It's not always binary: Connecting the continuum of caregiver depression with child adjustment in children who are high risk for maltreatment

Leanne Katz Levin; Elisa Brown Fuller; Edward Coffield; Debra Bendell

doi:10.1016/j.jad.2022.01.110

It's not always binary: Connecting the continuum of caregiver depression with child adjustment in children who are high risk for maltreatment

J Affect Disord. 2022 May 1:304:142-149. doi: 10.1016/j.jad.2022.01.110. Epub 2022 Feb 12.

Authors

Leanne Katz Levin¹, Elisa Brown Fuller², Edward Coffield³, Debra Bendell⁴

Affiliations

¹ Department of Medicine, Foundations of Clinical Medicine, New York Medical College, 7 Dana Road, Valhalla, New York 10595, USA; Department of Clinical Psychology, School of Psychology, Fielding Graduate University, 2020 De La Vina Street, Santa Barbara, CA 93105, USA. Electronic address: LLevin3@nymc.edu.
² Private Practice and Independent Researcher, CA, USA.
³ Department of Population Health, Hofstra University, New York, USA.
⁴ Department of Clinical Psychology, School of Psychology, Fielding Graduate University, 2020 De La Vina Street, Santa Barbara, CA 93105, USA.

PMID: 35167927
DOI: 10.1016/j.jad.2022.01.110

Abstract

Background: Young children living with a depressed parent are at risk for developing social, behavioral, and emotional problems. The purpose of this study was to evaluate whether an increase in subclinical caregiver depression scores was associated with increases in internalizing and externalizing behavior in children who are at high risk for maltreatment.

Methods: The 1019 U.S.-based dyads consisted of predominantly single (45.53%) and Black/African American (53.29%) caregivers and high-risk 4-year-olds from the LONGSCAN study. Multivariate regression analyzes were used to evaluate the relationship between caregiver Center for Epidemiological Studies-Depression (CES-D) scores, above and below the at-risk for depression CES-D score, and preschooler internalizing, externalizing, and total problem behaviors, measured with the Child Behavior Checklist (CBCL).

Results: Caregiver CES-D score increases, above and below the at-risk for depression score, were significantly associated (p < 0.05) with increased child internalizing, externalizing, and total problem behaviors. After adjusting for covariates, among dyads whose caregivers had subclinical (CES-D < 16) scores, a one-unit score increase was significantly associated with a 0.43 increase (p = 0.00) in children's CBCL internalizing score.

Limitations: These findings are restricted to preschool children who are at risk for maltreatment, limiting generalizability.

Conclusions: Low and moderate levels of caregiver depressive symptomatology were associated with a negative influence on preschoolers' adjustment. Practitioners should consider that the link between caregiver depression and child wellbeing may lie on a continuum. With consideration of the full continuum of symptoms, early intervention and anticipatory guidance may decrease the impact of depression on the caregiver, child, and system.

Keywords: Caregiver depression; Externalizing; High-risk preschool children; Internalizing; Subclinical depressive symptoms.

MeSH terms

Caregivers / psychology
Child
Child Behavior Disorders* / psychology
Child, Preschool
Depression / epidemiology
Depression / psychology
Female
Humans
Mothers / psychology
Problem Behavior* / psychology