Developmental pathways from toddler difficult temperament to adult depression: role of internalising problems and parenting

• In Event: Poster Session 06
  In Poster Session: PS 06 Topic - Developmental Psychopathology

Abstract

Background: Depression is a highly prevalent and debilitating psychiatric disorder, estimated to affect over 320 million people worldwide (World Health Organization, 2017). Individuals experiencing depression have elevated risks for comorbid psychiatric disorders (Kim-Cohen et al., 2003) and impaired psychosocial functioning (Fergusson & Woodward, 2002). While studies have confirmed long-term associations between depression and risk factors such as early difficult temperament (Caspi et al., 1996) and suboptimal parenting (McLeod, Weisz, & Wood, 2007), the underlying mechanisms are uncertain. Here, various developmental models have been proposed to explain this association, and we tested three longitudinal models: i) Precursor model (Klein, Kotov, & Bufferd, 2011), where early difficult temperament (age 24 months) directly associated with adult depression symptoms (age 23), and mediated by intermediate internalizing problems between ages 7-13; ii) Predisposition model (Klein et al., 2011), where negative or positive parenting moderates the aforementioned mediational pathway; and iii) Bidirectional Association model , where difficult temperament and parenting bidirectionally associate and additively relate to adult depression symptoms through internalizing problems (Klein et al., 2018).

Methods: Participants were 2996 mother-child dyads (36.5% male) from the Avon Longitudinal Study of Parents and Children. Mothers reported on their child’s difficult temperament (age 24 and 38 months), negative parenting (age 18 and 42 months), positive parenting (age 21 and 33 months), and child’s internalizing problems (age 7, 10, and 13). Depression symptoms were self-reported at age 23.

Results: First, the Precursor model was supported; difficult temperament directly associated with adult depression symptoms, and age 7-13 internalizing problems fully mediated the association. Second, the Predisposition model was not supported; negative and positive parenting did not moderate the mediational pathway. Third, the Bidirectional Association model was partially supported; difficult temperament predicted more negative and less positive parenting, while only positive parenting predicted (lower levels of) difficult child temperament. Moreover, difficult temperament consistently associated with adult depression symptoms via parenting and internalising problems; however, only positive parenting associated with adult depression symptoms via difficult temperament and internalising problems.

Conclusions: Given the prevalence and societal impact of depression, understanding its aetiology is vital. To our knowledge, the present study is the first to test several developmental models of the association between difficult early temperament and adult depression across two decades. Our results offer support for the Precursor and Bidirectional Association models, but no support for the Predisposition model. The results suggest that early early-life difficult temperament is a vulnerability factor for adult depression symptoms. This vulnerability manifests both through higher internalizing problems and lower positive parenting, whereas positive parenting appears to effectively mitigate this vulnerability. In other words, difficult temperament could be an important target for preventive interventions for later depression symptoms, while positive parenting can be fostered to alleviate associated risks

Authors

• Tom (Chin-Han) Wu, King’s College London
  Presenting Author

• Alan Meehan, King's College London
  Non-Presenting Author

• Jolien Rijlaarsdam, Erasmus University Medical Centre
  Non-Presenting Author

• Barbara Maughan, King’s College London
  Non-Presenting Author

• Pasco Fearon, University College London (UCL)
  Non-Presenting Author

• Edward D Barker, King’s College London
  Non-Presenting Author