Paternal Depression and Child Development Paternal Postnatal Depression and Child Development at Age 7 Years in a UK-Birth Cohort: The Mediating Roles of Paternal Parenting Confidence, Warmth, and Conflict

Iryna Culpin^1,2*Rebecca M Pearson^2,3,4Nicky Wright^3,5Alan Stein^6,7Marc H. Bornstein⁸Hening Tiemeier^10,9Eivor Fredriksen¹¹Jonathan Evans²Tina Miller¹²Esther Dermott¹³Jon Heron^2,4Hannah M Sallis^2,4Gemma Hammerton^2,4

• ¹Department of Child and Family Health, Department of Midwifery, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
• ²Centre for Academic Mental Health, University of Bristol Medical School, Bristol, United Kingdom
• ³Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
• ⁴Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
• ⁵Department of Psychology, University of Leeds, Leeds, United Kingdom
• ⁶Department of Psychiatry, University of Oxford, Oxford, United Kingdom
• ⁷School of Public Health, University of the Witwatersrand Johannesburg, Johannesburg, South Africa
• ⁸National Institute of Child Health and Human Development, Rockville, United States
• ⁹Department of Child and Adolescent Psychiatry, Erasmus MC, Rotterdam, Netherlands
• ¹⁰Department of Social and Behavioral Science, Harvard T H Chan School of Public Health, Boston, United States
• ¹¹Department of Psychology, Universitetet i Oslo, Oslo, Norway
• ¹²School of Social Sciences, Oxford Brookes University, Oxford, United Kingdom
• ¹³School for Policy Studies, University of Bristol, Bristol, United Kingdom

Introduction: Paternal postnatal depression (PND) and its likely adverse impact on child development are receiving increased attention. However, research that examines processes transmitting risks of paternal PND to adverse child outcomes remains limited. Methods: This study examines pathways from paternal PND (Edinburgh Postnatal Depression Scale; 8 months) to child emotional and behavioral development (Strengths and Difficulties Questionnaire; 7 years) through paternal parenting confidence, warmth, and father-child conflict (birth-4 years) in a UK-based birth cohort, the Avon Longitudinal Study of Parents and Children (N=9,628). Analyses were adjusted for socioeconomic, familial, parental, and child characteristics, including maternal PND during early postnatal period. Results: Adjusted models revealed evidence of total associations between paternal PND, child emotional symptoms, peer problems, and hyperactivity (albeit with wide 95% CIs), but not conduct problems. Indirect effects emerged from paternal PND to child emotional symptoms, hyperactivity, and peer problems through the combination of all paternal parenting factors, with no evidence of direct effects. Specificity analyses revealed indirect effects through paternal parenting confidence and father-child conflict in the associations between paternal PND and child emotional symptoms, hyperactivity, and peer problems (albeit with wide 95% CIs). Conclusions: Targeted intervention to increase paternal parenting confidence and decrease father-child conflict may improve outcomes in children whose fathers experience postnatal depression. Keywords: ALSPAC; population-based study; paternal postnatal depression; child development; father-child conflict and warmth; paternal parenting confidence.