Predictors of Maternal Depressive Symptom Trajectories Over the First 18 Months in Home Visiting




Angelique R. Teeters, Robert T. Ammerman, Chad E. Shenk, Neera K. Goyal, Alonzo T. Folger, Frank W. Putnam, and Judith B. Van Ginkel

Brief Type

Journal Publication


  • Healthy Families America (HFA)
  • Nurse-Family Partnership (NFP)


Maternal depression negatively impacts maternal functioning and parenting behaviors. Mothers participating in home visiting programs are at particularly elevated risk for depressive symptoms due to demographic and associated risk factors. Moreover, additional empirical evidence has demonstrated that mothers with depression do not benefit from home visiting interventions to the same extent as their peers without depression. The purpose of this study was to identify predictors of depression course in mothers participating in home visiting over the first 18 months of service. Participants were 220 low income mothers participating in a home visiting program who completed the Beck Depression Inventory-II (BDI-II) at enrollment and 9 and 18 months later. Measures of childhood maltreatment history, social support, and locus of control were also collected at enrollment. Group-based trajectory modeling revealed 3 groups labeled as minimal (63.6%), mild (30.5%), and moderate-severe (5.9%). Although a slight decrease in depressive symptoms was observed over time in the minimal and mild groups, mothers in the moderate-severe group exhibited a large increase from enrollment to 9 months that persisted through 18 months. Membership in the mild and moderate-severe groups was predicted by history of childhood maltreatment, low levels of social support, and an external locus of control. Implications of these findings for home visiting programs are discussed. (author abstract)

Data Collection Methods

  • Standardized assessment tools



For More Information

Teeters, A. R., Ammerman, R. T., Shenk, C. E., Goyal, N. K., Folger, A. T., Putnam, F. W., & Van Ginkel, J. B. (2016). Predictors of maternal depressive symptom trajectories over the first 18 months in home visiting. American Journal of Orthopsychiatry, 86(4), 415–424. https://doi.org/10.1037/ort0000159
Author Contact Information:
Robert T. Ammerman


  • Participant Characteristics
  • Participant, Family, and Program Outcomes