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Exposure to pre- and postnatal depression and anxiety symptom trajectories: Effect on adolescent psychiatric outcomes

Glasheen, Cristie (2010) Exposure to pre- and postnatal depression and anxiety symptom trajectories: Effect on adolescent psychiatric outcomes. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Exposure to maternal pre- and postnatal depression (PPND) and anxiety (PPNA) symptoms have been linked to a number of adverse outcomes in children. This research used growth mixture modeling (GMM) to examine individual-level PPND and PPNA symptom patterns in a sample of women and adolescents participating in a longitudinal study of maternal health practices. These trajectory groups were then used as exposure states for offspring in a series of analyses that examined whether symptom trajectory exposure was associated with age of onset of any psychiatric illness, the risk for Major Depressive Disorder (MDD), or the risk of Conduct Disorder (CD). Finally, path analysis was used to identify potential mechanisms associated with trajectory exposure and psychiatric illness.The GMM analyses found distinct trajectories of PPND and PPNA symptoms. Two groups of stable PPND symptom patterns were identified: low and high. PPNA exposure had three stable symptom patterns: low, medium, and high. Examination of the co-occurrence of PPND and PPNA found that those in the high PPND trajectory were more likely to be in the medium or high PPNA symptom trajectories, compared to the low PPND individuals. PPND, PPNA, and co-occurring trajectory group exposure were not associated with age of onset of first psychiatric illness or with MDD. The risk of CD onset was not associated with PPND or co-occurring trajectory exposure. However, males exposed to medium and high PPNA trajectories were at an increased risk of CD compared to low PPNA exposed males. Females exposed to medium or high PPNA trajectories were at a decreased risk of CD, compared to their low PPNA counterparts. Results of the path analysis suggested a direct path from PPNA to CD risk, moderated by gender. Furthermore, PPNA exposure predicted higher levels of emotionality, which predicted higher CD risk.CD is responsible for serious morbidity among affected children and places a large burden on society as a result of increased service use and involvement in the juvenile justice system. The public health significance of identifying a strong risk factor for CD in males is that it provides a new potential target for primary prevention.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairRichardson, Gale Agar@pitt.eduGAR
Committee MemberLarkby, Cynthia Alarkby@pitt.eduLARKBY
Committee MemberSwartz, Holly Ahas7@pitt.eduHAS7
Committee MemberKim, Kevin Hkhkim@pitt.eduKHKIM
Date: 28 January 2010
Date Type: Completion
Defense Date: 20 November 2009
Approval Date: 28 January 2010
Submission Date: 2 December 2009
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: conduct disorder; postpartum anxiety; prenatal anxiety; prenatal depression; adolescent psychiatry; postpartum depression
Other ID:, etd-12022009-120707
Date Deposited: 10 Nov 2011 20:07
Last Modified: 15 Nov 2016 13:52


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