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Poster #16 - Maternal antenatal depressive symptoms and risk for childhood depression: role of executive functions

Sat, March 25, 2:30 to 3:15pm, Salt Palace Convention Center, Floor: 1, Hall A-B

Abstract

Background:
Executive function (EF) deficits are present in children following exposure to maternal antenatal emotional problems (Park et al., 2018). Furthermore, studies have revealed that deficits in hot EF (e.g., emotional control) and cold EF (e.g., cognitive flexibility) predict childhood depressive symptoms (Halse et al., 2022, Patwardhan et al., 2021). Reduced EF competencies may predispose children to maladaptive strategies, increasing their vulnerability to psychopathology (Cicchetti and Toth, 1998, Cole et al., 1997). However, limited studies have used objective EF measures in young children to provide support for the competency model of childhood depression. The differential contributions of hot and cold EFs have also not been established. In this study, we examined hot and cold EFs as intermediary pathways from antenatal depression to childhood depressive symptoms.
Methods: Data were from the Growing up in Singapore Towards Healthy Outcomes (GUSTO) longitudinal birth cohort. This consisted of 1131 mothers with self-reported symptoms on the Edinburgh Prenatal/Postnatal Depression Scale (EPDS) at 26 weeks of gestation (Levis et al, 2020). Children completed EF laboratory tasks from 3.5 to 8.5 years of age and self-reported depressive symptoms from the Childhood Depression Inventory (CDI) at age 9 (n=639). Linear regression models examined the associations between maternal PEDS and child EF and also between individual measures of EF and later child depressive symptoms, while adjusting for household income, sex, and gestational age. To examine the contributions of hot and cold EF, a path analysis using a structural equation approach was conducted with antenatal EPDS as the exposure and child depressive symptoms as the outcome. A latent cold EF variable consisted of working memory (i.e., the ability to hold in mind and manipulate representations) and cognitive control (i.e., the ability to direct mental resources towards one’s goals ) measures and a latent hot EF variable consisted of motivational (i.e., the ability to persist in a challenge ) and emotional control (i.e., the ability to regulate negative emotions in stress-inducing situations) measures. A final path analysis was performed to delineate the most discriminating subdomain of cold and hot EF that mediated the path between EPDS and CDI.
Results: The mean age of follow up was 9.48 years (SD=0.65). There was no direct association between maternal EPDS and child CDI. Reduced working memory and cognitive flexibility were associated with higher child depressive symptoms (p<0.05).Path analysis (Figure 1) confirmed that increased antenatal EPDS was associated with decreased cold EF competency (ß= -0.14, 95% -0.28, -0.01, p=0.039). Decreased cold EF competency was associated with increased CDI (ß= -0.24, 95% CI -0.39, -0.09, p=0.001). No association was found between hot EF competency and CDI. This model demonstrated good fit indices (χ2=52.02, AIC= 10206.23, RMSEA=0.02, CFI=0.96). The subdomain of cognitive control was the most discriminating predictor of child depressive symptoms (ß = -0.32, 95% CI -0.56, -0.08, p=0.01; Figure 2).
Conclusions: Findings suggest that competency in EF, particularly cognitive control, may be contribute to the intergenerational continuity of depression. Studies examining the importance of EF competency in the development of depressive symptoms are warranted.

Group Authors

Meredith X. Han, Nixi Wang, Michelle Z.L. Kee, Lynette P. Shek, Johan G. Eriksson, Michael J. Meaney, Evelyn C. Law

Authors