Journal Article

Impacts of a tiered intervention on child internalizing and externalizing behavior in the context of maternal depression

Morris, Pamela, Miller, Elizabeth B., Rosas, Johana, Canfield, Caitlin Ford, Aviles, Ashleigh I., Mendelsohn, Alan L., Taraban, Lindsay, Shaw, Daniel

2025

Overview

Greater maternal depressive symptoms are consistently associated with higher levels of behavioral difficulties in children, emerging in early childhood and with long-lasting consequences for children’s development. Interventions promoting early relational health have been shown to have benefits for children’s behavior; however, these impacts are not always realized in the context of maternal depression. This study examined whether tiered programs could address this limitation by focusing on both parenting, through universal primary prevention, and psychosocial stressors and parent mental health, through tailored secondary prevention. Analysis of a randomized controlled trial (RCT) of the Smart Beginnings (SB) intervention was conducted to determine whether SB attenuated the association between maternal depression and early childhood internalizing and externalizing behaviors. Maternal depression significantly predicted both internalizing and externalizing behaviors in linear regression models. Further, there was a significant interaction between maternal depression and treatment group, such that among mothers with higher depressive symptoms, the SB treatment attenuated the magnitude of the association between depression and child behavior. Findings suggest that while parenting support is important for all families, it may be particularly critical for those with higher levels of depression and underscores the need to consider multidimensional family processes in both research and clinical practice.

• Publisher: Cambridge University Press
• Subject: Adult / Behavior / Caregivers / Child / Child Behavior - psychology / Child Behavior Disorders - prevention & control / Child Behavior Disorders - psychology / Child development / Child of Impaired Parents - psychology / Child, Preschool / Childhood / Children / Children & youth / Clinical medicine / Clinical research / Clinical trials / Depression - psychology / Depression - therapy / DNA methylation / Early childhood education / Early intervention / Externalizing behaviour / Families & family life / Female / Health behavior / Health education / Health promotion / Humans / Internalization / Intervention / Male / Maternal behavior / Maternal depression / Mental depression / Mental health / Mother-Child Relations - psychology / Mothers / Mothers - psychology / Parenting - psychology / Parents & parenting / Prevention / Preventive medicine / Psychosocial factors / Regression analysis / Secondary prevention / Stress / Symptoms