Maternal depression and comorbidity: Predicting early parenting, attachment security, and toddler social-emotional problems and competencies

Objective: To examine relations between maternal depression tin pure and co morbid forms) and mother-infant interactions, infant attachment, and toddle r social-emotional problems and competencies. A second objective was to exp lore sex differences. Method: Sixty-nine mother-infant dyads were followed from pregnancy to 30 months postpartum. Depression was measured at multiple times with self-report and interview assessments. Play was assessed at 4 m onths and attachment status at 14 months postpartum. At 30 months, mothers completed the Child Behavior Checklist and Infant-Toddler Social and Emotio nal Assessment. Results: Lifetime maternal depression predicted less optima l mother-infant interactions and insecure infant attachment. However, this "depression effect" was accounted for by mothers with comorbid diagnoses, w ho had less optimal interactions, and infants with higher rates of insecuri ty than either mothers with depression only or mothers with no psychopathol ogy. Prenatal and postpartum depressive symptoms were associated with probl em behaviors and lower competencies for boys. In contrast, quality of early interactions predicted problem behaviors in girls. Conclusions: It is impo rtant to examine the context of maternal depression with respect to additio nal psychopathology and environmental risks. Maternal depression in the pre sence of other psychopathology confers risk to the mother-child dyad. Consi stent with previous work, risk pathways appear to differ for boys and girls . Early identification and prevention efforts are warranted.