wolford, Cooper, & McWey, 2019 ); thus, retaining these families in treatment is particularly critical. Our results agree with certain studies ( Ammerman et al., 2006 ) but are contrary to other studies of retention in home visiting programs that report poorer mental health as associated with early attrition ( Bae et al., 2019 ;Foulon et al., 2015 ). ...
Home visiting programs are prominent prevention and intervention models that improve the well-being of infants, young children and their families who are at risk for negative outcomes. However, many home visiting programs struggle to retain families for the length of the intervention. We used survival analysis to examine the impact of demographic (e.g., education, socioeconomic status) and mental health concerns (e.g., maternal stress, therapist-rated mental health status) factors on the retention of 70 mothers in Infant Mental Health-Home Visiting (IMH-HV), a multi-faceted, needs-driven, relationship-focused psychotherapeutic home visiting model. The impact of both individual and cumulative factors on retention was examined. Results revealed that shorter retention in treatment was predicted by younger maternal age at the time of childbirth, lower levels of education, and an accumulation of demographic characteristics often reflecting structural inequalities. In contrast, mental health concerns, depression in particular, predicted longer retention. For each additional structural inequity, the risk of leaving treatment increased by 60%. For each additional mental health concern, the risk of leaving treatment decreased by 25%. The findings regarding structurally-driven inequities are consistent with much of the previous research. In contrast, the finding that those with a higher composite mental health score were more likely to remain in treatment longer than those with lower levels is counter to many studies. These results may be partially explained by the mental health and relational focus of the Michigan model of IMH-HV.
... The intergenerational transmission of internalizing symptoms was partially explained by the depressed mothers' greater use of harsh parenting strategies, especially psychological aggression [37,38]. Furthermore, child maltreatment was found to mediate the association between maternal depression and a disruptive mother-child attachment relationship [39]. Contradictory parenting behaviors may lead to child's lack of emotional security, which is associated with insecure attachment and disrupted emotional regulation development [8,32]. ...
This study aimed to examine the impact of maternal depressive symptoms trajectories on 15-year-old adolescents’ self-esteem and emotion regulation and test the mediating role of child maltreatment in this association. The 2004 Pelotas Birth Cohort is an ongoing cohort study originally comprised of 4231 live births in a southern Brazilian city. We examined a subsample of 1949 adolescents at age 15 years. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Trajectories of maternal depression from 3 months until the 11-year follow-up were calculated using a group-based modeling approach. Child maltreatment at age 11 years was measured using the parent-report version of the Parent–Child Conflict Tactics Scale. Adolescent outcomes at age 15 years were assessed by the self-report version of the Rosenberg Self-esteem Scale and the Emotion Regulation Index for Children and Adolescents. Path model analysis was conducted using a structural equation modeling framework in Mplus software. All maternal depression trajectories were negatively associated with offspring self-esteem and emotion regulation compared to the reference group (low depression trajectory). There was a significant indirect effect of maternal depression trajectories on emotion regulation mediated via child maltreatment. No evidence of moderation by sex was found for any pathway. The effects of maternal depression on adolescents’ emotion regulation are partly mediated by child maltreatment at age 11.
... Although global estimates are lacking, data from the United States suggest depression affects about 7.5 million parents and that approximately 15.6 million children, or 1 in 5, reside with a parent who is severely depressed (England & Sim, 2009). Depression is linked with lower parental sensitivity and responsiveness to children's emotions (Conroy et al., 2010;Dix et al., 2004;Maliken & Katz, 2013;Psychogiou & Parry, 2014;Sethna et al., 2018;Smith-Nielsen et al., 2016), less supportive parenting (Martoccio et al., 2016;Silk et al., 2011), and reduced engagement with children's learning activities (Finzi-Dottan et al., 2016;Kavanaugh et al., 2006;Paulson et al., 2006). Overall, there is strong evidence that depression reduces parents' capacity to engage in positive interactions with their children and provide stimulating home environments. ...
This study investigated the mediating role of parenting self-efficacy in the relationship between Chinese parents’ depressive symptoms and their young children’s social and emotional competence and tested whether the mediating relationship differed for fathers and mothers. Parents (N = 250) of children aged 3-to-8 years old in the eastern coastal region of China completed a cross-sectional survey. Questionnaires assessed parental depressive symptoms, parenting self-efficacy, and children’s social and emotional competence. Research questions were tested using mediation and moderated mediation within a multiple regression framework. Results supported a significant indirect effect of parental depressive symptoms on young children’s social and emotional competence through parenting self-efficacy, indicating that parenting self-efficacy served as a mediator. The mediational process did not differ for mothers and fathers. Parenting self-efficacy appears to be a mechanism in explaining the influence of parental depression on young children’s social and emotional development in a Chinese sample. Findings suggest that interventions with depressed parents should seek to improve parenting self-efficacy to support young children’s healthy development in the context of parental depression.
... Depression can impede healthy, effective parenting and contribute to risk for childhood disorder (Martoccio, Brophy-Herb, Maupin, & Robinson, 2016). However, evidence is limited regarding long-term impacts on teen depression and delinquency. ...
Background
Maternal depression is linked with a range of child and adolescent outcomes. Prior research suggests adverse consequences for child and youth development, but less is known about the role of adverse parenting in the pathways from maternal depression to adolescent emotional and behavioral problems.
Objective
The present study leveraged a large, longitudinal survey of families across the U.S. to investigate whether harsh parenting mediated the links between maternal depression and adolescent delinquency and depression.
Participants and setting
Data came from a national longitudinal survey of families with children born in large U.S. cities 1998-2000 in which mothers had at least partial custody of children (N = 2,719).
Methods
Structural equation modeling with latent variables estimated a measurement model using confirmatory factor analysis and a structural model testing direct and indirect pathways.
Results
Maternal depression was directly associated with both physical and psychological aggression in parenting (β = 0.08, p < 0.001 and β = 0.12, p < 0.001, respectively), and psychological aggression related directly with adolescent delinquency (β = 0.24, p < 0.01). Furthermore, maternal depression was indirectly associated with adolescent delinquency via psychological aggression in parenting (β = 0.03, p < 0.05). Physical aggression in parenting did not mediate links between maternal depression and either adolescent outcome.
Conclusions
Findings provide insights into the parent-level drivers of adolescent emotional and behavioral outcomes. Screening for maternal depression and providing parenting support to vulnerable families offers promise for preventing adverse parenting and supporting healthy adolescent development.
... This increased attention towards others may cause girls to notice and be more impacted by an impaired relationship stemming from maternal depression. For example, the link between maternal depression (when children were 1 year of age) and later dysregulation (when children were 5 years old) was mediated through maternal harshness for girls, but not for boys (Martoccio, Brophy-Herb, Maupin, & Robinson, 2016). Being more attuned to these relationship dynamics, such as decreased affection (Albright & Tamis-LeMonda, 2002), reduced warmth (Pineda, Cole, & Bruce, 2007), and decreased communication (Hwa-Froelich, Cook, & Flick, 2008), may cause girls to perceive their relationship with their mothers to be less secure. ...
This study investigated how mothers' depressive symptoms were related to their children's depressive symptoms through children's perceived attachment security to their mother. Ninety‐six mothers reported on their depressive symptoms. Children reported on their depressive symptoms and their attachment security with their mothers. The results indicated that children's perception of security with their mothers indirectly linked mothers' depressive symptoms to their children's depressive symptoms. Furthermore, this indirect association was moderated by child's sex because only girls, whose mothers reported higher depressive symptoms, reported lower perceived attachment security. This study advances the literature on mechanisms explaining how mothers' depressive symptoms are related to their children's depressive symptoms, which have critical implications for the prevention and intervention of child and adolescent depression.
Highlights
• Mothers' depressive symptoms were related to children's depressive symptoms through children's perceptions of mother–child attachment security
• One path in the indirect relation was moderated by child's sex such that maternal depression was associated with a less secure perceived attachment relationship for female youth but not male youth
• Child depression interventions may be improved by targeting attachment relationships, with particular attention for daughters of depressed mothers
... Regarding missing values, the higher amount of missing values for paternal rearing behavior among older participants can be explained by a high rate of orphans who lost their fathers in World War II. As research in children suggested that girls responded to harsh parenting with internalizing symptoms, while boys showed more behavioral dysregulation (Martoccio et al. 2016), future gender-sensitive research investigating the relationship between recalled parental behavior and externalizing problems (e. g. alcohol abuse) in adults would be worthwhile. ...
Objectives: Addressing the lack of population-based data, the purpose of this representative study was to assess sex- and age-specific associations of maternal and paternal rearing behavior with depressiveness and anxiety controlling for sociodemographic and somatic variables. Methods: 8,175 subjects participating in a population-based study completed standardized questionnaires measuring Recalled Parental Rearing Behavior and distress. Results: Women recalled their fathers as more controlling and warmer, and their mothers as more rejecting than men. Comparisons between age groups (≤ 60 vs. > 60 years) revealed that younger participants recalled more parental control and emotional warmth. In addition to sociodemographic and somatic risk factors, paternal rejection and maternal control were associated with depressiveness and anxiety both for women and men (OR 1.58-1.96; OR 1.37-1.66). Maternal warmth was negatively related to distress (OR 0.66-0.69). Conclusions: Findings suggested sex- and age-specific differences in recalled maternal and paternal rearing behavior. The current results highlighted the important role of recalled parental rearing behavior besides sociodemographic factors and somatic diseases for the occurrence of depression and anxiety symptoms across the age groups.
