Parent-child interactions and associative learning in infants of depressed mothers and fathers

Material Information

Parent-child interactions and associative learning in infants of depressed mothers and fathers
Sliter, Jessica Katherine
Publication Date:
Physical Description:
ix, 67 leaves : ; 28 cm


Subjects / Keywords:
Parent and child ( lcsh )
Infants ( lcsh )
Paired-association learning ( lcsh )
Children of depressed persons ( lcsh )
Depressed persons -- Family relationships ( lcsh )
Children of depressed persons ( fast )
Depressed persons -- Family relationships ( fast )
Infants ( fast )
Paired-association learning ( fast )
Parent and child ( fast )
bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )


Includes bibliographical references (leaves 58-67).
General Note:
Department of Psychology
Statement of Responsibility:
by Jessica Katherine Sliter.

Record Information

Source Institution:
University of Colorado Denver
Holding Location:
Auraria Library
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
66910544 ( OCLC )
LD1193.L645 2005m S54 ( lcc )

Full Text
Jessica Katherine Sliter
B.S., University of Colorado at Denver, 2003
A thesis submitted to the
University of Colorado at Denver
in partial fulfillment of
requirements for the degree of
Master of Arts

This thesis for the Master of Arts
degree by
Jessica Katherine Sliter
has been approved
Peter S. Kaplan
No'J i 7,

Sliter, Jessica Katherine (M.A., Psychology)
Parent-Child Interactions and Associative Learning in Infants of Depressed Mothers
and Fathers
Thesis directed by Professor Peter S. Kaplan
Previous research has indicated that maternal depression influences child
development. However, little research has been conducted investigating how paternal
involvement and paternal depression affect their infants cognitive development.
Research has suggested that disordered mother child and possibly father child
interactions, including less modulated vocal stimulation, is one mechanism by which
cognitive deficits are conferred. Some theorists suggest that there is a lack of
synchrony and reciprocity in the depressed parent-child relationship which lessons an
infants ability to attend to stimuli which, in turn, can lead to cognitive deficits.
Findings in the laboratory suggest that the quality of mothers voices, which can be
altered by depression, influences infants ability to learn in an associative learning
task using that mothers voice. The current study examined links between maternal
and paternal depression, and parent-child interactions. The study also investigated
associative learning in 4- to 12-month old infants in response to their own parents
voices. As has been demonstrated with depressed mothers, in the laboratory, paternal

depression was associated with a decreased quality of their infant-directed speech.
Furthermore, paternal depression was significantly linked to poorer infant learning in
response to their fathers voice. Although significant results were not obtained
relating parental depression and infant learning to the parent-child interaction, one
possible explanation could be our small sample size. Thus research should be
conducted in order to further investigate parent-infant interactions as they relate to
parental depression and infant associative learning in response to their parents
This abstract accurately represents the content of the candidates thesis. I recommend
its publication.
Peter S. Kaplan

1. INTRODUCTION.......................................................1
Parental Depression and Disordered Parent-Infant Interactions.2
Father-Infant Interactions........................7
Disordered Parent- Infant Interactions, Parental Depression, And
Infant/Child Cognitive Deficits........................10
Mediation Studies.............................. 15
Father-Infant Interactions and Infant Cognitive Deficits... 17
Parental Depression and Infant-Directed Speech.........20
2. METHOD............................................................27
Parental Clinical Assessment and Diagnosis.............28
Beck Depression Inventory........................28
Structured Clinical Interview for DSM-IV.........28
Speech Stimuli.........................................29

Parent-Child Interaction Assessment
Emotional Availability Scales......................31
3. RESULTS..............................................................36
Depression and Infant Learning............................42
Maternal Depression................................42
Paternal Depression................................42
Maternal and Paternal Depression...................43
Depression, ID Acoustic Analyses and Infant Learning......45
Mothers and Fathers.....Error! Bookmark not defined.
Emotional Availability Scales.............................48
EAS and Depression.................................53
EAS and Infant Learning............................53


3.1 Mean Difference Scores from the Summation Test for the Fathers
Voices as a Function of the Fathers BDI Category.....................43
3.2 Mean Difference Scores from the Summation Test for the Mothers and
Fathers Voices as a Function of the Joint BDI Category...............44

3.1 Demographics of Depressed and Nondepressed Mothers and
Their Infants...........................................................37
3.2 Correlations Between Demographics and Maternal Depression
3.3 Demographics of Depressed and Nondepressed Fathers and
Their Infants...........................................................40
3.4 Correlations Between Demographics and Paternal Depression
According to BDI-II Category............................................41
3.5 Correlations Between Parental Depression, Acoustic Analyses,
and Infant Difference Scores............................................46
3.6 Mean Acoustic Characteristics of Paternal Speech........................47
3.7 Mean Emotional Availability Scores for Mothers and Fathers..............49
3.8 Correlations Between Parental Depression and Mother-Infant
Emotional Availability Scores...........................................50
3.9 Correlations Between Parental Depression and Father-Infant
Emotional Availability Scores...........................................52

It has been suggested that as many as 10 to 15% of mothers experience clinical
depression in the postpartum period (Warner, 1996). The presence of maternal
depression is hypothesized to affect growing children throughout their lives. For
example, preschool children of depressed mothers have more externalizing and
internalizing behavior problems (Pickens & Field, 1993; Field et al., 1996). These
children may experience higher levels of emotional difficulties (Hay, 1997), and
insecure attachment (Whiffen & Gotlib, 1989; Murray, Fiori-Cowley, Hooper, &
Cooper, 1996). School-age children and adolescents of depressed mothers also have
more difficulty relating to peers and are at increased risk for developing various
psychological disorders including mood disorders, and anxiety disorders (Radke-
Yarrow, 1998). Children of depressed mothers also exhibit cognitive deficits
including failing at object permanence tasks (Murray, 1992), decreased ability to
acquire associations (Dunham & Dunham, 1990; Hay, 1997) lags in attaining school-
readiness (Hay, 1997; Murray et al., 1996) and lower IQ scores (Hay et al., (2001).
Researchers have suggested that disordered interactions between depressed mothers
and their infants is the mechanism by which risk for cognitive deficits are conferred,

because depressed mothers are not able to regulate their infants attention, arousal and
affect (Field, 1995; Hay, 1997). However, very little research has been conducted
regarding the possible effects of paternal depression on paternal-infant interactions
and infant cognitive abilities. This study examined maternal and paternal interactions
with their 4- to 12- month old infants separately to determine if these interactions
mediated the relationship between infant associative learning in response to the
parents voices and parental depression.
Parental Depression and Disordered
Parent-Infant Interactions
Research suggests that depressed mothers and their infants interact differently
than nondepressed dyads. Field et al. (1985) explored these issues with a sample of
24 depressed and nondepressed dyads. During face-to-face interactions, depressed
mothers compared to the nondepressed mothers showed a predominately depressed or
anxious state, with flat or tense facial expressions, less activity, and fewer imitative
behaviors and contingent responses (Field et al., 1985). These data suggested that
depressed mothers can be withdrawn during interactions with their child, and are less
likely to respond to their infants attempts to interact with them. Potentially as a
result of their mothers withdrawal, infants of depressed mothers appeared to be
drowsy, less relaxed, and fussier (Field et al., 1985). Other studies have shown that
infants of depressed mothers are more likely to have sad or angry expressions

possibly to protest their mothers withdrawal behavior (Cohn & Tronick, 1983).
Cohn and Tronick (1983) hypothesized that infants respond to the affective
characteristics of their primary caregivers behavior in a way that is specific to that
persons affect. Thus, these investigators asked mothers to simulate a neutral face as
a part of the still-face paradigm (Cohn & Tronick, 1983) Results revealed that
infants showed a pattern of crying/fussing and then turning away from their mother.
The behavior by the infant carried over even when the mother behaved normally
(Cohn & Tronick, 1983). Thus infant behavior in response to a depressed mother can
appear in the form of agitation or protest and withdrawal (Cohn & Tronick, 1983) and
cumulative experiences with such a mother may have lasting effects.
Another way in which depressed dyads are researched involves how infants
respond to being ignored by their mother. When nondepressed mothers were asked to
interact with a stranger holding a doll and cookbook while refraining from speaking
or gazing at their infant, these infants demonstrated more protest, negative
vocalization and inhibited play (Hart, Field, Letoumeau, & Del Valle, 1998). This
reaction by infants is said to be an objection to inequality in the distribution of
attention by their mother. This inequality in attention violates the infants
expectations of interactions with their mother, and thus protest behavior ensues (Hart
et al, 1998). The researchers postulated that infants of depressed mothers, having
experienced less exposure to maternal positive affect and greater inattentiveness, may
show less interest in objects and less responsiveness to mothers positive cues. Thus

Hart et al. (1998) investigated how infants of depressed mothers reacted when their
mothers refrained from talking to or looking at them; the objects used were identical
to those used with the nondepressed dyads.
Analyses found that infants of depressed mothers did not show as much
protest as infants of nondepressed mothers. Infants of depressed mothers also
demonstrated less touching of their mother, proximity to and gaze towards mother
across the conditions. Furthermore, in the doll condition, infants of depressed
mothers did not show an increase in touching their mother or gazing towards their
mother to the extent that infants of nondepressed mothers did. These results show
that infants of depressed mothers showed less protest behavior and approach towards
their mother when being ignored (Hart et al., 1998). Perhaps these infants have
learned in their interactions with their mothers that they cannot depend on contingent
responses or specific attention from their mother.
Field et al. (1988) extended mother-infant interaction research to investigate a
larger sample of depressed and nondepressed mothers-infant dyads. Consistent with
results found in Field et. al. (1985), depressed mothers and their infants in face-to-
face interactions received lower ratings than nondepressed dyads on all of the
interaction behaviors and the summary score of the interaction. Infants of depressed
mothers were also rated lower in interactions with a nondepressed stranger than
infants of nondepressed mothers. During interactions with the stranger, infants of
depressed mothers appeared drowsy and fussy, suggesting that infants may be

generalizing their responses to all females (Field et al., 1988).
In a longitudinal study, Fleming, Ruble, Flett and Shaul (1988) investigated
the depressed mother-infant interaction over a period of 16 months. At one and three
months postpartum but not before, depressed mothers engaged in significantly less
affectionate contact than nondepressed mothers. There were no significant results at
16 months, possibly because researchers were using depression categories based on
interview at three months postpartum. At one and three months depressed mothers
seemed to demonstrate a different response pattern than nondepressed mothers. They
vocalized in response to the limb movements of their infants rather than their
vocalizations (Fleming et al., 1988). Thus, it seems that depressed mothers have
some difficulty in expressing positive emotions and tend to engage in fewer vocal
exchanges with their infants, suggesting withdrawal behavior and depressed affect in
interactions with their child. Furthermore, this finding suggests that depressed
mothers may have a dysfunctional response system whereby they focus less on
emotional-based cues.
Field, Healy, Goldstein and Gunthertz (1990) gathered a sample of depressed
and nondepressed African-American dyads of lower socioeconomic status- a very
different sample than those from the majority of studies in the field. Mother and
infant behavior was assessed during a face-to-face interaction, and was coded using
the behavior-state system (Cohn, Matias, Tronick, Connell, & Lyons Ruth, 1986) in
which four mother behavior states: anger/poke, disengage, elicit and play are coded

along with four infant states: protest, look away, attend and play are coded (Field et
al., 1990).
In face-to-face interactions, depressed mothers as compared to the
nondepressed mothers spent more time in the anger/poke state, more time in the
disengaged state, and less time in the play state. Infants of depressed mothers versus
infants of nondepressed mothers spent more time in the protest state, and less time in
the play state. Depressed dyads spent more time in the anger-poke/protest state, more
time in the disengaged/look away state, and less time in the play/play state compared
to nondepressed dyads. Furthermore, the percentage of time spent in joint states was
less for depressed dyads then for nondepressed dyads (Field et al., 1990; Cohn,
Campbell, Matias & Hopkins, 1990).
Research discussed thus far illustrates that depressed mothers show withdrawn
behavior when interacting with their infants. Results by Field et al. (1990) offer an
alternative way in which depressed mothers interact with their infants: intrusively in
the form of an angry or forceful behavior. Results from this research also suggest that
not only are depressed dyads exhibiting negative behavior more than nondepressed
dyads, but they are exhibit significantly less synchrony in their interactions (Field et
al., 1990), and that the everyday give-and-take systems that seem to come naturally to
healthy dyads may be disordered in depressed dyads. This demonstrates that maternal
depression leads to changes in the tone of interactions and contingency of responses
within the interactions.

Father-Infant Interactions
Although fathers are present in 72% of U.S. households (U.S. Department of
Commerce, 2001), and are important in providing care for their infants, father-infant
interactions have been rarely investigated, especially not in the case where
postpartum depression exists. Chabrol, Bron, and Le Camus (1996) observed a
sample of 20 triads (10 depressed mothers/nondepressed fathers, 10 nondepressed
mothers/nondepressed fathers) but no significant influence of paternal depression was
found during father-infant interactions or interactions of the triad.
Hossain et al. (1994) recruited a sample of 12 depressed mothers and
nondepressed fathers and their infants, as well as 14 nondepressed mothers, fathers
and their infants. The researchers hypothesized that infants of depressed mothers
would interact better with their nondepressed fathers than with their depressed
mothers. They found that infants who experienced their depressed mothers negative
interaction style did not generalize their response to their nondepressed fathers,
suggesting that these fathers may serve as a natural buffer against the adverse
effects of depressed mother-infant interactions. (Hossain et al., 1994).
In addition, Edhborg, Lundh, Seimyr and Widstrom (2003) found that in
families with a depressed mother, fathers interacting with their 15 to 18 month olds
showed significantly more enjoyment and pleasure and a tendency toward more
visual contact than those fathers with nondepressed partners. Children of depressed

mothers expressed less negative affect and tended to be less serious in interactions
with their fathers significantly more than infants with a nondepressed mother. This
finding regarding infants of depressed mothers replicates the findings of Hossain et
al. (1994): infants negative interaction style does not generalize to their
nondepressed father and positive father-child interactions may act as a source of
resilience for infants of depressed mothers.
But these finding beg the question: what relative effect does paternal
depression have on father-child interactions? Field, Hossain, and Malphurs (1999)
collected a sample of four groups of triads: depressed father/depressed mother,
depressed father/nondepressed mother, nondepressed father/depressed mother and
nondepressed father/nondepressed mother. Analyses based on separate parental face-
to-face interactions found that depressed fathers interacted differently with their child
than depressed mothers. Depressed fathers were rated higher on physical activity,
facial expressions and positivity than depressed mothers. Infants of depressed fathers
appeared less fussy and vocalized more than infants of depressed mothers.
Comparisons between behaviors of one depressed parent versus two depressed
parents were nonsignificant (Field, Hossain, & Malphurs, 1999). Thus, depressed
fathers may not present themselves to their infants in the same way that depressed
mothers do. Depressed fathers seem to be more positive in their interactions and their
infants seem to respond in a positive manner as well.

Jacob and Johnson (1997) investigated whether parent-child interactions
moderate the effects of maternal depression, paternal depression or both with a
sample of families with a depressed father, with depressed mother and with
nondepressed parents. When observing the mother, father, and child, those triads
with a depressed parent were rated as less positive than families with nondepressed
parents. Families with depressed mothers were rated less positive than families with
depressed fathers (Jacob & Johnson, 1997). Thus this study indicates that maternal
versus paternal depression was associated with increased negativity in the
interactions, suggesting paternal depression may have a less detrimental effect on
parent-child interactions. This may be related to the relative time spent with the
infant by fathers as mothers tend to be the primary caregiver and therefore paternal
depression may not have enough time to set in. Furthermore, the expression of
depressive characteristics of fathers may vary from those expressed by mothers such
that depressive symptoms of father are more subdued or masked in parent-child
A large body of research collected demonstrates that depressed mothers
display a depressed or anxious state with flat affect (Field et al., 1985) and less
contingent responses towards their infant (Field et a., 1990). Infants of depressed
mothers appear withdrawn, drowsy and disinterested (Field et al., 1985). Field
(1986) hypothesized that depressed dyads were not in psychobiological attunement.
That is, depressed mothers are emotionally unavailable to their infant and unable to

provide adequate stimulation and arousal (Field, 1986) which is evident in
physiological assessments of the infant (Field et al., 1988). This lack of
psychobiological attunement interferes with the infants cognitive development
because the dysregulated affect interferes with the infants ability to take information
in and remember it (Hay, 1997). Similarly, Tronick and Gianino (1986) proposed a
mutual regulation model in which depressed mothers fail to respond contingently to
the infants regulatory signals which results in an increase in negative affect displayed
by the infant. After several unsuccessful attempts to engage an unresponsive,
depressed parent, the infant withdraws and uses less mature regulation strategies to
cope with the negative feelings (Ashman & Dawson, 1997). Infants have to use all of
their regulatory resources to reorganize their negative affective state, and while they
are doing this, they can do nothing else. This compromises the infants development
including cognition as infants in this affective state tend to fail on object permanence
tasks (Murray, 1992).
Disordered Parent- Infant Interactions. Parental
Depression. And Infant/Child Cognitive Deficits
Hypotheses by Field (1986) and Tronick and Gianino (1986) suggest that
emotional and state dysregulation in disordered interactions between depressed
mothers and their infants could confer other risks. Researchers have now attempted
to address the mechanisms by which children of depressed parents develop

vulnerabilities resulting from the aforementioned risks including cognitive deficits.
Whiffen and Gotlib (1989) researched the potential link between maternal
depression and infant cognitive development with depressed and nondepressed
mothers and their 2-month-olds. Analyses demonstrated that infants of depressed
mothers performed significantly worse on the mental subscale of the Bayley Scales of
Infant Development (Bayley, 1969) than infants of nondepressed mothers. Compared
to infants of nondepressed mothers, infants of depressed mothers were rated by the
Bayley examiner as more tense, less content and demonstrated quicker deterioration
under the stress of testing, thus replicating findings of various studies including Field
et al. (1985). The results of this research study are particularly poignant because
relatively poor cognitive performance can be seen with infants of depressed mothers
as young as two months of age (Whiffen & Gotlib, 1989).
Stanley, Murray, and Stein (2004) recruited a sample of depressed (N=72) and
nondepressed mothers (N=50) at six to eight weeks postpartum to investigate the
effect of maternal depression on mother-infant interactions, and infant response to
still-face perturbation, and an instrumental learning task. Analyses revealed a main
effect of maternal depression during the face-to-face interaction such that mothers
who experienced depression showed lower rates of contingent responsiveness to their
infants and more contingent negating of their infants behavior. Mothers who
experienced depression also showed lower rates of contingent positive responsiveness
and higher rates of maternal behaviors that were unrelated to infant behaviors. There

was also evidence that lower contingent maternal positive responsiveness may
influence the state of their infant such that the infant showed a less substantial
learning increment between baseline and the ends of the learning phase (Stanley,
Murray, & Stein, 2004). This result provides support to the hypotheses made by
Field (1986) and Tronick and Gianino (1986) because disordered mother-child
interactions in the form of decreased maternal responsiveness were predictive of
cognitive deficits in infants. Thus, this study offers support to the hypothesis that
disordered interactions is a mechanism by which depressed mothers confer risk for
cognitive deficits to their infants.
Researchers have also studied mothers that experienced depression prior to or
during pregnancy. Murray (1992) collected data from a sample of women that could
fit into one of four categories: no previous history of depression or depression after
delivery, no previous history of depression but depression since delivery, previous
history of major depression but no depression since the delivery, and finally a
previous history of depression and depression since the delivery.
Analyses found significant results associating infant cognitive development at
nine months with maternal depression status. Specifically, infants of mothers with
only postpartum depression were significantly more likely to fail on the object
concept task than infants whose mothers had experienced: a) previous depressive
episode before pregnancy, b) experienced depression both pre- and postnatally, and c)
no depression. This result was probably due to the acute effects of experiencing a

first onset of maternal depression after childbirth. Furthermore, infants of mothers
who had experienced a major depression postpartum were more likely to fail than
infants whose mothers had suffered from a minor episode. In addition, the pass rate
for object permanence tasks at nine months and 18 months for infants of mothers with
previous and postnatal depression dropped across the two assessments. There were
no significant differences according the depression diagnosis on the Bayley Mental
Development Scales or the Reynell Scales of Language Development (Murray, 1992).
Murray, Fiori-Cowley and Cooper (1996) investigated the relationship
between postpartum depression, early mother-infant interactions, and infant cognitive
outcome at two months and 18 months postpartum. Analyses revealed that those
parents who were depressed were rated overall less sensitive and they expressed
fewer affirmations and more negations toward their infants during face-to-face
interactions than nondepressed parents. The quality of infant communication in the
interaction was significantly correlated with maternal sensitivity such that the more
sensitive the mother, the more actively engaged the infant was. In addition, infant
disruptions were preceded by maternal negations, which in turn were preceded by
expressions of negative affect in the infant. Maternal affirmations, though, were
preceded by infant positive expressions.
At 18 months, infants of depressed mother did not differ in cognitive
development from infants of nondepressed mothers using the Bayley Scales of Infant
Mental Development (Murray, Fiori-Cowley, & Cooper, 1996). However, it was

found that the quality of mother-infant interactions at two months was a significant
predictor accounting for 29% of the variance on the Bayley Scales (Murray, Fiori-
Cowley, & Cooper, 1996). This finding suggests that early mother-infant interactions
are associated with later cognitive development such that the more sensitive the
mother and the more actively engaged the infant, the better the infant performed.
Petterson and Burke Albers (2001) investigated the association between
maternal depression and the developmental outcomes of their offspring on a very
large sample of 7,677 mothers and their 3-year old children. Approximately % of this
sample had experienced moderate to severe depression based on cutoff points
proposed by Radloff (1977) between three groups on the CES-D: nondepressed,
moderately depressed and severely depressed. Analyses revealed that maternal
depression had a significant adverse impact on the cognitive, motor, and summary
scores on the Denver Developmental Screening Test (DDST; Frankenburg, Camp,
Van Natta, & Demersseman, 1971). Moderate and severe maternal depression were
also associated with developmental delays in children (Petterson & Burke Albers,
The studies reviewed involving maternal depression and infant outcomes
including cognitive abilities indicate that infants of depressed mothers perform more
poorly on cognitive tasks than infants of nondepressed mothers. This effect can be
seen in infants of depressed mothers as young as two months. These studies also
indicate that disordered mother-infant interactions can significantly affect child

cognitive outcomes. The current study aims to examine this relationship as well, by
observing mother-child interactions in depressed and nondepressed dyads and infant
associative learning in response to the mothers voice.
Mediation Studies
The aforementioned studies suggest that maternal depression and disordered
parent-child interactions both lead to cognitive deficits. Researchers such as Field
(1986) and Tronick and Gianino (1986) suggest that it is the emotional and state
dysregulation in disordered interactions that is at the root of the other problems for
which children of depressed mothers are at increased risk. Thus a number of studies
have tested whether these disordered interactions could mediate the relationship
between maternal depression and infant cognitive outcome.
Milgrom, Westley, and Gemmill (2004) tested the hypothesis that low
maternal responsiveness played a mediating role between postnatal depression and
child developmental deficits. Analyses of maternal responsiveness at six months
postpartum showed that depressed mothers displayed less responsiveness in face-to-
face interactions compared to nondepressed mothers. Results on the Wechsler
Preschool Primary Scale of Intelligence (Revised) in a shorted form (WPPSI;
Wechsler, 1989) showed that children of nondepressed and depressed mothers did not
significantly differ on the Verbal IQ or the Performance IQ, but did significantly

differ on the Full IQ score. Researchers found that overall, the Cognitive/Language
Profile on the Early Screening Profiles (ESP; Harrison, Kaufman, Bruinicks, Rynders
& Ilmer et al., 1990) significantly differed in that infants of depressed mothers had
significantly lower scores on language, visual discrimination, basic skills,
expressivity and receptivity. Finally, researchers showed that maternal responsiveness
mediates the relationship between maternal depression and cognitive development.
A study by the National Institute of Child Health and Human Development
(NICHD) Early Child Care Research Network (1999) investigated the chronicity of
maternal depressive symptoms, maternal sensitivity and child functioning at 36
months. Analyses of a sample of 1,215 children yielded significant results regarding
maternal sensitivity and mother-child interactions. The group of women who were
never clinically depressed tended to be more sensitive in interactions than those
women who were in the clinical range for depression at least once, or those mothers
who were chronically in the clinical range. Women who were chronically depressed
showed more decline in sensitivity during the second year and some recovery at third
year which was a different pattern than demonstrated by women in the two other
Furthermore, children in the three different depression groups differed on five
out of six of the child outcomes at 36 months based on the Bracken Basic Concept
Scale (Bracken, 1984), the Reynell Developmental Language Scale (Reynell, 1991)
and the 99-item Child Behavior Checklist (CBCL-2/3; Achenbach, Edelbrock, &

Howell, 1987): school readiness score, expressive language, verbal comprehension
and maternal reports of problem behavior and cooperation. These comparisons
indicated that children with mothers who were chronically depressed had lower
school readiness, expressive language and verbal comprehension scores, with higher
reports of problem behavior and lower cooperation (NICHD, 1999).
Maternal sensitivity was also a strong predictor of all six child outcomes.
Higher sensitivity was related to higher scores on school readiness, expressive
language, verbal comprehension, observed compliance in the lab and to maternal
reports of more cooperation and less problem behaviors. Further analyses showed a
modest mediation of maternal sensitivity on maternal depression and infant outcomes
such as school readiness, expressive language, and verbal comprehension; the
variance (R2) was small (NICHD, 1999).
Father-Infant Interactions and Infant
Cognitive Deficits
Little is known about depressed father-child interactions and infant outcome
except that studies suggest that paternal depression some negative impacts on child
adjustment (Compas, Howell, Phares, Williams, & Ledoux, 1989). However, Hops
(1992) found that maternal depression has a stronger impact on child adjustment than
paternal depression. Thus, paternal depression does influence child outcome but
perhaps not to the extent that maternal depression does. Researchers have also been

investigating the effects of nondepressed father-child interaction on child outcomes in
families of depressed and nondepressed mothers.
Tamis-LeMonda, Shannon, Cabrera and Lamb (2004) studied longitudinal
parent-child interactions and cognitive and language development in a sample of 290
low-income families from the National Early Head Start Evaluation Study. The
mother-child and father-child dyads were observed in separate home visits when
children were 24 and 36 months. Researchers found that fathers scores on sensitivity,
positive regard, cognitive stimulation, intrusiveness, and negative regard during
interactions were positively correlated with the mothers scores on the same items at
24 months. At 36 months, the parents scores were similar on sensitivity, positive
regard, cognitive stimulation and intrusiveness. Additionally, the fathers sensitivity,
positive regard, cognitive stimulation and intrusiveness predicted the mothers
sensitivity, cognitive regard, and intrusiveness at 36 months (Tamis-LeMonda et al.,
2004). These results suggest that parents affect and behavior towards their child tend
to be similar.
Analyses revealed that mothers and fathers sensitivity, positive regard and
cognitive stimulation were associated with higher scores on the Mental Scale of the
Bayley Scale of Infant Development (Bayley, 1993) at both 24 and 36 months and
increased language development on the Peabody Picture Vocabulary Test H (PPVT;
Dunn & Dunn, 1997) scores at 36 months. Negative regard, intrusiveness, and
detachment were negatively associated with high scores on the Bayley and PPVT.

Composite measures of fathers and mothers supportive parenting (sum of
sensitivity, positive regard and cognitive stimulation) were independently associated
with the child outcome scores even after taking into account level of education and
employment. Thus, positive behavior by both the mothers and fathers benefited the
child directly (Tamis-LeMonda et al., 2004). This suggests that paternal positive
involvement in the home may act as a protective factor especially in instances where
mother-child interactions are not optimal, as Hossain et al. (1994) suggested.
These aforementioned studies provide further evidence that disordered
interactions with a depressed parent confer the risk of cognitive deficits. In fact, these
studies suggested that these disordered interactions especially focusing on parental
sensitivity or responsiveness partially mediated the relationship between parental
depression and cognitive deficits. Hay (1997) suggests maternal depression
influences infants ability to regulate their attention influencing their awareness of
contingencies in the social and nonsocial environments and their ability to modulate
their emotion while processing information, which is consistent with results by
Dunham and Dunham (1990). Field (1986) and Tronick and Gianino (1986)
hypothesized that depressed mothers asynchronous interactions with their infants
cause negative affect which hinders infants ability to learn. Each hypothesis
highlights the fact that depressed mothers and fathers do not provide appropriate
stimulation for their infants.

Parental Depression and Infant-Directed
Infants are stimulated by vocal behavior in their interactions with parents and
caregivers. When addressing infants, caregivers may use fewer words per utterance,
more repetition and articulation, and decreased structural complexity than when
speaking to adults. This infant directed (ID) speech is characterized by higher
overall pitch, exaggerated pitch contours, slower tempo, and longer pauses relative to
adult-directed (AD) speech (Femald & Simon, 1984). Regardless of the gender of the
individual or language spoken, ID speech elicits stronger responses by infants than
AD speech. Furthermore, Femald (1984; 1992) hypothesized that ID speech serves
very important functions during the first year of life. ID speech can improve can
infant state by soothing, rewarding and inhibiting; it is also an effective tool to elicit
infant attention and communicate affect. As infants begin to learn language, ID
speech cues can highlight sounds, and provide segmental cues (Femald & Mazzie,
A study by Bettes (1988) highlights the differences in ID speech produced by
depressed and nondepressed mothers, as defined by their BDI scores. A sample of 10
depressed and 26 nondepressed women and their infants were audio-recorded, and the
acoustic quality of the mothers speech was analyzed. Significant differences
between the depressed and nondepressed groups resulting from the analyses
demonstrated that the depressed mothers failed to make as extensive adjustments in

their vocal behaviors and were slow to respond to their infants. Depressed mothers
failed to impose structure to their vocal behavior compared to nondepressed mother,
and they were six times more likely to respond in a non-exaggerated manner (Bettes,
Kaplan, Bachorowski, Smoski, and Zinser (2001) investigated the acoustic
qualities of ID speech produced by depressed mothers, nondepressed mothers and
mothers in partial or full remission. These researchers found depressed mothers
produced ID speech with smaller changes in fundamental frequency modulation than
nondepressed mothers. Those mothers diagnosed as being in partial or full remission
produced ID speech with a fundamental frequency modulation similar to the ID
speech made by nondepressed mothers. These findings show links between Major
Depressive Disorder and fundamental frequency modulation, an important attribute or
ID speech that modulates infant state (Kaplan, Goldstein, Huckeby, Owren, &
Cooper, 1995) and learning (Kaplan et al., 1999). Depressed mothers fail to respond
to their infants in a way Femald (1984) hypothesized was so important to attention
and affect regulation, language development, and perhaps cognitive development.
Thus, Kaplan, Bachorowski, and Zarlengo-Strouse (1999) investigated infants
of depressed mothers in a conditioned-attention paradigm. This involves pairing of
10 s of the infants own mothers ID speech (conditioned stimulus; CS) with a
reinforcing photographic slide of an adult female face (unconditioned stimulus; UCS)
for 10 s six times, followed by a 10 s inter-stimulus interval. During this procedure

infants are given the opportunity to learn to associate a brief speech segment
(conditioned stimulus; CS) with a reinforcing face (unconditioned stimulus; UCS;
Kaplan, Bachorowski, & Zarlengo-Strouse, 1999). Acquisition of the association of
the conditioned stimulus to the unconconditioned stimulus is measured using a post-
conditioning test in which a novel visual pattern (checkerboard pattern) is introduced.
During the post-conditioning test, the checkerboard pattern is shown with the speech
segment during the first and fourth presentations and without the speech segment
during the second and third presentations (Kaplan, Jung, Ryther, & Zarlengo-Strouse,
1996). Analyses showed that these infants of depressed mothers did not show any
evidence of learning in response to their own mothers voice in this paradigm
(Kaplan, Bachorowski, & Zarlengo-Strouse, 1999).
Then, Kaplan, Bachorowski, and Zarlengo-Strouse (1999) recorded ID speech
samples of 20 mothers who varied in self-reported symptoms of depression according
to the Beck Depression Inventory (BDI; Beck, 1961) where higher scores signified
more depressive symptoms. Four-month-old infants of nondepressed mothers
randomly assigned to one of 20 independent groups based on the varying speech
segment used as a signal were tested in the associative learning paradigm. Speech
samples produced by mothers with higher BDI scores promoted weaker infant
learning. There was a significant difference in fundamental frequency modulation
between speech segments of depressed and nondepressed mothers; also there was a
significant difference in the corresponding mean difference scores such that speech

segments used with low BDI scores produced greater mean difference scores. Thus,
these results suggest that infants of nondepressed mothers react differently to ID
speech produced by depressed mothers relative to nondepressed mothers (Kaplan,
Bachorowski, & Zarlengo-Strouse, 1999).
Although this research with infants of nondepressed mothers suggested that
ID speech produced by depressed mothers lacked the quality to allow these infants to
learn in the conditioned attention paradigm, this hypothesis was further tested with
four-month-old infants of depressed mothers (Kaplan, Bachorowski, Smoski, &
2002). Associative learning difference scores were compared in four-month-old
infants of depressed and nondepressed mothers in response to ID speech produced by
their own mother, an unfamiliar depressed mother and an unfamiliar nondepressed
mother with the order counterbalanced across the infants. Infants of nondepressed
mothers failed to learn in response to ID speech produced by depressed mothers but
they did learn in response to their own mothers ID speech and the ID speech
produced by nondepressed mothers. Infants of depressed mothers did not learn in
response to their own mothers ID speech or the ID speech of the unfamiliar
depressed mothers ID speech; these infants did learn in response to the ID speech of
the unfamiliar nondepressed mother. This study suggests that infants of depressed
mothers are capable learners despite their lack of learning in response to depressed
mothers voices, including their own mother (Kaplan, Bachorowski, Smoski, &

Next, Kaplan, Dungan and Zinser (2004) extended this kind of analysis in a
study of infants of more chronically depressed mothers. Researchers examined how
six to 13-month old infants of depressed and nondepressed mothers responded to their
own mothers voice or an unfamiliar nondepressed mothers voice signaling the
reinforcing face. Again, infants of nondepressed mothers learned well in response to
their own mothers voice as well as the unfamiliar nondepressed mothers voice.
However, infants of depressed mothers showed no evidence of learning in either
condition. These results suggest that, although younger infants of depressed parents
exhibited learning in response to nondepressed mothers voices, older infants of
depressed parents showed no learning in the same condition. These results
demonstrate a generalized learning deficit in response to all maternal ID speech for
infants of chronically depressed mothers (Kaplan, Dungail, & Zinser, 2004).
An additional study conducted by Kaplan, Dungan and Zinser (2004) tested
the limits of this generalized learning deficit in infants of chronically depressed
mothers by looking at other possible sources of stimulation for the infant: paternal ID
speech. Thus six-to-13 month old infants of depressed and nondepressed were tested
in independent conditioned-attention sessions: once with an unfamiliar nondepressed
mothers ID speech and once with an unfamiliar nondepressed fathers ID speech.
Results indicate that infants of nondepressed mothers learned in response to both the
mother and father ID conditions. Infants of chronically depressed mothers learned in
response to the unfamiliar fathers ID speech but replicated earlier results by showing

no learning in response to the unfamiliar mothers ID speech. Furthermore, infants of
chronically depressed mothers exhibited a particularly strong learning response to the
unfamiliar fathers ID speech: significantly stronger learning than did infants of
nondepressed mothers (Kaplan, Dungan, & Zinser, 2004).
As stated previously, a number of studies have shown that depressed mother-
infant dyads behavior differs from nondepressed dyads as a result of disordered
interactions, possibly due to a lack of synchrony and reciprocity in the relationship.
Decreased synchrony and reciprocity in the interactions between infants and
depressed mothers is one plausible explanation for the generalized learning deficit
observed in such infants in response to womens voices. From this perspective, a
history of disordered infant/mother interactions may result in infants losing interest in
female voices. Learning in response to male ID speech by these infants may be as a
result of response to a novel stimulus or may be indicative of a male in the infants
life acting as a natural buffer (Hossain et al., 1994).
In the current study, depressed and non depressed mothers and fathers, and
their infants were recruited to test two hypotheses: (1) an infants own fathers
depression would adversely affect the acoustic quality of his ED speech and his
infants learning in response to his voice, and (2) the relationship between an infants
learning in response to their own mother or fathers voice and the parents depression
diagnosis would be mediated by the quality of the parent-infant interaction as coded
by the Emotional Availability Scales (Biringen, Robinson, & Emde, 2000) suggesting

that a possible mechanism of transfer of risk for cognitive deficits and other negative
outcomes by depressed parent is the disordered parent-infant interactions.

Thirty-one healthy, full-term infants ranging in age from 4- to 12- months (M = 257.2
days, SD = 83.03; range: 115 to 373 days; 13 males and 18 females), their mothers (M
= 29.57 years, SD 4.88 years; range: 23 to 41 years), and fathers (M =31.07 years,
SD = 5.8 years; range: 22 to 42 years) participated in the current study. Of the 31
mothers recruited to the study, 19 were Caucasian (50%), 8 were Latino (21.1%), and
3 were African Americans (7.9%). Of the fathers that participated, 17 were
Caucasian (54.8%), 7 were Latino (22.6%), 1 was Asian (3.2%), 4 were African
American (12.9%) and 2 were American Indian (6.5%). These triads were recruited
through an advertisement in Colorado Parent magazine. Six additional triads were
recruited but the infants did not provide data due to excessive crying during testing.

Parental Clinical Assessment and Diagnosis
Beck Depression Inventory
The Beck Depression Inventory-II (BDI; Steer, Ball, Ranieri, & Beck, 1997) is a 21-
item, self-report measure of the affective, cognitive, motivational and physiological
symptoms of depression. The measure asks a subject to report what symptoms of
depression, if any, they are experiencing and the severity of those symptoms during
the two weeks prior to filling out the questionnaire. Research assessing the validity
of the BDI has found significant correlations between the BDI and psychiatric ratings
in clinical samples (Steer et al., 1997)
Structured Clinical Interview for DSM-IV
Each mother also was interviewed using the Structured Clinical Interview for DSM-
IV Axis-I diagnoses (SCID; First, Spitzer, Gibbon, & William, 1997). The SCID is a
clinical interview in which the DSM-IV criteria are systemically examined for each
mental disorder; the criteria for each mental disorder are embedded directly into the
SCID. Results from research assessing the validity of the SCID when diagnosing
Major Depressive Disorder (MDD) have indicated significant correlations between
the diagnoses of several doctoral-level psychologists, especially when differentiating
between MDD and Generalized Anxiety Disorder (GAD; Riskind, Beck, Berchick,

Brown, & Steer, 1987).
Mothers were diagnosed based on the outcome of the SC1D. DSM-IV Axis-I
diagnoses of MDD (n=4, APA, 1994), MDD Partial Remission (=2), double
depression (DYS plus MDD or DBLD; n= 1), Bipolar I disorder (BP; n~ 1), DDNOS
(n=l), and MDD due to a GMC (=1) were made. Of the 10 mothers diagnosed with
MDD, MDD-PR, DBLD, BPI, DDNOS, or MDD due to GMC four were rated as
mildly, four as moderately and one as severely depressed. In addition, the mean
duration of the current depressive episode for these mothers was 6.65 months (range:
1.5 to 12months, 5Z)-3.92months). On average, mothers included in the
nondepressed category received no DSM-IV mood disorder diagnosis (n~30).
Fathers were included in the depressed category if they scored 13 or above on the
BDI (M=17.33, SD-3.38).
Speech Stimuli
Speech samples were recorded from mothers and fathers separately as they interacted
with their infant during a three-minute session in which the parent was asked to
interest their infant in a stuffed gorilla. The order of these sessions was
counterbalanced. After a 2-min free play warm-up period, mothers and fathers
were handed a stuffed toy gorilla and asked to interest their infants in the toy using
the phrase, pet the gorilla. From a 1-min stream of speech, each mothers first two
interrogative and first declarative pet the gorilla phrases were removed from the

rest of the stream of speech (e.g., Can you pet the gorilla? Will you pet the gorilla?
Pet the gorilla.), repeated once, and combined into a 10-s speech segment. All
speech stimuli will be matched for intensity level at an average of 68 dB (SPL),
measured at a point near the infants head.
In addition to editing the stream of speech, acoustic analyses were performed
on the speech stimuli. Mean fundamental frequency (Foj and mean change in
frequency (AFo) were calculated for each gorilla utterance. Means AFo were also
calculated for each entire pet the gorilla utterance. Because maternal ID speech has
been studied at length (Femald, 1984; Bettes, 1988; Kaplan et al., 2001), pitch
modulation for the word gorilla was the only acoustic analysis conducted for
Infants were placed in a car seat with a black board in front of them. A 4-inch
translucent Plexiglas projection screen was embedded in the board at the infants eye
level. At approximately 1.9 cm. to the infants left of the projection screen, a video
camera was placed through a hole in the board so observers could monitor the infants
face. Two full-face views of the infant were watched on 48.3 cm video monitors by
independent observers in different rooms. Infant-directed (ID) pet the gorilla
speech segments were presented to the infants using a cassette tape player. In order
to be certain that recorded looks were not just the infant orientating to the sound

source, the cassette player was positioned 10 cm. below and 33.5 cm. behind the
infants head. The distance from the infants head to the projection screen was
approximately 42 cm. depending on if the infant leaned forward. Visual stimuli, an
achromatic slide of a female smiling face and an achromatic slide of 4x4
checkerboard pattern, were presented to the infant using two computer-controlled
slide projectors with shutters.
Parent-Child Interaction Assessment
Emotional Availability Scales
The quality of current parent-child interactions were assessed using the Emotional
Availability Scales, Second Edition (EAS; Biringen, Robinson, & Emde, 2000)
during a 10-minute free-play interaction. The free play interaction was videotaped
through a one-way mirror.
The parents behavior was coded according to three scales: Parental
Sensitivity (9-point scale: 1,3,5,7,9), Parental Structuring/Parental Nonintrusiveness
(7-point scale: 1,3,5,6,7), and Parental Nonhostility (5-point scale: 1,2,3,4,5), and two
scales assessed the childs behavior: Child Responsiveness to Parent and Child
Involvement with Parent (9-point scales: 1,3,5,7.9). All five scales have specific
behavioral referents to assist coders with reliable assessments (Biringen, Robinson, &

Emde, 1993). Parental Sensitivity refers to various ways in which parents respond to
the child: their ability to be soothing during distress, their ability to resolve conflicts,
their ability to find creative and stimulating ways to play, and the quality of the
affective exchanges with the child. This scale was created so a score of 9 suggests
the optimal level of sensitivity such that the interaction is creative and enjoyable for
both the parent and infant. Parental Structuring/Nonintrusiveness refers to the
degree to which the parent appropriately structures the childs play, follows the
childs lead and sets limits for suitable child behavior/misbehavior when appropriate.
This 7-point scale is organized such that a score of 7 indicates that the parent is over-
stimulating and not enabling the child to contribute to the direction of interactions
while the low end of the scale indicates that the parent has no structuring and remains
passive during the interaction setting no limits for the child. A score of 5 indicates an
optimal level of structuring/non-intmsiveness such that the parent is an active
member of the interaction but the parent doesnt overpower the interaction. Parental
Hostility, assesses the degree of overt and covert hostility evident in the interaction.
Parents may show covert hostility by acting impatient or bored; parents exhibiting
this type of hostility may also be easily irritated or raise their voice at their child.
Overt hostility involves behavior that is blatantly and specifically harsh or abrasive
towards the child. For this scale, a score of 1 indicates that there are no expressions
of hostility toward the child while the highest score of a 5 indicate extremely hostile
behavior such as name-calling or harsh teasing.

Child Responsiveness to Parent refers to the childs eagerness or willingness
following a parental suggestion or exchange; it also involves clear signs of pleasure in
the interaction. A score of a 9 on this scale is a non-optimal upper bound score,
indicating enmeshment and over-responsiveness, such that the childs autonomy is
diminished. However, a score of 1 would indicate that the child was not responsive
to the mother at all. A child exhibiting the optimal score of a 7 responds to the bids
of their mother but without urgency and age-appropriate signs of autonomy would
also exist. Child Involvement of Parent refers to the extent to which the child
acknowledges and engages the parent in play. The highest rating on this 9-point scale
indicates that the child is over involving the parent by maintaining contact at all
times. The lowest rating on this scale is a 1 which indicates that the child does not
orient to the mother at all. The optimal rating of a 7 demonstrates that the child has a
balance between play by themselves and involvement of the parent.
Videotapes were coded later by observers who were blind to parental
diagnoses, and using the detailed criteria set forth for scoring the EAS published by
Biringen, Robinson, and Emde (1993). Reliability and validity of the EAS has been
established in many studies. Inter-observer reliabilities (percent agreement and kappa
values) are typically above .80. Observers were graduate students in clinical
psychology who were trained by an EAS trainer and expert in parent-child
interactions. Reliability videotapes and training manuals with behavioral descriptors
for every point-scale were be used to train observers to a reliability of .70 or greater

with the trainer on three consecutive tapes of lab visits. Reliability was also spot-
checked by the trainer from the videotapes.
Upon their arrival to the laboratory parents read and signed informed consent
statements for infant testing, audiotaping and videotaping. Mothers also gave consent
to participate in the SCID interview. Next, each mother and father was tape-recorded
to elicit pet the gorilla utterances by using a stuffed animal gorilla. The
audiotaping was followed by the 10-min EAS taping session during which the infant
and one parent and then the other were taken into a room with a blanket and two
crates of toys. Parents were asked to play with their child as they would if no one
was videotaping them. The video camera was set up behind a one-way mirror in the
next room. The procedure for coding the EAS tapes is outlined above. Audiotaping
and videotaping sessions were counterbalanced. During the videotaping, one
experimenter edited the ID speech tapes for the infant tests as described. Before and
following the EAS taping, parents were asked to fill out the BDI-II (Steer et al.,
The first infant test using the mother or fathers voice took place as soon as
the tapes were ready for use; the order of testing was counterbalanced. Following a
delay of at least 15 minutes, the second test with the other parents voice occurred.

For each of the six conditioning trials during the first and second tests, the infant
heard a 10-s segment of pet the gorilla speech with the projection screen uniformly
lit. When the speech segment ended, the infant received a 10-s presentation of slide
of a female smiling face. Following the presentation of the slide, there was a 10-s
inter-stimulus interval in which the projection screen was lit and the infant may hear
background noise. Background noise measured near the infants head was
approximately 58 dB. Ten s after the sixth face presentation, the post-conditioning
test started. Infants received four presentations of a slide of 4x4 checkerboard
patterns with 10-s inter-stimulus between presentations. The speech segment from
the pairing phase simultaneously accompanied the first and fourth checkerboard
presentations, but was absent during the second and third checkerboard presentations.
Infant looking time at the projection screen was recorded during the 10-s speech, face
and checkerboard trials. Looking was indicated to the independent observers when
the reflection of the visual stimulus was centered on the infants pupils.
If the infant is not in an appropriate state for testing, parents were offered the
options of waiting longer, returning on the next day (with an additional participant
payment), and/or moving on to the next phase of the study: the SCID for the mother.
If testing did occur with both parents voices, then the mother was interviewed using
the SCID.

Mean demographic data for depressed and nondepressed mothers are displayed in
Table 3.1; correlations between maternal demographics and depression are presented
in Table 3.2. There were no significant differences as a function of maternal
diagnosis in maternal age, infant age, marital status, ethnicity, or number of children.
There was a significant difference in maternal education level such that the
nondepressed mothers (M= 6.7, SD = 1.7) completed more years of school than
depressed mothers (M= 4.7, SD = 1.4; ?(33) =3.33,p = .002). Depressed mothers
significantly differed from nondepressed mothers in the percentage of mothers
working (20% versus 70%). As expected, depressed mothers scored higher on the
BDI (M= 27.3, SD = 10.4) than nondepressed mothers (M= 10.8, SD = 7.0)

Table 3.1
Demographics of Depressed and Nondepressed Mothers and Their Infants
Variable Depressed Non-Depressed
N 10 25
Maternal Age (years) 30.6 (6.6) 30.2 (4.9)
Infant Age (days) 292.8 (70.0) 251.0 (77.9)
Caucasian 5 (50%) 16 (64%)
Latina 3 (30%) 4 (16%)
Asian 0 2 (8%)
African American 1 (10%) 1 (4%)
Native American 1 (10%) 1 (4%)
Other 0 1 (4%)
Mothers Education 4.7 (1.4)** 6.7 (1.7)**
Family Income 5.4 (2.3) 6.8 (2.0)
Percent Working 20%* 70% *
Percent Married 80% 81%
Number of Children 1.7 (.95) 1.3 (.57)
BDI score 27.3 (10.4)** 10.8 (7.0)**
Note: For education, 3.0 = no high school degree, 4.0 = high school degree, 5.0- associates
degree, 6.0 = 4-year college, 8.0 = advanced degree; for income, 1.0 = under $6,000, 2.0 =
$6,000-10,000, 3.0 = $11,000-20,000, 4.0 = $21,000-25,000, 5.0 = $26,000-30,000, 6.0 =
$31,000-40,000, 7.0 = $41,000-50,000, and 8.0 = above $50,000. Numbers in parentheses
are standard deviations. p <.05, ** p <.01.

Table 3.2
Correlations Between Demographics and Maternal Depression Diagnosis
Variable Depression Age (M) Age (I) Education Married Income Work Children Ethnicity
Depression .03 .25 -.50** -.10 -.29 -.42* .25 .14
Age (M) -- -.04 49** .13 .19 .08 .27 -.30
Age (I) - -.n -.13 .04 .32 -.14 -.15
Education - .49** .48** .48** -.27 -.53**
Married - .58** .15 -.21 -.39*
Income -- .39* -.31 -.50**
Work - -.28 -.43**
Children - .27
Ethnicity ~
Note: M = mother. I = infant. p <.05. ** p <01.

Mean demographic data for depressed and nondepressed fathers are presented in
Table 3.3; correlations between these variables are presented in Table 3.4. There
were no significant differences as a function of depression diagnosis in paternal age,
education, income, work status, marital status, or number of children. However,
depressed fathers had significantly older infants,(t (33) = -2.5, p = .025), than
nondepressed fathers. As expected, depressed fathers had significant higher BDI
scores, (t (34) = -8.2, p = .000), than nondepressed fathers.

Table 3.3
Demographics of Depressed and Nondepressed Fathers and Their Infants
Variable Depressed Non-Depressed
N 7 28
Paternal Age (years) 29.0 (5.9) 32.5 (6.9)
Infant Age (days) 311.6(49.2)* 251.8 (81.3)*
Caucasian 3 (42.9%) 20 (71.4%)
Latina 3 (42.9%) 5 (17.9%)
Asian 0 1 (3.6%)
African American 1 (14.2%) 2(7.1%)
Fathers Education 5.8 (2.0) 5.4 (1.7)
Family Income 4.9 (2.0) 6.6 (2.1)
Percent Working 57.1% 96.4%
Percent Married 57.1% 89.3%
Number of Children 1.6 (.79) 1.4 (.73)
BDI score 18.1 (6.5)** 4.9 (6.5)**
Note: For education, 3.0 = no high school degree, 4.0 = high school degree, 5.0= associates
degree, 6.0 = 4-year college, 8.0 = advanced degree; for income, 1.0 = under $6,000, 2.0 =
$6,000-10,000, 3.0 = $11,000-20,000, 4.0 = $21,000-25,000, 5.0 = $26,000-30,000, 6.0 =
$31,000-40,000, 7.0 = $41,000-50,000, and 8.0 = above $50,000. Numbers in parentheses
are standard deviations. p <.05, ** p <.01.

Table 3.4
Correlations Between Demographics and Paternal Depression According to BDI Category
Variable Depression Age (D) Age (I) Education Married Income Work Children Ethnicity
Depression -.21 .31 .08 -.35* -.33 -.46** .07 .16
Age (D) -.04 .41 * .26 .21 .27 .08 -.08
Age (1) - .24 -.12 .05 -.11 -.13 .10
Education - .37* .48** .34 .14 -.55**
Married - .58** .28 -.22 -.55**
Income - .53** -.33* .70**
Work - .02 -.32
Children -- 49**
Ethnicity ~
Note: D = father. I = infant. p <.05, ** p <.01.

Depression and Infant Learning
Maternal Depression
The summary measure of associative learning, the difference score, was calculated
from the summation test data by subtracting the average duration of looking during
the two checkerboard-alone trials from the two checkerboard-plus-matemal ID
speech trials. A mean difference scores in response to mothers voices were available
for each of 29 infants. An independent samples /-test was conducted with maternal
depression diagnosis and mean difference scores in response to the mothers voice.
In contrast to prior research (Kaplan, Bachorowski, & Zarlengo-Strouse, 1999), the
results were not significant, t = .696,/? = .493.
Paternal Depression
Difference scores were also calculated in response to each fathers voice for 30
infants. Positive difference scores indicate that the paternal ID speech, on average,
increased looking at the checkerboard pattern. An independent samples /-test was also
conducted with paternal depression diagnosis and learning in response to the fathers
voice yielding significant results, /= 2.39,/?= .024. Figure 3.1 presents this significant
result, as predicted, with infants of depressed fathers learning significantly less in
response to their fathers voice.

Figure 3.1
Mean Difference Scores from the Summation Test for the Fathers Voices as a
Function of the Fathers BDI Category
Maternal and Paternal Depression
A variable was created based on the BDI categories of both the mother and father (1.0
= neither parent depressed (where depression is defined as having a BDI score > 13),
2.0 = mother depressed, 3.0 = father depressed and finally 4.0 = both parents
depressed). A MANOVA was conducted with the joint depression rating and
learning in response to both parents voices but no significant results were obtained
(see Figure 3.2). Although no significant results were found, there was a trend

MEAN DIFFERENCE SCORE towards infants responding less well to the mothers voice when both parents are
depressed as compared to when only the mother was depressed.
Figure 3.2
Mean Difference Scores from the Summation Test for the Mothers and Fathers
Voices as a Function of the Joint BDI Category

Depression. ID Acoustic Analyses and Infant Learning
A correlation was conducted between maternal depression diagnosis and mothers
pitch modulation for the word gorilla, however, no significant correlations the
results were not significant (r = .03,/? = .86). Another correlation was performed
between the mothers pitch modulation of gorilla and mean difference scores in
response to mothers voices. There were no significant correlations between the pitch
modulation and the difference score in response to the mothers voice (r = -.07,/? =
.71) (see Table 3.5).

Table 3.5
Correlations Between Parental Depression, and Acoustic Analyses and Infant Learning Scores
Variable MDep DDep MDBDI OwnM OwnD DGo DPGo DFo MGo
MDep -.12 .23 -.14 -.05 .09 .10 .07 .03
DDep - .86** _ 49* * -.41* -.39* _ 4-s** -.31 -.03
MDBDI -- -.54** -.33 -.36* -.38* -.26 -.12
OwnM - .56** -.06 -.003 -.07 -.07
OwnD - .20 .25 .08 -.15
DGo - .96** .70** .14
DPGo - .76** .13
DFo - .19
MGo -
Note: MDep = Maternal Depression; DDep = Paternal Depression: MDBDI -- Combined mother/fathcr depression score based on
BDI categories; OwnM = learning in response to the mother's voice; OvvnD = learning in response to the fathers voice; DGo =
lathers mean change in fundamental frequency of gorilla; DPGo = Father's mean change in fundamental frequency of pet the
gorilla" ; DFo = Fathers mean fundamental frequency : MGo = Mothers mean change in fundamental frequency of gorilla.

Means for the acoustic data from fathers appears in Table 3.6. The fathers pitch
modulation of the word gorilla and the sentence pet the gorilla were significantly
correlated with paternal BDI category as demonstrated on Table 3.5. These variables
were negatively correlated: those fathers who were depressed showed less pitch
modulation in the word gorilla (r = -.39, p = .017) and the sentence pet the gorilla
(r = -.45,p = .006). An additional correlation was performed between fathers pitch
modulation of gorilla and pet the gorilla and the difference scores in response to
the fathers voice but no significant results were obtained.
Table 3.6
Mean Acoustic Characteristics of Paternal Speech
Variable Fathers
N 18
DGo 57.43 (22.37)* 104.3 (48.1)*
DPGo 69.30 (22.62)** 129.62 (52.66)**
DFo 159.00(19.59) 193.96 (49.89)
Note: DGo = Fathers mean change in fundamental frequency of gorilla; DPGo = Fathers
mean change in fundamental frequency of pet the gorilla ; DFo = Fathers mean
fundamental frequency. Numbers in parentheses are standard deviations. p<.05, ** p <.01.

Emotional Availability Scales
Table 3.7 shows the mean Emotional Availability Scores for depressed and
nondepressed mothers and fathers. Furthermore, Table 3.8 displays correlations
between parental depression diagnoses and Emotional Availability Scores in the
mother-child interactions. Analyses of data from the mother-child interaction
revealed several significant intracorrelations. Maternal sensitivity was negatively
correlated with maternal hostility (r = -.66, p = .003). Maternal sensitivity was
positively correlated with child responsiveness (r = .68,/? = .002) and child
involvement (r = .57,/? = .013). Child involvement and child responsiveness were
positively correlated (r = .82,/? = .000).

Table 3.7
Mean Emotional Availability Scores for Mothers and Fathers
Variable Mothers Fathers
N 18 18
Sensitivity 7.88 (.48) 7.54 (1.1) 6.67(1.4) 7.33 (.88)
Structuring/Intrusiveness 5.13 (.48) 5.60(1.2) 6.83 (.76) 5.8 (1.2)
Hostility 1.00(0) 1.04 (.13) 1.17 (.29) 1.10 (.20)
Child Responsiveness 6.25 (.29) 6.32 (.75) 6.33 (.76) 5.97(1.0)
Child Involvement 6.13 (.48) 5.89 (1.1) 5.33 (.76) 5.47 (.93)
Note: Numbers in parentheses are standard deviations. p <.05, ** p <.01.

Tabic 3.8
Correlations Betweem Parental Depression and Mother-Infant Emotional Availability Scores
Variable MDep DDep MSens MStruc Mhos CRespM CInvolM
MDep -.12 .15 -.18 -.13 -.05 .10
DDep - -.21 .13 .54* -.10 -.21
MSens - -.04 -.66** .68** .57*
MStruc - .11 -.20 -.31
Milos -- -.30 -.12
CRespM - .82**
CInvolM -
Note: MDep = Maternal Depression; DDep = Paternal Depression: MSens = Maternal Sensitivity; MStruc = Maternal
Structuring/Intrusiveness; Mhos ~ Maternal Hostility; CRespM Child Responsiveness to the Mother; CInvolM =
Child Involvement with the Mother. Numbers in parentheses are standard deviations. Values that differ by diagnostic
category at thep < .05 level are noted with an asterisk. Values that differ at the p < .01 are noted with two asterisks.

Table 3.9 presents correlations between parental depression and Emotional
Availability Scores in the father-child interaction. Analyses of the data from the
father-child interactions revealed additional subscale intracorrelations. Paternal
sensitivity was negatively correlated with paternal hostility (r = -.69, p ~ .002), and
positively correlated with child involvement {r = .66, p = .003). Paternal
structuring/nonintrusiveness was positively correlated with child responsiveness (r =
.65, p .003). Child involvement and child responsiveness were positively correlated
(r = .60, p = .008).

Table 3.9
Correlations Between Parental Depression and Father-Infant Emotional Availability Scores
Variable MDep DDep DSens DStruc Dhos CRespD CInvolD
MDep -.12 -.04 -.12 .04 -.24 -.38
DDep - -.26 .33 .12 .15 -.06
DSens - .22 _ 69** .45 .66**
DStruc -- -.33 .65** .26
DHos - -.45 -.43
CRespD - .60**
CInvolD -
Note: MDep = Maternal Depression; DDep = Paternal Depression; DSens = Paternal Sensitivity; DStruc = Paternal
Structuring/Intrusiveness; Mhos = Paternal Hostility; CRespD ~ Child Responsiveness to the Father; CInvolD = Child
Involvement with the Father. Numbers in parentheses are standard deviations. Values that differ by diagnostic
category at thep < .05 level are noted with an asterisk. Values that differ at thep < .01 are noted with two asterisks.

EAS and Depression
A MANOVA was conducted between maternal depression and the EAS subscales
during the mother-infant interaction but did not yield significant results. A MANOVA
was also conducted between paternal depression and the EAS subscales during the
father-child interaction but did not yield significant results. MANOVAs were also
conducted using the joint BDI categories for the mother and father. Results showed
that the joint depression variable significantly predicted maternal hostility (F= 4.15,
p = .027).
EAS and Infant Learning
A MANOVA was conducted between infants difference scores to their mother and
fathers ID speech and the EAS subscales, however, no significant results were

The results of this study indicate new findings regarding paternal depression. As was
found with depressed mothers in Kaplan et al. (2001), depressed fathers produced
speech with smaller changes in fundamental frequency than nondepressed fathers.
This was the case during each fathers pitch modulation of gorilla and pet the
gorilla. Paternal depression also predicted lower learning scores for infants
responding to that fathers voice. This finding was also demonstrated by depressed
mothers in Kaplan, Bachorowski and Zarlengo-Strouse (1999). These findings
suggest that maternal and paternal depression influences the pitch modulation in
ones voice. Furthermore, the vocal stimulation provided by depressed mothers and
fathers does not promote associative learning in response to their voices.
In addition, a variable was created to describe each mother and fathers joint
depression category according to suggested cutoffs for the BDI. There were four
groups: nondepressed mother/nondepressed father, depressed mother/nondepressed
father, nondepressed mother/depressed father and depressed father/depressed mother.
Overall, there was a significant difference between the depression groups and
learning in response to each parents voice; however, when investigating the specific

difference between categories several pairs of categories were approaching
significance but none were significant at the .05 level. There was a trend suggesting
that infants with two depressed parents respond less in response to their mothers
voice than if just the mother was depressed. This finding may relate to the role of the
father in the family system. As Hossain et al. (1994) suggested, a nondepressed
father may play an important role as a buffer against some of the negative outcome
that infants of depressed mothers are prone to. In this case, fathers may help to buffer
the negative infant cognitive effects that maternal depression is said to influence.
However, when that buffer is not in place, the infant responds negatively to their
primary caregiver which in most cases is the mother.
Contradictory to previous findings there were no significant findings with
respect to maternal depression and acoustic analyses or infant learning in response to
the mothers voice. Perhaps this was also a result of a small sample size. It might
have also been due to the severity of the depression. Half of the depressed women
seen were experiencing a mild case of depression. It may be the case that mild
depression might not create a significant difference in the acoustics of these mothers
voices. If the voice were not compromised by the depression, one would not expect
their child to react differently in an associative learning task involving the mothers
Analyses of the components of the parent-child interactions yield correlations
between the subscales such that maternal sensitivity was negatively correlated with

maternal hostility but positively correlated with child responsiveness and involvement
in interactions with the mother. Child responsiveness and child involvement were
correlated in the interaction with the mom as well. This same findings exist with the
EAS data from the father-infant interaction This finding demonstrates the internal
consistency of the EAS such that the subscales appropriate correlate with each other;
this is particularly interesting as it occurred similarly for mothers and fathers.
Results from analyses of the EAS subscales and parental depression yielded
few results. Paternal depression was positively correlated with maternal hostility
which might suggest that the fathers relationship with his partner influences his risk
for depression. There was a significant result between the joint depression variable
and maternal hostility between the conditions where neither parent was depressed and
where both were depressed. However, the overall variance of the hostility subscale
was very little, thus the distinction is being made between a score of no hostility
present and very slight hostility/boredom present. This result may not continue if
there was a larger data set.
Lastly, there were no significant results obtained relating infant learning and
the EAS subscales for this data set. However, our sample only included 18 parents
and infants. In another sample of depressed women, Burgess, Sliter, and Kaplan
(unpublished) have found a significant correlation between learning score and
maternal sensitivity. Mediation analyses were not conducted due to a lack of
significant results between the EAS and parental depression as well as infant learning.

In future studies, it would be helpful to obtain data for at least double the
number of parents in this study including more families with depressed fathers. In the
future, both fathers and mothers should be interviewed using the SCID to determine
an appropriate DSM-IV diagnosis for both parents which would eliminate using the
BDI as a possible way to diagnose depression as opposed to helping to detect it.
Adjusting these features of the study may enable researchers to analyze if parent-
infant interactions do mediate the relationship between that parents depression and
their infants response to the parents voice.

Achenback, T.M., Edelbrock, C., & Howell, C.T. (1987). Empirically based
assessment of behavioral/emotional problems of 2- and 3-year old children.
Journal of Abnormal Child Psychology, 15, 629-650.
Baron, R.M., & Kenny, D.A. (1986). The moderator-mediator variable distinction in
social psychological research: Conceptual, strategic, and statistical
considerations. Journal of Personality and Social Psychology, 51, 1173-1182.
Bayley, N. (1969). Bayley Scales of Infant Development. New York: Psychological
Bayley, N. (1993). Manual for Bayley Scales of Infant Development (2nd ed.). San
Antonio, TX: Psychological Corporation.
Bettes, B. (1988). Maternal depression and motherese: Temporal and intonational
features. Child Development, 59, 1089-1096.
Biringen, Z., Robinson, J., & Emde, R. (1993). Manual for scoring the Emotional
Availability Scales: Infancy to early childhood version. Fort Collins, CO:
Department of Human Development and Family Studies, Colorado State

Biringen, Z., Robinson, J., & Emde, R. (2000). Appendix A: The Emotional
Availability Scales (2nd ed.). Attachment and Human Development, 2, 256-
Bracken, B.A. (1984). Bracken Basic Concept Scale. San Antonio, TX: Psychological
Campbell, S.B., Cohn, J.F., & Meyers, T. (1995). Depression in first time mothers:
Mother-infant interaction and depression chronocity. Developmental
Psychology, 57(3), 349-357.
Chabrol, H., Bron, N., & Le Camus, J. (1996). Mother-infant and father-infant
interactions in postpartum depression. Infant Behavior and Development, 19,
Cohn, J. F., Campbell, S. B., Matias, R., & Hopkins, J. (1990). Face-to-face
interactions of postpartum depressed mother-infant pairs at 2 months.
Developmental Psychology, 26, 15-23.
Cohn, J.F., Matias, R., Tronick, E.Z., Connell, D., & Lyons-Ruth, K. (1986). Face to
face interaction of depressed mothers and their infants. In E.Z. Tronick & T.
Field (Eds.), Maternal depression and infant disturbance (pp.31-45). San
Francisco: Jossey-Bass.
Cohn, J.F., & Tronick, E.Z. (1983). Three-month old infants reaction to simulated
maternal depression. Child Development, 54, 185-193.

Compas, B.R., Howell, D.C., Phares, V., Williams, R.A., & Ledoux, N. (1989).
Parents and child stress symptoms: An integrative analysis. Developmental
Psychology, 25, 550-559.
Dunham, P., & Dunham, F. (1990). Effects of mother-infant social interactions on
infants subsequent contingency task performance. Child Development, 61,
Dunn, L., & Dunn, L. (1997). Peabody Picture Vocabulary Test III Manual. Circle
Pines, MN: American Guidance Service.
Edhborg, M., Lundh, W., Seimyr, L., & Widstrom, A.M. (2003). The parent-child
relationship in the context of maternal depressive mood. Archives of Womens
Mental Health, 6, 211 -216.
Femald, A. (1984). The perceptual and affective salience of mothers speech to
infants. In L. Feagans, C. Garvey, and R. Golinkoff (Eds.), The origins and
growth of communication (pp.5-29). Norwood, NJ: Ablex.
Femald, A. (1992). Human maternal vocalizations to infants as biologically relevant
symbols: An evolutionary perspective. In J. Barklow & L. Cosmides (Eds.),
The adapted mind: Evolutionary psychology and the generation of culture
(pp. 391-428). New York: Oxford University Press.
Femald, A., & Mazzie, C. (1991). Prosody and focus in speech to infants and adults.
Developmental Psychology, 27, 104-113.

Femald, A., & Simon, T. (1984). Expanded intonation contours in mothers speech to
newborns. Developmental Psychology, 20, 104-113.
Field, T. (1980). Interactions of high-risk infants: Quantitative and qualitative
differences. In D.B. Sawin, B.C. Hawkins, L. Walker, & J. Penticuff (Eds.),
Current perspectives on psychosocial risk during pregnancy and early infancy
(pp.120-143). New York: Brunner/Mazel.
Field, T. (1985). Attachment as psychobiological attunement: Being on the same
wavelength. In M. Reite & T. Field (Eds.), Psychobiology of attachment (pp.
415-454). New York: Academic Press.
Field, T. (1995). Infants of depressed mothers. Infant Behavior and Development, 18,
Field, T., Healy, B., Goldstein, S., & Guthertz, M. (1990). Behavior-state matching
and synchrony in mother-infant interactions of nondepressed versus depressed
dyads. Developmental Psychology, 26, 7-14.
Field, T., Healy, B., Goldstein, S., Perry, S., Schanberg, S., Zimmerman, E.A. et al.
(1988). Infants of depressed mothers show depressed behavior even with
nondepressed adults. Child Development, 59, 1569-1579.
Field, T., Lang, C., Martinez, A., Yando, R., Pickens, J., & Bendell, D. (1996).
Preschool follow-up of infants of dysphoric mothers. Journal of Clinical
Child Psychology, 25(3), 272-279.

Field, T., Sandberg, D., Garcia, R., Vega-Lahr, N., Goldstein, S., & Guy, L. (1985).
Pregnancy problems, postpartum depression and early mother-infant
interactions. Developmental Psychology, 21(6), 1152-1156.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B.W. (1997). Structured
clinical interview for DSM-IV Axis I Disorders. Clinician version (SCID-CV).
Washington, DC: American Psychiatric Press.
Fleming, A.S. Flett, G.L., Ruble, D.N., & Shaul, D.L. (1988). Postpartum adjustment
in first time mothers: Relations between mood, maternal attitudes, and
mother-infant interactions. Developmental Psychology, 24(1), 71-81.
Forehand, R., & McMahon, R.J. (1981). Helping the noncompliant child: A
clinician's guide to parent training. New York: Guilford.
Frankenburg, W.K., Camp, B.W., Van Natta, P.A., & Demersseman, J.A. (1971).
Reliability and stability of the Denver Developmental Screening Test. Child
Development, 42, 1315-1325.
Hamish, J.D., Dodge, K.A., & Valente, E. (1995). Mother-child interaction quality as
a partial mediator of the roles of maternal depressive symptomatology and
socioeconomic status in the development of child behavior problems. Child
Development, 66, 739-753.
Harrison, P.L., Kaufman, A.S., Kaufman N.L., Bruinicks, R.H., Rynders, J., & Ilmer,
S. et al. (1990). AGS early screening profiles, Journal of Psychoeducational
Assessment, 13, 101-104.

Hart, S., Field, T., Letoumeau, M., & Del Valle, C. (1998). Jealousy protests in
infants of depressed mothers. Infant Behavior and Development, 27(1), 137-
Hay, D. F. (1997). Postpartum depression and cognitive development. In L. Murray
and P.J. Cooper (Eds.), Postpatum depression and child development (pp.85-
110). New York: Guilford.
Hay, D. F., Pawlby, S., Sharp, D., Asten, P., Mills. A., & Kumar, R. (2001).
Intellectual problems shown by 11-year-old children whose mothers had
postnatal depression. Journal of Child Psychology and Psychiatry, 42, 871-
Hogan, A.E., Scott, K.G., & Bauer, C.R. (1992). The Adaptive Social Behavior
Inventory (ASBI): A new assessment of social competence in high risk three-
year-olds. Journal of Psychoeducational Assessment, 70,230-239.
Hops, H. (1992). Age- and gender-specific effects of parental depression: A
commentary. Developmental Psychology, 37,428-431.
Hossain, Z., Field, T., Gonzales, J., & Malphurs, J. (1994). Infants of depressed
mothers interact better with their nondepressed fathers. Infant Mental Health
Journal, 15, 348-357.
Izard, C.E., Hembree, E.A., Dougherty, L.M., & Spizzirri, C.C. (1983). Changes in
facial expressions of 2- to 19- month-old infants following acute pain.
Developmental Psychology, 79(3), 418-426.

Jacob, T., & Johnson, S.L. (1997). Parent-child interaction among depressed fathers
and mothers: Impact on child functioning. Journal of Family Psychology,
77(4), 391-409.
Kaplan, P. S., Bachorowski, J., Smoski, M. J., & Hudenko, W. J. (2001). Infants of
depressed mothers, although competent learners, fail to learn in response to
their own mothers infant directed speech. Psychological Science 13(3), 268-
Kaplan, P. S., Bachorowski, J., Smoski, M. J., & Zinser, M. (2001). Role of clinical
diagnosis and medication use in effects of maternal depression on infant-
directed speech. Infancy, 2(4), 537-548.
Kaplan, P. S., Bachorowski, J., & Zarlengo-Strouse, P. (1999). Child-directed
speech produced by mothers with symptoms of depression fails to promote
associative learning in 4-month-old infants. Child Development, 70(3), 560-
Kaplan, P. S., Dungan, J. K., & Zinser, M. C. (2004). Infants of chronically depressed
mothers leam in response to male, but not female, infant-directed speech.
Developmental Psychology, 40, 140-148.
Kaplan, P. S., Goldstein, M. H., Huckeby, E. R., Owren, M. J., & Cooper, R. P.
(1995). Dishabituation of vision attention by infant- versus adult-directed
speech: Effects of frequency modulation and spectral composition. Infant
Behavior and Development, 75,209-223.

Milgrom, J., Westley, D.T., & Gemmill, A.W. (2004). The mediating role of maternal
responsiveness in some longer term effects of postnatal depression on infant
development. Infant Behavior and Devlopment, 27(4), 443-454.
Murray, L. (1992). The impact of postnatal depression on infant development.
Journal of Child Psychology and Psychiatry, 33, 543-561.
Murray, L., & Cooper, P. J. (1997). Postpartum depression and child development.
New York: Guilford.
Murray, L., & Cooper, P.J. (1997). Postpartum depression and child development.
Psychological Medicine, 27, 253-260.
Murray, L., Fiori-Cowley, A., Hooper, R., & Cooper, P. (1996). The impact of
postnatal depression and associated adversity on early mother-infant
interactions and later infant outcome. Child Development, 67, 2512-2526.
Petterson, S.M., & Burke Albers, A. (2001). Effects of poverty and maternal
depression on early child development. Child Development, 72(6), 1794-1813.
Pickens, J., & Field, T. (1993). Facial expressivity in infants of depressed mothers.
Developmental Psychology, 29, 986-988.
Radke-Yarrow, M. (1998). Children of depressed mothers: From early childhood to
maturity. Cambridge, England: Cambridge University Press.
Radke-Yarrow, M., McCann, K., DeMulder, E., Belmont, B., Martinez, P., &
Richardson, D. (1995). Attachment in the context of high-risk conditions.
Development & Psychopathology, 7(2), 247-265.

Reynell, J. (1991). Reynell Developmental Language Scales. Los Angeles: Western
Psychological Service.
Riskind, K. H., Beck, A. T., Berchick, R. J., Brown, G., & Steer, R. A. (1987).
Relability of DSM-m diagnoses for major depression and generalized anxiety
disorder using the structured clinical interview for DSM-HI. Archives of
General Psychiatry, 44, 817-820.
Spitzer, R.L., Endicott, J., & Robins, E. (1978). Research diagnostic criteria:
Rationale and reliability. Archives of General Psychiatry, 35(6), 773-782.
Stanley, C., Murray, L., & Stein, A. (2004). The effect of postnatal depression on
mother-infant interaction, infant response to the still-face perturbation, and
performance on an instrumental learning task. Development and
Psychopathology, 16, 1-18.
Steer, R.A., Ball, R., Ranieri, W.F., & Beck, A.T. (1997). Further evidence for the
construct validity of the Beck Depression Inventory-II with psychiatric
outpatients. Psychiatric Reports, 80(2), 443-446.
Tamis-LeMonda, C.S., Shannon, J.D., Cabrera, N.J., & Lamb, M.E. (2004). Fathers
and mothers play with their 2- and 3-year olds: Contributions to language and
cognitive development. Child Development, 75(6), 1806-1820.

Tronick, E.Z., & Gianino, A.F. (1986). The transmission of maternal disturbance to
the infant. In E.Z. & T. Field (Eds.), Maternal depression and infant
disturbance [New Directions for Child Development, No. 34] (pp. 61-82). San
Francisco: JosseyBass.
U.S. Department of Commerce. (2001). Profiles of demographic characteristics:
2000 census of population and housing, United States. Washington D.C.:
U.S. Census Bureau.
Warner, R., Appleby, L., Whitton A., & Faragher, B. (1996). Demographic and
obstetric risk factors for postnatal psychiatric morbidity. British Journal of
Psychiatry, 168,607-611
Wechsler, D. (1989). Wechsler Preschool and Primary Scale of IntelligenceRevised
manual. San Antonio: Psychological Corporation
Weinberg, M. (1996). Gender differences in depressed mothers interactions with
their infants. In D.M. Teti (Chair), Maternal depression and child
development: Short and longtem sequelae for mothers, infants and families.
Symposium conducted at the International Conference for Infant Studies,
Providence, Rhode Island.
Whiffen, V. E., & Gotlib, I. M. (1989). Infants of postpartum depressed mothers:
Temperament and cognitive status. Journal of Abnormal Psychology, 98, 274-