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Title: Maternal depression during and after pregnancy and associations with offspring behavioural problems : a systematic review, empirical study and critical evaluation
Author: Morgan, Joanne
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2018
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This thesis was submitted for the partial fulfilment of the requirement for the degree of Doctor of Clinical Psychology. It comprises a systematic review and empirical study, which have both been prepared for submission to European Child and Adolescent Psychiatry, followed by a critical appraisal of the research as a whole. The objective of the systematic review was to synthesise and evaluate the findings of longitudinal studies of maternal depression and offspring antisocial behaviour. Longitudinal studies, examining maternal depression during pregnancy and beyond, provide the opportunity to examine the independent and cumulative effects of exposure. Three databases were searched (Psychinfo, Web of Science, Medline) from the period of January 1900 to December 2017. Twenty of 5936 studies met the inclusion criteria. Overall, the findings indicated significant, independent effects of exposure to maternal depression during pregnancy, postnatal depression and exposure to maternal depression after the perinatal period on offspring antisocial outcomes. The few studies that examined the effect of cumulative exposure to depression found a significant effect on child behaviour. Several limitations in the literature were identified, including a reliance on maternal reports for both depression and child outcomes and a limited conceptualisation of the antisocial behaviour construct. The empirical study examined maternal depression from pregnancy to age 7 years postpartum and the association with Callous-Unemotional (CU) behaviour. The study was embedded within a longitudinal study of a British birth cohort (the Cardiff Child Development Study); mothers (n = 249) were assessed for depression at pregnancy, 6 months postpartum and at 7 years postpartum using a diagnostic interview. CU behaviour was measured in children at 7 years old using primary caregiver and teacher reports on the Inventory for Callous-Unemotional Traits (ICU; Frick, 2004). Contrary to hypotheses, maternal depression during pregnancy and at 6 months postpartum was not associated with any aspect of the offspring’s CU behaviour. However, regression analyses controlling for social adversity found that cumulative exposure to maternal depression from pregnancy to 7 years significantly predicted increased CU behaviour, according to the primary-caregiver but not teacher report. The preliminary evidence supports the need to intervene early to manage an often recurring depressive illness. The final critical evaluation considers the research process undertaken in both the systematic review and empirical study as well as the research enquiry as a whole. Future research directions and implications for theory, policy, clinical practice and service development are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available