Análise de Estudos Sobre Suporte Social e Filhos de Mães Deprimidas: Uma Revisão Sistemática

Loureiro, Sonia Regina; Silva, Ana Paula Casagrande

doi:10.1590/S1413-294X2013000200010

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Systematic Literature Review • Paidéia (Ribeirão Preto) 24 (59) • Dez 2014 • https://doi.org/10.1590/S1413-294X2013000200010 copiar

Análise de Estudos Sobre Suporte Social e Filhos de Mães Deprimidas: Uma Revisão Sistemática

Autoria SCIMAGO INSTITUTIONS RANKINGS

Reconhecer condições que minimizem o impacto da depressão materna para as crianças tem relevância clínica. Objetivou-se analisar estudos empíricos recentes que investigaram as associações da depressão materna a condições de suporte social. Procedeu-se a revisão sistemática de artigos indexados no período de 2007 a 2014 nas bases de dados MEDLINE, PubMed, PsycINFO, Web of Science, LILACS e SciELO, utilizando-se as palavras-chave: maternal depression, social support e child behavior. Foram incluídos e analisados 27 artigos. Os estudos analisados incluíram uma ampla diversidade de condições de risco e de fontes de suporte social, e nos modelos preditivos utilizados, constatou-se que menos risco contextual, mais recursos parentais e suporte social foram preditores de menos problemas para as crianças. O suporte social atenuou o impacto da depressão maternal para os desfechos das crianças, o que tem implicações para o planejamento de programas de prevenção e intervenção.

depressão; mães; psicologia da criança; fatores psicossociais; revisão de literatura

Contextual Risk Factors	Social Support
	Environmental, Family, and Neighborhood Resources	Parental Resources
Maternal Clinical Conditions (n = 16)	2, 3, 5, 6, 12, 14, 15, 16, 17, 20, 23, 24	1, 6, 12, 18, 21, 22
Low Socioeconomic Status (n = 14)	2, 4, 5, 6, 10, 12, 13, 14, 15, 16, 17, 18, 20	6, 10, 11, 12, 16
Negative Parental Practices (n = 12)	5, 9, 10, 13, 15, 18, 20, 25	7, 8, 9, 10, 18, 21, 26
Family Conflicts (n = 10)	4, 5, 6, 15, 17, 18, 19, 20, 22, 23	6, 18
Low Maternal Educational Level (n = 8)	2, 4, 5, 6, 13, 16, 20	6, 18
One-Parent Family (n = 6)	4, 13, 15	1, 11, 18
High-Risk Neighborhood (n = 3)	16, 27	7

Note. 1 = Allen‐Meares et al. (2010); 2 = Anhalt et al. (2007)Anhalt, K., Telzrow, C. F., & Brown, C. L. (2007). Maternal stress and emotional status during the perinatal period and childhood adjustment. School Psychology Quarterly, 22(1), 74-90. doi:10.1037/1045-3830.22.1.74; 3 = Ashman et al. (2008)Ashman, S. B., Dawson, G., & Panagiotides, H. (2008). Trajectories of maternal depression over 7 years: Relations with child psychophysiology and behavior and role of contextual risks. Development and Psychopathology, 20(1), 55-77. doi:10.1017/S0954579408000035; 4 = Barker et al. (2012)Barker, E. D., Copeland, W., Maughan, B., Jaffee S. R., & Uher, R. (2012). Relative impact of maternal depression and associated risk factors on offspring psychopathology. The British Journal of Psychiatry, 200(2), 124-129. doi:10.1192/bjp.bp.111.092346; 5 = Barker e Maughan (2009)Barker, E. D., & Maughan, B. (2009). Differentiating early-onset persistent versus childhood-limited conduct problem youth. The American Journal of Psychiatry, 166(8), 900-908. doi:10.1176/appi.ajp.2009.08121770; 6 = Campbell et al. (2007)Campbell, S. B., Matestic, P., von Stauffenberg, C., Mohan, R., & Kirchner, T. (2007). Trajectories of maternal depressive symptoms, maternal sensitivity, and children’s functioning at school entry. Developmental Psychology, 43(5), 1202-1215. doi:10.1037/0012-1649.43.5.1202; 7 = Criss et al. (2009)Criss, M. M., Shaw, D. S., Moilanen, K. L., Hitchings, J. E., & Ingoldsby, E. M. (2009). Family, neighborhood, and peer characteristics as predictors of child adjustment: A longitudinal analysis of additive and mediation models. Social Development, 18(3), 511-535. doi:10.1111/j.1467-9507.2008.00520.x; 8 = Foster et al. (2008)Foster, C. E., Webster, M. C., Weissman, M. M., Pilowsky, D. J., Wickramaratne, P. J., Talati, A., … King, C. A. (2008). Remission of maternal depression: Relations to family functioning and youth internalizing and externalizing symptoms. Journal of Clinical Child & Adolescent Psychology, 37(4), 714-724. doi:10.1080/15374410802359726; 9 = Gerkensmeyer, Perkins, Scott, et al. (2008); 10 = Gerkensmeyer, Perkins, Day, et al. (2011); 11 = Goosby (2007)Goosby, B. J. (2007). Poverty duration, maternal psychological resources, and adolescent socioemotional outcomes. Journal of Family Issues, 28(8), 1113-1134. doi:10.1177/0192513X07300712; 12 = Gross et al. (2009)Gross, H. E., Shaw, D. S., Burwell, R. A., & Nagin, D. S. (2009). Transactional processes in child disruptive behavior and maternal depression: A longitudinal study from early childhood to adolescence. Development and Psychopathology, 21(1), 139-156. doi:10.1017/S0954579409000091; 13 = Hart et al. (2008)Hart, D., Atkins, R., & Matsuba, M. K. (2008). The association of neighborhood poverty with personality change in childhood. Journal of Personality and Social Psychology, 94(6), 1048-1061. doi:10.1037/0022-3514.94.6.1048; 14 = Karevold et al. (2009)Karevold, E., Roysamb, E., Ystrom, E., & Mathiesen, K. S. (2009). Predictors and pathways from infancy to symptoms of anxiety and depression in early adolescence. Developmental Psychology, 45(4), 1051-1060. doi:10.1037/a0016123; 15 = Lau et al. (2007)Lau, J. Y. F., Rijsdijk, F., Gregory, A. M., McGuffin, P., & Eley, T. C. (2007). Pathways to childhood depressive symptoms: The role of social, cognitive, and genetic risk factors. Developmental Psychology, 43(6), 1402-1414. doi:10.1037/0012-1649.43.6.1402; 16 = Lengua et al. (2008)Lengua, L. J., Bush, N. R., Long, A. C., Kovacs, E. A., & Trancik, A. M. (2008). Effortful control as a moderator of the relation between contextual risk factors and growth in adjustment problems. Development and Psychopathology, 20(2), 509-528. doi:10.1017/S0954579408000254; 17 = Mickelson e Demmings (2009)Mickelson, K. D., & Demmings, J. L. (2009). The impact of support network substitution on low-income women’s health: Are minor children beneficial substitutes? Social Science & Medicine, 68(1), 80-88. doi:10.1016/j.socscimed.2008.09.057; 18 = Piché et al. (2011)Piché, G., Bergeron, L., Cyr, M., & Berthiaume, C. (2011). Interaction effects between maternal lifetime depressive/anxiety disorders and correlates of children’s externalizing symptoms. Journal of Child and Family Studies, 20(5), 596-604. doi:10.1007/s10826-010-9433-0; 19 = Rhodes e Iwashyna (2007)Rhodes, K. V., & Iwashyna, T. J. (2007). Child injury risks are close to home: Parent psychosocial factors associated with child safety. Maternal and Child Health Journal, 11(3), 269-275. doi:10.1007/s10995-006-0171-2; 20 = Fatori et al. (2013)Fatori, D., Bordin, I. A., Curto, B. M., & de Paula, C. S. (2013). Influence of psychosocial risk factors on the trajectory of mental health problems from childhood to adolescence: A longitudinal study. BMC Psychiatry, 13, 31. doi:10.1186/1471-244X-13-31; 21 = Wang et al. (2013)Wang, F., Christ, S. L., Milss-Koonce, W. R., Garrett-Peters, P., & Cox, M. J. (2013). Association between maternal sensitivity and externalizing behavior from preschool to preadolescence. Journal of Applied Developmental Psychology, 34(2), 89-100. doi:10.1016/j.appdev.2012.11.003; 22 = Parent et al. (2013)Parent, J., Jones, D. J., Forehand, R., Cuellar, J., & Shoulberg, E. K. (2013). The role of coparents in African American single-mother families: The indirect effect of coparent identity on youth psychosocial adjustment. Journal of Family Psychology, 27(2), 252-262. doi:10.1037/a0031477; 23 = Zanca et al. (2013)Zanca, C. G., Pizeta, F. A., Osório, F. L., & Loureiro, S. R. (2013). Percepção do apoio social de famílias que convivem com a depressão materna. Estudos de Psicologia (Natal), 18(2), 249-257. doi:10.1590/S1413-294X2013000200010; 24 = Boyd e Tervo-Clemmens (2013)Boyd, R. C., & Tervo-Clemmens, B. (2013). Exploring maternal and child effects of comorbid anxiety disorders among African American mothers with depression. Journal of Depression & Anxiety, 2(129), 1000129. doi:10.4172/2167-1044.1000129; 25 = Heberle et al. (2014)Heberle, A. E., Krill, S. C., Briggs-Gowan, M. J., & Carter, A. S. (2014). Predicting externalizing and internalizing behavior in kindergarten: Examining the buffering role of early social support. Journal of Clinical Child & Adolescent Psychology. doi:10.1080/15374416.2014.886254; 26 = Dubois-Comtois et al. (2013)Dubois-Comtois, K., Moss, E., Cyr, C., & Pascuzzo, K. (2013). Behavior problems in middle childhood: The predictive role of maternal distress, child attachment, and mother-child interactions. Journal of Abnormal Child Psychology, 41(8), 1311-1324. doi:10.1007/s10802-013-9764-6; 27 = Brown et al. (2013)Brown, J., Barbarin, O., & Scott, K. (2013). Socioemotional trajectories in black boys between kindergarten and the fifth grade: The role of cognitive skills and family in promoting resiliency. American Journal of Orthopsychiatry, 83(2-3), 176-184. doi:10.1111/ajop.12027.

Study	Major Outcomes

	Significant Associations Between Social Support and Risks for Children
9	Present h Social support i Parental depression i Behavioral problems
10	Present h Social support i Maternal depression i Behavioral problems
17	Present h Social support i Child depression
18	Absent
19	Present h Social support i Home insecurity i Children at risk of accidents h Social support i Marital conflicts i Children at risk of accidents
22	Present h Social support i Behavioral problems
23	Present h Social support i Behavioral problems h Social support i Chronic adversity i Behavioral problems
24	Present h Social support i Maternal comorbid anxiety disorders i Behavioral problems

Study	Major Outcomes

	Significant Associations Between Social Support and Risks for Children
2	Present h Social support (1 month old) i E (6/7 years old) i Stressor events (1 month old) i I (6/7 years old)
4	Present h Social support i E i I
6	Present Severe/chronic MD trajectory h Social support (1 month old to 7 years old) i E (7 years old)
8	Present MD remission post-treatment h Social support i I i Conflicting stressors i I
20	Absent

Study	Major Outcomes

	Social Supports that Predict Outcomes in Children

1	Present – Behavior h Father involvement i I i Lower academic performance h Social skills i Risk behavior
3	Present – Behavior i Family contextual risk i E ♂ i I ♀
5	Present – Behavior i Stressors i Persistent behavioral issues in childhood and adolescence ♂ h Social support for mothers i Persistent behavioral issues in children and adolescents ♀
7	Present – Psychopathology High-risk neighborhood h Social support i Antisocial behaviors in adolescents ♂
11	Present – Behavior and Psychopathology Continuous exposure to poverty h Parental resources (i.e., perception of mother’s control) i Behavioral Problems i Depression and anxiety in adolescence
12	Present – Behavior and Psychopathology Mild MD trajectory i E i Delinquency in adolescence ♂
13	Present – Behavior Low poverty neighborhood i Behavioral problems over 2 years old h Maternal educational level h Social support i Unstable personality profiles
14	Present – Behavior and Psychopathology i Family adversity i Child depression h Social support for mothers of timid ♀ i I
15	Present – Psychopathology i Negative locus of control i Punitive parental discipline i Children with depressive symptoms i Negative locus of control i Negative events i Children with depressive symptoms
16	Present – Behavior h Children’s self-control i Maternal risk i I h Children’s self-control i Environmental risk i I i E
21	Present – Behavior h Maternal harshness h E
25	Present – Behavior h Informal social support i Maternal psychological distress i Suboptimal parenting behavior i I
26	Present – Behavior i Maternal psychosocial distress and controlling attachment patterns i I i E i Maternal psychosocial distress h Quality of mother-child interactions i I i E
27	Absent – Behavior

Note. h = More; i = Less; E = Externalizing; I = Internalizing; MD = Maternal Depression; 1 = Allen‐Meares et al. (2010); 3 = Ashman et al. (2008)Ashman, S. B., Dawson, G., & Panagiotides, H. (2008). Trajectories of maternal depression over 7 years: Relations with child psychophysiology and behavior and role of contextual risks. Development and Psychopathology, 20(1), 55-77. doi:10.1017/S0954579408000035; 5 = Barker e Maughan (2009)Barker, E. D., & Maughan, B. (2009). Differentiating early-onset persistent versus childhood-limited conduct problem youth. The American Journal of Psychiatry, 166(8), 900-908. doi:10.1176/appi.ajp.2009.08121770; 7 = Criss et al. (2009)Criss, M. M., Shaw, D. S., Moilanen, K. L., Hitchings, J. E., & Ingoldsby, E. M. (2009). Family, neighborhood, and peer characteristics as predictors of child adjustment: A longitudinal analysis of additive and mediation models. Social Development, 18(3), 511-535. doi:10.1111/j.1467-9507.2008.00520.x; 11 = Goosby (2007)Goosby, B. J. (2007). Poverty duration, maternal psychological resources, and adolescent socioemotional outcomes. Journal of Family Issues, 28(8), 1113-1134. doi:10.1177/0192513X07300712; 12 = Gross et al. (2009)Gross, H. E., Shaw, D. S., Burwell, R. A., & Nagin, D. S. (2009). Transactional processes in child disruptive behavior and maternal depression: A longitudinal study from early childhood to adolescence. Development and Psychopathology, 21(1), 139-156. doi:10.1017/S0954579409000091; 13 = Hart et al. (2008)Hart, D., Atkins, R., & Matsuba, M. K. (2008). The association of neighborhood poverty with personality change in childhood. Journal of Personality and Social Psychology, 94(6), 1048-1061. doi:10.1037/0022-3514.94.6.1048; 14 = Karevold et al. (2009)Karevold, E., Roysamb, E., Ystrom, E., & Mathiesen, K. S. (2009). Predictors and pathways from infancy to symptoms of anxiety and depression in early adolescence. Developmental Psychology, 45(4), 1051-1060. doi:10.1037/a0016123; 15 = Lau et al. (2007)Lau, J. Y. F., Rijsdijk, F., Gregory, A. M., McGuffin, P., & Eley, T. C. (2007). Pathways to childhood depressive symptoms: The role of social, cognitive, and genetic risk factors. Developmental Psychology, 43(6), 1402-1414. doi:10.1037/0012-1649.43.6.1402; 16 = Lengua et al. (2008)Lengua, L. J., Bush, N. R., Long, A. C., Kovacs, E. A., & Trancik, A. M. (2008). Effortful control as a moderator of the relation between contextual risk factors and growth in adjustment problems. Development and Psychopathology, 20(2), 509-528. doi:10.1017/S0954579408000254; 21 = Wang et al. (2013)Wang, F., Christ, S. L., Milss-Koonce, W. R., Garrett-Peters, P., & Cox, M. J. (2013). Association between maternal sensitivity and externalizing behavior from preschool to preadolescence. Journal of Applied Developmental Psychology, 34(2), 89-100. doi:10.1016/j.appdev.2012.11.003; 25 = Heberle et al. (2014)Heberle, A. E., Krill, S. C., Briggs-Gowan, M. J., & Carter, A. S. (2014). Predicting externalizing and internalizing behavior in kindergarten: Examining the buffering role of early social support. Journal of Clinical Child & Adolescent Psychology. doi:10.1080/15374416.2014.886254; 26 = Dubois-Comtois et al. (2013)Dubois-Comtois, K., Moss, E., Cyr, C., & Pascuzzo, K. (2013). Behavior problems in middle childhood: The predictive role of maternal distress, child attachment, and mother-child interactions. Journal of Abnormal Child Psychology, 41(8), 1311-1324. doi:10.1007/s10802-013-9764-6; 27 = Brown et al. (2013)Brown, J., Barbarin, O., & Scott, K. (2013). Socioemotional trajectories in black boys between kindergarten and the fifth grade: The role of cognitive skills and family in promoting resiliency. American Journal of Orthopsychiatry, 83(2-3), 176-184. doi:10.1111/ajop.12027.

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E-mail: paideia@usp.br

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[1] Correspondence address: Ana Paula Casagrande Silva. Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Avenida Tenente Catão Roxo, 2650. Vila Monte Alegre. CEP 14051-140. Ribeirão Preto-SP, Brazil. E-mail: anapaulacasagrande@usp.br