Maternal depressive symptoms were associated with an increase in the number of unhealthy adolescent behaviors, a 15-year longitudinal study showed.
While unhealthy behaviors were found to be common among adolescents in general, with two out of three engaging in at least one, higher levels of maternal depressive symptoms during a child’s middle childhood and adolescence were associated with engagement in more unhealthy behaviors at 16 to 17 years of age, reported Laura Bechtiger, MSc, of the Jacobs Center for Productive Youth Development in Zurich, and colleagues.
Of 213 participants included in the study, two-thirds reported at least one unhealthy behavior, and a fifth reported three or more unhealthy behaviors, they noted in Pediatrics.
One in four adolescents reported poor sleep and an unhealthy diet, two in five reported physical inactivity, and one in seven reported being sedentary often and smoking at some time point.
No differences between the sexes were seen in the overall number of unhealthy behaviors, though boys were more likely to report a poor diet, while girls were more likely to report physical inactivity and sedentary behavior.
“Notably, all associations are small in size, which highlights that maternal depressive symptoms are not inevitably associated with unhealthy behaviors in adolescents,” Bechtiger and team wrote. “This suggests complex developmental processes to adolescent unhealthy behaviors that need to be examined in future research.”
“It will be relevant to include repeated measures of unhealthy behavior already in childhood” in this future research, Bechtiger told MedPage Today. “This would allow us to better understand whether depressive symptoms in mothers and children actually predate children’s unhealthy behaviors, or whether the associations between these are more dynamic.”
The authors pointed out that adolescence is a time when children are presented with new opportunities to engage in unhealthy behaviors, noting that such behaviors such as poor diet and smoking can be risk factors for cardiovascular disease and cancer later in life.
“Our findings suggest that being attentive to children’s and parents’ mental health is important in pediatric practice,” Bechtiger said. “While promoting mental health, including that of parents, may not seem to be directly linked to pediatric practice, doing so could prevent negative long-term health consequences down the line.”
Previous research has suggested that as many as one in five U.S. children are exposed to maternal clinical depression.
“Core depressive symptoms include lack of energy and motivation. Such anhedonia constitutes a significant barrier to maternal engagement in health-promoting activities. For example, mothers with depression might lack the energy to be active with their child(ren) and model unhealthy habits, such as maladaptive sleep patterns or unhealthy diet,” the authors noted.
“Promoting mothers’ well-being and mental health is not only crucial for mothers themselves but can contribute to addressing one of the most pressing public health problems by promoting children’s healthy behaviors,” Bechtiger and team wrote.
“Screening for parental and child mental health in primary care settings, such as during well-child visits, could be one way to identify affected families early and refer them to relevant resources and services, as well as an opportunity to initiate a conversation about unhealthy behaviors in adults and children,” they added.
This 15-year prospective-longitudinal community study was conducted using data from the RIGHT Track health project in North Carolina. Data were collected for children ages 2 to 17 years.
Families were recruited through child daycare centers, the County Health Department, and the local Women, Infants, and Children program. The final sample included 213 children, with an average age of 16.62 years at time of assessment; 42% were boys, 65% were white, 29% were Black, and mean Hollingshead Index score was 39.88.
Unhealthy behavior was assessed at the ages of 16 to 17 by a cumulative adolescent unhealthy behavior index based on self-reported presence of poor sleep, poor diet, physical inactivity, sedentary behavior, and smoking. Timing of exposure to maternal depressive symptoms was broken into early childhood (2-5 years old), middle childhood (7-10 years old), and adolescence (15 years old).
The authors noted that the frequency of maternal depressive symptoms during early childhood (9.1%), middle childhood (5.7%), and adolescence (13.4%) was low.
The total indirect effect from maternal depressive symptoms to children’s depressive symptoms to unhealthy adolescent behaviors was significant (B=0.08, 95% CI 0.01-0.18). The indirect effect observed through the continuity of maternal depressive symptoms was also significant (B=0.19, 95% CI 0.01-0.39).
Bechtiger and team noted that unhealthy behavior was measured in adolescence only, which limited the ability to determine directionality of association. In addition, the sample was small in size and unhealthy behaviors were self-reported. Furthermore, the study design was correlational in nature and not conclusive regarding causality. Psychiatric diagnoses and use of services among mothers were also not measured.
This study was supported by a grant from the National Institutes of Health.
The study authors reported no conflicts of interest.