Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. e792-e800 (doi:10.1542/peds.2005-1841)
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ARTICLE

Maternal Depression and Violence Exposure: Double Jeopardy for Child School Functioning

Michael Silverstein, MD, MPHa, Marilyn Augustyn, MDa, Howard Cabral, PhD, MPHb and Barry Zuckerman, MDa

a Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts
b Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts

OBJECTIVE. The goal was to determine how violence exposure affects the relationship between maternal depression, cognitive ability, and child behavior.

METHODS. A multivariate regression analysis of data for a nationally representative sample of kindergarten students was performed. Maternal depression and violence exposure were measured with standardized parent interviews. Standardized T scores were derived from direct testing of children in reading, mathematics, and general knowledge; child behavior was reported by teachers.

RESULTS. A total of 9360 children had neither maternal depression nor violence exposure, 779 violence only, 1564 depression only, and 380 both. Maternal depression alone was associated with poorer mean T scores for reading, mathematics, and general knowledge. However, this effect was attenuated by nearly 25% for reading and general knowledge with adjustment for violence. Children with concurrent exposure to depression and violence had lower mean T scores for reading, mathematics, and general knowledge, as well as more-concerning behaviors, than did those exposed to either factor alone. Across all outcome measures, boys seemed more affected than girls.

CONCLUSIONS. Violence compounds the effect of maternal depression on school functioning and behavior. Research and intervention planning for children affected by maternal depression should consider violence exposure.

Key Words: maternal depression • violence • school readiness • child development

Abbreviations: ECLS-K—Early Childhood Longitudinal Survey, Kindergarten Cohort • CES-D—Center for Epidemiologic Studies Depression Scale • OR—odds ratio • aOR—adjusted odds ratio • CI—confidence interval

Accepted Apr 10, 2006.