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Cited by 257Maternal Mental Health During Pregnancy and PostpartumChild and Adolescent Psychosocial and Emotional DevelopmentFamily Dynamics and Relationships

The effects of paternal depression on child and adolescent outcomes: A systematic review

Open access
Sweeney, Shaun, MacBeth, Angus·2016·Journal of Affective Disorders
DOI 10.1016/j.jad.2016.05.073
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Abstract

Background Paternal depression has been associated with suboptimal developmental outcomes in offspring. We sought to systematically review the research evidence from prospective studies for an association between paternal depression and child adolescent emotional and behavioral outcomes. We also reviewed potential mediators of this association and sources of methodological bias.Methods A systematic review was conducted using the following databases: Medline, EMBASE, PsycINFO and Google Scholar. Reference lists of the included papers were also searched.Results Twenty-one studies were included in the review. Findings suggested that paternal depression does negatively impact upon offspring development. This impact is observable when paternal depression is present in the antenatal and postnatal stages and during offspring adolescence. The strength of this association is strongly reliant upon a number of contextual mediators, namely; paternal negative expressiveness, hostility and involvement and marital conflict. A quality assessment rating showed the studies were relatively strong methodologically.Limitations Heterogeneity regarding method of assessment and the magnitude and timing of exposure hinder attempts to make strong conclusions regarding the trajectory of paternal depression and its effects on child and adolescent outcomes.Conclusions Paternal mental health screening during pregnancy is necessary in order to identify and prevent depression negatively impacting offspring functioning. Including both parents in this process should encourage the alleviation of the environmental mediators which dominate the negative association outlined within the review. Research examining gene-environment interaction is necessary to uncover more accurate details regarding paternal depression and subsequent offspring vulnerability.

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Crossref · 10.1016/j.jad.2016.05.073

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Claims the paper makes

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  • Findingnone given
    § Characteristics of the Studies

    All 21 included studies employed a prospective cohort design.

    “All 21 of the studies included in the review employed a prospective cohort design”
    Quote in the paperNot a substantial claim
  • Findingnone given
    § Methodological Considerations

    There is evidence of variance in the measurement of paternal depression.

    “In addition, there is evidence of variance in the measurement of paternal depression.”
    Quote in the paperSubstantial claim
  • Findingnone given
    § Sample Population

    Only four studies examined offspring outcomes beyond 13 years old.

    “Only four studies examined offspring outcomes beyond 13 years old.”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Paternal Depression and Offspring Internalizing and Externalizing Behaviours

    Results across studies indicate a pattern of weak to moderate significant negative associations between paternal depression and offspring outcomes.

    “As can be seen in Table 2, results across studies indicate a pattern of weak to moderate significant negative associations between paternal depression and offspring outcomes.”
    • Also stated in: § Discussion · hedged
      “The results of our systematic review indicate a pattern of associations between paternal depression and increased risk of internalizing and externalizing behaviours in offspring.”
    Quote in the paperSubstantial claim
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    § Paternal Depression and Offspring Internalizing and Externalizing Behaviours

    The association is observable when paternal depression is present in the antenatal stage, infancy, childhood or adolescence.

    “This association is observable when paternal depression is present in the antenatal stage, infancy, childhood or adolescence.”
    • Also stated in: § Discussion · plain
      “This association is evident across the developmental frame from offspring age of 2 months to 21 years old.”
    Quote in the paperSubstantial claim
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    Findingown data
    § Sample Population

    The review identified a combined total of 21,970 fathers, with samples ranging from 9 to 10,975.

    “The review identified a combined total of n=21970 fathers with samples ranging from n=9 (Pilowsky et al. 2014) to n=10975 (Ramchandani et al. 2008b).”
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    • cites Pilowsky et al. 2014 source

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    • cites Ramchandani et al. 2008b

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    Findingown data
    § Measurement of Paternal Depression

    Paternal depression was assessed using a variety of self-report or interview measures, with measurement points from 18 weeks gestation to offspring age 21.

    “Paternal depression (incorporating paternal depressive symptoms and clinical diagnoses of depression) was assessed using a variety of self-report or interview measures with measurement points ranging from 18 weeks gestation to offspring age 21.”
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    Findingown data
    § Study Quality

    All studies scored highly on validation and reliability of measurement tools, but reporting of testing for validity is not always clear.

    “Concerning the validation and reliability of the measurement tools used to assess paternal depression, all studies scored highly on this criterion, however the reporting of testing for this validity is not always clear”
    Quote in the paperNot a substantial claim

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    Findingcitation
    § Van Batenburg-Eddes et al. (2013) (Generation R cohort) and Ramchandani et al.

    Van Batenburg-Eddes et al. (2013) and Ramchandani et al. found no significant association between paternal depression and offspring attention and externalizing problems, respectively.

    “Van Batenburg-Eddes et al. (2013) (Generation R cohort) and Ramchandani et al. (2013) (age 3 & 12 months) found no significant association between paternal depression and offspring attention and externalizing problems, respectively.”
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    • cites Van Batenburg-Eddes et al. (2013)

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    Findingcitation
    § Mediators

    Fathers' non-involvement accounted for 5.4% of the total effect of paternal depression on child development at age 3.5 and 8.4% at age 7.

    “(2015) showed fathers' non-involvement accounted for 5.4% of the total effect of paternal depression on child development at age 3.5 and 8.4% at age 7.”
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    • cites Gutierrez-Galve et al. (2015) source

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    § Study Quality

    Assessment of confounding variables and their inclusion in analyses was relatively strong; all studies considered at least one of maternal depression, parenting behaviours or marital conflict.

    “The assessment of confounding variables and their inclusion in analyses was relatively strong throughout the included studies.Consideration of at least of one of maternal depression, parenting behaviours or marital conflict were considered by all of the studies.”
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    Findingnone given
    § Discussion

    The reported association was evident both for depression measured at antenatal and postnatal time-points.

    “The reported association was evident both for depression measured at antenatal and postnatal time-points.”
    Quote in the paperSubstantial claim

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    Findingown data
    § Measurement of Paternal Depression

    The EPDS was the most commonly used assessment tool, used in 10 studies.

    “The most commonly used assessment tool was the Edinburgh Postnatal Depression Scale (EPDS), which was utilized in 10 of the studies.”
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    Findingcitation
    § Sample Population

    A total of 23,385 offspring were included, ranging from 19 to 10,494.

    “A total of n=23,385 offspring were included, ranging from n=19 (Pilowsky et al. 2014) to n=10,494 (Hanington et al. 2010).”
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    • cites Pilowsky et al. 2014 source

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    • cites Hanington et al. 2010 source

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    Findingcitation
    § Timing of Depression

    Postnatal paternal depression was associated with internalizing problems in 11 studies and externalizing problems in 7 studies, in offspring from 2 months to 8 years.

    “In the postnatal period, paternal depression was also associated with both internalizing (11 included studies) and externalizing problems (7 included studies) in early to late childhood, with associations present in offspring from 2 months old to 8 years old”
    Quote in the paperSubstantial claim

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    § Sample Population

    The age range of fathers was 28 to 43 years where reported.

    “Based on studies where it was reported, the age range of fathers was from 28 to 43.”
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    Findingnone given
    § Study Quality

    The majority of studies provide a comprehensive outline of effect sizes and confidence intervals.

    “Regarding the statistical analyses utilized, the majority of the studies provide a comprehensive outline of effect sizes and confidence intervals.”
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    § Mediators

    The most common mediators were parenting behaviours (paternal hostility, father involvement, negative expressiveness) in 7 studies and marital conflict in 5 studies.

    “The most common mediators of risk were parenting behaviours (paternal hostility, father involvement, father's negative expressiveness), with this association arising in 7 of the included studies and marital conflict, which was apparent in 5 of the included studies.”
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    § Study Quality

    Drop-out figures are reported in all but two studies, and missing data calculation is reported in a minority.

    “With regards to attrition rates, drop-out figures are reported in all but two of the studies (Fletcher et al. 2011;Gross et al. 2008) and the calculation of missing data to account for any potential bias of the dropouts is reported in a minority of studies”
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    • cites Fletcher et al. 2011 source

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    Findingcitation
    § Timing of Depression

    Antenatal paternal depression was associated with emotional problems in all 5 studies and behavioural problems in 4 of 5, in children aged 2 months to 7.5 years.

    “Although only measured in 5 of the included studies, antenatal paternal depression associated with emotional problems in all 5 studies and behavioural problems in 4 of 5 included studies, in children aged between 2 months and 7.5 years”
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    Findingcitation
    § Sample Population

    Offspring age ranged from 1 month to 21 years.

    “Offspring age ranged from 1 month old (Carro et al. 1993) to 21 years old (Reeb et al. 2015).”
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    • cites Carro et al. 1993 source

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    • cites Reeb et al. 2015 source

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    § Study Quality

    The mean total quality score was 14, with only one study more than two points below and twelve equal to or above.

    “In terms of quantifying study quality, the mean total score was 14, with only one study rated more than two points below this.The remaining studies scored within two points of this mean, with twelve rated equal to, or above this.”
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    Findingown data
    § Discussion

    Associations remain significant across offspring development at follow-up and into young adulthood, but fewer studies examined outcomes beyond age 13.

    “Associations remain significant across offspring development at follow-up and into young adulthood, however fewer studies examined outcomes beyond the age of 13.”
    Quote in the paperSubstantial claim

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    Findingcitation
    § Mediators

    Prosocial and problem behaviours were less common with high father involvement but more likely with higher paternal depression.

    “Ramchandani et al. (2010) indicated that prosocial and problem behaviours were less common with high levels of father involvement but were more likely with higher levels of paternal depression.”
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    • cites Ramchandani et al. (2010) source

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    § Measurement of Child and Adolescent Outcomes

    Child and adolescent outcomes were measured from 2 months to 21 years old.

    “Child and adolescent outcomes were measured at assessment points ranging from 2 months old to 21 years old.”
    Quote in the paperNot a substantial claim

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    Findingown data
    § Study Quality

    The majority of literature (10 papers) is derived from three large cohort designs (ALSPAC, Generation R, LSAC) and relies on these cohort protocols for details.

    “However, we note that the majority of the literature (10 papers) in this area are derived from analyses of three large cohort designs such as ALSPAC, Generation R and LSAC, and as such rely on these cohort protocols for these details.”
    Quote in the paperNot a substantial claim

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    Findingreasoning
    § Conclusion

    The review identified and quantified many mechanisms through which paternal symptoms exert influence, primarily through family environment mechanisms.

    “This review has also identified and quantified the many mechanisms in which paternal symptoms exert their influence.This primarily occurs through family environment mechanisms.”
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    Findingcitation
    § Conclusion

    The strength of the association varied across the literature, but it supports recent findings that fathers can significantly affect offspring outcomes.

    “The strength of the association varied in the literature, however it supports the findings of recent literature that fathers can have a significant impact on offspring outcomes (Ramchandani & Psychogiou, 2009).”
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    • cites Ramchandani & Psychogiou, 2009 source

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    Findingreasoning
    § Additional information

    Postnatal paternal depression is a predictor for father-reports of child behaviour but is not significant when controlling for marital discord.

    “Postnatal PDep was a predictor for father-reports of child behaviour but was not significant when controlling for marital discord”
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    Findingcitation
    § Limitations

    Children whose fathers had more symptoms were less likely to take part in follow-up, and that subgroup had higher rates of anxiety disorder.

    “Children of fathers with higher symptoms were less likely to partake in the follow-up and this sub-group had higher rates of anxiety disorder (Ramchandani et al. 2008a).”
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    • cites Ramchandani et al. 2008a

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    § Additional information

    Paternal age is significantly associated with child externalizing behaviours (Beta=.214, t(2.521), p<0.013).

    “Paternal age (Beta=.214,t(2.521) p<0.013) and paternal remoteness (Beta=0.175,t(2.001) p<.048) were significantly associated with child externalizing behaviours.”
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    § Additional information

    Postpartum paternal depression symptoms significantly predicted child outcome before (sr2=0.14, p<.001) and after (sr2=0.11, p=0.004) entering maternal depression.

    “Postpartum PDep symptoms significantly predicted child outcome before (sr2=0.14,p < .001)and after (sr2=0.11,p=0.004) entering MDep.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Findingnone given
    § Implications for Future Research

    Data on the severity of paternal depression are relatively sparse.

    “We also note that the data on severity of paternal depression is relatively sparse;”
    Quote in the paperSubstantial claim

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    Findingcitation
    § Implications for Future Research

    Offspring vary in their susceptibility to paternal depression, and there is no clear gender-specific pattern of risk for girls versus boys.

    “The research suggests that offspring differ in their susceptibility to paternal depression, with no clear pattern with regard to gender specific risk factors between girls or boys (Hanington et al. 2010;Reeb et al. 2010;Ramchandani et al. 2005).”
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    Findingnone given
    § Additional information

    Paternal depression symptoms at 3 and 36 months predict more father-reported child problems at 51 months but not mother-reported problems.

    “PDep symptoms (3 & 36 months) predicted more father-reported child problems (51 months) but not mother-reported problems.”
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    § Additional information

    Maternal education is associated with increased internalizing and externalizing behaviours.

    “Child noncompliance (age 2) and maternal education were associated with increased internalizing and externalizing behaviours.”
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    Findingown data
    § Additional information

    Postpartum paternal depression symptoms were significantly related to externalizing problems at entry (sr2=0.07, p=0.02) but less significant when entered after mothers' symptoms (sr2=0.05, p=0.07).

    “Postpartum PDep symptoms were significantly related to externalizing problems at entry (sr2=0.07,p=0.02) but less significant when entered after mothers' symptoms (sr2=0.05,p=0.07).”
    Quote in the paperNot a substantial claim

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    Findingown data
    § Limitations

    The review found consistent links between paternal depression and offspring outcomes; these links are small to moderate in size and have multiple mediators.

    “although there are consistent associations between paternal depression and offspring outcomes, these are of a small to moderate magnitude and subject to multiple mediators.”
    Quote in the paperSubstantial claim

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    Findingnone given
    § Additional information

    Most offspring symptoms decrease with treatment of maternal depression but not for offspring of treated depressed fathers.

    “Most offspring symptoms decreased with treatment of MDep but not for offspring of treated depressed fathers.”
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    Premisecitation
    § Mechanisms of Risk

    As parenting behaviours change due to depressive symptoms, hostility and marital conflict may increase, while the quality and frequency of father-child interaction decreases, impacting offspring functioning.

    “As parenting behaviours change due to depressive symptoms, hostility and marital conflict may increase, whilst the quality and frequency of father-child interaction decreases, which consequently impacts on offspring functioning (Davé et al. 2008;Franck & Buehler 2007;Gutierrez-Galve et al. 2015;Middleton et al. 2009;Wilson & Durbin, 2010).”
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    Premisecitation
    § Mechanisms of Risk

    About 10% of fathers are susceptible to depression in the prenatal and postpartum stage, with the highest risk in the 3-6 month postpartum period.

    “Epidemiological research suggests that approximately 10% of fathers are susceptible to depression in the prenatal and postpartum stage with the highest risk existing in the 3-6 month postpartum period (Paulson et al. 2010).”
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    § Mechanisms of Risk

    Gene-environment interactions may be important moderators of risk for developing children.

    “gene environment interactions may constitute important moderators of risk for developing children (Caspi et al. 2003).”
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    § Mechanisms of Risk

    The impact of depression on parenting behaviours could mediate transmission of risk to offspring.

    “In light of this, it has been proposed that the impact of depression on parenting behaviours (Middleton et al. 2009;Ramchandani & Psychogiou, 2009) could be a mediating mechanism for transmission of risk to offspring.”
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    Study design and conductown data
    § Literature Search

    Where eligibility was unclear, texts were reviewed by the second author and consensus agreement was reached.

    “Where eligibility of inclusion in the review was unclear (n=6), texts were reviewed for inclusion by the second author and a consensus agreement was reached.”
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    Premisecitation
    § Timing of Paternal Depression and Offspring Outcomes

    Paternal depression is associated with increased likelihood of anxiety and depressive symptoms and Major Depressive Disorder in adolescents.

    “Similar results exist regarding the association of paternal depression and adolescent functioning with increased likelihood of anxiety and depressive symptoms and Major Depressive Disorder (Klein et al. 2005;Reeb et al. 2010;Reeb et al. 2015).”
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    § Mechanisms of Risk

    Depressed mothers are more likely than nondepressed mothers to practice poor parenting behaviours and have negative interactions with their children.

    “There is also evidence that suggests depressed mothers are more likely than nondepressed mothers to practice poor parenting behaviours and have negative interactions with their children (Hops, 1995).”
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    § Mechanisms of Risk

    Depressed mothers are less likely to promote safety behaviours and more likely to use corporal punishment.

    “Depressed mothers are also less likely to promote safety behaviours that may prevent injury and harm among their children and are more likely to use corporal punishment (Chung et al. 2004;Mclennan & Kotelchuck, 2000).”
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    § Mechanisms of Risk

    Exposure to stress has a greater detrimental effect on developmental outcomes on a dose-equivalent basis, and if exposure occurs in the first 2-3 years of life.

    “In addition, the ACE literature indicates that exposure to stress has a greater detrimental effect of developmental outcomes on a doseequivalent basis, and if exposure to stress occurs in the first 2 -3 years of life (e.g.Shonkoff et al., 2012;Kelly-Irving et al., 2013).”
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    Study design and conductcitation
    § Literature Search

    The review followed PRISMA guidelines.

    “The review followed PRISMA guidelines (BMJ, 2009).”
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    Premisecitation
    § Timing of Paternal Depression and Offspring Outcomes

    Postnatal paternal depression is linked to poorer academic performance in offspring.

    “These heightened risks have also been linked with poorer academic performance (Doctoroff et al. 2006;Metsapelto et al. 2015)”
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    Study design and conductown data
    § Quality Assessment

    An individual blind to the aims rated 30% of the studies, with 91.5% agreement on criteria.

    “An individual blind to the aims of this review rated 30% of the studies, with 91.5% agreement on criteria.”
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    Premisecitation
    § Timing of Paternal Depression and Offspring Outcomes

    Postnatal paternal depression is linked to prosocial behaviour and peer problems.

    “prosocial behaviour and peer problems (Davé et al. 2008)”
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    Study design and conductcitation
    § Quality Assessment

    A supplementary reporting bias checklist was created using the STROBE checklist.

    “A supplementary checklist on reporting bias was also created using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist (Von Elm et al. 2007)”
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    Premisecitation
    § Mechanisms of Risk

    Genetic risks have been identified in the transmission of depression.

    “Although genetic risks have been identified in the transmission of depression (Merikangas et al. 2002)”
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    Study design and conductcitation
    § Quality Assessment

    Quality assessment was conducted with an adapted version of the AHRQ methodology checklist.

    “Quality assessment was conducted with an adapted version of the Agency for Healthcare Research and Quality (AHRQ) methodology checklist (Williams et al. 2010).”
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    Study design and conductown data
    § Study Quality

    Blinding of assessors was unaccounted for consistently, with only one study employing partial blinding.

    “The blinding of the assessors was unaccounted for consistently across the included studies, with again only one study employing partial blinding of the researchers (Pilowsky et al. 2014).”
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    Study design and conductreasoning
    § Study Quality

    The length of follow-up points varied considerably, meaning the influence of time is unclear.

    “Yet, the length of these follow-up points varied considerably, meaning the influence of time is unclear.”
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    Interpretationreasoning
    § Indirect Effect of Paternal Depression

    The findings suggest a multi-factorial model of offspring risk, with direct and indirect effects on offspring outcomes.

    “This suggests a multi-factorial model of offspring risk, with direct and indirect effects on offspring outcomes.(See figure 2).”
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    Premisecitation
    § Mechanisms of Transmissions of Risk

    Fathers who exhibit depressive symptoms during the postnatal period have a lesser sense of parenting efficacy and increased parental distress.

    “Fathers who exhibit depressive symptoms during the postnatal period have been found to obtain a lesser sense of parenting efficacy and increased levels of parental distress (Demontigny et al. 2013).”
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    Interpretationown data
    § Discussion

    The findings do not necessarily suggest a direct causal link for transmission of risk, as the direct effect of paternal depression on offspring problem behaviours was relatively modest.

    “This does not necessarily suggest a direct causal link for transmission of risk, as the direct of paternal depression on offspring problem behaviours was of a relatively modest size.”
    Quote in the paperSubstantial claim

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    Premisecitation
    § Mechanisms of Transmissions of Risk

    Maternal depression decreases the likelihood of secure attachment and increases the risk for avoidant and disorganized attachment.

    “Research suggests that maternal depression decreases the likelihood of secure attachment and increases the risk for avoidant and disorganized attachment (Martins & Gaffan, 2000;Teti et al. 1995).”
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    Interpretationown data
    § Discussion

    Associations were stronger and more common in early childhood, suggesting this may be a particularly sensitive period.

    “Associations were stronger and more common in early childhood, suggesting this may be a particularly sensitive period of development.”
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    Interpretationown data
    § Study Quality

    The highest quality rating was 18 points, achieved by Ramchandani et al. 2008b and Smith et al. 2013, suggesting these are strongest methodologically.

    “The highest rating achieved was 18 points (Ramchandani et al. 2008b;Smith et al. 2013), suggesting that these two studies are strongest methodologically.”
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    • cites Ramchandani et al. 2008b

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    Premisecitation
    § Mechanisms of Transmissions of Risk

    In families with depressed parents, marital conflict has been suggested to rise by as much as 50% from the antenatal to the postnatal period, producing a substantial increase in risk for children.

    “this conflict has been suggested to increase by up to 50% between the antenatal and postnatal period in families with depressed parents, resulting in a large risk increase for children (Hanington et al. 2012).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hanington et al. 2012 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § Mechanisms of Transmissions of Risk

    Maternal depression influences offspring in a more direct way and depends less on contextual mechanisms than paternal depression does.

    “This method is considerably different to how maternal depression impacts offspring, with the influence much more direct and less reliant on contextual mechanisms (Gutierrez-Galve et al. 2015).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Gutierrez-Galve et al. 2015 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § Mechanisms of Transmissions of Risk

    Father interaction and father non-involvement are both associated with child internalizing and externalizing behaviours.

    “Consistent with this model, father interaction and father noninvolvement are both associated with child internalizing and externalizing behaviours (Wilson & Durbin, 2010)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Wilson & Durbin, 2010 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data
    § Limitations

    The included studies examined cohorts in the UK, USA, Netherlands and Australia, so the review has some generalizability.

    “However, studies that were included examined cohorts in the UK, the USA, the Netherlands and Australia, meaning there is more than an element of generalizability for this review.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning
    § Limitations

    More severe or clinical depression in fathers may intensify the harmful effect on offspring development.

    “This suggests that clinical or more severe cases of depression may increase the negative effect on offspring development.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation
    § Implications for Future Research

    It is well known that genders differ in risk for specific forms of developmental psychopathology: girls are more likely to have internalizing disorders and boys externalizing disorders.

    “This is puzzling, given the well-known observation of differing patterns of risk to specific forms of developmental psychopathology between genders, with girls more likely to exhibit internalizing disorders, and boys to present with externalizing disorders (Zahn-Waxler, Shirtcliff and Marceau, 2008).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Zahn-Waxler, Shirtcliff and Marceau, 2008 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning
    § Limitations

    Because studies were conducted only in the UK, Europe, Australia and the USA, the findings have limited cross-cultural generalizability.

    “In addition, studies were only conducted in UK, Europe, Australia and USA limiting cross-cultural generalizability of the findings.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § Limitations

    The most commonly used measure was the EPDS; although validated for men, it combines depressive and anxiety symptoms.

    “The most frequent measure utilized was the EPDS, which although validated for use in men, also conflates depressive and anxiety symptoms (Green, 1998;Stuart et al. 1998).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Green, 1998 source

      Not checked in the free run.

    • cites Stuart et al. 1998 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Limitations

    The father's role varies across cultures, and father involvement differs worldwide; therefore, paternal depression may have a weaker effect on children in other cultures.

    “The role of the father differs across cultures, with father-involvement varying in degree throughout the world and as such the effect of paternal depression may not be as strong on children in other cultures (Munroe & Munroe, 1992).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Munroe & Munroe, 1992

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation
    § Limitations

    Paternal depression was almost always measured with self-report questionnaires, which introduces a potential reporting bias.

    “Paternal depression was almost exclusively measured using self-report questionnaires introducing a potential reporting bias.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation
    § Implications for Clinical Practice

    Infant constitutional difficulties such as colic or dysregulated sleep may increase family stress, which can raise parental sleeplessness, distress and low mood, affecting parenting and making the baby more uncomfortable or difficult.

    “For instance, an infants' constitutional difficulties at any given time (e.g.colic, dysregulated sleep patterns) may contribute to family stress, which in turn may contribute to increased levels of parental sleeplessness, distress and low mood, which can affect parenting, and lead to babies becoming more uncomfortable/difficult (Gross et al., 2008;Hestbaek et al., 2014).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Gross et al., 2008 source

      Not checked in the free run.

    • cites Hestbaek et al., 2014 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning
    § Implications for Clinical Practice

    Parenting relationships are complex and interactional, especially when viewed over time.

    “Finally, the review highlights the complex interactional nature of parenting relationships, particularly when viewed longitudinally.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning
    § Limitations

    Being monitored in a cohort study may provide extra support that buffers the effect of paternal symptoms, possibly explaining the modest associations.

    “Consequently, the act of being monitored within a cohort study may act as a form of additional support, buffering the effect for paternal symptoms, which again may explain the modest associations.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation
    § Mechanisms of Transmissions of Risk

    Father interaction and non-involvement are two primary mechanisms through which paternal depression can negatively impact child outcomes.

    “and these are two primary mechanisms through which paternal depression can negatively impact upon child outcomes.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning
    § Limitations

    Bidirectional relationships may also affect how fathers interpret and later rate their child's symptoms.

    “this may also impact on fathers' interpretation and subsequent rating of child symptoms.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § Implications for Clinical Practice

    Women are routinely screened for postnatal depression, whereas until recently men rarely were.

    “Women are consistently screened for postnatal depression but this was until recently, rarely the case for men (Goodman, 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Goodman, 2004 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § Implications for Clinical Practice

    The risk of depression in partners is higher, and typical paternal mental health may cushion the impact of maternal depression on child outcomes.

    “This is especially important as the risk of depression co-existing in partners is higher, and normal paternal mental health can buffer the effects of maternal depression on offspring outcomes (Gere et al. 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Gere et al. 2013 source

      Not checked in the free run.

75 of 75

  • The authors state this as an assumption.

    Perinatal maternal depression and perinatal paternal depression present in the same way.

    “However, this rests on the proposition that perinatal maternal and paternal present in the same way.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentt(384) = 1.11reported n.s. · recomputed p = .268

    “t(384)=1.11, ns.”

  • Consistentt(384) = 0.52reported n.s. · recomputed p = .603

    “t(384)=0.52, ns”

2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Paternal non-involvement percentage is miscalculated

    Major

    The stated 5.4% share uses 0.046 divided by 0.168, which is 27.4%. The same numerator is also given for couple conflict, which is correctly reported as 27.4%.

    Reported 5.4 · recomputed 27.380952

  • Marital-conflict study count changes

    Minor

    The results section says marital conflict was a mediator in five included studies, while the discussion says it mediated the association in seven.

  • Reported percentages reverse the stated group comparison

    Minor

    The text says offspring of depressed fathers were less likely to have these problems, but its displayed comparison puts the fathers' group at 11% and the mothers' group at .37%. As printed, 11% is higher.

  • Full-text screening counts omit five articles

    Minor

    The flowchart reports 52 articles after abstract review and 31 excluded after full-text review. That leaves 21, not the reported 16 included after full-text review.

    Reported 16 · recomputed 21

4 of 4

Cites

Flagged first, then by citations

2 of the 107 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Sweeney, S., & MacBeth, A.
Affiliations
University of Edinburgh (GB)
Corresponding author
MacBeth, Angus
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2016-11
Volume
205
Pages
44-59
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2016.05.073
OpenAlex
W2473908384
Cited by
257
References
107
Citations by year
2026: 30 · 2025: 28 · 2024: 27 · 2023: 37 · 2022: 23 · 2021: 39 · 2020: 30 · 2019: 23 · 2018: 12 · 2017: 8
FWCI
2.12
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Demography › Family Dynamics and Relationships
Keywords
paternal depression, child development, adolescent outcomes, father involvement, marital conflict, antenatal depression, postpartum depression, gene-environment interaction
MeSH terms
Adolescent, Child, Child Development, Depressive Disorder, Fathers, Female, Humans, Male, Pregnancy, Prenatal Exposure Delayed Effects, Adolescent Development

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-01.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-01.

Statistics and arithmetic are recomputed, not judged.

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