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Trajectories and Associations Between Maternal Depressive Symptoms, Household Chaos and Children's Adjustment through the COVID-19 Pandemic: A Four-Wave Longitudinal Study.

ABSTRACT: The COVID-19 pandemic and associated public health measures have adversely affected the lives of people worldwide, raising concern over the pandemic's mental health consequences. Guided by a systemic model of family functioning during the COVID-19 pandemic (Prime et al., 2020), the current study aimed to examine how caregiver well-being (i.e., maternal depressive symptoms) and family organization (i.e., household chaos) are related to longitudinal trajectories of children's emotional and behavioral problems. Data were collected at four time points during and after home lockdown periods. Mothers of children (N = 230; 55% male) between the ages of two to five years were asked to complete questionnaires via an Israeli online research platform. Results indicated that emotional and behavioral problems, household chaos, and maternal depressive symptoms were the highest during the first lockdown assessment and dropped in the post-lockdown periods. Multilevel models further revealed that at the between-participants level, maternal depressive symptoms and household chaos positively predicted children's emotional and behavioral problems. At the within-participants level, household chaos fluctuations positively predicted fluctuations in child behavioral but not emotional problems. Our findings suggest that lockdowns have adverse effects on both maternal and child mental health. Screening for depressive symptoms among mothers of young children and maintaining household structure are important targets for future interventions to assist parents in navigating the multiple challenges brought upon by the COVID-19 pandemic.

SUBMITTER: Gordon-Hacker A

PROVIDER: S-EPMC9247896 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundChaotic home environments may contribute to children's attention-deficit hyperactivity disorder (ADHD) symptoms. However, ADHD genetic risk may also influence household chaos. This study investigated whether children in chaotic households had more ADHD symptoms, if mothers and children with higher ADHD genetic risk lived in more chaotic households, and the joint association of genetic risk and household chaos on the longitudinal course of ADHD symptoms across childhood.MethodsParticipants were mothers and children from the Environmental Risk (E-Risk) Longitudinal Twin Study, a UK population-representative birth cohort of 2,232 twins. Children's ADHD symptoms were assessed at ages 5, 7, 10 and 12 years. Household chaos was rated by research workers at ages 7, 10 and 12, and by mother's and twin's self-report at age 12. Genome-wide ADHD polygenic risk scores (PRS) were calculated for mothers (n = 880) and twins (n = 1,999); of these, n = 871 mothers and n = 1,925 children had information on children's ADHD and household chaos.ResultsChildren in more chaotic households had higher ADHD symptoms. Mothers and children with higher ADHD PRS lived in more chaotic households. Children's ADHD PRS was associated with household chaos over and above mother's PRS, suggesting evocative gene-environment correlation. Children in more chaotic households had higher baseline ADHD symptoms and a slower rate of decline in symptoms. However, sensitivity analyses estimated that gene-environment correlation accounted for a large proportion of the association of household chaos on ADHD symptoms.ConclusionsChildren's ADHD genetic risk was independently associated with higher levels of household chaos, emphasising the active role of children in shaping their home environment. Our findings suggest that household chaos partly reflects children's genetic risk for ADHD, calling into question whether household chaos directly influences children's core ADHD symptoms. Our findings highlight the importance of considering parent and child genetic risk in relation to apparent environmental exposures.

Project description:ImportanceDepressive symptoms during pregnancy influence the development and health of the offspring, underscoring the need for timely intervention. However, the course of depressive symptoms across the perinatal period remains unclear, thus complicating screening and referral guidelines.ObjectiveTo examine the course and stability of depressive symptoms across the perinatal period in multiple, ethnically diverse independent observational cohorts.Design, setting, and participantsThis cohort study included self-reported depressive symptoms at multiple time points from 7 prospective cohorts spanning 3 continents (United Kingdom: Avon Longitudinal Study of Parents and Children from 1991 to 1995; Canada: Maternal Adversity, Vulnerability and Neurodevelopment from 2003 to 2007; Montreal Antenatal Well-being Study from 2019 to 2022; Alberta Pregnancy Outcomes and Nutrition from 2009 to 2014; and Singapore: Growing Up in Singapore Toward Healthy Outcomes from 2009 to 2013; Singapore Preconception Study of Long-Term Maternal and Child Outcomes from 2015 to 2019; and Mapping Antenatal Maternal Stress from 2019 to 2022). Participants were recruited either during preconception or pregnancy and observed into the postnatal period. All data from each cohort were analyzed from July 2022 to April 2023.Main outcomes and measuresSelf-reported depressive symptoms from pregnancy to 2 years following childbirth using either the Edinburgh Postnatal Depression Scale or the Center for Epidemiological Studies Depression were analyzed independently within each cohort using item response theory (IRT) techniques. K-means clustering was used to identify groups of participants with similar trajectories.ResultsA total of 11 563 pregnant women (mean [SD] age, 29 [5] years; 569 [4.9%] East Asian women; 304 [2.6%] Southeast Asian women; 10 133 [87.6%] White women) self-reported depressive symptoms from pregnancy to 2 years following childbirth. Analytic methods from Item Response Theory identified 3 groups of mothers based on depressive symptoms: low, mild, and high levels in each of the 7 cohorts. Mothers within and across all cohorts had stable trajectories of maternal depressive symptoms from pregnancy onwards. Mothers with clinical levels of depressive symptoms likewise showed stable trajectories from pregnancy into the postnatal period.Conclusions and relevanceIn this study, trajectories of depressive symptoms remained stable from pregnancy across the perinatal period, a finding that conflicts with a continuing emphasis on postpartum or postnatal onset of depression that persists in some health policy guidelines. Interventions and public health initiatives should focus on reducing depressive symptoms during pregnancy in addition to following birth.

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Trajectories and Associations Between Maternal Depressive Symptoms, Household Chaos and Children's Adjustment through the COVID-19 Pandemic: A Four-Wave Longitudinal Study.

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