Maternal anxiety and depression and their associations with mother-child pretend play: a longitudinal observational study

Abstract

Background: Parental anxiety and depression have been associated with changes to parent-child interactions. Although play constitutes an important part of parent-child interactions and affords critical developmental opportunities, little is known regarding how parental anxiety and depression are related to parent-child play. This is an important knowledge gap because parents play a crucial role in children's early play experience. The purpose of the current study was to examine whether levels of maternal anxiety and depression respectively predicted frequencies of pretend play in both mothers and their children, and whether mothers' engagement in pretend play predicted child behaviour problems two years later.

Methods: Pretend play in 60 mother-toddler dyads (M_{age of child} = 29.67 months, SD = 3.25, 41.7% girls) was assessed during home visits. Maternal anxiety and depression were assessed using self-report questionnaires. Children's behaviour problems were rated by mothers at baseline and two years later. Hierarchical regression analyses examined concurrent associations between mother-child pretend play and maternal anxiety and depression at baseline, and longitudinal associations between baseline mother pretend play and child behavioural problems two years later.

Results: Higher maternal anxiety predicted less pretend play in mothers and children (β = - .23, BCa 95% CI: [- .018, - .001]) and β = - .22, BCa 95% CI [- .014, - .001]). Higher maternal depression predicted less child pretend play (β = - .20, BCa 95% CI [- .012, - .001]). There was evidence (albeit weak) that more mother pretend play at baseline predicted fewer child behaviour problems two years later (β = - .18, BCa 95% CI [- 62.38, 11.69]), when baseline child behaviour problems and maternal anxiety were controlled for.

Conclusions: Maternal anxiety and depression are associated with less pretend play during mother-child interaction. Mother's pretend play might help reduce child behavioural problems risks, suggesting that play might be one mechanism by which maternal mental health influences children's development.

Keywords: Anxiety; Behavioural problem; Depression; Mother–child interaction; Pretend play.