by Raj Persaud Consultant Psychiatrist The Bethlem Royal and Maudsley NHS Hospitals Trust; Gresham Professor for Public Understanding of Psychiatry

When anyone gets depressed its vital to treat the illness urgently as depression has important, often devastating, effects on a person’s life. What often gets neglected though is the impact on others – mediated through relationships – of someone suffering depression. For example, given that mothers lie at the heart of families and are at the cross-section of a series of vital relationships in any family ie martial connections and parent-child affiliations, when mums get depressed the knock on effect on others is much more fundamental than is often realised by society at large or even doctors.

Now there is new research to suggest that maternal depression could have long-standing effects on children’s futures, mediated by the impact of the depression on children’s later ability to develop friendships.

Children’s social skills appear to develop out of their experience of relationships in families and these relationships are often profoundly effected by maternal mood and in particular depression.

Researchers Rachel Lucas-Thompson and Alison Clarke-Stewart from the Department of Psychology and Social Behaviour at the University of California following up a large group of children from birth found that better quality friendships at school for the children were significantly associated with better marital quality and greater attachment security within the family from early in the child’s life.

The researchers, whose paper was recently published in the Journal of Applied Developmental Psychology, point out that psychologists have become much more intrigued by what predicts children’s ability to develop friendships successfully. This is because strong friendships now appear fundamental for children’s well-being. In the absence of friends, children end up lonely and suffering low self-esteem, which is bad enough, but perhaps most startling is the research finding that childrens’ friendships predicts academic performance. Those without good quality friendships actually do poorly in the longer term at school. Not having friends during childhood even predicts psychological and behaviour problems in adulthood.

Where do children learn about relationships and in particular how to conduct them? Psychological theory predicts that as children witness at first hand relationships within their family they must use these as the basis for their own grasp of how you get on with others. They will experience their own relationships with their parents and siblings but also observe the relationships between others in the family being played out before them.

Lucas-Thompson and Clarke-Stewart point out in their paper entitled ‘Forecasting friendship: The links from marital quality, maternal mood, and attachment security to children’s peer relationships’ that previous research confirms that children who are securely attached to their mothers in the first year and a half are found to be more competent with peers at school in later life – they were better liked by their classmates, less socially withdrawn, more active in the peer group, less aggressive, and had more cooperative friendships.

Secure attachment by a child to a parent or ‘primary caregiver’ means that the relationship allows a child to learn that others are accessible and responsive to us and our needs. We therefore develop in this context positive expectations of others – that they will be helpful and cooperative and it’s in the context of this background that we become motivated to undertake relationships. As a result we learn to regulate our emotions and so develop socially competent interaction styles with others.

In other words we don’t throw a hissy fit because we don’t get our way because we realise there are other ways of getting what we want which are more constructive and also that this is not likely to endear us to others.

Insecure parent child relationships inevitably produce children who are less trusting of others and so find it difficult to form reliable relationships, they start from a standpoint of experiencing relationships which are not positive or supportive when it comes to their parents and so come to have that expectation of all others.

Now comes the thorny problem of an added complexity in the mix of parental attachment to children is their attachment to each other. Poor marital quality is likely to mean that parents themselves become less trusting and pessimistic about relationships and this may be transmitted to their children either directly or also indirectly because they are so preoccupied with the marital conflict this distracts them from looking after the children properly.

Psychologists do indeed find that children are more likely to have relationship problems if their parents don’t just get angry a lot but it isn’t resolved.

A depressed mother is going, according to all this theory, to have a toxic effect on their children’s relationships with friends through several mechanisms. One is that the depression might arise out of poor marital quality or may itself cause it. A depressed mother may not be able to look after her children as well as she might like to.

And as the theory predicts, Lucas-Thompson and Clarke-Stewart point out there is evidence that maternal depression in early childhood is related to children’s ability to form friendships later in life. Children whose mothers experience depression during the child’s early years are likely to be more aggressive and antisocial later in life – hardly endearing them to friends.

In their unique study, Lucas-Thompson and Clarke-Stewart followed up 1364 families in the USA over several years and found that a more secure attachment relationship with the mother and a more emotionally intimate relationship between the parents predicted children’s positive interactions with a close friend later in life.

Lucas-Thompson and Clarke-Stewart argue that their research and other findings in the field suggest that to understand the development of children’s social relationships and social skills, the mother–child relationship is not the only key, but we need to take a broader focus on the whole family system. Their research found the parent–parent relationship has a direct impact with later childrens’ friendship quality that is comparable in magnitude to that of how securely attached children felt to their parents.

The bottom line implication of this research is that maternal mood is vital to get treatment for if it’s problematic as otherwise the impact could be felt for generations to come.


Forecasting friendship: The links from marital quality, maternal mood, and attachment security to children’s peer relationships
Journal of Applied Developmental Psychology, In Press, Uncorrected Proof, Available online 19 July 2007,
Rachel Lucas-Thompson and K. Alison Clarke-Stewart

Dr Raj Persaud BSc MSc MB BS MPhil FRCPsych
Consultant Psychiatrist The Maudsley Hospital London
Gresham Professor for Public Understanding of Psychiatry