FATHER ABSENCE AND DEPRESSIVE SYMPTOMS IN ADOLESCENT GIRLS FROM A UK COHORT

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1 FATHER ABSENCE AND DEPRESSIVE SYMPTOMS IN ADOLESCENT GIRLS FROM A UK COHORT Iryna Culpin, Roberto Melotti, Ricardo Araya, Carol Joinson School of Social and Community Medicine Avon Longitudinal Study of Parents and Children ALSPAC

2 DEMOGRAPHIC TRENDS IN THE UK One in 15 homes in UK are headed by lone women (Source: Eurostat) One in 4 children in Wales have no contact with their biological father (Source: Growing up with Dad; Catch22) Between a third and a half of all children in the UK will have a non-resident parent during childhood (Source: Demographic Trends in the UK) Source:Eurostat ( B/KS-NK /EN/KS-NK EN.PDF)

3 BACKGROUND TO OUR STUDY Growing evidence of the association between childhood changes infamily structure following parental divorce or separation and negative psychological and mental health outcomes in adolescence (Amato, 1991). Specifically, absence of biological father in childhood has beenlinked to increased risk of depressive symptoms in adolescence in both crosssectional (Bramlett et al.,2007) and prospective (Jaffe et al., 2002) research. The effect appears to be stronger for girls than for boys (Cuffe et al., 2005). Timing of father absence, albeit inconsistently, has been found to have differential effect on subsequent development of psychopathology (Amato, 2005).

4 LIMITATIONS OF PREVIOUS RESEARCH Distinct lack of studies that examine the effects of father absence in childhood on adolescent s psychological well-being. Most evidence is of cross-sectional nature. Available longitudinal studies are scarce and based on small, highlyselected clinical samples. Retrospective measures of family structure and depressive symptoms. Lack of adjustment for potential confounders.

5 CONFOUNDING FACTORS Association between paternal absence and development of depressive symptoms may be spurious, i.e. due to common socio-economic and familial confounders. Lack of adjustment for confounding factors may increase the riskof inflated estimates of the association between father absence and depressive symptoms (Fergusson et al., 1994). Very few studies controlled for a comprehensive range of prospectively measured confounding factors.

6 CURRENT STUDY Seeks to address methodological limitations of previous studies. Examines whether girls who experience father absence at different periods during childhood (birth to 5 years and 5 to 10 years) have higher levels of depressive symptoms at age 14 years than father-present girls. Examines possible differential effect of father absence timing on levels of depressive symptoms.

7 OUR DATA: ALSPAC Avon Longitudinal Study of Parents and Children AKA Children of the Nineties Cohort study of ~14,000 children and their parents, based in southwest England Eligibility criteria: Mothers had to be resident in Avon and have an expected date of delivery between April 1 st 1991 and December 31 st 1992 Population based prospective cohort study

8 EXPLANATORY VARIABLE Absence of the biological father : assessed at regular intervals since the birth of the study child to age 10 (1 year 7 months, 2 years 7 months, 3 years 9 months, 7 years, 8 years, and 10 years) through self-completion questionnaires asking whether the present live-in-father figure was the natural father. If not, how old was the child when father left. Advantage: gives exact age at which father left Percentage 25% 20% 15% 10% 5% 0% 21.93% 17.09% 12.28% 10.78% 8.71% 7.13% 5.67% 5.22% 4.66% 3.49% 3.04% Disadvantage: gives no indication as to alternative father-figure Absent at birth Before 1st Year 1 to 2 Years 2 to 3 Years 3 to 4 Years 4 to 5 Years 5 to 6 Years Age Biological Father Left (n = 2,671) 6 to 7 Years 7 to 8 Years 8 to 9 Years 9 to 10 Years

9 EXPLANATORY VARIABLE Absence of the biological father : father absence divided into two distinct age categories: -0 5 years years Father Absence Period 0 5 years 5 10 years No 4,334 (81.8%) 3,972 (91.6%) Yes 961 (18.1%) 362 (8.3%)

10 OUTCOME VARIABLE Depressive symptoms assessed via Short Form of Mood and Feelings Questionnaire. Mean age at assessment = 13 years 10 months (SD= 0.2). Scores are highly skewed. The majority of the girls reported no depressive symptoms. Angold, A., Costello, E. J., Messer, S. C., Pickles, A., Winder, F., & Silver, D. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5, Binary measure of depressive symptoms (cut-off score 11). Density SMFQ sumscore at age 13 years 10 months Low levels of depressive symptoms High levels of depressive symptoms 2,591 (84.3%) 482 (15.7%)

11 MODEL EXAMINED IN THE STUDY Father Absence (0 5; 5 10 years) Depressive Symptoms (14 years) Socio-Economic Adversity a, b Maternal Characteristics c, d Marital Conflict e, f (antenatal 1 and early childhood 2 ) 1 Antenatal: a social class; home ownership status; car access; major financial difficulties;mother's educational attainment; family size c early parenthood; maternal psychopathology e mother/partner s aggressive/affectionate behaviour toward each other 2 Early childhood (0 5): b home ownership status; car access; major financial difficulties d maternal psychopathology f mother s satisfaction with relationship; frequency of disagreement between mother and partner; partner s warm/authoritative behaviour toward mother

12 STATISTICAL ANALYSES Chi-square test of association to examine the distribution of socio-economic and familial factors in father-present and father-absent samples. Binary logistic regression to examine the association between father absence during the periods 0 5 and 5 10 years (father present=reference group) and binary indicator of depressive symptoms (low levels of depressive symptoms = reference group) adjusted for the confounding variables. All analyses were carried out using Stata version 11 ( logit command).

13 RESULTS Table 1. Odds ratios (95% CI) for depressive symptoms in girls from father absent compared to father present families (0 5 years) adjusted for antenatal confounders Father Absence (Ref = Father Present N Depressive Symptoms Unadjusted Model Adjusted 1 Adjusted 2 (SES) a (Maternal Characteristics) a Adjusted 3 (Marital Conflict) c 0-5 2,151 Yes Global p No (1.27, 2.54) (1.21, 2.50) (1.18, 2.45) (1.12, 2.34) 1.00 ref 1.00 ref 1.00 ref 1.00 ref a Adjusted 1: Adjusted for indices of socioeconomic background: socioeconomic status, home ownership status, car access, major financial difficulties, mother's educational attainment and family size. b Adjusted 2: Adjusted 1 further adjusted for maternal characteristics: early parenthood and maternal antenatal depression. c Adjusted 3: Adjusted 2 further adjusted for marital conflict: mother s partner levels of aggression and affection

14 RESULTS Table 2. Odds ratios (95% CI) for depressive symptoms in girls from father absent compared to father present families (5-10 years) adjusted for early childhood (0 5 years) confounders Father Absence (Ref = Father Present N Depressive Symptoms Unadjusted Model Adjusted 1 Adjusted 2 (SES) a (Maternal Characteristics) b Adjusted 3 (Marital Conflict) c ,648 Yes Global p No ( ) (0.59, 1.68) (0.57, 1.65) (0.58, 1.68) 1.00 ref 1.00 ref 1.00 ref 1.00 ref a Adjusted 1: Adjusted for antenatal and early childhood (0-5) indices of socioeconomic background: socioeconomic status, mother s educational attainment, family size, home ownership status, car access, major financial difficulties. b Adjusted 2: Adjusted 1 further adjusted for antenatal and early childhood (0-5) maternal characteristics: early parenthood and maternal post-natal depression. c Adjusted 3: Adjusted 2 further adjusted for early childhood (0-5) marital conflict: mother s partner levels of aggression, affection and frequency of arguments.

15 MAIN FINDING There was evidence for an association between father absence from birth to five years and increased levels of depressive symptoms at 14 years. The effect remained independent after adjusting for a range of wellestablished shared risk factors for father absence and depressive symptoms (e.g., socioeconomic disadvantage and maternal depression). Conversely, there was no evidence for an association between father absence from five to ten years and increased levels of depressive symptoms at 14 years.

16 STUDY S S STRENGHT AND LIMITATIONS STRENGHT Large sample size Prospective self-reports of depressive symptoms Repeated measures of father absence from birth to late childhood Prospective data on potential confounding factors LIMITATIONS Sample Attrition Other unmeasured factors may be explaining the association (e.g.,, quality of parent-child relationship, non-resident father s s involvement;black & Pedrocarroll, 1993; Videon, 2005)

17 POSSIBLE EXPLANATIONS FOR THE FINDINGS Sensitive period in development : Exposure to adverse experiences during sensitive developmental stages is associated with structural and functional neurodevelopmental changes (e.g., heightened stress reactivity) that may increase susceptibility to psychopathology later on in life (Teicher et al., 2002). Disrupted attachment: Disrupted attachment to fathers may have comparable effect to that of mother s on development of depressive symptoms in adolescence (de Minzi, 2006). Deteriorated parenting: Conflict and stress associated with family breakdown and father absence mayinterfere with mother s parenting skills (i.e. increased conflict, decreased emotional support and control) lack of which is associated with adolescent psychopathology (Hetherington et al., 1998). Stress: Cascading effect of exposure to multiple stressors associated with family disruption (i.e., socio-economic disadvantage, residential and school changes, exposure to alternative father-figure, mother s remarriage).

18 FUTURE DIRECTIONS & IMPLICATIONS Future research should focus on the mechanisms by which changes in family structure (i.e. absence of biological parent) is associated with increased risks of developmental psychopathology. Possible mediating (moderating) effects of proximal familial experiences and pubertal development. Our findings emphasise the importance of fathers for children s psychological well-being and the need of fathers inclusion in the research on children s and adolescents developmental outcomes.

19 ACKNOWLEDGEMENTS We are extremely grateful to all the families who took part in the ALSPAC study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. The UK Medical Research Council, the Wellcome Trust and the University of Bristol provide core support for ALSPAC. This research was specifically funded by a grant from the Medical Research Council (Pubertal Timing and Depressive Symptoms in Adolescent Girls: the Roles of Family and Peer Relationships - MRC DTG/COMB.SD ). Contact details: Iryna.Culpin@bristol.ac.uk