Maternal symptoms of anxiety and depression increased the risk of emotional and disruptive problem behaviors in children as early as 18 months of age, according to new research findings from the TOPP study. The risk persisted into adolescence and also gave an increased risk of depressive symptoms. The study is published in the Journal of Developmental and Behavioral Pediatrics.
"The findings emphasize the importance of health professionals spotting mental health problems in the mother and/or the child as early as possible, for example when the child attends their regular health check-ups at the health clinic in the early years," says Wendy Nilsen, head of the TOPP study at the Norwegian Institute of Public Health. She is also the lead author of the paper, which is a part of her doctoral thesis from 2012.
Nilsen points out that the health clinic is a meeting point for over 95 per cent of all Norwegian families with young children.
"This gives health professionals a unique opportunity to introduce early preventive measures against the development of mental health problems," says Nilsen.
Results from the study
- When the mother reported high levels of anxiety and depression symptoms early in the children's lives, the children had a higher risk of emotional and disruptive problem behaviors during their childhood. In addition, the children had a higher risk of reporting depressive symptoms during adolescence.
- The association between maternal and later child problem behaviors was already present when the children were 18 months old.
- Disruptive and emotional problems and behaviors in the children were not affected by the mothers' mental health.
- The researchers found that there was a tendency for disruptive problem behaviors to be a risk factor for later emotional problems, but not vice versa.
- Boys and girls were generally similar with regards to these findings. However, the researchers reported a tendency for problem behaviors in early school age (8.5 years) to be associated with later problems in adolescence for girls, but not for boys.
Paternal mental health in relation to child health is not examined in this study but has been examined in the TOPP-study at later time points.
Importance of early prevention
The results support former findings that also highlight early prevention and intervention.
"This is particularly important when the mother has reported high anxiety and depressive symptoms in the child's first two years of life. These children had a higher risk of more depressive symptoms in adolescence. Problem behaviors in early life were also associated with later problems in adolescence," says Nilsen.
The study also highlights the importance of research that follows children and their families from early childhood to adolescence.
"In this way we can gain knowledge about early traits of children and families that increase the likelihood of later mental health problems. This is important knowledge," says Nilsen.
About the study
The data are from the TOPP study. The researchers wanted to examine whether and how maternal mental health and children's disruptive and emotional problems affected each other. They also wanted to examine how these factors from childhood to early adolescence were associated with the adolescents' self-reported depressive symptoms during adolescence and whether there were gender differences.
The study uses Norwegian mothers' self-reports of their own mental health and their children's problem behaviors (both disruptive and emotional) at five different ages from early childhood (18 months) to early adolescence (12.5 years). Questionnaire data from the adolescents are from 14.5 years and 16.5 years old.
As with other studies that follow families and their children over a longer period, some participants in the TOPP study have dropped out. It appears that the families who have participated in the later rounds have higher levels of education than those who have dropped out. The researchers point out that even though the findings of this study applies to most families, care must be taken when generalizing the results to those with the lowest educational levels. The researchers further state that it is possible that associations could be stronger and the levels of problems could be higher if these groups had been included.
About the TOPP-study
Through eight rounds of data collection, the TOPP study ("Tracking Opportunities and Problems in Childhood and Adolescence") has collected questionnaire data about children and young people and their families. The study examines the pathways to well-being, good mental health and mental disorders in children, adolescents and their families.
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Nilsen, W., Gustavson, K., Kjeldsen, A., Røysamb, E., & Karevold, E. (2013). Pathways from maternal distress and child problem behavior to adolescent depressive symptoms – A prospective examination from 18 months to 17 years of age. Journal of Developmental and Behavioral Pediatrics, 35(5), 303-313