Antenatal anxiety, parenting and behavioural/emotional problems in children

J. Barlow

Health Services Research Unit, Department of Public Health, University of Oxford, Institute of Health Sciences, Old Road, Headington OX3 7LF, UK

O'Connor et al (2002) report the effects of antenatal anxiety on behavioural/emotional problems in 4-year-old children. Their analysis of the Avon Longitudinal Study of Parents and Children (ALSPAC), a longitudinal, prospective study of women, their partners and an index child (Golding et al, 2001) takes into account a number of important covariates, including postnatal anxiety, gestational age, birth weight, and socio-economic status. They have not, however, included any measures of parenting. This is of concern because there is now a substantial body of evidence to indicate a clear association between parenting and child emotional and behavioural problems. For example, there are now a number of empirically validated models depicting the developmental progression for conduct and behaviour problems. These show a clear association between parenting practices characterised by harsh and inconsistent discipline, little positive parental involvement with the child, poor monitoring and supervision, and behaviour and conduct problems in early childhood (Patterson et al, 1989). Indeed, work using structural equation models showed that parenting and family interaction variables accounted for 30-40% of the variance in child antisocial behaviour (Patterson et al, 1989).

It seems likely that parenting practices would not be adequately controlled for through the use of a socio-economic covariate owing to the fact that, although parenting practices are influenced by social and cultural factors such as class (Hoff et al, 2002), one of the most extensive epidemiological studies of childhood psychiatric disorders showed that social class was a poor predictor of child adjustment (Rutter et al, 1975).

It seems likely that parenting exerts an independent effect on child outcomes such as emotional and behavioural adjustment. The ALSPAC data contain a number of measures of parenting, including, for example, a standardised instrument measuring parenting practices during toddlerhood. It would be useful if further analysis of this data-set were undertaken to establish whether these important findings are maintained when parenting is included in the model.

EDITED BY KHALIDA ISMAIL

REFERENCES

Golding, J., Pembrey, M., Jones, R., et al (2001) ALSPAC — The Avon Longitudinal Study of Parents and Children. 1. Study methodology. Paediatric and Perinatal Epidemiology, 15, 74-87.[CrossRef][Medline]

Hoff, E., Laursen, B. & Tardif, T. (2002) Socioeconomic status and parenting. In Handbook of Parenting: Vol. 2: Biology and Ecology of Parenting (2nd edn) (ed. M. H. Bornstein), pp. 231-252. Rahwah, NJ: Lawrence Erlbaum.

McLoyd, V. C. & Glanagan, C. A. (1990) Economic stress: effects on family life and child development. New Directions in Child Development, 46, 71-86.

O'Connor, T. G., Heron, J., Golding, J., et al (2002) Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and Children. British Journal of Psychiatry, 180, 502-508.[Abstract/Free Full Text]

Patterson, G. R., DeBaryshe, D. & Ramsey, E. (1989) A developmental perspective on antisocial behavior. American Psychologist, 44, 329-335.[CrossRef][Medline]

Rutter, M., Cox, A., Templing, C., et al (1975) Attainment and adjustment in two geographical areas. 1. The prevalence of psychiatric disorders. British Journal of Psychiatry, 126, 493-509.[Medline]


 

Author's reply

T. G. O'Connor

Departments of Child & Adolescent Psychiatry and Social, Genetic and Developmental Psychiatry, Institute of Psychiatry, Box number PO 80, 111 Denmark Hill, London SE5 8AF, UK

EDITED BY KHALIDA ISMAIL

A recent study from our group indicated that antenatal anxiety is associated with a significantly increased risk of behavioural/emotional problems in young children (O'Connor et al, 2002). The study was based on the ALSPAC cohort, a prospective, longitudinal study of women followed since pregnancy. Analyses indicated that antenatal anxiety at 32 weeks' gestation was associated with an approximately 2-fold increase in behavioural/emotional problems in boys and girls at age 4 years; these associations were observed after accounting for key antenatal, obstetric and psychosocial risks, and postnatal anxiety and depression. The findings are important in providing the strongest evidence to date that the substantial evidence for long-term effects of antenatal stress/anxiety found in numerous animal investigations (e.g. Schneider & Moore, 2000) may extend to humans.

In our paper, the focus was on whether or not the antenatal environment had a role in the development of behavioural/emotional problems, an issue with substantial implications for our understanding of development, as well as for prevention and public health. Dr Barlow's letter helps draw attention to a separate research base linking behavioural/emotional problems in children with postnatal factors, particularly parent—child relationship quality. Although there remain some controversial matters in that field of research, especially concerning causal mechanisms (see O'Connor, 2002), parent—child relationship quality is certainly a robust predictor of children's psychological development. Given the multiple-risk nature of development and psychopathology, we would agree with Dr Barlow that there is a need to bring together findings from different lines of research and to revise our models and theories that consider multiple levels of risk. Indeed, there are a number of directions for this research to pursue, including the consideration of how postnatal experiences such as parent—child relationship quality moderate the effects of antenatal anxiety/stress and how the role of genetic factors may explain individual differences in response to antenatal anxiety/stress. Research along these lines is underway. Because it has tracked women intensively since pregnancy and has continued to collect information on a wide range of biological and psychosocial variables, the ALSPAC study is an especially important resource for studies of this kind.

REFERENCES

O'Connor, T. G. (2002) Annotation: The ‘effects’ of parenting reconsidered: findings, challenges, and applications. Journal of Child Psychology and Psychiatry, 43, 555-572.[CrossRef]

O'Connor, T. G., Heron, J., Golding, J., et al (2002) Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and Children. British Journal of Psychiatry, 180, 502-515.[Abstract/Free Full Text]

Schneider, M. L. & Moore, C. F. (2000) Effect of antenatal stress on development: a nonhuman primate model. In Minnesota Symposium on Child Psychology (ed. C. Nelson), pp. 201-243. Rahwah, NJ: Lawrence Erlbaum.





This Article
Submit a response
Alert me when this article is cited
Alert me when eLetters are posted
Alert me if a correction is posted
Services
Email this article to a friend
Similar articles in this journal
Similar articles in PubMed
Alert me to new issues of the journal
Download to citation manager
Google Scholar
Articles by Barlow, J.
Articles by O'Connor, T. G.
Articles citing this Article
PubMed
PubMed Citation
Articles by Barlow, J.
Articles by O'Connor, T. G.


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Psychiatric Bulletin Advances in Psychiatric Treatment All RCPsych Journals