Maternal Postnatal Depression, Expressed Emotion and Associated Child Internalising and Externalising Problems Aged 2-Years

Background: Maternal postnatal depression (MPND) has been associated with child emotional, behavioural and cognitive problems, placing them at greater risk for later psychopathology. Therefore research into mechanisms of risk transmission is important. This longitudinal study considers the emotional quality of the mother-child relationship, using a measure of Expressed Emotion (EE), as a potential mechanism explaining the link between MPND and child emotional and behavioural problems in the postnatal period. It was predicted mothers with higher depressive symptoms at 3-months would show more negative EE and their child would have more internalising and externalising problems at 2-years, with maternal EE acting as a mediator. Methods: Data from the longitudinal Oxford Father’s Project for 130 (of 192 originally recruited) mother-child dyads was used. Mother’s depressive symptoms were measured using the Edinburgh Postnatal Depression Scale at 3-months. Maternal EE, specifically critical and positive comments, was coded from the Preschool Five Minute Speech Sample measured at 2-years. Maternal, paternal and independently rated child outcomes were measured at 2-years using the Child Behaviour Checklist for ages 1.5-5. Results: Mothers, fathers and “others” rated child problems similarly. EE-positive comments showed stability from 1-2 years. Mothers with more depressive symptoms at 3-months showed more EE-criticism at 2-years especially towards boys and rated their children higher in internalising and externalising problems. Maternal EE-criticism predicted child internalising and externalising problems at 2-years. EE was not a significant mediator between maternal depressive symptoms and child problems. Conclusions: Children of mothers with more depressive symptoms 3-months post-birth experience more maternal EE-criticism and show more internalising and externalising problems aged 2-years. Given the long-term consequences of early childhood problems, postnatal depression should be screened and treated early to reduce EE-criticism and negative child outcomes. Research should consider why mothers experiencing postnatal depression may be more critical of male children and how this may impact on development