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. 2023 Nov;51(11):1611-1626.
doi: 10.1007/s10802-023-01086-5. Epub 2023 Jul 4.

Maternal Mental Health and Children's Problem Behaviours: A Bi-directional Relationship?

Emily Lowthian  1   2 , Stuart Bedston #  3 , Sara Madeleine Kristensen #  4 , Ashley Akbari  3 , Richard Fry  3 , Katy Huxley  5 , Rhodri Johnson  3 , Hyun Sue Kim  6 , Rhiannon K Owen  3 , Chris Taylor  5 , Lucy Griffiths  3
Affiliations

Maternal Mental Health and Children's Problem Behaviours: A Bi-directional Relationship?

Emily Lowthian et al. Res Child Adolesc Psychopathol. 2023 Nov.

Abstract

Transactional theory and the coercive family process model have illustrated how the parent-child relationship is reciprocal. Emerging research using advanced statistical methods has examined these theories, but further investigations are necessary. In this study, we utilised linked health data on maternal mental health disorders and explored their relationship with child problem behaviours via the Strengths and Difficulties Questionnaire for over 13 years. We accessed data from the Millennium Cohort Study, linked to anonymised individual-level population-scale health and administrative data within the Secure Anonymised Information Linkage (SAIL) Databank. We used Bayesian Structural Equation Modelling, specifically Random-Intercept Cross-Lagged Panel Models, to analyse the relationships between mothers and their children. We then explored these models with the addition of time-invariant covariates. We found that a mother's mental health was strongly associated over time, as were children's problem behaviours. We found mixed evidence for bi-directional relationships, with only emotional problems showing bi-directional associations in mid to late childhood. Only child-to-mother pathways were identified for the overall problem behaviour score and peer problems; no associations were found for conduct problems or hyperactivity. All models had strong between-effects and clear socioeconomic and sex differences. We encourage the use of whole family-based support for mental health and problem behaviours, and recommend that socioeconomic, sex and wider differences should be considered as factors in tailoring family-based interventions and support.

Keywords: Bayesian analysis; Child development; Maternal mental health; Millennium Cohort Study; Structural equation modelling.

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Conflict of interest statement

RKO is a member of the National Institute for Health and Care Excellence (NICE) Technology Appraisal Committee, member of the NICE Decision Support Unit (DSU), and associate member of the NICE Technical Support Unit (TSU). She has served as a paid consultant to the pharmaceutical industry, providing unrelated methodological advice. She reports teaching fees from the Association of British Pharmaceutical Industry (ABPI) and the University of Bristol.

Figures

Fig. 1
Fig. 1
Sample selection households available given time-point and data linkage availability
Fig. 2
Fig. 2
Time periods of data collection for maternal mental health (MH1-5) and child strengths and difficulties (SDQ1 – 5)
Fig. 3
Fig. 3
Probit estimates with 95% credible intervals from a random intercept cross-lagged panel model of total Strengths and Difficulties Questionnaire (SDQ) score and maternal mental health (MH). *Adjusted for maternal qualifications and child sex (N = 1835)
Fig. 4
Fig. 4
Probit estimates with 95% credible intervals from a random intercept cross-lagged panel model of Emotional Problems (EP) and maternal mental health (MH). *Adjusted for maternal qualifications and child sex. (N = 1842)
Fig. 5
Fig. 5
Probit estimates with 95% credible intervals from a random intercept cross-lagged panel model of Conduct Problems (CP) and maternal mental health (MH). *Adjusted for maternal qualifications and child sex. (N=1842)
See this image and copyright information in PMC

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