Thursday May 16 2013
The link was seen when fathers were absent in early childhood
“Study shows girls with absent fathers more likely to develop depression," the Mail Online has revealed.
It reports on a large UK study that found that girls whose biological fathers were absent during the first five years of their childhood had an increased risk of symptoms of depression. No increase in risk was found for girls whose fathers were absent later in childhood, and no increase in risk was found for boys with absent fathers.
Researchers collected information regarding the physical absence of the biological father during childhood, as well as information on depression symptoms when the child was 14. They assessed whether there was any association between these factors.
During their analysis, the researchers took into account several factors that may influence the link, such as family characteristics. However, despite the researchers' efforts to take these variables into account, the reasons why a father may be absent from the family home can be incredibly complicated. This means we can’t be sure whether other factors have produced the association between absent fathers and depression in girls.
Where did the story come from?
The study was carried out by researchers from the University of Bristol and was funded by the UK Medical Research Council, the Wellcome Trust and the University of Bristol.
The study was published in the peer-reviewed journal Psychological Medicine.
Media coverage of this research was broadly accurate, though neither ITV nor Mail Online outlined any of the study’s limitations.
What kind of research was this?
This was an analysis of data from a prospective cohort study called the Avon Longitudinal Study of Parents and Children. This is a study that has been ongoing since the 1990s that assesses influences on the health and development of children.
The researchers were interested in the potential link between the absence of the biological father in early childhood and the risk of mental health problems. They were specifically interested in symptoms of depression that were not necessarily severe enough to be considered clinical depression.
As a prospective cohort study, this research is less likely to be affected by certain types of bias, especially recall bias. It was important that the researchers collected data on the effect of family factors on the children’s mental health at the time, rather than at a later date, to help ensure the information was accurate. Prospective studies allow for this.
What did the research involve?
The researchers measured two main factors:
- absence of the biological father during childhood
- experience of depressive symptoms during the teenage years
To measure parental absence, the researchers used questionnaires, filled out by the children’s mothers regularly throughout the children’s lives. These questionnaires asked whether the ‘present live-in father-figure is the natural father of the child and, if not, how old the child was when the natural father stopped living with the family’. This information was used to divide the children into three groups:
- biological father present
- biological father not present during the first five years of life (during early childhood)
- biological father not present from age 5 to 10 (during middle childhood)
To assess the teenagers’ experiences of depressive symptoms, the researchers asked the study participants to complete a 13-item questionnaire when they were approximately 14 years old. This asked about the presence of certain symptoms over the previous two weeks. The questionnaire is reported to be a reliable and valid measure of depression in children. Children scoring 11 or higher on this questionnaire were considered to have high levels of depressive symptoms. This is not the same as being diagnosed with depression, however.
The researchers then analysed the data, comparing the risk of having high levels of depressive symptoms among children whose biological father left during early or middle childhood to the risk in children whose fathers were still living with them. These analyses were adjusted for several factors (confounders) that could be linked to both the absence of the father and depressive symptoms, including:
- socioeconomic status (including home or car ownership, major financial problems, family size and parents’ jobs)
- mother’s characteristics (including having a child before the age of 20, experiencing depression during pregnancy), and
- any parental conflict between the mother and her current partner
Separate analyses were carried out for boys and girls, to determine whether the child’s gender had any impact on the relationship between father’s absence and depressive risk.
What were the basic results?
There were approximately 14,500 children in the original cohort study, approximately 11,000 of whom had data available on the presence or absence of their biological father. Among these children, approximately 6,000 had available data regarding depressive symptoms at age 14.
Overall, girls reported higher levels of depressive symptoms than boys, regardless of whether their father lived with them or not – a trend that has also been found in previous studies.
The study included:
- 374 girls whose father left during early childhood, 87 (23.3%) of whom had high depressive symptoms at age 14
- 193 girls whose father left during middle childhood, 27 (14.0%) of whom had high depressive symptoms at age 14
- 2,295 girls whose father was present throughout childhood, 332 (14.5%) of whom had high depressive symptoms at age 14
The study included:
- 357 boys whose father left during early childhood, 30 (8.4%) of whom had high depressive symptoms at age 14
- 185 boys whose father left during middle childhood, 17 (9.2%) of whom had high depressive symptoms at age 14
- 2,227 boys whose father was present throughout childhood, 166 (7.4%) of whom had high depressive symptoms at age 14
When assessing the association between the absence of the father in early childhood and teenage depressive symptoms, researchers found that:
- Girls with absent fathers during early childhood had a 53% greater chance of experiencing high levels of depressive symptoms compared with girls with fathers present during this time (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.07 to 2.21).
- Boys with absent fathers were no more likely to report high levels of depressive symptoms at age 14 than boys whose fathers were present during early childhood (OR 1.08, 95% CI 0.65 to 1.79).
There was no significant association between middle childhood father absence and teenage depressive symptoms.
How did the researchers interpret the results?
The researchers concluded that “father absence in early childhood increases risk for adolescent depressive symptoms, particularly in girls”.
This large prospective cohort study suggests that there is a link between a father’s absence during the first few years of life and a girl’s risk of experiencing depressive symptoms.
This study has several strengths, including its large sample size, its long-term follow-up and prospective collection of data for the analyses. It also attempted to consider confounding variables during the analysis and was based in the UK, which helps to ensure that the results are applicable here.
There are some limitations, however, that should be taken into account, including the following.
- Only a third of the original cohort was analysed due to missing data on key factors. It is unclear to what extent those included differed from the entire population-based cohort. The researchers report that drop-outs were more likely among participants in lower socioeconomic groups. This factor is linked to both parental absence and depressive symptoms, so it could reduce the validity of the results and how much we can infer from them.
- The adjusted analyses further reduced the available sample size due to missing data on confounding factors, and the researchers suggest that this may have resulted in loss of statistical power to detect an effect.
- Several potential confounders were not included in the analysis, and could have influenced the results. The study authors report some of these potential confounders (quality of parent-child relationship, the father’s involvement in the child’s life regardless of whether he lived in the same house).
- The questionnaire used to assess depressive symptoms is not a measure of clinical depression. A high score on this questionnaire does not indicate that the child has or will develop a diagnosable depressive disorder.
Overall, this study suggests that early childhood family environments may play an important role in the mental health of children. At this stage we don’t know what accounts for the study’s results, and the researchers say that this should inspire future research into the possible biological and psychological mechanisms underpinning this relationship.
Depression is one of the most common mental health conditions, yet there is very little good quality evidence about how to prevent people developing depression. Research that gives us insight into the factors that increase children’s likelihood of developing depression would be invaluable.
Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter.