Prenatal maternal mood instability and child externalizing problems: An ecological momentary assessment study

This study examines whether exposure to affect fluctuations during fetal development have implications for child psychopathology. To evaluate maternal mood instability, participants (N = 154) completed Ecological Momentary Assessment (EMA) eight times per day across three days at 15-, 25-, and 35-weeks' gestation, and then at two months postpartum. The EMA measured depressive symptoms (Center for Epidemiologic Studies Depression Scale), anxiety (Profile of Mood States), and stress (Perceived Stress Scale). Mood instability was quantified by calculating root mean square of successive differences (RMSSD), which captures both variability and temporal dependency of mood states. When the children were 3 years old, mothers reported on their child's externalizing symptoms with the Child Behavior Checklist (CBCL) and then again at 4.5 years with the Strengths and Difficulties Questionnaire (SDQ). Bivariate correlations indicated a positive association between prenatal mood instability and child externalizing problems at both ages (r = 0.34, r = 0.29, respectively; all p < .05). Sensitivity analyses indicated that mood instability was predictive of child externalizing problems, even after consideration of potential confounding factors, including prenatal and postnatal negative mood level as well as postnatal mood instability. Examination of maternal mood instability, in addition to mood level, provides additional and unique information regarding how maternal mental health affects child psychopathology and underscores the developmental importance of patterns of parental signals even in the very earliest stages of neurodevelopment.