Maternal Mental Wellbeing Shapes Children’s Early Cognitive Development, Gusto Study Finds

Singapore study finds that absence of anxiety or depressive symptoms in mothers does not necessarily indicate wellbeing, and positive maternal wellbeing is linked to stronger cognitive development in preschool children

SINGAPORE — A Singapore study tracking 328 mother-child pairs has found two distinct pathways linking maternal mental health to child outcomes at age four. The research from A*STAR Institute for Human Development and Potential (A*STAR IHDP), in collaboration with the Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), and KK Women's and Children's Hospital (KKH), draws on data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort.

While poor maternal mental health, including anxiety and depression symptoms, was linked to harsher or more lenient parenting and behavioural difficulties in children, positive maternal wellbeing was linked to warm parenting characterised by clear boundaries and stronger cognitive abilities. Crucially, the researchers found that positive and negative mental health operate largely independently – meaning that treating depression does not automatically boost positive mental health.

These findings suggest that supporting mothers to thrive emotionally, not just reducing psychological distress, may be an important lever for enhancing children’s early cognitive development.

"Not depressed" is not the same as thriving

Standard mental health screening typically places mothers on a single scale: from "depressed" to "not depressed." But this study supports a dual-factor model where mental health consists of two separate dimensions:

• Negative mental health: The presence of distress, such as depression and anxiety.
• Positive mental health: The presence of wellness, such as feeling calm, confident, and optimistic.

Under this model, a mother can score low on negative mental health – appearing healthy on standard screenings – and yet score low on positive wellbeing. She is "functional but not flourishing." The study found that while such mothers may avoid the negative impacts of negative mental health, their children may still miss out on the developmental benefits associated with high positive wellbeing.

Two pathways to child development

The researchers assessed children at ages 4 to 4.5 — a critical window before formal schooling — using standardised tests for IQ, vocabulary, numeracy, and executive function. They found that the two dimensions of maternal mental health influence children through different parenting styles, leading to different outcomes:

• The "risk" pathway: Mothers with higher depression or anxiety symptoms tended toward strict, punitive parenting or overly lenient parenting with few boundaries. These styles were linked to more behavioural difficulties in children.
• The "benefit" pathway: Mothers with higher positive wellbeing were more likely to parent with warmth while setting clear boundaries and explaining rules. This style was linked to cognitive benefits: stronger IQ, vocabulary, numeracy, and executive function in children.

In short, addressing negative mental health and promoting wellbeing in mothers are two separate goals — with two separate benefits for children.

Why parenting style matters

The study highlights "authoritative" parenting as the key link between maternal wellbeing and child cognitive development. Researchers distinguish between three primary styles:

• Authoritative: High warmth paired with clear standards. These parents set boundaries but explain the reasoning behind rules, fostering understanding.
• Authoritarian: Low warmth, high control. These parents demand obedience and use punishment without explanation.
• Permissive: High warmth, low standards. These parents are lenient and often avoid enforcing boundaries.

Of these three styles, authoritative parenting has long been linked to better cognitive outcomes in children — a finding supported by multiple studies over several decades. What this study adds is evidence that a mother's positive emotional state may be what enables her to maintain this engaged, patience-demanding style.

"Our findings suggest that public health policies could go beyond treating mental disorders to actively support mothers' positive wellbeing. Helping mothers feel calm and confident may benefit both parenting and children's cognitive development during the preschool years," said Dr Michelle Kee, the study's first author and Principal Scientist at A*STAR IHDP.

"In clinical practice, some Asian mothers may have grown up in families where an authoritarian parenting style is not uncommon, so it can be a challenge to adopt a warmer style without being permissive. This study provides good evidence that we can share with mothers to nudge them to shift their caregiving approach towards a more authoritative one,” said Associate Professor Helen Chen, co-author of the study and Senior Consultant, Department of Psychological Medicine, KK Women’s and Children’s Hospital.

Study citation:

Kee MZL, Phua DY, Chen HY, et al. Distinct Roles of Positive and Negative Maternal Mental Health in Parenting Styles and Child Development. JAACAP Open (2025). https://doi.org/10.1016/j.jaacop.2025.11.007