Paternal depression associated with adverse childhood experiences in children: © San4ezz007 - stock.adobe.com
- The study focus: The conversation centers on a study examining the association between paternal depression during the first year of a child's life and subsequent adverse childhood experiences (ACEs) when the child reaches the age of 5.
- Underrecognition of paternal depression: Paternal depression is discussed as a significant concern, with potentially high rates of up to 25%. It is underrecognized and underreported, but its impact on child outcomes, such as parenting difficulties, child behavior, and school performance, is acknowledged.
- ACEs and their lifelong effects: The conversation also highlights ACEs, which include child maltreatment, abuse, neglect, and household dysfunctions like substance abuse and violence at home. It emphasizes the long-lasting effects of ACEs on individuals.
- The unique dataset: The study uses the "Future Families and Child Wellbeing" dataset, which is unique because it intentionally includes unmarried mothers and active involvement of fathers, focusing on an understudied population.
- Preliminary findings and implications: The preliminary findings of the study indicate a robust association between paternal depression in the child's first year of life and later childhood adversity. The absence of the father from the family was a common ACE. The conversation emphasizes the importance of recognizing the role of fathers, engaging with them in pediatric care, advocating for better father-focused interventions, and including fathers in maternal and child health policies.
In the below transcript from a Q&A session with Contemporary Pediatrics®, Kristine H. Schmitz, MD, assistant professor, Rutgers Robert Wood Johnson Medical School New Brunswick, New Jersey, explained her team's recent research on paternal depression and adverse childhood experiences during the 2023 American Academy of Pediatrics National Conference & Exhibition.
Contemporary Pediatrics®: Could you tell us about your study and its subsequent findings?
Kristine H. Schmitz, MD: The study that I did was looking at [the] association of [paternal] depression in the first year of life, or what we call the postpartum period, and subsequent adverse childhood experiences or ACEs when the child was 5. Before we start talking about our results, I just want to quickly talk a little bit about [the] background because I'm not sure what everybody's baseline knowledge of [paternal] depression is.
But there are varying rates, but it can be as high as 25%. We recognize that it's very under-recognized and often underreported. But we also know that it has lots of downstream effects on child outcomes, including things like difficulties with parenting, difficulties with child behavior, as well as school performance, which is part of what motivated us to study.
Additionally, ACEs also have long lifelong effects. And those include, when we talk about ACEs, we're talking about things like child maltreatment, abuse or neglect, as well as household dysfunctions, things like exposure to substance abuse, or violence at home, for instance. And the data set that we use for this study was the Future Families and Child Wellbeing study, which is also pretty unique, and I wanted to highlight that point. It's a US birth cohort study that interviewed mothers and fathers at the child's birth and then followed them for years and got really robust information.
But what really makes it unique is that 75% of the moms are unmarried, and that was intentional. And we know that about 40% of children come from families of parents who are unmarried. We also know this from other earlier studies of this dataset that fathers, even if they're not married or cohabiting with their kids, are still actively involved. So it's important as a pediatrician because a lot of patients I see are in this situation and it's a really under studied population, and particularly thinking about things that affect fathers are often forgotten.
So, moving on to our study. We were looking at [paternal] depression in the first year of life, and then the subsequent ACEs, excluding father's mental health as an ACE, at the time when the child was going into kindergarten or 5 years old. We found that children had 2 times greater odds of having 3 or more ACEs by the time they were 5 [years old]. And of those ACEs, the most common was actually dad's absence from the family. So, remembering kind of our important population that's under-recognized, this might be a risk factor for those feelings dissolving. This remained true even when we accounted for maternal postpartum depression, as well as other sociodemographic factors.
So, what do we make of these findings? The first thing I want to point out is these are preliminary findings. And so we can't make broad-based conclusions. But we can as pediatricians reflect on what this means. We found this robust association between later adversity in childhood if dad had early depression.
And we know that dads play a critical role in the family. I know and I can't speak for all the pediatricians here at the [American Academy of Pediatrics], but we realize we have a really unique position with families, and we should capitalize on that opportunity to engage just like we do with mothers around postpartum depression, with fathers. And hopefully, by doing that we'll reduce hardships for children and families down the road. In addition to that, we have an opportunity to advocate from a policy level to really include dads more explicitly in maternal and child health policy and advocate for better father-focused interventions, and better father-focused research.
Reichman NE, Schmitz KH, Jimenez ME, Corman H, Noonan K. P3B305: Paternal Postpartum Depression and Children’s Adverse Childhood Experiences at Age 5. Poster. Presented at: 2023 American Academy of Pediatrics National Conference & Exhibition.