This piece was written by Tamara Spiewak Toub in collaboration with study author Allison Frost. It is based on research originally published in: Frost, A., Scherer, E., Chung, E. O., Gallis, J. A., Sanborn, K., Zhou, Y., Hagaman, A., LeMasters, K., Sikander, S., Turner, E., & Maselko, J. (2025). Longitudinal pathways between maternal depression, parenting behaviors, and early childhood development: A mediation analysis. International Journal of Behavioral Development, 49(3).
Photo by Kamaji Ogino on Pexels
Many caregivers and professionals wonder how a mother’s emotional well-being affects her child’s development, especially when mothers struggle with clinical depression. Distinct from the sadness that most people feel occasionally, clinical depression involves a persistent loss of interest or engagement, changes in sleep and appetite, and a level of emotional distress that interferes with daily life – often lasting for weeks or longer.
In low- and middle-income countries, roughly one in four mothers experiences postnatal depression in the year after childbirth. Mothers frequently suffer from depression in higher income countries, too.
Extensive research has linked maternal depression to challenges in children’s physical, cognitive, and emotional development, making it a major public health priority for families and communities worldwide. Investigating how or why mothers’ depression connects to children’s emotions, behaviors, and skills improves our understanding and can ultimately help communities provide families with more effective support.
In a recent study, we focused on the potential role of parenting behaviors in the link between mothers’ depression and children’s development. We asked: Do mothers with a history of depression show different patterns in their parenting than mothers who have not been depressed?
Symptoms of depression can get in the way of positive parenting behaviors.For example, some mothers with depression may be more likely to withdraw from their children, show less warmth in their interactions, or express more anger and negativity. Do such differences in parenting explain the link between maternal depression and children’s development?
We focus here on children’s socioemotional development, such as symptoms of anxiety or depression or struggles with behavior or peer relationships.
More than 840 families in rural villages in Pakistan participated in our longitudinal study. Researchers followed families from the time children were one year old through the time they were three years old. About half the children were boys and about half were girls. At the start of the study, mothers were between 18 and 45 years old (about 26 years old on average) and were married.
Most of the families lived in extended-family households, with parents and children living together with other relatives (e.g., the parents’ siblings, the grandparents), which is very common in rural Pakistani villages. In terms of formal education, mothers and fathers each had from none to 18 years, with the average being about seven to nine years.
Photo by Albin Biju on Pexels
Over three yearly time points, we used a combination of established, structural interviews; parent surveys; and observations of mothers interacting with their children to help us identify patterns across the families.
Researchers used a common and internationally respected interview approach to determine which mothers were experiencing clinical levels of depression. Mothers were categorized as “depressed” or “not depressed” based on their reports of specific symptoms (e.g., sadness; lack of interest in daily life; disturbances in sleeping, eating, or concentration) and the severity of those symptoms, including whether the symptoms interfered with their daily lives.
The use of a simple cut-off is valuable for dividing mothers into these two groups for clinical and research purposes. However, mothers’ experiences varied along a spectrum, and even the mothers characterized as “not depressed” could have experienced some degree of sadness and other disturbances.
Mothers were invited to play and talk with their young children while looking at a picture book provided by researchers. Trained observers watched mothers and noted how much they showed three specific parenting behaviors:
Mothers completed established questionnaires, rating their children’s levels of various challenges (anxiety, depression, hyperactivity, trouble behaving appropriately, and problems with peers).
Our main question was: Do observed parenting behaviors explain – or mediate – the links between earlier maternal depression and later children’s outcomes? In other words, do differences in parenting help account for why children of depressed mothers might show more challenges? To dig into this query, we broke it down into steps.
First, we confirmed that the general patterns found in prior studies on maternal depression and children’s development were evident in our study, too. We established that just over 18% of the Pakistani mothers in our study had depression when their children were one year old.
Also, compared to children whose mothers were not depressed, the children of depressed mothers showed more emotional and behavioral challenges at age three – such as signs of sadness or irritability, behavior problems, or trouble getting along with peers. While the mothers’ mood-related biases might have affected their reports of children’s challenges and these findings, the general pattern is consistent with research that has used measures without such possible bias.
The next question was whether mothers with depression showed differences in parenting behaviors compared to mothers without depression. Could that help explain why these two groups of children showed differences in socioemotional development?
Key takeaways for caregivers
- Children learn, and their brains grow, partially through watching and interacting with their parents.
- Prior research in various communities has revealed that children whose mothers are clinically depressed tend to develop differently than children whose mothers are not depressed. They are also at higher risk for having social, emotional, or other struggles.
- In our recent study in rural Pakistan, children whose mothers were depressed when the children were one year old showed greater emotional and behavioral difficulties at age three than those whose mothers were not depressed.
- We explored whether parenting behaviors serve as a bridge connecting maternal depression and children’s development. We asked: Do depressed mothers show less warmth or harsher parenting than mothers who are not depressed? Could this explain why children of depressed mothers develop differently?
- In our study, mothers with depression were observed using more harsh parenting behaviors, such as looking angry or saying mean or critical things, than mothers without depression. But the mothers’ warmth toward their children did not differ.
- Parenting behaviors, including harsh parenting, did not explain the link between maternal depression and children’s development. Other factors, such as stress, division of caregiving responsibilities, living conditions, and children’s biology or behaviors, may play important roles.
- While more research is needed, supporting maternal well-being and encouraging caregiving without harshness can benefit children’s early development.
Photo by Kamaji Ogino on Pexels
Mothers’ emotional well-being and children’s development
Many caregivers and professionals wonder how a mother’s emotional well-being affects her child’s development, especially when mothers struggle with clinical depression. Distinct from the sadness that most people feel occasionally, clinical depression involves a persistent loss of interest or engagement, changes in sleep and appetite, and a level of emotional distress that interferes with daily life – often lasting for weeks or longer.
In low- and middle-income countries, roughly one in four mothers experiences postnatal depression in the year after childbirth. Mothers frequently suffer from depression in higher income countries, too.
Why maternal depression is a public health priority
Extensive research has linked maternal depression to challenges in children’s physical, cognitive, and emotional development, making it a major public health priority for families and communities worldwide. Investigating how or why mothers’ depression connects to children’s emotions, behaviors, and skills improves our understanding and can ultimately help communities provide families with more effective support.
Exploring links among mothers’ depression, their parenting behaviors, and children’s development
In a recent study, we focused on the potential role of parenting behaviors in the link between mothers’ depression and children’s development. We asked: Do mothers with a history of depression show different patterns in their parenting than mothers who have not been depressed?
Symptoms of depression can get in the way of positive parenting behaviors.For example, some mothers with depression may be more likely to withdraw from their children, show less warmth in their interactions, or express more anger and negativity. Do such differences in parenting explain the link between maternal depression and children’s development?
We focus here on children’s socioemotional development, such as symptoms of anxiety or depression or struggles with behavior or peer relationships.
Who participated in the study?
More than 840 families in rural villages in Pakistan participated in our longitudinal study. Researchers followed families from the time children were one year old through the time they were three years old. About half the children were boys and about half were girls. At the start of the study, mothers were between 18 and 45 years old (about 26 years old on average) and were married.
Most of the families lived in extended-family households, with parents and children living together with other relatives (e.g., the parents’ siblings, the grandparents), which is very common in rural Pakistani villages. In terms of formal education, mothers and fathers each had from none to 18 years, with the average being about seven to nine years.
Photo by Albin Biju on Pexels
How did we measure maternal depression, parenting behaviors, and children’s outcomes?
Over three yearly time points, we used a combination of established, structural interviews; parent surveys; and observations of mothers interacting with their children to help us identify patterns across the families.
Maternal depression (when children were one year old)
Researchers used a common and internationally respected interview approach to determine which mothers were experiencing clinical levels of depression. Mothers were categorized as “depressed” or “not depressed” based on their reports of specific symptoms (e.g., sadness; lack of interest in daily life; disturbances in sleeping, eating, or concentration) and the severity of those symptoms, including whether the symptoms interfered with their daily lives.
The use of a simple cut-off is valuable for dividing mothers into these two groups for clinical and research purposes. However, mothers’ experiences varied along a spectrum, and even the mothers characterized as “not depressed” could have experienced some degree of sadness and other disturbances.
Mothers’ parenting behaviors (when children were two years old)
Mothers were invited to play and talk with their young children while looking at a picture book provided by researchers. Trained observers watched mothers and noted how much they showed three specific parenting behaviors:
- Warmth: showing affection through positive physical touch, such as snuggles, and positive, encouraging talk (“Yay! You found it, Sweetie!”)
- Stimulation: challenging the child to think and engage, such as by asking questions and pointing to items in the book (“What will they do with this ball?”)
- Harshness: looking or sounding negative, such as yelling, verbally expressing anger or being critical (“Stop fooling around! We’re supposed to be looking at this book!”).
Children’s socioemotional outcomes (when children were three years old)
Mothers completed established questionnaires, rating their children’s levels of various challenges (anxiety, depression, hyperactivity, trouble behaving appropriately, and problems with peers).
What did we find?
Our main question was: Do observed parenting behaviors explain – or mediate – the links between earlier maternal depression and later children’s outcomes? In other words, do differences in parenting help account for why children of depressed mothers might show more challenges? To dig into this query, we broke it down into steps.
Children of depressed mothers experienced more socioemotional challenges
First, we confirmed that the general patterns found in prior studies on maternal depression and children’s development were evident in our study, too. We established that just over 18% of the Pakistani mothers in our study had depression when their children were one year old.
Also, compared to children whose mothers were not depressed, the children of depressed mothers showed more emotional and behavioral challenges at age three – such as signs of sadness or irritability, behavior problems, or trouble getting along with peers. While the mothers’ mood-related biases might have affected their reports of children’s challenges and these findings, the general pattern is consistent with research that has used measures without such possible bias.
The next question was whether mothers with depression showed differences in parenting behaviors compared to mothers without depression. Could that help explain why these two groups of children showed differences in socioemotional development?