Father's Depression Affects Behavior Toward Infant

Depressed fathers of 1-year-old children were less likely to read to their children and four times more likely to spank them than nondepressed fathers, and that may be a signal to pediatricians to screen fathers as well as mothers at well-child visits.

"Irritability and anger, common symptoms of depression, may be implicated in the increased likelihood of depressed fathers spanking their 1-year-old children," wrote R. Neal Davis, M.D., M.Sc., of Intermountain Healthcare in Murray, Utah, and his former colleagues at the University of Michigan Health System in Ann Arbor, in the April Pediatrics.

The researchers used data from 1,746 fathers interviewed in the Fragile Families and Child Wellbeing Study (FFCWS), the aim of which was to examine associations between positive and negative parenting behaviors.

The study follows nearly 5,000 children born in large U.S. cities from 1998 to 2000. About three-quarters of those children were born to unmarried parents, who are at greater risk of breaking up and living in poverty than are what the authors call "more traditional families."

Unlike many other studies, the FFCWS interviewed fathers directly rather than relying on maternal reports for information on child-rearing practices, Davis said. These fathers said they were living with their children "all or most of the time."

When the children were a year old, the researchers assessed the fathers with the World Health Organization's Composite International Diagnostic Interview Short Form, asking if they had a major depressive episode in the previous year. Those who indicated that they had had such an episode were then asked a further series of questions based on DSM-IV depression criteria.

About 7 percent of the fathers reported a major depressive episode in the prior year. Fathers who reported major depression were more likely to be unemployed and to report substance abuse than were nondepressed fathers.

Many factors may contribute to the increase in depression surrounding the birth of a child, suggested child psychologist James Paulson, Ph.D., an associate professor of pediatrics at Eastern Virginia Medical School in Norfolk. Paulson has studied perinatal depression in fathers but was not involved in the current study.

"It's a time of transition in life roles," said Paulson in an interview with Psychiatric News. "Parents may lose sleep or worry about money. The marital relationship may change too."

Fathers in the study were also asked about how many days a week they played simple games (like "peek-a-boo") with their children, how often they sang songs or recited nursery rhymes to them, and how often they read to them.

Results showed that both groups of fathers played or sang songs with their children at equal rates. However, fathers with depression read to their children less often (41 percent read to them) than nondepressed fathers (58 percent). Anhedonia may affect the extent to which depressed fathers read to their children, suggested the authors.

"You don't need tools or planning for peek-a-boo," said Paulson. "Reading requires settling into a chair and picking up a book, demanding an effort that may be too much for a depressed parent."

Respondents were also asked if they had spanked misbehaving children within the previous month. Only 13 percent of nondepressed fathers said they had spanked their children, compared with 41 percent of depressed fathers.

"Although associations between spanking and maternal depression have been previously reported, this is the first study, to our knowledge, to report an association between spanking and paternal depression," said the authors.

In an encouraging finding, 82 percent of the fathers participating in the study said they had spoken with their child's pediatrician in the previous year, and there were no significant differences between the depressed and nondepressed fathers. That may offer an opportunity for pediatricians to screen fathers for symptoms of depression and refer them for treatment, a practice that has been shown to work with mothers.

"I have begun asking fathers how they are handling the added stress of having an infant in the home," said Davis in an interview. "I mention that recent research suggests that about 1 in 10 dads can experience symptoms of depression, such as sadness or irritability, and that these symptoms can affect how fathers interact with their children."

He is considering adding the validated PHQ-2 depression screening tool to his clinic's intake forms, with sections for mothers, fathers, and other caregivers to answer, he said. "Positive responses could be discussed during the clinic visit."

In addition, children's doctors can use those interactions to counsel fathers about why they should not use corporal punishment and better ways to discipline children and deal with their own feelings of frustration when a child misbehaves.

Increasing positive interactions and reducing negative ones between fathers and young children could improve children's mental and physical health throughout the development process, suggested the authors.

"We've known about the negative effects of mothers' depression on parenting," said Paulson. "In the past 10 years we've learned about fathers' increased risk for perinatal depression, but this study documents that fact in a compelling way."

An abstract of "Fathers' Depression Related to Positive and Negative Parenting Behaviors With 1-Year-Old Children" is posted at <http://pediatrics.aappublications.org/cgi/content/abstract/peds.2010-1779v1>.