Intergenerational transmission and continuity of stress and depression: depressed women and their offspring in 20 years of follow-up.

BACKGROUND Children of depressed mothers not only have higher risk of depression, but also may experience both elevated and continuing exposure to stressful experiences. The study tested hypotheses of the intergenerational transmission of stress and depression and examined the role of early childhood adversity and maternal depression in the interplay between youth depression and stress over 20 years. METHOD In a longitudinal community study of 705 families selected for history or absence of maternal depression, mothers and youth were studied from pregnancy to age 5 years and at youth ages 15 and 20 years. Youth and maternal depression were assessed with diagnostic interviews, acute and chronic interview-based stress assessment in the youth and contemporaneous measures of childhood adversity obtained between pregnancy and youth age 5 years. RESULTS Regression analyses indicated evidence of intergenerational transmission and continuity of depression over time, continuity of acute and chronic stress and reciprocal predictive associations between depression and stress. Maternal depression and exposure to adversities by child's age 5 years contributed to the youth's continuing experiences of depression and stress. An overall path model was consistent with stress continuity and intergenerational transmission and highlighted the mediating role of age 15 youth chronic interpersonal stress. CONCLUSIONS Youth of depressed mothers are at risk not only for depression but also for continuing experiences of acute and chronic stress from childhood to age 20. The associations among depression and stress are bidirectional and portend continuing experiences of depression and further stress.