Excellent! Thank you Chris.
Bill Mannle
-----Original Message-----
From: Chris Walsh <chrisjwalsh@xxxxxxxxxxxxxxx>
Sent: Jan 10, 2007 3:44 AM
To: ConstellationTalk@xxxxxxxxxxxxxxx
Subject: [ConstellationTalk] Paternal Depression
Hi all
a recently published rigorous scientific epidemiological study fro Oxford
shows that there is a higher incidence in conduct disorder and Attention
Deficit disorder in young children of fathers suffering depression - and wait
for it - especially in the boys.
OK that's no surprise to us. However it is an important validation of the sort
of assertions we make ( or conclusions we reach) through constellation work.
A longish summary of the findings is pasted below
hasta la vista
Chris Walsh
Melbourne, Australia
webpage: www.cwalsh.com.au
June 27, 2005 - Paternal depression may hinder early behavioral and emotional
development of men's children, according to the results of a prospective study
published in the June 25 issue of The Lancet.
"Depression is common and frequently affects mothers and fathers of young
children," write Paul Ramchandani from the University of Oxford, England, and
colleagues from the ALSPAC (Avon Longitudinal Study of Parents and Children)
study team. "Postnatal depression in mothers affects the quality of maternal
care, and can lead to disturbances in their children's social, behavioural,
cognitive, and physical development. However, the effect of depression in
fathers during the early years of a child's life has received little
attention."
As part of a large, population-based study of childhood, the investigators
evaluated depressive symptoms using the Edinburgh Postnatal Depression Scale
(EPDS) in 13,351 mothers and in 12,884 fathers eight weeks after the birth of
their children. Fathers were reevaluated at 21 months. Maternal reports on the
Rutter revised preschool scales were used to identify any subsequent
development of behavioral and emotional problems in their 3.5-year-old
children.
Data were available for 8,431 fathers, 11,833 mothers, and 10,024 children.
Paternal depression during the postnatal period was associated with adverse
emotional and behavioral outcomes in children at age 3.5 years (adjusted odds
ratio [OR], 2.09; 95% confidence interval [CI], 1.42 - 3.08), and an increased
risk of conduct problems in boys (OR, 2.66; 96% CI, 1.67 - 4.25). Controlling
for maternal postnatal depression and later paternal depression did not affect
these findings.
"Our findings indicate that paternal depression has a specific and persisting
detrimental effect on their children's early behavioural and emotional
development," the authors write. "Our findings further indicate that the
association between paternal depression and child behaviour problems is
stronger in boys than in girls. This notion warrants further investigation."
The Medical Research Council, the Wellcome Trust, UK government departments,
medical charities, and others funded this study. The ALSPAC study is part of
the European Longitudinal Study of Pregnancy and Childhood, initiated by the
World Health Organization. One of the authors has received payments to give
lectures from pharmaceutical companies marketing antidepressants.
In an accompanying editorial, Tytti Solantaus, from the National Research and
Development Centre for Welfare and Health, and Saara Salo from Children's
Hospital, both in Helsinki, Finland, call this study "beautiful in its
simplicity," despite limitations such as being based solely on questionnaire
data.
"Fathers are sometimes kept away from the nursery (and from developmental
theories) by the argument that men lack 'maternal instinct,' understood as an
inborn quality, which supposedly makes mothers more sensitive to their babies
than fathers are," Drs. Solantaus and Salo write. "This [study suggests] that
infants are also sensitive to their fathers. There is no longer any excuse to
exclude fathers from mainstream research into infant development and
psychopathology."
Drs. Solantaus and Salo report no conflict of interest.
Lancet. 2005;365:2158-2159, 2201-2205
Learning Objectives for This Educational Activity
Upon completion of this activity, participants will be able to:
a.. Describe the effect of paternal postnatal depression on behavioral
outcomes in men's children.
b.. Compare the effect of paternal postnatal depression on boys vs girls.
Clinical Context
Worldwide, depression is the fourth largest cause of disability and a major
health problem, with an increase in incidence expected by 2020. Symptoms of
depression can interfere with responsive parenting, and the quality of early
parenting can have persistent effects on later development. Maternal postnatal
depression affects the quality of maternal care and predicts later social,
behavioral, cognitive, and physical development. According to the authors, the
effect of depression in fathers during the first months of their children's
lives has been little studied. There is research to show that the adolescent
children of depressed fathers have increased rates of psychopathology.
This is a prospective cohort study examining 13,351 mothers and 12,884 fathers
of newborns within eight weeks of birth and correlating maternal and paternal
postnatal depression with behavior of their offspring at age 3.5 years.
Study Highlights
a.. 85% to 90% of pregnant mothers were recruited from 1 area of the United
Kingdom.
b.. Questionnaires were sent to the mothers and fathers to assess a wide
range of factors, including environmental toxins and psychosocial risks.
c.. For this study, the validated self-report 10-item EPDS was administered
to fathers and mothers.
d.. Paternal depression was reassessed at 21 months after birth.
e.. Specificity of the EPDS was reported by the authors as 95.7%, and
sensitivity was 81.6% on the basis of previous studies, using a cutoff of 12
points to identify major depression.
f.. Disturbance of children's emotional and behavioral development was
measured at age 3.5 years (42 months) with maternal reports, using the Rutter
revised scale for behavior.
g.. Responses to the Rutter scale consisted of "Yes certainly," "Yes
sometimes," and "No" to questions about conduct disorder, emotional problems,
hyperactivity, and prosocial behaviors. A total problems score was derived.
h.. A cutoff of the top 10% was used to identify children with problems on
the basis of previous research showing a substantially increased risk of
psychiatric disorder with this criterion.
i.. Logistic regression analysis was used, controlling for social class,
maternal depression, and education.
j.. Data were available for maternal postnatal depression in 11,833 (89%) of
women and 8,431 (65%) of men.
k.. Questionnaires were completed about children age 3.5 years by 75% of
mothers for 10,024 children.
l.. High amounts of maternal but not paternal depression were predictive of
study dropout at a follow-up point of 42 months.
m.. 10% of mothers and 4% of fathers scored more than 12 points on the EPDS.
n.. Scores for the EPDS for mothers and fathers were significantly
correlated (P < .001).
o.. Paternal depression was highly correlated with high total problems score
on the Rutter preschool scale (OR, 2.19; 95% CI, 1.55 - 3.08) and with high
scores on all 3 problem subscales (emotional, conduct, and hyperactivity) but
not on prosocial behaviors. The association persisted for all behaviors
except emotional problems when social class, education, and maternal
depression were controlled for.
p.. Maternal depression was also associated with high problems scores on the
Rutter scale (OR, 3.08; 95% CI, 2.57 - 3.69) in all the problem subscale
areas. This association persisted when social class, paternal depression and
education were controlled for.
q.. When paternal depression at 21 months was controlled for, the
associations for conduct problems (OR, 1.73) and hyperactivity (OR, 1.96)
persisted. However, the association with the total problems score was no
longer significant.
r.. The association between paternal depression and later conduct problems
was stronger in boys than in girls (likelihood ratio test, 5.26; P = .022).
s.. Maternal depression was associated with high problems scores across all
domains of child psychological functioning.
t.. Paternal depression was associated only with raised levels of problems
for boys.
u.. The association between paternal depression and later emotional and
behavioral problems is largely accounted for by an increased risk to boys.
This association was more pronounced for behavioral (conduct and
hyperactivity) than for emotional (worry and sadness) symptoms.
Pearls for Practice
a.. Children of fathers with depression during the postnatal period are at
increased risk of behavioral problems at age 3.5 years.
b.. Increased risk of behavioral problems in children of fathers with
postnatal depression is higher in boys than girls and specific to conduct and
hyperactivity rather than emotional problems.
June 27, 2005 - Paternal depression may hinder early behavioral and
emotional development of men's children, according to the results of a
prospective study published in the June 25 issue of The Lancet.
"Depression is common and frequently affects mothers and fathers of young
children," write Paul Ramchandani from the University of Oxford, England, and
colleagues from the ALSPAC (Avon Longitudinal Study of Parents and Children)
study team. "Postnatal depression in mothers affects the quality of maternal
care, and can lead to disturbances in their children's social, behavioural,
cognitive, and physical development. However, the effect of depression in
fathers during the early years of a child's life has received little
attention."
As part of a large, population-based study of childhood, the investigators
evaluated depressive symptoms using the Edinburgh Postnatal Depression Scale
(EPDS) in 13,351 mothers and in 12,884 fathers eight weeks after the birth of
their children. Fathers were reevaluated at 21 months. Maternal reports on
the Rutter revised preschool scales were used to identify any subsequent
development of behavioral and emotional problems in their 3.5-year-old
children.
Data were available for 8,431 fathers, 11,833 mothers, and 10,024 children.
Paternal depression during the postnatal period was associated with adverse
emotional and behavioral outcomes in children at age 3.5 years (adjusted odds
ratio [OR], 2.09; 95% confidence interval [CI], 1.42 - 3.08), and an
increased risk of conduct problems in boys (OR, 2.66; 96% CI, 1.67 - 4.25).
Controlling for maternal postnatal depression and later paternal depression
did not affect these findings.
"Our findings indicate that paternal depression has a specific and
persisting detrimental effect on their children's early behavioural and
emotional development," the authors write. "Our findings further indicate
that the association between paternal depression and child behaviour problems
is stronger in boys than in girls. This notion warrants further
investigation."
The Medical Research Council, the Wellcome Trust, UK government departments,
medical charities, and others funded this study. The ALSPAC study is part of
the European Longitudinal Study of Pregnancy and Childhood, initiated by the
World Health Organization. One of the authors has received payments to give
lectures from pharmaceutical companies marketing antidepressants.
In an accompanying editorial, Tytti Solantaus, from the National Research
and Development Centre for Welfare and Health, and Saara Salo from Children's
Hospital, both in Helsinki, Finland, call this study "beautiful in its
simplicity," despite limitations such as being based solely on questionnaire
data.
"Fathers are sometimes kept away from the nursery (and from developmental
theories) by the argument that men lack 'maternal instinct,' understood as an
inborn quality, which supposedly makes mothers more sensitive to their babies
than fathers are," Drs. Solantaus and Salo write. "This [study suggests] that
infants are also sensitive to their fathers. There is no longer any excuse to
exclude fathers from mainstream research into infant development and
psychopathology."
Drs. Solantaus and Salo report no conflict of interest.
Lancet. 2005;365:2158-2159, 2201-2205
Learning Objectives for This Educational Activity
Upon completion of this activity, participants will be able to:
a.. Describe the effect of paternal postnatal depression on behavioral
outcomes in men's children.
b.. Compare the effect of paternal postnatal depression on boys vs girls.
Clinical Context
Worldwide, depression is the fourth largest cause of disability and a major
health problem, with an increase in incidence expected by 2020. Symptoms of
depression can interfere with responsive parenting, and the quality of early
parenting can have persistent effects on later development. Maternal
postnatal depression affects the quality of maternal care and predicts later
social, behavioral, cognitive, and physical development. According to the
authors, the effect of depression in fathers during the first months of their
children's lives has been little studied. There is research to show that the
adolescent children of depressed fathers have increased rates of
psychopathology.
This is a prospective cohort study examining 13,351 mothers and 12,884
fathers of newborns within eight weeks of birth and correlating maternal and
paternal postnatal depression with behavior of their offspring at age 3.5
years.
Study Highlights
a.. 85% to 90% of pregnant mothers were recruited from 1 area of the
United Kingdom.
b.. Questionnaires were sent to the mothers and fathers to assess a wide
range of factors, including environmental toxins and psychosocial risks.
c.. For this study, the validated self-report 10-item EPDS was
administered to fathers and mothers.
d.. Paternal depression was reassessed at 21 months after birth.
e.. Specificity of the EPDS was reported by the authors as 95.7%, and
sensitivity was 81.6% on the basis of previous studies, using a cutoff of 12
points to identify major depression.
f.. Disturbance of children's emotional and behavioral development was
measured at age 3.5 years (42 months) with maternal reports, using the Rutter
revised scale for behavior.
g.. Responses to the Rutter scale consisted of "Yes certainly," "Yes
sometimes," and "No" to questions about conduct disorder, emotional problems,
hyperactivity, and prosocial behaviors. A total problems score was derived.
h.. A cutoff of the top 10% was used to identify children with problems on
the basis of previous research showing a substantially increased risk of
psychiatric disorder with this criterion.
i.. Logistic regression analysis was used, controlling for social class,
maternal depression, and education.
j.. Data were available for maternal postnatal depression in 11,833 (89%)
of women and 8,431 (65%) of men.
k.. Questionnaires were completed about children age 3.5 years by 75% of
mothers for 10,024 children.
l.. High amounts of maternal but not paternal depression were predictive
of study dropout at a follow-up point of 42 months.
m.. 10% of mothers and 4% of fathers scored more than 12 points on the
EPDS.
n.. Scores for the EPDS for mothers and fathers were significantly
correlated (P < .001).
o.. Paternal depression was highly correlated with high total problems
score on the Rutter preschool scale (OR, 2.19; 95% CI, 1.55 - 3.08) and with
high scores on all 3 problem subscales (emotional, conduct, and
hyperactivity) but not on prosocial behaviors. The association persisted for
all behaviors except emotional problems when social class, education, and
maternal depression were controlled for.
p.. Maternal depression was also associated with high problems scores on
the Rutter scale (OR, 3.08; 95% CI, 2.57 - 3.69) in all the problem subscale
areas. This association persisted when social class, paternal depression and
education were controlled for.
q.. When paternal depression at 21 months was controlled for, the
associations for conduct problems (OR, 1.73) and hyperactivity (OR, 1.96)
persisted. However, the association with the total problems score was no
longer significant.
r.. The association between paternal depression and later conduct problems
was stronger in boys than in girls (likelihood ratio test, 5.26; P = .022).
s.. Maternal depression was associated with high problems scores across
all domains of child psychological functioning.
t.. Paternal depression was associated only with raised levels of problems
for boys.
u.. The association between paternal depression and later emotional and
behavioral problems is largely accounted for by an increased risk to boys.
This association was more pronounced for behavioral (conduct and
hyperactivity) than for emotional (worry and sadness) symptoms.
Pearls for Practice
a.. Children of fathers with depression during the postnatal period are at
increased risk of behavioral problems at age 3.5 years.
b.. Increased risk of behavioral problems in children of fathers with
postnatal depression is higher in boys than girls and specific to conduct and
hyperactivity rather than emotional problems.
[Non-text portions of this message have been removed]
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