High rates of depression have been found in most countries (McManus et al., 2016). Multiple factors have been linked to depression development, including the endorsement of negative thinking styles or ‘negative cognitive schemas’ (Beck, 2008). Negative schemas are suggested to alter the interpretation of new experiences, and in turn increase the risk of depression. Preventing the development of negative cognitive styles could present as an effective method to reduce depression rates.

Pearson et al (2013) previously presented evidence of an association between a mother’s negative thinking styles during pregnancy and offspring negative thinking styles 18 years later. However, despite the increasing involvement of fathers in child’s care, only a handful of studies, with clear methodological limitations, investigated the association between paternal and offspring thinking styles.

This study aimed to fill the current gap in the literature and investigated associations between paternal negative cognitive styles during pregnancy and offspring negative cognitive styles 18 years later, in a large population‐based birth cohort (Lewis et al, 2018).

Methods

Sample

The authors utilised The Avon Longitudinal Study of Parents and Children (ALSPAC), which is an on-going birth-cohort study. Pregnant women with an expected delivery date between 1^st April 1991 and 31^st December 1992, from Avon, Bristol were recruited to take part in the study. This dataset consists of 14,541 women and 13,154 fathers/partners of these women.

Measures

1. In order to assess offspring negative cognitive styles, the Cognitive Style Questionnaire Short form (CSQ-SF) was used for adolescents with an average age of 17 years and 10 months

2. Paternal negative cognitive style was measured for both parents when the mothers were 18 weeks into the pregnancy, using ‘The Interpersonal Sensitivity Measure’

3. Offspring depressive symptoms were measured using a computerised self-administered version of the Clinical Interview Schedule-Revised (CIS-R).

Confounders

The authors accounted for: parent age, highest educational qualification, social class, smoking during pregnancy and depressive symptoms.

The authors used linear regression models, with paternal negative cognitive style scores as the exposure and offspring negative cognitive style scores as the outcome. The authors adjusted for maternal negative cognitive style after which all potential confounders were added to the model. The authors also assessed if the association between paternal and adolescent cognitive style differed from that of maternal cognitive style and if this association differed based on the gender of the offspring.

Further, the authors utilised structural equation modelling to test if the association between paternal cognitive styles during pregnancy and offspring cognitive styles at age 18 was independent of offspring depressive symptoms at age 18.

Missing data

To account for missing data, the authors utilised multiple imputation; a process that involved replacing missing data with substituted values based on the initial complete-case data for paternal cognitive style at 18 weeks pregnancy. The resulting sample-size was 6,123. They compared this to the analysis on complete-case, with total sample-size 1,881.

Results

• Compared to the entire ALSPAC cohort, families with complete data tended to be from higher social classes, were more educated, and had lower parental depressive symptoms scores.
• Authors also found evidence of an association between paternal and offspring cognitive style at age 18, and this association remained even after controlling for maternal cognitive styles.
  • It is worth noting that the magnitude of this association did not differ from the association previously found with maternal cognitive styles.
  • Furthermore, adjusted associations between paternal and offspring cognitive styles for the imputed sample (p=0.012) yielded similar results compared to complete case sample (p=0.005).
• An interesting finding was that the interaction between paternal and offspring cognitive styles was independent of the sex of the child, suggesting that the association was similar for females and males.
• After adjustments for confounders, authors found strong evidence that paternal negative cognitive styles during pregnancy were associated with offspring depressive symptoms at age 16.
  • 20% of the association between paternal cognitive styles during pregnancy and offspring cognitive styles at age 18 was mediated through offspring depressive symptoms at age 16.
  • This evidence does suggest a direct effect of paternal cognitive styles on offspring cognitive styles.

Discussion

• This study demonstrated an association between paternal negative cognitive styles, independent of maternal negative cognitive styles
• This suggests that mothers and fathers independently contribute to the development of negative cognitive styles in their children. 

Strengths and limitations

This was the largest and first longitudinal study to date, addressing the relationship between paternal and offspring negative cognitive styles. A strength of this study was its methodology, whereby the authors accounted for numerous other factors that may have had an influence on the outcome and as well as that, displayed that missing data did not bias their results. Another strength was that the authors collected data on parental cognitive styles before the child was born to ensure a clear direction of the cause-and-effect relationship.

Nonetheless, the authors acknowledged a handful of limitations, including loss of data at follow up, which can affect the precision of findings (Sterne et al, 2009). Furthermore, there was still a possibility that factors not accounted by the study may have influenced the outcome. Finally, while these results demonstrate the influence of negative paternal cognitive styles on offspring negative cognitive styles, this study cannot explain the mechanism underlying this effect. The authors did, however, suggest some possible explanations, such as genetic transmission, parenting styles, and social learning/modelling.

Implications

• While this paper was methodologically strong, more research is needed to corroborate the findings of this study and investigate the possible mechanisms underlying this finding.
• Considering the novel finding of this study, future interventions may need to increase acknowledgement of the role of paternal influence.
• As adolescents with negative cognitive styles are at risk for future depression, it is possible that preventing such cognitive styles could prevent depression.
• Therefore, future research may need to focus on developing interventions that modify parental cognitive styles and testing the effectiveness of such.

Contributors

Thanks to the UCL Mental Health MSc students who wrote this blog: Aleksandra Paksina (@a_paksina) Alice O’Mahony, Franca Onyeama, Hin Ching Koey Tin, Maitri Khurana, Natalia Chemas Lopez, Nora Bahhar, Sedigheh Zabihi, Tabs Craston (@CrastonTabs) and Terry Lau.

Conflicts of interest

None.

UCL MSc in Mental Health Studies

This blog has been written by a group of students on the Clinical Mental Health Sciences MSc at University College London. A full list of blogs by UCL MSc students from can be found here, and you can follow the Mental Health Studies MSc team on Twitter.

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Links

Primary paper

Lewis G, Wen S, Pearson RM, Lewis G. (2018) The association between paternal depressogenic cognitive styles during pregnancy and offspring depressogenic cognitive styles: an 18-year prospective cohort study. J Child Psychol Psychiatry. 2018;59(5):604–614. doi:10.1111/jcpp.12847

Other references

Beck, A. (2008). The evolution of the cognitive model of depression and its neurobiological correlates. American Journal of Psychiatry, 165, 969– 977

McManus, S., Bebbington, P., Jenkins, R., & Brugha, T.S. (2016). Mental health and well‐being in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital

Pearson, R.M., Fernyhough, C., Bentall, R., Evans, J., Heron, J., Joinson, C. & Lewis, G. (2013). Association between maternal depressogenic cognitive style during pregnancy and offspring cognitive style 18 years later. American Journal of Psychiatry, 170, 434– 441

Sterne, J.A.C., White, I.R., Carlin, J.B., Spratt, M., Royston, P., Kenward, M.G. & Carpenter, J.R. (2009). Multiple imputation for missing data in epidemiological and clinical research: Potential and pitfalls. BMJ (Clinical Research ed.), 338, b2393