Abstract
BACKGROUND: Cognitive development and childhood behaviour is affected by maternal mood disorders during pregnancy. Concurrent maternal mood has been associated with disrupted home environments - both are independently associated with less effective executive functions in children.
OBJECTIVES: We examined relationships between household chaos and self-regulation in children of depressed mothers and how prenatal selective serotonin reuptake inhibitor (SSRI) exposure may mediate this relationship.
DESIGN/METHODS: Regression modeling examined the impact of maternal report of depressed mood symptoms (3rd trimester and 6 years) and a measure of household environmental confusion (Confusion, Hubbub, and Order Scale [CHAOS]) on child behavioral self-regulation (Behaviour Rating Inventory of Executive Function [BRIEF]) at age 6 years (N=118 [47 prenatally SSRI exposed, 71 non-exposed]. Confirmatory regression models were conducted to examine if children were susceptible to household CHAOS (differential susceptibility) or positively influenced by lower household CHAOS (vantage sensitivity).
RESULTS: Prenatal SSRI exposure, 3rd trimester maternal depressed mood symptoms and home chaos predicted measures of self-regulation within a model of strong differential susceptibility. Analysis of this interaction revealed that when CHAOS scores were low (< 23.64), children of non-prenatally depressed mothers were better off than children of prenatally depressed mothers (regardless of prenatal SSRI treatment, or maternal mood at 6 years). However, when home chaos was high (> 23.64), these children (of non-depressed mothers and exposed to an SSRI namely children of mothers whose symptoms remitted) were worse off than children of prenatally depressed mothers (Figure 1).
CONCLUSION: The degree of susceptibility to household CHAOS depended on whether mothers were prenatally depressed and whether mothers were treated with an SSRI. Children who had prenatally symptomatic mothers were not affected by home chaos. Children of not particularly symptomatic mothers were affected by home chaos - the degree to which they were affected depended on prenatal exposure to an SSRI. Children exposed to SSRIs prenatally were more susceptible to higher levels of home chaos, reflecting that they had better self-regulation in low levels of CHAOS and poorer self-regulation with high levels of CHAOS than the children not exposed to SSRIs prenatally, suggesting a “vantage sensitivity”. In this way prenatal depressed maternal mood may “buffer” a child against a subsequently chaotic home environment. Moreover, prenatal SSRI exposure appeared to increase a susceptibility to home CHAOS especially when the mothers were not particularly symptomatic during pregnancy.(Fig 4)
