title: Mechanisms of Resilience in Children of Mothers Who Self-Report with Depressive Symptoms in the First Postnatal Year.
abstract: BACKGROUND
  Symptoms of maternal postnatal depression are associated with an increased risk of adverse effects on child development. However, some children exposed to postnatal depression have outcomes similar to unexposed children, and can be referred to as resilient. This study aimed to determine the mechanisms of resilience in children exposed to depressive symptoms postnatally.
  
  
  METHODS
  Data are from a prospective cohort study, the Avon Longitudinal Study of Parents and Children. Self-report questionnaire data were collected during pregnancy and the child's first 2 years regarding maternal views of parenting and her perception of the child. The Edinburgh Postnatal Depression Scale (EPDS) was completed postnatally at 8 months and the Strengths and Difficulties Questionnaire (SDQ) at age 11 years. Exposed children who scored above the median score of non-exposed children were defined as resilient. Structural equation modeling was used to investigate the development of resilience.
  
  
  RESULTS
  From the core ALSPAC cohort, 1,009 children (6.9%) were exposed to maternal depression at 8 months postnatally. The SDQ total difficulties scores at 11 years of age indicated that 325 (32.2%) were resilient, 684 were non-resilient. Maternal positive feelings about parenting and child non-verbal communication at 15 months increased the likelihood of later resilience.
  
  
  CONCLUSIONS
  In this study, resilience was associated with two factors: the child's nonverbal communication at 15 months and by maternal positive feelings about parenting. Early intervention to support mother-child interaction and foster child development in women identified with postnatal depressive symptoms may benefit later child resilience.
authors.affiliation: Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, United Kingdom.
authors.forename: Emily
authors.initials: E
authors.lastname: Savage-McGlynn
authors.affiliation: Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, United Kingdom.
authors.forename: Maggie
authors.initials: M
authors.lastname: Redshaw
authors.affiliation: School of Social and Community Medicine, Faculty of Medicine and Dentistry, University of Bristol, Bristol, United Kingdom.
authors.forename: Jon
authors.initials: J
authors.lastname: Heron
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Stein
authors.affiliation: Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, United Kingdom.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Quigley
authors.affiliation: Centre for Academic Mental Health, University of Bristol, Bristol, United Kingdom.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Evans
authors.affiliation: Department of Medicine, Imperial College London, London, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Ramchandani
authors.affiliation: Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, United Kingdom.
authors.forename: Ron
authors.initials: R
authors.lastname: Gray
mesh_terms: D000293:Adolescent; D000328:Adult; D002657:Child Development; D019052:Depression, Postpartum / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009034:Mother-Child Relations; D055500:Resilience, Psychological; D057566:Self Report