Parenting Practices among Depressed Mothers in the Child Welfare System

The purpose of this study was to analyze a nationally representative sample of families referred to Child Protective Services (CPS) agencies, the National Survey of Child and Adolescent Well-Being, to examine the association between maternal depression and parenting practices over a 36-month follow-up period. Three hypotheses were tested: (1) Depressed mothers are more likely to demonstrate harsh parenting than are nondepressed mothers; (2) depressed mothers are more likely to demonstrate neglectful parenting than are nondepressed mothers; and (3) depressed mothers are more likely to demonstrate emotional maltreatment than are nondepressed mothers. The interaction between depression and time was also analyzed for each parenting practice to determine how changes in maternal depression affected changes in parenting. The sample for this study was 1,536 mother--child dyads in which the child was age three to 10 years and remained in the home after a CPS investigation. Depression remained high across time points and was associated with increased risk of emotional maltreatment and neglect over a 36-month period. In addition, self-reported emotional maltreatment remained high across time points. Implications of this work are the needs for better identification of mental health needs for mothers entering the child welfare system and parent training to specifically address positive parenting. KEY WORDS: child welfare; maternal depression; National Survey of Child and Adolescent Well-Being; parenting ********** Maternal depression, a critical public health concern, is prevalent among mothers referred to Child Protective Services (CPS) agencies. In fact, nearly a quarter of adults entering the child welfare system meet the diagnostic criteria for a major depressive episode in the preceding 12 months (U.S. Department of Health and Human Services, Administration on Children, Youth and Families [HHS, ACYF], 2005), compared with only 7% of adults in the general population (Kessler, Chiu, Demler, & Walters, 2005). Furthermore, women have an increased likelihood of experiencing depression compared with men (Kessler et al., 2003), and women exposed to a high number of chronic stressors--as many women referred to CPS agencies are--are three times more likely than women with less exposure to stressors to experience maternal depression (Orr, James, Burns, & Thompson, 1989). Given that women comprise the vast majority of primary caregivers among the child welfare population (HHS, ACYF, 2005), it is important to understand how maternal depression affects outcomes after a CPS referral. The high rate of maternal depression in the child welfare system is a concern given its influence on parenting practices. Symptoms of depression may impede a woman's capacity to provide care for her children, placing her at risk to engage in neglectful parenting practices. For instance, depressed mothers may lack sensitivity to their children's physical and emotional needs (Campbell et al., 2004; Trapolini, Ungerer, & McMahon, 2008) or may be unavailable or otherwise unresponsive to their children (Cummings & Cicchetti, 1993). The literature also demonstrates that maternal depression is related to a higher risk of other harmful parenting behaviors, including emotional maltreatment and harsh parenting. Depressed mothers are more likely than are nondepressed mothers to have conflict-related interactions with their children, including feeling aggravated with the child, yelling at the child, and spanking the child (Lyons-Ruth, Wolfe, Lyubchik, & Steingard, 2002). Maternal depression increases the likelihood of corporal punishment toward children (Chung, McCollum, Elo, Lee, & Culhane, 2004; Shin & Stein, 2008). Using meta-analysis techniques to examine reported findings about maternal depression and parenting behavior across 46 studies, Lovejoy, Craczyk, O'Hare, and Neuman (2000) found a moderate effect size (d = . …