Maternal depression in the intergenerational transmission of childhood maltreatment and its sequelae: Testing postpartum effects in a longitudinal birth cohort

Abstract

Mothers who have experienced childhood maltreatment are more likely to have children also exposed to maltreatment, a phenomenon known as intergenerational transmission. Factors in the perinatal period may contribute uniquely to this transmission, but timing effects have not been ascertained. Using structural equation modeling with 1,016 mothers and their 2,032 children in the Environmental Risk Longitudinal Twin Study, we tested the mediating role of postpartum depression between maternal childhood maltreatment and a cascade of negative child outcomes, specifically child exposure to maltreatment, internalizing symptoms, and externalizing symptoms: (a) adjusting for later maternal depression, (b) comparing across sex differences, and (c) examining the relative role of maltreatment subtypes. Mothers who had been maltreated as children, especially those who had experienced emotional or sexual abuse, were at increased risk for postpartum depression. In turn, postpartum depression predicted children's exposure to maltreatment, followed by emotional and behavioral problems. Indirect effects from maternal childhood maltreatment to child outcomes were robust across child sex and supported significant mediation through postpartum depression; however, this appeared to be carried by mothers' depression beyond the postpartum period. Identifying and treating postpartum depression, and preventing its recurrence, may help interrupt the intergenerational transmission of maltreatment and its sequelae.

Figure 1. Main structural model with postpartum depression as mediator.

Rectangles represent observed variables; ovals represent latent variables on which younger and elder twin scores have been regressed (paths not shown to improve readability). Solid lines represent paths with coefficients significant at p<.05* or p<.001***, with only significant paths shown in the model.

Figure 2. Sensitivity analyses of mother- versus teacher-only informant reports.

Rectangles represent observed variables; ovals represent latent variables on which younger and elder twin scores have been regressed (paths not shown to improve readability). Solid lines represent significant paths. Of note, bolded lines represent significant paths that were different across child outcomes as measured by mother- versus teacher-only reports.

Figure 3. Adjusted structural model including later maternal depression.

Rectangles represent observed variables; ovals represent latent variables on which younger and elder twin scores have been regressed (paths not shown to improve readability). Solid lines represent paths with coefficients significant at p<.05* or p<.001***, with only significant paths shown in the model.

Figure 4. Examining the relative contribution of maltreatment subtypes.

Rectangles represent observed variables; ovals represent latent variables on which younger and elder twin scores have been regressed (paths not shown to improve readability). Solid lines represent paths with coefficients significant at p<.05* or p<.001***, with only significant paths shown in the model.