A father’s poor mental health may harm his children’s development, study finds

By Kristen Rogers, CNN

(CNN) — Mothers bear much of the burden for a child’s healthy development, from pregnancy through their teen years.

But a large, new study adds to the growing body of evidence saying fathers, too, are responsible for the types of development that help children grow physically, emotionally and cognitively.

Fathers’ mental distress is slightly associated with subpar child development, including cognitive, social-emotional, language and physical development, according to the study published Monday in the journal JAMA Pediatrics. The researchers defined mental distress as symptoms or a diagnosis of depression, anxiety, a mix of both or stress. The findings were especially true in the perinatal period, which spans from conception to two years postpartum.

During this time, the developing fetus, infant then toddler is particularly sensitive to any mental distress parents, especially the mother, experience, according to the study.

“Men are at risk of increased mental distress during the transition to fatherhood, with prevalence rates among men during the perinatal period as high as 8% for clinical depression, 11% for anxiety, and 6% to 9% for elevated stress,” the authors wrote in the study.

“This represents the most comprehensive global review to date on the association between fathers’ perinatal mental health and offspring development,” said Dr. Delyse Hutchinson, senior author of the study and associate professor in the SEED Lifespan Research Centre at Deakin University in Australia, via email.

“What stood out was the striking consistency in the trends observed in the results,” Hutchinson, a clinical psychologist, said. “This highlights the importance of supporting fathers if we want to see better outcomes for families.”

While previous studies have linked fathers’ poor mental health with potential harms on their children’s development, the results were limited by the number of forms of development they investigated or the strength of their results.

In addition to expanding this kind of research beyond mother-child pairs, the authors also wanted to fill those research gaps. They analyzed ties between paternal depression, anxiety or stress and six types of child development: social-emotional, adaptive, cognitive, language, physical and motor development from birth to age 18.

Factors of social-emotional development included a child’s ability to form positive relationships with peers, act in ways that benefit others, have healthy relational attachment, self-soothe and have a healthy temperament. Adaptability referred to a child’s ability to respond to change and manage daily needs. Cognitive development included the health of a child’s executive function skills, decision-making, memory, attention, learning, IQ and academic performance.

Physical development factors included preterm birth, gestational growth and childhood height, weight, stunting, abdominal pain and sleep health. Motor development referred to fine motor skills, which involve the use of small muscles for actions such as writing or buttoning, and gross motor skills. Those latter skills use larger muscles for movements including waving your arm, walking or chewing.

Building evidence on paternal health

The findings derive from 84 previous studies totaling thousands of father-child pairs. All studies had followed participants over time, with mental distress measured from pregnancy to two years post birth, Hutchinson said. The authors excluded studies with fathers who had a medical condition, took medication or consumed alcohol or other drugs.

There was no evidence for links between paternal mental distress and adaptive and motor development, the study found. But there were negligible to small associations with the other developmental outcomes including social-emotional, cognitive, language and physical maturation. The largest impacts were in early childhood, then infancy, then middle childhood.

The associations were also generally stronger for postnatal mental distress than preconception mental distress, “suggesting that a father’s mental state may exert a more direct influence on the developing child after birth,” the authors said. A father’s mental distress may affect his sensitivity and responsiveness in interactions with his child and disrupt attachment security, Hutchinson said.

“The timing of this review is excellent,” wrote independent experts Dr. Craig Garfield, Dr. Clarissa Simon and Dr. John James Parker of Ann & Robert H. Lurie Children’s Hospital in a commentary on the study. “Fathers spend more time than ever on childcare and are increasingly recognized as important contributors to family health and well-being.”

The results affirm well-established evidence of the importance of supportive parenting on the well-being of children, said Dr. Arwa Nasir, a professor of pediatrics at the University of Nebraska Medical Center in Omaha, Nebraska, via email. Nasir wasn’t involved in the study.

Research on the role that fathers play in the lives of their children is important,” Nasir added. “I hope future research will also clarify all the important and wonderful ways that fathers can enrich and support the health and development of their children.”

What remains unknown

Though the idea of a father’s well-being influencing his child could be a natural conclusion, one drawback of the study is its partial reliance on gray literature — unpublished research that, in this case, included doctoral theses and interviews with authors of published studies that met criteria but hadn’t reported relevant data. Of the 674 associations found, 286 were from unpublished work.

However, the authors of the new study said when they compared their findings based on published research with their results reliant on unpublished studies, the new associations remained similar for most categories of development.

Additionally, while the study is “well-designed,” it doesn’t prove a causal relationship and lacks larger context, Nasir said.

“It could simply be that both fathers and children’s emotional wellbeing are impacted by the same larger psychosocial factors and socioeconomic pressures, such as poverty, structural racism and health disparities,” Nasir explained. “Presenting the association between fathers’ mental health and children’s health outcomes in isolation from the larger societal factors risks presenting the fathers as the cause of children’s problems.”

This interpretation can also be stigmatizing, Nasir added. “If the goal is supporting optimal health and development of children, I believe our focus in research and action should be exploring ways that society can support parents through economic security, equity, and justice.”

Improving fathers’ well-being

The study emphasizes the importance of assessing and treating the well-being of both parents during health care visits in the perinatal period, experts said.

“Borrowing from the decades-old strategy of perinatal maternal screening for (postpartum depression), clinicians, researchers, and policymakers can build on the existing maternal infrastructure to design father-tailored programs and policies that strive to improve the mental health of fathers and families,” Garfield, Simon and Parker wrote.

Parents are the guardians of “society’s future generations,” Nasir added. “Supporting the well-being of families should be a national priority.”

But to receive help, fathers have to speak up and honestly answer questions about mental health concerns, they added.

“It’s important for fathers to be aware that becoming a parent can be a challenging period, and that many fathers go through ups and downs during this time,” Hutchinson said.

Seeking support early can make a difference, she added, and it’s a strength, not a weakness. Fathers can talk with general physicians, therapists or providers at specialized pregnancy or postpartum clinics about mental health symptoms, Hutchinson said. Peer group support and online apps that use mindfulness and cognitive behavioral therapy to help manage moods can also be effective, she added.

Even if your children are older, it’s still never too late to prioritize your health, Hutchinson said. Every age and stage across child development is important, not just one period in time.

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