preschoolers' response to maternal sadness: relationships with maternal depression and...

Infant Mental Health Journal, Vol. 13. No. 2. Summa 1992

Preschoolers’ Response to Maternal Sadness: Relationships with Maternal Depression and Emotional Availability

KAREN A. FRANKEL, KRISTIN LINDAHL, AND ROBERT J. HARMON Division of Child Psychiatry

University of Colorado School of Medicine

ABSTRACT: Previous research has documented that children of depressed mothers are at risk for a variety of emotional/behavioral problems and impairments in mothcr-child interaction. Depressed mothers have been characterized as withdrawn and unavailable. The present study examined behavior of preschool children of depressed and nondepressed mothers in response to their mothers’ feigned sadness. The study assessed maternal depression and maternal emotional availability to determine how these related to preschoolers’ expression of empathy. Sixty-two mothers and their 3 H-year-olds participated in the study. Mother-child interaction was coded from four tasks: free play, eating a snack. problem solving. and sadness simulation. Children of depressed mothers were not less empathic than children of nondeprcssed mothm. However. the mother‘s mood on day of testing related to child response. Maternal emotional availability interacted with the credibility/intensity of her simulation of sadness to predict child empathy.

R&SUMe: Des recherches prCctdentes ont montrt que les enfants dc mtres dtprimtcs sont P risque pour plusieurs problbmes Cmotionnds/de comportement et pour les dctuiorations dans l’interaction mbre-cnfant. Les mtres dtprimks ont Ctt CaractCrisCeS comme &ant rcnfermtes et non-disponibles. Cettc Ctude-ci a examint le comportcment d’enfants d’agc prtscolaire de mbrcs dCprimtes et de mbres non-dtprimtes en rCponse P la tristesse feinte de la part dc leurs mhes. Cctte Ctude tvalue la dtpression matcrnellc et la disponibilitd Cmotionnde maternelk de fawn P dctcrmincr la manihe dont d e s c i ctaient likes P l’expression d’cmpathie des enfants en age prCscolaire. 62 mbra ct lcun enfant de trois ans ont participt P cette ttude. Yinteraction mbrc-enfant fut cod& A partir de quatre Cpreuva: jeu libre, collation. rhlution de problhc, et simulation de tristesse. Les enfants de m h a dCprimCu n’ktaient pas moins empathiques quc la enfants de mbres non-dCprimCts. Cependant, l‘humcur de la mbre le jour de l’dvaluation ttait litc P la rhction de l’enfant. La dkponibilitt Cmotionnelle maternelle conjointemmt A la crCdibilitt/intcnsitt de sa simulation dc tristesse scrvaient P prCdirc l‘empathie de l’enfant.

RESUMEN: lnvatigaciones previas han documentado el hecho de quc 10s d o s de madres depresivas estan en riesgo de una variedad de problemas emocionala y de conducta y de impedimentos en la interac- ci6n maternc-infanta. Las madres depresivas han sido caracterizadar como apartadas y no disponibles. El prcsente s tudio examina la conducta de niiios en edad prccscolar y sus respuestas a la aparcnte tristeza

This research was supported by NIMH postdoctoral training Grant #F32 MHU9516-01, a NIMH Small Grant IR03 MH4244MlA1, and a grant from the Developmental Psychobiology Research Group (DPRG) to the h and third authors. Thanks to Nancy Plummer. Gale Terry, Leola Schultz, and DavidJkle for their help with data collec-

tion and analysis, and to Marcia Smith, David Oppenheim, and members of the DPRG for comments and feedback on the project and manuscript. and the mothers and children who participated in the study. Reprint requests should be sent to: Karen Frankd, University of Colorado School of Medicine, Box C268-52, 4200 East Ninth Avenue, Denver. Colorado 80262.

132 @Michigan Association

for Infant Mental H d t h

K . A. Frankel, K. Lindahl. and R. J. Harmon 133

de sus madres. Para esto se han considerado niiios de madres tanto depresivas como no depresivas. El studio evalua la deprcsidn maternal y la disponibilidad emotional de la madre para determinar c6mo s t o esth relacionado con la urprai6n dc identificaci6n quc muestran 10s nifios prccscolares. En el estudio partidparon 62 rnadres y sus nifios de t r a aiios y medio de edad. La intcracci6n materno-infantil fue codificada considerando hs siguientes cuatro labores: jucgo libre, corniendo bocadillos. resolvicndo problemas y sirnulaa6n de tristeza. Los niiIos de madres depresivas no mostraron UM identificaci6n menor quc 10s nifios de madres no depresivas. Sin embargo, el estado, el humor y la disposici6n dc la madre el dia de la prueba estuvo directamente relacionado con la respusta del niiio. La disponibilidad emotional dc la madre intcractud con la aedibilidad y la intensidad dc su estirnulaci6n de tristeza para predecir la identificaci6n dcl nifio.

Within the last decade there has been an explosion of research on children of depressed mothers. Many of these studies demonstrate a significant degree of risk to the child. Preschool children of depressed mothers show increased rates in the entire spectrum of behavior problems in sleeping, eating, conduct, anxiety, fearfulness, and temper tantrums (Ghodsian, Zajicek, & Wolkind, 1984; Pound, Cox, Puckering, & Mills, 1985; Richman, Stevenson, & Graham, 1982; Rolf, Crowther, Ten, & Bond, 1984). School-aged children of depressed parents evidence more psychiatric symptoms and actual psychiatric diagnoses than children of well parents (Dodge, 1990; Downey & Coyne, 1990; Hammen, Gordon et al., 1987).

How maternal depression compromises children’s development is not yet known. One likely mechanism is through impaired parent-child interaction. Studies of mother-child interaction in samples of depressed women find numerous deficits and deviations in parenting ability. Generally, depressed mothers have been found to be less positive, less active, and less vocalizing in interaction with their infants (Field, 1984) and less affectionate (Coyne & Gotlib, 1985) than well mothers. Two integrative reviews of research on maternal depression and mother-child interaction note that depressed mothers are more negative, more hostile, more inconsistent, more punitive, and more irritable (Downey & Coyne, 1990; Radke-Yarrow & Zahn-Waxler, 1991) than well mothers. These reviews conclude that depressed mothers exhibit both less positive and more sadhegative affect.

Although much is known about the psychiatric outcomes and mother behavior of depressed mothers and their children, less is known about the emotional development of the children of depressed mothers. These children live in environments with more frequent displays of negative emotions and varying deficits in parental responding which could impair their own emotional development. It is likely that the development of affect regulation (Downey & Coyne, 1990; Zahn-Waxler, Cummings, McKnew, & Radke-Yarrow, 1984) and empathic responses to emotions (Radke- Yarrow & Zahn-Waxler, 1991) may be impaired in children of depressed parents.

I34 Infant MentaI Health JournaI

Recently, empirid studies have begun to identify the parental factors associated with normal children’s responsiveness to others’ emotions, and particularly to distress. Barnett (1987) found maternal empathy and supportive parenting, especially by mothers, was positively related to children’s responsivity to others. Parents who report being more restrictive of their children’s expression of emotion tend to have children who score lower on empathy measures (Eisenberg et al., 1988). Children who are securely attached with their caregivers, a measure of the global quality of the parent-child relationship, tend to show more empathy than insecurely attached children (Kestenbaum, Farber, & Sroufe, 1989). Furthermore, researchers have suggested a link between empathy and prosocial behavior (Chapman, Zahn-Waxler, Cooperman, & Iannotti, 1987; Eisenberg & Miller, 1987), assuming that a person who vicariously feels the distress of another is more likely to attempt to help this person. Parental correlates for related prosocial responses to distress include caregivers who model comforting, helping, and nurturance (Staub, 1971; Yarrow, Scott, & Waxler, 1973). Thus, the parental correlates of vicarious emotional responding and prosocial behavior are similar (Fabes, Eisenberg, & Miller, 1990). Parents who are responsive, warm, sympathetic, and accepting of their children’s emotional responses, i.e., generally emotionally available, tend to have children who are more able to respond empathically. As noted above, depressed mothers have been found to be less responsive, less warm,

more punitive, and more negative than nondepressed mothers-all of the qualities likely to be associated with decreased ability to show empathic responses and related prosocial behaviors. Specifically, it has been suggested that in addition to these negative traits, a depressed woman may be so preoccupied with her own internal state that she is unable to read and respond to her child’s cues, impairing her general capacity to be emotionally available (Cohn, Matias, Tronick, Connell, & Lyons-Ruth, 1986; Goodman & Brumley, 1990). It is suggested that depressed mothers, by virtue of their emotional unavailability, will have children who are less able to respond empathically to their mother’s distress.

The present study examined empathic behavior in preschool children of depressed and nondepressed mothers in response to simulated maternal sadness. Empathy was defined as the child‘s capacity for vicarious emotional responding to the mother’s distress and the associated altruistic and prosocial behaviors that can accompany it (Miller, Eisenberg, Fabes, Shell, & Gular, 1989).

Previous research with infants has shown striking patterns of infant behavior in mother-infant face-to-face interaction when mothers are asked to ”look depressed.” When Cohn and Tronick (1983) asked “normal” (nondepressed) mothers to look depressed during a session of face-to-face interaction with their young infants, these mothers portrayed a stilled, nonresponsive facial expression. In response, the infants became quite distressed, showing increased negative facial expressions, protesting, looking away, increased activity rate, and increased heart rate (Cohn & Tronick, 1983). These infants were “surprised” (i.e., their flow of interaction was disrupted) and distressed by the unusual contingencies interrupting their expected pat- tern of interaction with their mothers. Their responses can be interpreted as the infants’ attempts to reinstate regularity and reciprocity into the mother-child interaction (Field, 1984).

K. A . Frankel, K . Lindahl, and R. J , Harmon I35

Researchers then investigated the reactions of infants of naturally depressed mothers to the still-face manipulation. It is interesting to note that the lookingdepressed condition did not appear to distress these infants as it had infants of healthy mothers. Infants of postpartum depressed mothers did not react any differently to the still- face condition than to the other interactions in the session (Field, 1984). Field (1984) suggested that these infants were ”used to“ their mothers looking depressed (i.e., not surprised) and therefore no longer attempted to correct the interaction. Alternatively, Downey and Coyne (1990) suggest that perhaps infants learn to imitate the passive nonresponding posture of their depressed mother.

However, few researchers have looked beyond infancy to examine the empathic responses of children of depressed mothers. In a study of children of bipolar mothers, toddlers’ responses to maternal distress, combining pain and sadness, were examined (Zahn-Waxler, Cummings, Iannotti, & Radke-Yarrow, 1984). Children of bipolar mothers tended to show more preoccupations with the simulations of pain and sadness than children of nondepressed mothers. They were less able to remove themselves from the situation and re-engage in other activities. However, this study did not specifically isolate sad or depressed maternal affect, but rather it assessed physical pain, infant crying, and adult conflict (Zahn-Wader, Cummings, McKnew, & Radke- Yarrow, 1984). It is somewhat surprising that, given that depressed af€ect is the hallmark of the depressive disorder, more attention has not been paid to children’s responses to it (Downey & Coyne, 1990). Furthermore, the mothers in the Zahn- Waxler study had bipolar illness rather than unipolar depression or dysthymia. Past research suggests that parental bipolar illness affects children differently than depression alone (Downey & Coyne, 1990).

In summary, past research on children’s responses to maternal emotions indicates that infants and young children whose mothers experience depression react differently than children of well mothers. However, research specifically isolating children’s response to sadness has not been done. Furthermore, maternal emotional availability appears to be a crucial component of children’s development of emotional responding. When maternal availability is compromised through depression, deficits in empathic responding may arise. Alternatively, however, depression may exert its impact on child responding through modeling or some other as yet unidentified process. Therefore, the objective of this study was to examine whether emotional availability and depression impacted child responding independently of one another or whether the effect of depression was related to the mother’s emotional availability.

One final issue concerns the construct of depression. Many studies have considered depression to be a unitary construct. However, in fact, depression can be seen as a “continuum of psychological distress,” e.g., as a mood state, or as a “discrete clinical entity” (Downey & Coyne, 1990). Some studies have used self-report measures of current mood to define depression (Field, 1984), whereas others have used interview measures with clinical diagnoses (Radke-Yarrow .& Zahn-Waxler, 1991), and still others use both (Hammen, Adrian, Gordon, Burge, & Jaenicke, 1987). In previous studies, the results have been equivocal, with some studies finding that mood im- pacts children’s functioning whereas others find that it is the diagnostic status of the mother that determines the outcome of the child (Downey & Coyne, 1990). For example, Hammen, Adrian et al. (1987) found that current mood significantly

136 Infant Mental Health Journal

predicted most of the child outcome variables they examined, whereas mother’s history of affective illness only predicted child’s history of affective illness. On the contrary, research by Billings and Moos (1985) suggested that children of diagnosed depressed parents were impaired relative to controls, and that child functioning did not fluc- tuate as the parent moved in and out of episodes of depression. Therefore, in the current study, both diagnostic and mood measures were used to describe maternal depression and the effects of each were examined separately.

The purpose of this study was to examine the relationships of maternal depression and maternal emotional availability to preschool-age child empathic response to maternal sadness. First, the study investigated whether 3-year-old children of depressed mothers respond differently to maternal sadness simulations than children of nondepressed mothers. Based on infant and preschool studies, it appears that children of depressed women may be accustomed to their mothers’ displays of negative emotions and so react less responsively. It was expected that children of depressed mothers would be less surprised by maternal depression and less empathic to it. Depression was examined both as a mood and as a diagnostic status. Based on the equivocal nature of past findings, no specific hypotheses were formulated regarding the effects of these different types of depression.

Second, the study investigated whether child empathic responding was related to maternal emotional availability. It was hypothesized that children of emotionally available mothers would show more empathic and related prosocial behaviors to the mothers’ distress than children of emotionally unavailable mothers. Further, it was expected that if maternal depression and child empathic responding were related, this relationship may be related to the emotional availability of the mother.

METHOD

Subjects

Sixty-two mothers and preschoolers participated in the present study. The majority of subjects (N = 60) responded to an advertisement run in the city newspapers and in a local newspaper for parents that was distributed at preschools and day care centers. The advertisement solicited women and their 3-year-old children to participate in important child development research and stated that women who were experiencing or had experienced a depression during the life of their child were particularly desired by the project. Additionally, letters and phone contacts were made with local psychotherapists to recruit the depressed sample, however, this only yielded two mothers. A total of 109 women responded to the advertisements: 33 were determined to be ineligible (unlikely to meet diagnostic criteria) by telephone screening, and 14 were enrolled in the study but unable to complete all of the protocol. The remaining 62 mothers and their children came into the lab at the University of Colorado Health Sciences Center for three sessions: (1) mother interviews, (2) mother-child interaction visits, and (3) children’s play groups. The present study describes results from the first two sessions.

On the basis of a psychiatric diagnostic interview, women were assigned to either the depressed group (N = 30) or the comparison group (N = 32). There were no significant differences between the two groups on maternal age (M = 34, SD = .7),

K . A. Frunkel. K. Lindahl, und R. J. Harmon 137

,,ruternal employment, maternal marital status, maternal race, family income, child J I~ )VT scores, birth order of subject child, number of siblings, number of hours child :rl)ent in day care, or the proportion of boy:girl subject children (16:14 in depressed

16: 16 in comparison). There were three significant differences between the depressed and comparison group: (1) the mean age of the children in the depressed

was 2 months older than the children in the comparison group (Md = 43 mos.; M~ = 41 mos.), a difference which was not considered of developmental significance; (2) mothers in the comparison group were slightly more educated than mothers in lhe depressed group (Md = some college; Mc = college graduate); and (3) mothers in the depressed group reported working outside of the home more hours (Md = 18.8; Mc = 11.3).

All of the 62 women were interviewed with the Schedule for Affective Disorders and Schizophrenia - Lifetime Version (SADS-L) and were given diagnoses based on the Research Diagnostic Criteria (Spitzer & Endicott, 1978). Women who received diagnoses of “No Mental Disorder” were assigned to the comparison group. Women who were assigned to the depressed group had received a diagnosis of either Major Depressive Syndrome (recurrent episodes), Minor Depressive Syndrome (recurrent episodes), or Intermittent Depressive Disorder. The first two forms of depression describe disorders where the woman experiences discrete episodes of depression with an identifiable beginning and end, and a symptom-free period in between episodes. Women who experience intermittent depression (which is similar to Dysthymia in DSM-111-R; American Psychiatric Association, 1987) have had depressive symptoms, much of the time, on and off for days or weeks at a time over the last 2 years. There may be periods of normal functioning but it blends in between the days of depressed functioning. All of the women were interviewed by either authors K. F. or R. J. H. to assign diagnosis and group status. Eleven of the 62 women were interviewed separately by both investigators for reliability purposes. Interrater reliability on group assignment was loo%, and interrater reliability on specific diagnostic assignment (major vs. minor vs. intermittent) was 91%. All diagnostic interviews (both reliability and others) were reviewed by both interviewers to assign diagnosis.

Of the 30 women in the depressed group, 13 experienced recurrent unipolar depression, seven experienced dysthymia and 10 had double depression, both unipolar episodes and dysthymia (Keller & Shapiro, 1982). Five of the depressed mothers had no previous psychiatric treatment, whereas 20 had brief courses of psychotherapy and five had 1 or more years of treatment. Only five women in this group had been psychiatrically hospitalized, three prior to the birth of the subject child and the other two for less than 3 weeks. Therefore, this sample differs from many previous studies of clinically depressed women in that these women were generally not hospitalized and were not referred from treatment to the study (Downey & Coyne, 1990). However, they appear similar in nature to other clinical samples (Hammen, Gordon et al., 1987; Kadke-Yarrow, Nottleman, Martinez, Fox, & Belmont, 1992). The 19 women who could count their depressive episodes experienced a mean of 9.1 lifetime episodes (range 1-50). Four women had experienced too many episodes to count. AU had cxperienced at least one episode during the life of the child. The women experienc- h g dysthymia spent an average of 49.5% of their time in the last year feeling clepressed.

138 Infant Mentol Health Journal

Procedures

Mothers who volunteered for the study were initially telephone-screened and then, if appropriate, interviewed. Women who met interview diagnostic criteria were then invited back for mother-child visits. The mother-child visits consisted of a series of naturalistic interaction tasks. The present study included coded interaction from: (1) free play, (2) eating a snack, (3) problem-solving tasks, and (4) sadness simulation. For the initial free-play period, mothers and children were asked to behave as if they were at home and feel free to do whatever they liked. The mothers then filled out the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), while the child was administered the Peabody Picture Vocabulary Test (DUM & Dunn, 1981). Next, during the snack period, the mother and child had to negotiate what topping to eat with their graham crackers. This was followed by the sadness-simulation task which was used to assess children’s responsiveness to maternal distress, specifically maternal sadness. The mothers were given eight pictures of infants displaying a variety of emotions such as happiness, anger, contentment, and sadness. The mothers were instructed to go through the entire stack of pictures with their child. Then, they were to return to the picture of the crying infant and to act sad (Zahn-Waxler, Ridgeway, Denham, Usher, & Cole, in press). Finally, the mother and child were presented with a challenging puzzle and the mother was instructed to help the child solve the puzzle. The interactions were videotaped behind a one-way mirror. Videotapes were rated by two separate sets of raters (one for child response and one for maternal emotional availability), each naive to maternal diagnosis and other ratings.

Measures

Early Relational Assessment Scales. The free-play, snack, and puzzle-solving interaction periods were rated with a shortened version of the Early Relational Assessment Scales (ERAS) (Clark, Musick, Stott, Klehr, & Cohler, 1983). These scales are designed to describe the affective and behavioral characteristics that the mother and child show in the interaction and the emotional quality or tone of the relationship. Using a 5-point Likert-type scale, 22 maternal codes were assessed. Based on factor analysis conducted on this data, 11 variables were computed into a composite variable calIed Early Rela- tional Assessment Maternal Emotional Availability. The following variables were included in the composite code: wardkind tone of voice, positive affect, quality of verbalizations, contingent responsivity to child positive behavior, structures and mediates environment, reads cues and responds sensitively and appropriately, con- nectedness, mirroring, flexibility, consistency, and enjoymentlpleasure. Raters reached a mean interrater reliability (within one scale point) of 98% on the 22 individual codes, with a range of 93%-100% agreement on a subsample of 23 cases.

Empathy coding. Children’s empathic responding to their mother’s simulation of sadness was assessed with the Empathy Simulation G1.obal Coding System (ESGCS) (Buchsbaum & Emde, in Lindahl, 1988). The ESGCS is a global measure of children’s empathic and prosocial responses to the display of emotion. This coding system consists of 17 codes, only 9 of which were chosen for the present study because of their theoretical interest. Ratings were made on a 5-point scale, from “1” indicating ”very low” to “5” indicating ”very high.“ Denial assessed looking away or physically

K. A. Frankel. K. Lindahl. and R . J. Harmon 139

backing away from or verbally minimizing the mother’s distress. Caring assessed verbal or nonverbal solutions or interventions the child used in an attempt to alleviate the mother’s distress. Empathy assessed the level of concern and worry the child displayed facially. Hypothesis testing assessed the child‘s investigations into the mother’s distress by asking questions or nonverbal requests for information about the distress. Latency assessed the length of time that passed between the onset of the mother’s distress and a response by the child, higher numbers indicating a longer latency. Freezing assessed the extent to which the child remained motionless and seemingly ”paralyzed” during the simulation. Callousness assessed aggressive or otherwise insensitive responses to the mother. Inappropriate Uect assessed the display of emotions such as pleasure that were inappropriate in the face of maternal sadness. Credibility/Drama is a summary code of the credibility of the mother’s portrayal of distress and the intensity with which she displayed the emotion as judged by the rater. Adequate reliability for these codes has been previously established (Lindahl, 1988) and was not recalculated for this study. A trained rater rated all of the cases for the current study. Pearson correlation co- efficients between coders on 40 cases in the reliability study ranged from .77 to .92.

RESULTS

Descriptive Statistics

The empathy variables were examined to describe the children’s responses for the sample as a whole. On average, children in this sample showed low to moderate levels of both positive and negative empathy behaviors. Three variables (freezing, callousness, inappropriate affect) were eliminated from further analyses due to insufficient variance. These variables were included in the original version of the coding system which was used to code a child’s response to an adult’s simulation of physical injury and pain. It is likely that these reactions are less appropriate responses to simulated sadness, thus accounting for the limited variability. Thus, six empathy variables (five child variables and one mother variable) were retained: (1) child denial, (2) child caring, (3) child empathy, (4) child hypothesis testing, ( 5 ) child latency, and (6) maternal credibility/drama. There were no sex differences found on any of the child empathy variables. Overall, the situation seemed to pull for a moderately strong behavioral response from these children.

Table 1 Descriptive Statistics for Empathy Variables

Variables M SD

Denial Caring Empathy (to mother) Hypothesis testing (to mother) Latency Maternal credibility/drama Freezing. Callousness* Inappropriate affect*

3.11 1.97 2.01 2.16

.91 4.95 I .02 1.40 1.11

1.45 1.34 1.38 1.35 1.41 2.21

.13

.96

.31

N = 62. *Less than 10 subjects had a value different than 1 on these variables.


The relationships between the independent variables (depression and maternal emotional availability) were also examined. Surprisingly, and contrary to previous ex- pectations, maternal depression and maternal emotional availability were not related in this sample (Terry, Frankel, & Harmon, 1990). The depressed and nondepressed groups did not differ significantly on the level of maternal emotional availability displayed during the experimental session. Correlations between the Beck Depres- sion Inventory total score and the ERA Maternal Emotional Availability score were modest but nonsignificant as well. This community sample contained both depressed mothers who were still able to be emotionally available and mothers who were emotionally unavailable for reasons other than depression.

By contrast, there was a clear relationship between mood and diagnosis: Mothers in the depressed group scored higher than comparison mothers on the Beck Depression Inventory (Md = 12.6, SD = 8.0; Mc = 4.0, SD = 4.0). Additionally, the sample was divided into high Beck scoring women (BDI 2 16, N = 9) and low scorers (N = 53), because a score of 16 is considered likely to reflect clinical depression (Beck & Steer, 1987). All of the women in the high Beck group were in the diagnosed depressed group; there were no very depressed-mood mothers in the normal comparison group.

Depression and Empathy

The hypothesis that children of depressed mothers would react less empathically to maternal sadness than children of nondepressed mothers was examined using both diagnostic status and mood on the day of session as independent variables. First, diagnosis effects were tested using two-sample t tests with maternal diagnosis (depressed vs. nondepressed) as the independent variable and the child empathy codes as the dependent variables. Because the outcome variables were only moderately intercor- related, and represented empathy and related behaviors, and because of the ex- ploratory nature of this study, separate analyses were run for each of the outcome variables without Bonferonni corrections. (See Breznitz & Friedman, 1988.) Multivariate analyses were done, showing that the overall multivariate Fs were not significant, whereas the univariate tes& remained significant. Therefore, the univariate results presented below should be considered preliminary.

The hypothesis that preschoolers of diagnosed depressed mothers would be less “surprised” and less empathic was not supported. There were no significant differences between groups on any of the child empathy variables. Children of diagnosed depressed mothers did not react differently to their mothers’ simulation of sadness than children of women without clinical depression.

The hypothesis that maternal depression, as defined by self-reported mood, is related to child empathy was tested using the mothers’ scores on the Beck Depression Inven- tory as the measure of depression. T tests were performed with high and low Beck score groups as the independent variable and child empathy codes as the dependent variables. Children of high-scoring mothers (more depressed) showed significantly quicker response to the mother’s distress ( M h i b k e k = 0.33 and Mlowkck = 1.08; p = .03) and tended to show less empathy than children of less depressed mothers (hfhi‘hbcck = 1.33, and Mlowbeck = 2.12, p = -09). Thus, the children of high depressed-mood mothers showed a more immediate response to their mothers’ negative affect but showed less empathic responding.

K. A. Frankel. K. Lindahl, and R. J. Harmon I41

Maternal Emotional A vailability and Empathy

The second hypothesis, that children of emotionally available mothers would be more empathic than children of less available mothers (regardless of whether or not the mother was depressed) was examined by comparing children of emotionally available mothers and children of unavailable mothers. A median split was performed on the Maternal Emotional Availability variable, yielding high and low availability groups. T tests were performed between these groups on the child empathy codes. Children of high emotional availability mothers showed more caregiving, less denial, and a longer latency to respond than children of low emotional availability mothers. This finding provides moderate support for the hypothesis that children of emotionally available mothers would be more empathic to maternal sadness, but also more surprised, as inferred by the children’s increased latency to respond.

Table 2 Di@erences in Child Responding by Maternal Emotional Availability

Mean scores

Available mothers Unavailable mothers P8 (N = 29) (N = 33)

Caregiving 2.33 Denial 2.76 Latency 1.30 Hypothesis testing 2.27 Empathy to mother 2.27

1.55 3.52

.59

2.03 1.68

.03

.03

.09

NS NS

‘Two-tailed t tests performed.

Next, the joint effects of depression and emotional availability were considered. Because the depressed and nondepressed groups did not differ on child empathic behavior, the hypothesis that deficits in emotional availability might account for deficits in child empathy in children of depressed mothers could not be tested. The interactive effects of diagnosis and emotional availability were tested using two-way (diagnosis x emotional availability) analyses of variance; no significant interactions were found. Then, the joint effects of mood and emotional availability were examined. Again, two (High and Low Beck) x two (High and Low Emotional Availability) analyses of variance were performed. There were no significant interactions between depressed mood and emotional availability.

Post HOC Analyses

Just as the children’s responses varied, it was noted that the quality of the mother’s simulation also differed. The mothers showed a wide range of ability to feign sadness and the intensity with which they portrayed the emotion. To assess whether varia- tions on maternal simulation affected children’s responses, post hoc analyses examined the relationship between children’s empathic responding and the credibility and dramatic intensity of the mothers’ depression simulation. A median split was performed on a composite variable of maternal credibility/drama to form a high


credibility/drama group of mothers and a low credibility/drama group of mothers. Ttests compared the empathic responses of the children in each of these two groups.

Table 3 Di@erences in Child Responding by Maternal Credibility/Drarna

Mean scores

Low credibility High credibility P’

Children’s responses Care giving 1.20 2.69 .m Empathy to mother 1.37 2.71 .m Avoidancc/denial 3.60 2.66 .009

Latency to respond .40 1 .so .003 Hypothesis testing 1.47 2.81 .m

*Two-tailed t tests performed.

As can be seen in Table 3, how a child responded to his or her mother’s sadness was strongly related to the quality of the mother’s depiction of the affect. Mothers whose simulations were credible and intense had children who showed more empathy, more caregiving, less denial, more hypothesis testing, and a longer latency to respond than children whose mothers had lesstonvincing simulations.

In and of itself, this finding is not surprising-the better the stimulus, the more appropriate the response. However, we wondered whether the mother’s credibility/ drama might interact with her emotional availability to predict her child’s response. That is, would a mother who was both credible and available have a child who responded differently than a noncredible but available mother’s child, or a child whose mother was neither credible nor available. Two-way analyses of variance were performed with maternal emotional availability and credibility/drama as the independent variables and child empathy codes as the dependent variables. As can be seen in Table 4, three of five interactions were significant between maternal

credibility/drama and emotional availability to predict child behavior. In general, mothers who were both available and credible had children who were more caring, showed less denial, and had a longer latency to respond. Women in the three other conditions had children who were less empathic, denied more, and were quicker to respond. The combination of high credibilityidrama and availability seemed to be associated with a uniquely empathic child.

DISCUSSION

This paper examined whether preschool children of depressed mothers showed different responses to maternal sadness simulation than children of nondepressed mothers. In general, this was not found to be the case. Preschool-aged children of women diagnosed with depression did not react differently to maternal feigned sadness than children of women who were not diagnosed as depressed. One explanation for the current results is that the 3-year-old sadness simulation was not as compelling a stimulus as the infant still-face situation. Alternatively, this one-time assessment

K. A. Frankel, K. Lindahl. and R. J. Harmon I43

Table 4 Interactions Between Maternal Availability and Credibility to Predict Child Response

Low availability High availability

Child caregiving Low credibility/drama 1.28

(18). High credibility/drama 2.00

(10)

Overall F = 15.48. p = .00; Interaction F = 4.71, p = .03.

Child latency to respond Low credibility/drama

High crcdibility/drama

Overall F = 6.00, p = .W; Interaction F = 9.20, p = .004.

Child denial/avoidance Low credibility/drama 3.39

(18) High credibility/drama 3.60

(10) Overall F = 4.44, p = .02; Interaction F = 6.46, p = .02.

3.82 (1 1) 2.23 (22)

‘Numbers in parentheses are cell sizes.

of empathic responding may be more related to “state” variables (e.g., mood on the day and credibility of the simulation) than to more enduring and global variables such as diagnostic status.

There was a suggestion that the mother’s mood on the day of testing did relate to the child’s ability to respond empathically. Children of women with high depressed mood showed less empathy and a quicker latency to respond. The decreased empathy was intuitively sensible and was predicted based on the infancy studies showing less response from infants of depressed mothers to the still-face manipulation (Field, 1984); however, the quick response time was somewhat puzzling. The meaning of the latency- to-respond variable is explored below. Overall, maternal depression seemed to impact child behavior only inasmuch as it affected the mother’s mood on the day of the simulation. Because mood on the day is not completely independent of diagnosis, it is difficult to conclude that diagnosis has no effect at all. However, these results are similar to those found by Hammen, Adrian et al. (1987) in finding a more direct effect of mother’s current mood rather than her diagnostic status on her child‘s adjustment.

The hypothesis that the mother’s emotional availability would be related to child responding was supported more strongly. It was hypothesized that children of available mothers, regardless of whether or not the mother was depressed, would show more empathic behavior when presented with maternal distress. The results support this hypothesis. Children of emotionally available mothers showed lower levels of denial of maternal distress and were more likely to offer prosocial interventions to their mother than children of emotionally unavailable mothers. Children of emotionally


available mothers also showed a longer latency to respond to her sadness. These findings support the formulation that children whose mothers mirror their emotions and show comforting behaviors are children who can internalize and reproduce these behaviors in order to soothe someone else.

An interesting and unexpected result was that the credibility and intensity of the mother’s display of distress was found to interact with her emotional availability to predict children’s empathic responding. It was found that when mothers were both emotionally available and showed high levels of credibility and intensity, children showed the highest levels of prosocial behavior and the lowest levels of denial of maternal distress. Here again, when a mother was both credible and available there was a longer latency to respond to the mother’s distress.

When considered together, the findings on latency-to-respond seem to suggest that this variable may be tapping into the child‘s surprise in a way that mirrors the findings from the infancy face-to-face data. We hypothesize that children of women without depressed mood, of emotionally available women, and of available and expressive women were caught off guard by their mother’s persistent negative affect. Perhaps they expected their mothers to be able to regulate their own affect so the children stood watching and waiting longer before deciding that it was necessary to intervene. Once they did intervene, they did so more empathically than children of depressed- mood or unavailable mothers. These findings suggest that children of depressed-mood mothers had, in fact, become accustomed to their mother’s depression, as did the infants in the earlier face-to-face studies. The familiarity with depression was opera- tionalized by an immediate response, albeit a less empathic response, to her negative mood: Their mothers’ sadness did not interrupt the flow of their behaviors as did the sadness of the nondepressed or emotionally available mothers.

In conclusion, one of the goals of this study was to consider maternal depression and maternal emotional availability independently in predicting children’s emotional development. Depression and emotional availability were found to be independent of one another and did not interact to predict child empathic responding. Contrary to predictions, maternal history of depression did not discriminate between different levels of empathic responding. However, children of mothers who reported depressed affect on the day of the session were somewhat less empathic than children of mothers who reported little to no depressed mood at the time. This finding is encouraging as it suggests that maternal depression does not necessarily spell dire consequences for children’s emotional development. It does suggest, perhaps, that clinicians need to pay close attention to the current mood and parent-child interaction of depressed women and their children to determine if detrimental events are occurring, because diagnosis alone may not be informative.

In contrast, maternal emotional availability was more successful in differentiating high- versus low-empathic responsiveness in children. Further, highly empathic children tended to have mothers that were available and credible in their presenta- tion. Thus, in addition to emotional availability, these results suggest that children’s empathic responding is also affected by maternal expressiveness. Mothers who are consistent and sensitive in meeting their children’s emotional needs and who are genuine and emotive in expressing their own emotions tend to have children who are more empathic when their mothers are upset. Intriguingly, there were modest

K. A . Frankel. K. Lindahl, and R . J. Harmon 145

but significant positive correlations for the depressed women between their ability to credibly portray sadness and a prior history of psychotherapy.

This study raises several questions for future research. It is unclear why maternal emotional availability would be stronger than depression at predicting empathic development in children, and this result needs to be replicated. It may be that unless the depression is present during the interaction or the disorder is very serious, the illness does not cause a long-lasting disruption in all aspects of the child’s develop ment. The interaction between emotional availability and ability to portray sadness credibly also warrants further attention. The results suggest that optimal child outcomes are achieved when mothers are available and genuine in their expression of emotion. Further exploration of qualities in the mother that allow her to be genuine in the expression of emotion would be enlightening.

REFERENCES

American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed.. rev.). Washington, DC: Author.

Barnett. M. A. (1987). Empathy and related responses in children. In N. Eisenberg & J. Strayer (Eds.), Empathy and its development (pp. 146-162). Cambridge: Cambridge University Press.

Beck, A. T.. & Steer, R. A. (1987). Beck Depression Inventory-Manual. San Antonio, TX: The Psychological Corporation, Harcourt Brace Jovanovich.

Beck, A. T.. Ward, C. H.. Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for mcasur- ing depression. Archives of General Psychiatry, 4, 53-63.

Billings, A. G., &Moos, R. H. (1985). Children of parents with unipolar depression: A controlled 1-year follow-up. Journal of Abnormal Child Psychology, 14, 149-166.

Bremitz, Z., & Friedman, S. L. (1988). Toddlers’ concentration: Does maternal depression make a difference? Journal of Child Psychology and Psychiatry, 3, 267-279.

Chapman, M.. Zahn-Waxler, C., Cooperman. G., & lannotti, R. (1987). Empathy and responsibility in the motivation of children’s helping. Developmental Psychology, 23, 140-145.

Clark, R., Musick, J. S., Stott, F. M., Klehr, K, & Cohler, B. (1983). Social adjustment among schizophrenic, depressed, and well mothers and their school-aged children. In H. L. Morrison (Ed.), Children of depressedparents @p. 65-98). New York: Grune & Stratton.

Cohn, J. F.. Matias. R., Tronick, E. Z., Connell. D., & Lyons-Ruth, K. (1986). Face to face intaac- tions of depressed mothers and their infants. In E. 2. Tronick & T. Field (Eds.). Maternal depression and infant disturbance. New Directiom in Child Development, 34, 31-46.

Cohn. J. F., & Tronick, E. Z. (1983). Three-month-old infants’reactions to simulated maternal depression. Child Development, 54, 185-193.

Cope, J. F.. & Gotlib, I. H. (1985). Depression andparenthood: An integrative review. Unpublished manuscript, University of Michigan, Ann Arbor.

Dodgc, K. A. (1990). Developmental psychopathology in children of depressed mothers. Journal of Developmental Psychology, 26. 3-7.

Downey, G.. & Cope, J. C. (1990). Children of depressed parents: An integrative review. Psychological BulIetin, 108(1). 50-76.

DUM, L. M., & Durn. L. M . (1981). Peabody Picture Vocabulaty Test- Revised Manual. Circle Pines, MN: American Guidance Service.

Eisenberg, N., & Miller, P. A. (1987). The relation of empathy to prosocial and related behaviors. Psychological Bulletin, 101. 91-1 19.

Eisenberg. N., Schaller, M., Fabu, R. A., Bustamante, D., Mathy, R. M., Shell, R., & Rhoda. K. (1988). Differentiation of personal distress and sympathy in children and adults. Developmental Psychology, 24. 766-77 5 .

Fabes, R. A., Eisenberg. N., I% Miller, P. A. (1990). Maternal correlates of children’s vicarious emotional responsiveness. Developmental Psychology, 26, 639-648.


Field, T. (1984). Early interactions between infants and their postpartum depressed mothers. Infant Behavior and Development, 7, 51 7-522.

Ghodsian, M., Zajicek, E., & Wolkind, S. (1984). A longitudinal study of maternal depression and child behavior problems. Journal of Child Psychology and Psychiatry, 25( 1). 91-109.

Goodman, S. H., & Brumley, H. E. (1990). Schizophrenic and depressed mothers: Relational deficits in parenting. Developmental Psychology. 26, 3 1-39.

Hammen. C.. Adrian, C., Gordon, D.. Burge, D., & Jaenicke, C. (1987). Children of depressed mothers: Maternal strain and symptom predictors of dysfuncfion. Journalof Abnormal Aychology, 96, 190-198.

Hammen. C.. Gordon, D.. Burge, D., Adrian, C.. Jaenicke. C., & Hiroto, D. (1987). Maternal affective disorders. illness, and stress: Risk for children’s psychopathology. American Journal of Psychiatry, 144. 736-741.

Keller, M. B.. & Shapiro, R. (1982). “Double depression”: Superimposition of acute depressive episodes on chronic depressive disorders. American Journal of Psychiatry, 139(4), 438-442.

Kestenbaum, R., Farber, E. A.. & Sroufe, L. A. (1989). Individual differences in empathy among preschoolers: Relation to attachment history. In N. Eisenberg (Ed.), Empathy and related emotional processes. New Directions for Child Development (Vol. 55, pp. 51-64). San Francisco: Jossey-Bass.

Lindahl, K. (1988). Marital andparental correlates of empathy in toddlers. Unpublished master’s thesis, University of Denver, Denver, CO.

Miller, P. A. Eisenberg. N.. Fabes, R., Shell, R., & Gular, S. (1989). Mother’s emotional arousal as a moderator in the socialization of children’s empathy. In N. Eisenberg (Ed.), Empathy and related emotional responses. New Directions for Child Development (Vol. 44, pp. 65-84). San Francisco:

Pound, A., COX. A.. Puckering, C., & Mills, M. (1985). The impact of maternal depression on young children. in J. E. Stevenson (Ed.), Recent research in developmenfal psychopathology (pp. 3-10). Oxford: Pergamon Press.

Young children of affectively ill parents: A longitudinal study of psychosocial development. Journal of the American Academy of Child and Adolescent Psychiatry, 31(1), 68-77.

Radke-Yarrow, M.. & Zahn-Waxler, C. (1991). Research on children of affectively ill parents: Some considerations for theory and research on normal development. Development and Psychopathology, 2, 349-366.

Richman. N.. Stevenson, J., & Graham, P. J. (1982). Pre-schooltoschool: A behavioralstudy. London: Academic Press.

Rolf, J. E., Crowther. J.. Teri. L., & Bond. L. (1984). Contrasting developmental risks in preschool children of psychiatrically hospitalized parents. In N. F. Watt, E. J. Anthony, L. C. Wynne, & J. E. Rolf (Eds.). Children at risk for schizophrenia: A longitudinal perspective @p. 526-534). New York: Cambridge University Press.

Spitzer. R. L., & Endicott, G. (1978). Schedule of Mective dirorders and schizophrenia-llifetime version. New York: New York State Psychiatric Institute, Biometrics Research.

Staub, E. (1971). A child in distress: The importance of nurturance and modeling on children’s attempts to help. Developmental Psychology, 5, 124132.

Terry, G. J., Frankel. K. A., & Harmon. R. J. (1990, October). Emotional availability and depresrion in mothers of preschool children. Presented at the 37th annual American Academy of Child and Adoles- cent Psychiatry meeting. Chicago, IL.

Yarrow, M. R., Scott. P. M., & Wider, C. Z. (1973). Learning concern for others. Developmental Psychology. 8, 240-260.

Zahn-Wider, C.. Cummings, E. M., Iannotti, R. J., & RadkcYarrow. M. (1984). Young offspring of depressed parents: A population at risk for affective problems. In D. Cicchetti & K. Schneider-Rosen (Eds.), Childhood depression. New Duectionr for Child Devefopment (Vol. 26, pp. 81-105). San Fran-

Zahn-Wider. C., Cummings, E. M., McKnew, D.. & Radke-Yarrow, M. (1984). Altruism, aggression and social interactions in young children with a manic-depressive parent. Child Development, 55, 112-122.

Zahn-Waxier, C., Ridgeway, D., Denham, S., Usher, B., & Cole, P. (in press). Pictures of infants’ emotions: A task for assessing mothers’ and young children’s verbal communications about affect. In R. N. Emde, J. D. Osofsky. & P. M. Butterfield (Eds.). The I-FeelPictures-A new instrument for in- terpreting emotions. New York: International Universities Press.

JOSSCY-B~SS.

Radke-Yarrow, M.. Nottleman, E., Martinez. P., Fox, M. B., & Belmont. B. (1992).

cisco: Joss~y-Bass.

preschoolers' response to maternal sadness: relationships with maternal depression and...

Documents