Institutional members access full text with Ovid®

Share this article on:

Pathways from Maternal Distress and Child Problem Behavior to Adolescent Depressive Symptoms: A Prospective Examination from Early Childhood to Adolescence

Nilsen, Wendy PhD*; Gustavson, Kristin PhD*; Røysamb, Espen PhD*,†; Kjeldsen, Anne PhD*; Karevold, Evalill PhD*

Journal of Developmental & Behavioral Pediatrics: June 2013 - Volume 34 - Issue 5 - p 303–313
doi: 10.1097/DBP.0b013e318293ab05
Original Articles

Objective: The main aim of this study was to identify the pathways from maternal distress and child problem behaviors (i.e., internalizing and externalizing problems) across childhood and their impact on depressive symptoms during adolescence among girls and boys.

Method: Data from families of 921 Norwegian children in a 15-year longitudinal community sample were used. Using structural equation modeling, the authors explored the interplay between maternal-reported distress and child problem behaviors measured at 5 time points from early (ages 1.5, 2.5, and 4.5 years) and middle (age 8.5 years) childhood to early adolescence (age 12.5 years), and their prediction of self-reported depressive symptoms during adolescence (ages 14.5 and 16.5 years).

Results: The findings revealed paths from internalizing and externalizing problems throughout the development for corresponding problems (homotypic paths) and paths from early externalizing to subsequent internalizing problems (heterotypic paths). The findings suggest 2 pathways linking maternal-rated risk factors to self-reported adolescent depressive symptoms. There was a direct path from early externalizing problems to depressive symptoms. There was an indirect path from early maternal distress going through child problem behavior to depressive symptoms. In general, girls and boys were similar, but some gender-specific effects appeared. Problem behaviors in middle childhood had heterotypic paths to subsequent problems only for girls.

Conclusion: The findings highlight the developmental importance of child externalizing problems, as well as the impact of maternal distress as early as age 1.5 years for the development of adolescent depressive symptoms. Findings also indicate a certain vulnerable period in middle childhood for girls.

Note: See Supplemental Digital Content 1, at, for a video introduction to this article.

Supplemental Digital Content is Available in the Text.

*Department of Childhood, Development and Cultural Diversity, Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway;

Department of Psychology, University of Oslo, Oslo, Norway.

Address for reprints: Wendy Nilsen, MSc, Division of Mental Health, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, No-0403 Oslo, Norway; e-mail:

Disclosure: W. Nilsen, K. Gustavson, and A. Kjeldsen are supported by the Research Council in Norway for their doctoral student positions. The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions this article on the journal's Web site (

Received May , 2012

Accepted March , 2013

© 2013 by Lippincott Williams & Wilkins