Maternal mental health and children's internalizing and externalizing behaviors: Beyond maternal substance use...

Maternal substance abuse and mental disorders can have adverse impacts on child development. We investigated the impact of maternal mental health on child behaviors based on a long-term follow-up study of mothers and their children approximately 10 years after mothers' admission to drug abuse treatment. Mothers (n=396) were assessed at admission to drug treatment during 2000 to 2002, and at follow-up in 2010-2011. At follow-up, each mother was asked to assess one target child using the Child Behavior Checklist for ages 6-18 (CBCL). Mothers' mental disorder diagnoses were obtained from records maintained by the California Department of Mental Health in 2009. About 46% of mothers had comorbid mental disorders; 27% had depressive disorder, 15% bipolar disorder, 15% adjustment disorder, 13% anxiety disorder, and 6% psychotic disorder. Of these mothers, more than half had two or more mental disorder diagnoses. The average age of the target child was approximately 10 years old (range 6 to 17). Relative to children of mothers without comorbid mental disorders, children were more likely to demonstrate internalizing behaviors if their mothers had comorbid depression/anxiety disorders (OR=2.0, 95%CI:1.0-4.0) or severe mental disorders (psychoses, bipolar) (OR=3.4, 95%CI:1.5-7.6). For externalizing behaviors, family problems was the only significant predictor (OR=3.2, 95%CI:1.7-6.0 for children of mothers with depression/anxiety disorders, OR=3.9, 95%CI:1.9-7.8 for severe mental disorders). Addressing maternal mental disorders (particularly severe mental disorders) and family problems are important for child well-being as these factors were significantly related to emotional and problem behaviors of children.