Maternal Depression and Parenting in Relation to Child Internalizing Symptoms and Asthma Disease Activity

This study tested a hypothesized model of the relationship between maternal depression and child psychological and physical dysfunction mediated by parenting and medication adherence. A sample of 242 children with asthma, aged 7 to 17, participated with their mothers. Maternal depression was assessed by self-report, and parenting was observed during family interaction tasks. Internalizing symptoms were assessed by self- and clinician reports. Asthma disease activity was assessed according to National Heart Lung and Blood Institute guidelines, and medication adherence was evaluated with a 24-hr recall method. Structural equation modeling indicated that negative parenting partially mediated the relationship between maternal depression and child internalizing symptoms. Child internalizing symptoms, in turn, mediated the associations between both maternal depression and negative parenting and asthma disease activity. Medication adherence did not mediate the link from maternal depression to disease activity. Thus, maternal depression was linked to child psychological dysfunction both directly and indirectly via negative parenting but linked to physical dysfunction only indirectly through psychological dysfunction. These findings suggest that diagnosing and treating depression in mothers of children with asthma would enhance child well-being both psychologically and physically.