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fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Languages: English
Types: Doctoral thesis
Subjects: R1
Background: There is evidence to suggest that maternal depression is associated with suicide-related behaviour in offspring; however pathways contributing to risk remain unclear. The aim of this thesis was to investigate mechanisms of the association between maternal depression and offspring suicidal ideation and attempt in a general population sample.\ud Methods: Data were utilised from a population-based birth cohort, the Avon Longitudinal Study of Parents and Children. Maternal depression symptoms were assessed on 10 occasions from pregnancy to child age 11 years. Offspring suicide-related behaviour was assessed at age 16 years. Latent class growth analysis was used to derive trajectories of maternal depression symptoms. Pathways mediating risk between maternal depression and offspring suicide-related behaviour were then examined using structural equation modelling.\ud Results: Five distinct classes of maternal depression symptoms were identified (minimal, mild, increasing, sub-threshold, chronic-severe). Compared to offspring of mothers with minimal symptoms, the greatest risk of suicidal ideation was found for offspring of mothers with chronic-severe symptoms [OR 3.04 (95% CI 2.19, 4.21)], with evidence for smaller increases in risk for offspring of mothers with sub-threshold, increasing and mild symptoms. The pattern of findings was similar when examining risk for offspring suicide attempt. The majority of the association between maternal chronic-severe depression and offspring suicidal ideation was explained through maternal suicide attempt and offspring psychopathology. However, there was also evidence for indirect effects via both the parent-child relationship and peer victimisation.\ud Conclusion: Findings from this thesis highlight that risk for suicide-related behaviour should be considered in offspring of mothers with sustained depression symptoms, even when symptoms are below clinical levels. Suicide prevention efforts in offspring of depressed mothers should be targeted at offspring with psychopathology and offspring whose mothers have made a suicide attempt. Interventions aimed at improving the parent-child relationship, or reducing peer victimisation may also be beneficial.
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    • 2.4.4: Offspring psychiatric disorder and symptoms.............................................................. 48
    • 2.4.5: Potential confounders ................................................................................................... 48
    • 2.5.1: Latent Class Growth Analysis ...................................................................................... 49
    • 2.5.2: Structural Equation Modelling and mediation analyses ............................................... 51
    • Chapter 3: Derivation of maternal depression symptom trajectories and association with subsequent offspring suicide-related behaviour ..................................................................... 55
    • 3.3.3: Statistical analyses........................................................................................................ 59
    • 3.4.1: Latent classes of maternal depression symptoms ......................................................... 60
    • 3.4.2: Validation of latent classes of maternal depression symptoms .................................... 63
    • 3.4.3: Prevalence of offspring suicide-related behaviour ....................................................... 65 4.4.1: Descriptive data for maternal depression, offspring psychopathology and offspring suicidal ideation........................................................................................................................... 86 4.4.2: Associations between maternal depression, offspring psychopathology and offspring suicidal ideation........................................................................................................................... 87
    • 4.4.3: Mediation of effect of maternal depression on offspring suicidal ideation .................. 90
    • 4.4.4: Mediation of effect of maternal depression on offspring lifetime suicide attempt....... 96 Brent, D. A., Oquendo, M., Birmaher, B., Greenhill, L., Kolko, D., Stanley, B., Zelazny, J., Brodsky, B., Melhem, N., Ellis, S. P., & Mann, J. J. (2004). Familial transmission of mood disorders: convergence and divergence with transmission of suicidal behavior. Journal of the American Academy of Child and Adolescent Psychiatry, 43(10), 1259-1266.
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