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Sensitive and Harsh Parenting of Infants: Associations with Maternal Depression, Generalized Anxiety, and Empathic Concern

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Abstract

Many studies have identified associations between maternal depression and decreased quality of parenting. In addition to maternal depression, we examined associations of maternal generalized anxiety and empathy with quality of parenting. Mothers (N = 133) participating in a statewide home visiting implementation study completed baseline and follow-up interviews during which information on demographic and psychosocial characteristics were collected. As part of follow-up data collection, mothers were videotaped for fifteen minutes while playing with their infants, aged 4–13 months, using standardized toys. The videos were coded using qualitative rating scales. Multivariate linear regression was used to assess associations of maternal psychosocial well-being: depression, generalized anxiety, and empathy with two parenting outcomes: sensitive and harsh parenting. Depression and anxiety were negatively associated with sensitive parenting. Empathy was negatively associated with harsh parenting. At follow-up, mothers who screened positive for depression or anxiety exhibited less sensitive parenting than those who screened negative for both conditions. Mothers who screened positive for depression or anxiety at baseline but screened negative at follow-up, had similar sensitive parenting scores to mothers who screened negative at both time points. These findings demonstrate the potential benefits of responding effectively to maternal depression and anxiety and the need for programs to identify and respond to maternal depression and anxiety on a continuing basis, not just at enrollment.

Highlights

  • Maternal anxiety and depression were associated with less sensitive parenting of infants.

  • Maternal empathy was associated with less harsh parenting of infants.

  • Mothers with resolved anxiety or depression parented with similar sensitivity as those never screening positive.

  • Providers should screen perinatal women for depression and anxiety regularly and respond to these conditions.

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Acknowledgements

The authors thank our partners at NJ Department of Children and Families, NJ Department of Health, as well as local program leadership and staff for their commitment to home visiting research and support of this study. Thanks also goes to Jennica Bouquet who coded all the videos in this study and provided feedback on an earlier version of this manuscript. We would like to thank Dr. Cynthia Frosch, who trained the coders on “Qualitative Ratings for Parent–Child Interaction at 3–15 Months of Age”, was the expert coder, and provided on-going technical support related to coding parent–child interaction. We would also like to thank Dr. Allison West, who provided helpful feedback on this manuscript.

Funding

This work was supported by the following federal grant initiatives: The US Department of Health and Human Services (HHS), Administration for Children and Families (ACF), Children’s Bureau, Office of Child Abuse and Neglect, Supporting Evidence-Based Home Visiting to Prevent Child Maltreatment (EBHV) (2008-2011: Contract No. HHS-2008-ACF-ACYC-CA-0130). The US Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Maternal, Infant, Early Childhood Home Visiting Program (MIECHV) (NJ 2011-2015 Formula Grant Award X02MC23119; NJ 2013-2015 X02MC26333; NJ 2014-2016 Formula Grant Award X02MC27410; NJ 2015-2017 Formula Grant Award X02MC28235; NJ 2016-2018 Home Visiting Grant Program X10MC29491; NJ 2012-2016 Competitive Grant D89MC23540; NJ 2015-2017 Competitive Grant Award D89MC28268.

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Authors and Affiliations

  1. Infectious Disease Epidemiology, Prevention and Control Department, Minnesota Department of Health, 625 Robert St. N., St. Paul, MN, 55155, USA

    Kristen D. Ojo

  2. Department of Epidemiology and Biostatistics, Temple University, 1301 Cecil B. Moore Ave., Philadelphia, PA, 19122, USA

    Ryan Snead

  3. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA

    Lori Burrell, Kay M. G. O’Neill & Anne K. Duggan

  4. Child Trends, 7315 Wisconsin Ave., Suite 1200W, Bethesda, MD, 20814, USA

    Sarah S. Crowne

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  1. Kristen D. Ojo
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  5. Kay M. G. O’Neill
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  6. Anne K. Duggan
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Contributions

K.D.O. wrote the original draft with support from L.K.B. and S.S.C. A.K.D. provided conceptualization, methodology, and funding acquisition. A.K.D., L.K.B., and S.S.C. provided supervision for the study. K.D.O., R.S., and L.K.B. were responsible for data curation and the formal analyses. K.D.O. provided project coordination with support from K.M.G.O. Both K.D.O. and K.M.G.O. constructed the baseline and follow-up survey tools. All authors reviewed and approved the final paper.

Corresponding author

Correspondence to Kristen D. Ojo.

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Conflict of Interest

The authors declare no competing interests.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the IRB at the Johns Hopkins School of Medicine and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

K.D.O., R.S., and S.S.C. completed this manuscript under affiliation with Johns Hopkins School of Public Health.

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Ojo, K.D., Snead, R., Burrell, L. et al. Sensitive and Harsh Parenting of Infants: Associations with Maternal Depression, Generalized Anxiety, and Empathic Concern. J Child Fam Stud 30, 2925–2937 (2021). https://doi.org/10.1007/s10826-021-02077-0

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