In a recently published study, Dr Frontiers in Psychology, Researchers assessed the link between fathers’ mental health and a child’s development during middle childhood.
Study: Longitudinal associations between paternal mental health and child behavior and cognition in middle childhood. Image Credit: PeopleImages.com – Yuri A/Shutterstock.com
Middle childhood, beginning at age six, is important for every child because a child learns novel cognitive, social, and behavioral skills during this transitory stage.
Studies have examined the impact of paternal health on a child’s development at this critical stage; However, focusing only on paternal depression but not on other risk factors, such as anxiety and perceived stress.
A meta-analysis reported that parental mental health problems during pregnancy (prenatal) doubled the risk of psychiatric disorders in 6–8-year-old school-going children. Even paternal mental health-related conditions, such as substance abuse, have been shown to adversely affect children.
Similarly, environmental factors such as family conflict and differing views of parents may influence these associations. However, longitudinal follow-up studies examining the same are lacking.
Furthermore, there is a lack of understanding of how the type of paternal mental health symptoms, their timing and severity, and other socio-environmental factors interact or mediate this association during middle childhood.
About the study
In the current study, researchers collected data from 2,366 mother-father-child triads from the first trimester of pregnancy until a child was six to eight years old in the Design, Develop, Discover (3D) Pregnancy Cohort Study in Canada.
Antenatal assessments covered the first self-reported episode of parental depression, anxiety, and stress symptoms and psychosocial measures, such as highest education, marital quality index (QMI), and parental perceptions of pregnancy.
They used the Center for Epidemiological Studies Depression Scale (CES-D) to measure paternal depressive symptoms during the first trimester.
Similarly, they assessed the QMI, a six-item self-report questionnaire that measures the level of help received from the partner in childcare, housework, etc., three, 12, and 24 months after the birth of the child.
At these three time points, each parent also self-reported the Parenting Knowledge and Behavior Per Child Scale (PACOTIS).
During follow-up assessments in middle childhood, they assessed paternal depression and anxiety symptoms using the Beck Depression Inventory and Anxiety Inventory (BDI and BAI), respectively.
Similarly, a four-item self-reported perceived stress scale (PSS) helped measure their level of parental stress. They used the Wechsler Intelligence Scale for Children (WISC-V) and the Strengths and Difficulties Questionnaire (SDQ) to assess cognitive and behavioral outcomes in children aged 6–8 years, respectively.
A full-scale IQ score was derived from a verbal comprehension index score, and a fluid reasoning index score was derived from the matrix reasoning and image weighting subscales. Further, the team collected information on the parents’ and children’s health history.
Before proceeding to more complex statistical analyses, the team performed descriptive analyzes for variables of interest and used Pearson correlations to assess simple associations between predictors and outcomes.
They carefully selected maternal mental health symptoms and highest parental education level as covariates and accounted for their potential influence on all study outcomes.
They also identified outliers that could have skewed the results using criteria of >2.5 standard deviations (SDs) from the mean; However, they found that all data points were within an acceptable range.
Additionally, the team applied a correction for multiple comparisons using the false discovery rate (FDR) method, as this study involved numerous statistical tests.
The researchers then proceeded to regression-based mediation and moderation analyzes to determine the mechanisms through which the variables were related (mediation) and the conditions under which this relationship might change (moderation). Statistical significance threshold was set at a p-value of ≤0.05.
Measures of paternal mental health are the CES-D, PSS, STR, BDI, and BAI, and child outcomes are the SDQ and WISC-V.
The researchers used multiple linear regression to analyze the relationship between these and analyzed each combination of both outcomes using regression analysis.
Further, the researchers assessed whether paternal mental health during pregnancy or early childhood was associated with specific child outcomes using multiple regression and moderation analyses.
Furthermore, the researchers explored the mediating effects of fathers’ parenting styles on child development at 24 months.
All measures of paternal mental health (CES-D, STR, BDI, BAI, and PSS) and child development outcomes (WISC-V, SDQ) were within normal limits, and more importantly, these were lower than maternal scores.
However, lower QMI scores at 24 months postpartum were associated with higher paternal prenatal depression and anxiety symptoms.
A similar correlation between paternal QMI and concurrent paternal anxiety and depressive symptoms or child behavioral symptoms, however, was nonexistent in middle childhood.
Linear regression models showed that higher prenatal paternal depressive symptoms, as reflected in CES-D scores, were associated with fewer behavioral and emotional problems in children.
post-hoc Analysis showed that this correlation was associated with externalizing symptoms such as child conduct problems and hyperactivity with independent beta-weights (β) of −0.285 and −0.275.
Conversely, no significant relationship was detected between prenatal PSS or STR scores and a child’s cognitive development.
At the follow-up assessment, linear regression models showed that more paternal depressive symptoms measured concurrently with the BDI were associated with the WISC-V (β = 0.246, P = 0.050).
These associations were primarily related to children’s performance on the Fluid and Matrix Reasoning subscales, reflecting that these children had a receptive ability to think logically and solve complex problems even without prior knowledge.
The relative strength of associations between childhood paternal anxiety and depressive symptoms and full-scale IQ were similar, suggesting that these were unique.
Furthermore, duration of mental health symptoms and parental perceptions of fatherhood (Pacotis) did not moderate the observed associations. Similarly, paternal ratings of quality marriage (QMI) did not moderate the observed relationships.
Moreover, evidence of a moderating or mediating role of some environmental factors in these associations was lacking.
Conversely, maternal anxiety moderated the association between higher levels of paternal depression and cognitive outcomes in children aged 6–8 years.
Findings are clear regarding the timing of when exposure to parental mental health problems affects child developmental outcomes. Thus, there is a need to support the emotional well-being of parents before and after birth.
Overall, study data suggest that prenatal paternal mental health may be moderately predictive; However, contemporary paternal mental health is highly predictive of a child’s cognitive performance in middle childhood.
Yet it is unclear when this change occurs and what the underlying mechanisms are, which presents an apparent paradox considering the existing literature.
It is also noteworthy that a father’s parenting style, such as showing warmth, was associated with lower internalizing behavior in the child, suggesting that fathers may help moderate the effect of high maternal depression on child behavioral problems.
Follow-up studies with larger sample sizes, even within the same cohort, may be able to examine these complex interactions.
In this study, children of fathers who self-reported higher anxious or depressive symptoms during pregnancy or middle childhood performed better on cognitive assessments and showed no or fewer behavioral difficulties in school.
However, given the complex nature of these associations, continued research is needed on the severity of mental health symptoms and across the spectrum of a child’s long-term social, emotional, and cognitive development.