{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:03:26Z","timestamp":1786964606033,"version":"build-2736575974"},"reference-count":53,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Pediatr"],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:sec id=\"ab-poi250044-4\"><jats:title>Importance<\/jats:title><jats:p>Research has consistently shown links between parent and child depression. The prevailing assumption is that parent depression precedes the onset, persistence, and even exacerbation of child depression. However, it is plausible, albeit infrequently tested, that child depression triggers subsequent parent depression. Clarifying the direction and developmental timing of these associations is critical for designing and advocating for family-centered approaches to pediatric care.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi250044-5\"><jats:title>Objective<\/jats:title><jats:p>To estimate the longitudinal bidirectional associations between maternal and child depression from middle childhood through emerging adolescence during a period that coincided with the COVID-19 pandemic, and to assess whether these associations are moderated by key sociodemographic factors.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi250044-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This study used data from the All Our Families (Calgary, Alberta, Canada) cohort across multiple waves during and beyond the COVID-19 pandemic when children were aged 10.3 (May 20 to July 15, 2020), 10.9 (March 4 to April 30, 2021), 11.6 (November 22, 2021 to January 17, 2022), and 12.8 (January 16 to July 7, 2024) years. Data were analyzed between March 1 and August 31, 2024, using random-intercept cross-lagged panel models.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi250044-7\"><jats:title>Exposures<\/jats:title><jats:p>Maternal and child report of depressive symptoms.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi250044-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The Behavior Assessment System for Children for child depression and the Center for Epidemiologic Studies Depression Scale-10 for maternal depression.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi250044-9\"><jats:title>Results<\/jats:title><jats:p>The sample included 1801 mother-child dyads (52% boys, 48% girls). Mothers were a mean (SD) 41.6 (4.4) years old at study entry and most had completed postsecondary education (80%), had an annual income more than CAD $100\u202f000 (75%), and were married or in common-law relationships (71.4%). Consistent cross-sectional correlations were observed, reflecting stable between-participant associations for maternal depression and child depression throughout the study period. Within-participant increases in child depression scores at ages 10.3 and 10.9 years were associated with subsequent increases in maternal depression scores at child ages 10.9 (standardized coefficient 0.12; 95% CI, 0.02-0.22) and 11.6 (0.17; 95% CI, 0.07-0.26) years; however, this was not present for maternal depression. These patterns of associations were moderated by household income (difference test for \u03c7<jats:sup>2<\/jats:sup><jats:sub>12<\/jats:sub>\u2009=\u200923.0; <jats:italic>P<\/jats:italic>\u2009=\u2009.03) and within-participant increases in child depression were consistently associated with subsequent increases in maternal depression for the higher income group.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi250044-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Contrary to prevailing assumptions, these findings suggest that children\u2019s depression over time may have contributed to worsening maternal depression, rather than the other way around. While these results should be replicated in nonpandemic contexts to confirm their generalizability, they highlight the need for family-centered approaches to mental health care.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapediatrics.2025.2822","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T15:31:00Z","timestamp":1756135860000},"page":"1100","source":"Crossref","is-referenced-by-count":4,"title":["Testing Bidirectional Associations Between Maternal and Child Depression During Emerging Adolescence"],"prefix":"10.1001","volume":"179","author":[{"given":"Jackson M.A.","family":"Hewitt","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Calgary, Calgary, Alberta, Canada"},{"name":"Alberta Children\u2019s Hospital Research Institute, Calgary, Alberta, Canada"},{"name":"Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brae Anne","family":"McArthur","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Calgary, Calgary, Alberta, Canada"},{"name":"Alberta Children\u2019s Hospital Research Institute, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross D.","family":"Neville","sequence":"additional","affiliation":[{"name":"School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne L.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Psychology, Mount Royal University, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Tough","sequence":"additional","affiliation":[{"name":"Alberta Children\u2019s Hospital Research Institute, Calgary, Alberta, Canada"},{"name":"Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"},{"name":"Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheri","family":"Madigan","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Calgary, Calgary, Alberta, Canada"},{"name":"Alberta Children\u2019s Hospital Research Institute, Calgary, Alberta, Canada"},{"name":"Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada"},{"name":"JAMA Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"6","key":"poi250044r1","doi-asserted-by":"publisher","first-page":"275","DOI":"10.9740\/mhc.2018.11.275","article-title":"Major depressive disorder in children and adolescents.","volume":"8","author":"Mullen","year":"2018","journal-title":"Ment Health Clin"},{"key":"poi250044r2","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/j.jad.2024.03.074","article-title":"Global burden of depression or depressive symptoms in children and adolescents: a systematic review and meta-analysis.","volume":"354","author":"Lu","year":"2024","journal-title":"J Affect Disord"},{"issue":"11","key":"poi250044r3","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1001\/jamapediatrics.2021.2482","article-title":"Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a meta-analysis.","volume":"175","author":"Racine","year":"2021","journal-title":"JAMA Pediatr"},{"issue":"4","key":"poi250044r4","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1001\/jamapsychiatry.2023.5051","article-title":"Worldwide prevalence and disability from mental disorders across childhood and adolescence: evidence from the global burden of disease study.","volume":"81","author":"Kieling","year":"2024","journal-title":"JAMA Psychiatry"},{"issue":"8","key":"poi250044r5","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1002\/da.22777","article-title":"Adult mental health outcomes of adolescent depression: a systematic review.","volume":"35","author":"Johnson","year":"2018","journal-title":"Depress Anxiety"},{"issue":"4","key":"poi250044r6","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1377\/hlthaff.2018.05246","article-title":"Measuring the lifetime costs of serious mental illness and the mitigating effects of educational attainment.","volume":"38","author":"Seabury","year":"2019","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"poi250044r7","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1017\/S0033291708003188","article-title":"Mental-physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys.","volume":"39","author":"Scott","year":"2009","journal-title":"Psychol Med"},{"issue":"9820","key":"poi250044r8","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/S0140-6736(11)60871-4","article-title":"Depression in adolescence.","volume":"379","author":"Thapar","year":"2012","journal-title":"Lancet"},{"issue":"11","key":"poi250044r9","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1001\/jamapediatrics.2020.2910","article-title":"Association between maternal perinatal depression and anxiety and child and adolescent development: a meta-analysis.","volume":"174","author":"Rogers","year":"2020","journal-title":"JAMA Pediatr"},{"issue":"3","key":"poi250044r10","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1037\/0033-295X.106.3.458","article-title":"Risk for psychopathology in the children of depressed mothers: a developmental model for understanding mechanisms of transmission.","volume":"106","author":"Goodman","year":"1999","journal-title":"Psychol Rev"},{"issue":"9","key":"poi250044r11","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1016\/j.jaac.2018.06.012","article-title":"A meta-analysis of maternal prenatal depression and anxiety on child socioemotional development.","volume":"57","author":"Madigan","year":"2018","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"poi250044r12","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.jpsychires.2018.08.001","article-title":"Prevalence and incidence of postpartum depression among healthy mothers: a systematic review and meta-analysis.","volume":"104","author":"Shorey","year":"2018","journal-title":"J Psychiatr Res"},{"issue":"5","key":"poi250044r13","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/S2215-0366(21)00074-2","article-title":"Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: a longitudinal analysis.","volume":"8","author":"Racine","year":"2021","journal-title":"Lancet Psychiatry"},{"issue":"1","key":"poi250044r14","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1037\/0033-2909.118.1.108","article-title":"Interrelatedness of marital relations and parent-child relations: a meta-analytic review.","volume":"118","author":"Erel","year":"1995","journal-title":"Psychol Bull"},{"issue":"6","key":"poi250044r15","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1192\/bjp.147.6.598","article-title":"Resilience in the face of adversity. Protective factors and resistance to psychiatric disorder.","volume":"147","author":"Rutter","year":"1985","journal-title":"Br J Psychiatry"},{"issue":"1","key":"poi250044r16","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1111\/j.1469-7610.1994.tb01133.x","article-title":"Maternal depression and child development.","volume":"35","author":"Cummings","year":"1994","journal-title":"J Child Psychol Psychiatry"},{"key":"poi250044r17","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-071519-113915","article-title":"Intergenerational transmission of depression.","author":"Goodman","year":"2020","journal-title":"Annu Rev Clin Psychol"},{"issue":"7","key":"poi250044r18","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1111\/jcpp.14118","article-title":"The long reach of adversity: intermediary pathways from maternal adverse childhood experiences to child socio-emotional and cognitive outcomes.","volume":"66","author":"Madigan","year":"2025","journal-title":"J Child Psychol Psychiatry"},{"issue":"4","key":"poi250044r19","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1080\/14616734.2024.2359689","article-title":"A meta-analytic examination of sensitive responsiveness as a mediator between depression in mothers and psychopathology in children.","volume":"26","author":"Borairi","year":"2024","journal-title":"Attach Hum Dev"},{"issue":"11","key":"poi250044r20","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1007\/s10802-023-01086-5","article-title":"Maternal mental health and children\u2019s problem behaviours: a bi-directional relationship?","volume":"51","author":"Lowthian","year":"2023","journal-title":"Res Child Adolesc Psychopathol"},{"issue":"10","key":"poi250044r22","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1177\/07067437241271708","article-title":"Prevalence of common child mental health disorders using administrative health data and parent report in a prospective community-based cohort from Alberta, Canada: Pr\u00e9valence des troubles communs de sant\u00e9 mentale de l\u2019enfant \u00e0 l\u2019aide des donn\u00e9es de sant\u00e9 administratives et des rapports des parents dans une cohorte prospective communautaire d\u2019Alberta, Canada.","volume":"69","author":"Racine","year":"2024","journal-title":"Can J Psychiatry"},{"issue":"3","key":"poi250044r23","first-page":"1","article-title":"Within-person pathways among maternal depressive symptoms and offspring internalizing problems from early childhood through adolescence.","volume":"36","author":"Chad-Friedman","year":"2023","journal-title":"Dev Psychopathol"},{"issue":"4","key":"poi250044r24","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1037\/a0038498","article-title":"The validity of the multi-informant approach to assessing child and adolescent mental health.","volume":"141","author":"De Los Reyes","year":"2015","journal-title":"Psychol Bull"},{"issue":"7486","key":"poi250044r25","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1136\/bmj.330.7486.301","article-title":"Adolescent development.","volume":"330","author":"Christie","year":"2005","journal-title":"BMJ"},{"issue":"6","key":"poi250044r26","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1001\/jamapediatrics.2023.0846","article-title":"Changes in depression and anxiety among children and adolescents from before to during the COVID-19 pandemic: a systematic review and meta-analysis.","volume":"177","author":"Madigan","year":"2023","journal-title":"JAMA Pediatr"},{"issue":"5","key":"poi250044r27","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/S2215-0366(23)00036-6","article-title":"Comparison of paediatric emergency department visits for attempted suicide, self-harm, and suicidal ideation before and during the COVID-19 pandemic: a systematic review and meta-analysis.","volume":"10","author":"Madigan","year":"2023","journal-title":"Lancet Psychiatry"},{"issue":"1","key":"poi250044r28","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1037\/a0038889","article-title":"A critique of the cross-lagged panel model.","volume":"20","author":"Hamaker","year":"2015","journal-title":"Psychol Methods"},{"key":"poi250044r29","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2020.101933","article-title":"Socioeconomic status and child psychopathology in the United States: a meta-analysis of population-based studies.","volume":"83","author":"Peverill","year":"2021","journal-title":"Clin Psychol Rev"},{"issue":"4","key":"poi250044r30","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1080\/15374410902976288","article-title":"Development of sex differences in depressive and co-occurring anxious symptoms during adolescence: descriptive trajectories and potential explanations in a multiwave prospective study.","volume":"38","author":"Hankin","year":"2009","journal-title":"J Clin Child Adolesc Psychol"},{"issue":"Suppl 1","key":"poi250044r31","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1186\/1471-2393-13-S1-S2","article-title":"The All Our Babies pregnancy cohort: design, methods, and participant characteristics.","volume":"13","author":"McDonald","year":"2013","journal-title":"BMC Pregnancy Childbirth"},{"issue":"5","key":"poi250044r32","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1093\/ije\/dyw363","article-title":"Cohort profile: the All Our Babies pregnancy cohort (AOB).","volume":"46","author":"Tough","year":"2017","journal-title":"Int J Epidemiol"},{"issue":"1","key":"poi250044r35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives.","volume":"6","author":"Hu","year":"1999","journal-title":"Struct Equ Modeling"},{"issue":"1","key":"poi250044r36","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1177\/0956797613504966","article-title":"The new statistics: why and how.","volume":"25","author":"Cumming","year":"2014","journal-title":"Psychol Sci"},{"issue":"2","key":"poi250044r37","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1177\/2515245919847202","article-title":"Evaluating effect size in psychological research: sense and nonsense.","volume":"2","author":"Funder","year":"2019","journal-title":"Adv Methods Pract Psychol Sci"},{"issue":"12","key":"poi250044r38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/S0033291724001491","article-title":"The course of children\u2019s mental health symptoms during and beyond the COVID-19 pandemic.","volume":"54","author":"Park","year":"2024","journal-title":"Psychol Med"},{"issue":"2","key":"poi250044r39","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.acap.2016.10.011","article-title":"Major depressive disorder among preadolescent Canadian children: rare disorder or rarely detected?","volume":"17","author":"Korczak","year":"2017","journal-title":"Acad Pediatr"},{"key":"poi250044r40","doi-asserted-by":"publisher","DOI":"10.1177\/0963721420901590","article-title":"Studying the intergenerational transmission of risk for depression: current status and future directions.","author":"Gotlib","year":"2020","journal-title":"Curr Dir Psychol Sci"},{"issue":"2","key":"poi250044r41","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1037\/met0000499","article-title":"Effect size guidelines for cross-lagged effects.","volume":"29","author":"Orth","year":"2024","journal-title":"Psychol Methods"},{"issue":"1","key":"poi250044r42","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1080\/17405629.2014.963549","article-title":"Interpreting effect sizes when controlling for stability effects in longitudinal autoregressive models: implications for psychological science.","volume":"12","author":"Adachi","year":"2015","journal-title":"Eur J Dev Psychol"},{"issue":"11","key":"poi250044r43","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.1111\/jcpp.13817","article-title":"Editorial perspective: When is a \u2018small effect\u2019 actually large and impactful?","volume":"64","author":"Carey","year":"2023","journal-title":"J Child Psychol Psychiatry"},{"issue":"9","key":"poi250044r44","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1001\/jamapediatrics.2022.2313","article-title":"Global changes in child and adolescent physical activity during the COVID-19 pandemic: a systematic review and meta-analysis.","volume":"176","author":"Neville","year":"2022","journal-title":"JAMA Pediatr"},{"issue":"4","key":"poi250044r45","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2266","article-title":"Children\u2019s physical activity and depression: a meta-analysis.","volume":"139","author":"Korczak","year":"2017","journal-title":"Pediatrics"},{"issue":"3","key":"poi250044r46","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s10804-021-09381-5","article-title":"Parent-child relationships and the COVID-19 pandemic: an exploratory qualitative study with parents in early, middle, and late adulthood.","volume":"28","author":"Vaterlaus","year":"2021","journal-title":"J Adult Dev"},{"issue":"1","key":"poi250044r47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10567-010-0080-1","article-title":"Maternal depression and child psychopathology: a meta-analytic review.","volume":"14","author":"Goodman","year":"2011","journal-title":"Clin Child Fam Psychol Rev"},{"issue":"5","key":"poi250044r48","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-043397","article-title":"How is the COVID-19 lockdown impacting the mental health of parents of school-age children in the UK? A cross-sectional online survey.","volume":"11","author":"El-Osta","year":"2021","journal-title":"BMJ Open"},{"issue":"1","key":"poi250044r49","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1007\/s00787-021-01884-6","article-title":"The effects of psychological treatments of depression in children and adolescents on response, reliable change, and deterioration: a systematic review and meta-analysis.","volume":"32","author":"Cuijpers","year":"2023","journal-title":"Eur Child Adolesc Psychiatry"},{"issue":"6","key":"poi250044r51","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1001\/jamapediatrics.2020.0065","article-title":"Pediatric mental health care must be family mental health care.","volume":"174","author":"Biel","year":"2020","journal-title":"JAMA Pediatr"},{"issue":"2","key":"poi250044r52","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1037\/dev0000612","article-title":"The role of fathers\u2019 versus mothers\u2019 parenting in emotion-regulation development from mid-late adolescence: disentangling between-family differences from within-family effects.","volume":"55","author":"Van Lissa","year":"2019","journal-title":"Dev Psychol"},{"issue":"3","key":"poi250044r53","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1007\/s10802-017-0309-2","article-title":"Disentangling child-specific and family-wide processes underlying negative mother-child transactions.","volume":"46","author":"Plamondon","year":"2018","journal-title":"J Abnorm Child Psychol"},{"key":"poi250044r21","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1037\/11877-001","volume-title":"The Transactional Model of Development: How Children and Contexts Shape Each Other","author":"Sameroff","year":"2009"},{"key":"poi250044r50","first-page":"375","volume-title":"Handbook of Attachment-Based Interventions","author":"Moretti","year":"2018"},{"key":"poi250044r33","unstructured":"Statistics Canada. Median after-tax income, Canadian income survey, 2021. Accessed July 22, 2025. https:\/\/www150.statcan.gc.ca\/n1\/pub\/12-581-x\/2023001\/sec12-eng.htm"},{"key":"poi250044r34","unstructured":"Muth\u00e9n? B, Muth\u00e9n? L. Mplus user\u2019s guide (version 8.8). Accessed July 29, 2025. https:\/\/www.statmodel.com\/download\/usersguide\/MplusUserGuideVer_8.pdf"}],"container-title":["JAMA Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/articlepdf\/2837969\/jamapediatrics_hewitt_2025_oi_250044_1759167986.79038.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T15:01:46Z","timestamp":1759762906000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/fullarticle\/2837969"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":53,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapediatrics.2025.2822","relation":{},"ISSN":["2168-6203"],"issn-type":[{"value":"2168-6203","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,1]]}}}