Maternal Depressive Symptoms and Risk for Childhood Depression: Role of Executive Functions

J Am Acad Child Adolesc Psychiatry. 2024 Oct 16:S0890-8567(24)01939-7. doi: 10.1016/j.jaac.2024.08.503. Online ahead of print.

Abstract

Objective: Offspring of mothers with depression are at increased risk for executive function (EF) deficits and later depressive symptoms, but limited studies have examined EF as an intermediary pathway. This study examined the role of EF in mediating the association between maternal and child depressive symptoms.

Method: Data were from a longitudinal birth cohort comprising 739 participants followed from the antenatal period for 12 years. Mothers completed the Edinburgh Perinatal Depression Scale at 26 to 28 weeks' gestation and at 3 and 24 months postpartum. At ages 8.5 to 10 years, children self-reported using the Children's Depression Inventory, Second Edition. Task-based and parent-reported EF measures were collected at 4 time points between 3.5 and 8.5 years. Latent growth curve models examined antenatal depressive symptoms and their trajectory in contributing to cold (ie, cognitive) and hot (ie, affective) EFs. The extent to which EF mediated this association was then assessed.

Results: Maternal depressive symptoms did not directly predict depressive symptoms in late childhood. Antenatal depressive symptoms predicted lower cold EF (β = -.13, 95% CI [-0.25, -0.004]) and hot EF (β = -.26, 95% CI [-0.38, -0.15]). Deficits in cold EF (β = -.26, 95% CI [-0.41, -0.11]) acted as an intermediary path to depressive symptoms, whereas hot EF mediated the association between maternal and child depressive symptoms, forming an indirect path that accounted for 37.5% of the association.

Conclusion: Deficits in hot EF may be a pathway in explaining the intergenerational transmission of depression. This finding suggests fostering EF skills as a potential strategy for at-risk children.

Clinical trial registration information: Growing Up in Singapore Towards Healthy Outcomes (GUSTO); https://clinicaltrials.gov/study; NCT01174875.

Diversity & inclusion statement: We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability.

Keywords: child development; depression; executive function; intergenerational relations; mediation analysis.

Associated data

  • ClinicalTrials.gov/NCT01174875