Prospective Bidirectional Associations between Attachment and Depressive Symptoms from Middle Childhood to Adolescence

Understanding the transdiagnostic mechanisms underlying emerging psychopathology in adolescence: study protocol of a 1-year prospective epidemiological (EMERGE) study

INTRODUCTION

Adolescent mental health is a global public health challenge as most cases remain undetected and untreated, and consequently, have a high likelihood of persistence or recurrence. It is critical to improve early detection of mental disorders and to target individuals experiencing subclinical symptoms. However, most indicated prevention approaches have been developed for risk syndromes of specific mental disorders. This contradicts the increasing recognition of emerging psychopathology as a complex system characterised by rapid shifts in subclinical symptoms, cutting across diagnostic categories and interacting with each other over time. Therefore, this study aims to examine the dynamic course, pattern and network of subclinical symptoms and transdiagnostic mechanisms over time.

METHOD AND ANALYSIS

The EMERGE-study is a prospective, naturalistic, 1-year follow-up study. A general population sample of 1196 adolescents will be recruited. Inclusion criteria are age between 11 and 17 years, German language skills, main residency in Switzerland and access to internet. Individuals will be excluded if they have a current or lifetime axis I mental disorder. Assessments of subclinical symptoms of several mental disorders and potential transdiagnostic mechanisms will be conducted at baseline and at 3-month, 6-month, 9-month and 12-month follow-up. Structural equation modelling will be used to estimate the homotypic and heterotypic patterns of subclinical symptoms and the associations with transdiagnostic mechanisms. Latent growth mixture modelling and growth mixture survival analysis will be carried out to identify subclasses of individuals with different trajectories of subclinical symptoms that may be predictive of an onset of a mental disorder. Network analysis will be applied to assess the centrality of subclinical symptoms and how networks of emerging psychopathology change over time.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the Bern Cantonal Ethics Committee (ID 2020-02108). All findings will be disseminated by publication in peer-reviewed scientific journals and by presentation of the results to conferences and stakeholder organisation events.

Parent-child relationship, parenting behaviors, and adolescents' depressive symptoms after an earthquake: unraveling within-adolescent associations from between-adolescent differences

This study assessed temporal associations between parent-child relationship, parenting behaviors (i.e., warmth, rejection, and overprotection), and adolescents' depressive symptoms after trauma, using random-intercept cross-lagged panel models to distinguish between- and within-adolescent differences. We surveyed Chinese adolescents 12 (Aug 2018; T1), 21 (May 2019; T2), 27 (Nov 2019; T3) months after the Jiuzhaigou earthquake that occurred in August 2017. Of the 585 adolescents who participated in at least two waves of the study, mean age at T1 was 15.50 years old (SD = 1.58 years) and 57.8% were girls. Controlling adolescents' gender, age, ethnicity, trauma exposure at T1, and parents' marital status, between-adolescent results showed that parent-child relationship and parenting behaviors, parent-child relationship and depressive symptoms were correlated across models of parental warmth, rejection, and overprotection, whereas depressive symptoms were only correlated with parental rejection and overprotection. Within-adolescent results indicated that parent-child relationship and adolescents' depressive symptoms had bidirectional associations via the mediation of parental warmth from T1 to T3. Over the longer term following the earthquake, we found that parental rejection was bidirectionally associated with adolescents' depressive symptoms, whereas parental overprotection was unidirectionally influenced by adolescents' depressive symptoms from T2 to T3. In addition, more depressive symptoms in adolescents were associated with worsening parent-child relationship from T2 to T3. In conclusion, shortly after trauma, interventions should focus on improving parent-child relationship and relieving adolescents' depressive symptoms. Over the longer term after trauma, relieving adolescents' depressive symptoms should be prioritized to avoid its eroding effects on parent-child relationship and parenting behaviors, and to break the "vicious cycle".

Parent-Child Attachment Security and Depressive Symptoms in Early Adolescence: The Mediating Roles of Gratitude and Forgiveness

Although greater parent-child attachment security is linked with children's lower levels of depressive symptoms, little research has evaluated potential explanatory mechanisms. We investigated whether dispositional gratitude and interpersonal forgiveness explain the relation between attachment security with parents and early adolescents' depressive symptoms. Early adolescents (N = 105; M age = 12.3 years; 51% girls) completed questionnaires assessing their attachment security to mother and father figures, depressive symptoms, and dispositional gratitude, and an interview assessing interpersonal forgiveness. Results revealed that greater attachment security to mothers and fathers was associated with fewer depressive symptoms and greater levels of dispositional gratitude and interpersonal forgiveness. Further, dispositional gratitude and interpersonal forgiveness were negatively associated with depressive symptoms. Dispositional gratitude emerged as a mediator between attachment security with each parent and depressive symptoms. Our findings suggest that greater parent-child security may promote early adolescents' appreciation of positive events, which in turn may relate to fewer depressive symptoms.

Gendered Parenting: Maternal Son Preference and Depressive Symptoms in Chinese Early Adolescents

This study focused on the nuanced phenomenon of gendered parenting by exploring how maternal son preference is associated with depressive symptoms among Chinese early adolescents. Focusing on 1093 junior high school students from a relatively affluent city in Western China, this study examined the mediating roles of mother-child attachment and father-child attachment as well as the moderating role of school connectedness in the relationship between maternal son preference and depressive symptoms. The results revealed a noteworthy positive correlation between maternal son preference and depressive symptoms among female adolescents, with no significant association observed in males. In addition, mother-child attachment and father-child attachment mediated the relationship between maternal son preference and girls' depressive symptoms, supporting the "spillover effect" and "crossover effect". Moreover, a moderation effect analysis indicated that a higher level of school connectedness can buffer the effect of maternal son preference on girls' depressive symptoms, while a lower level of school connectedness can enhance the effect of maternal son preference on girls' depressive symptoms. In addition, maternal son preference was negatively correlated with boys' depressive symptoms in relation to high school connectedness. These insights help enhance people's understanding of gendered parenting, emphasizing the enduring necessity of addressing son preference within the broader context of promoting gender equality.

Maternal Mental Health and Children's Problem Behaviours: A Bi-directional Relationship?

Transactional theory and the coercive family process model have illustrated how the parent-child relationship is reciprocal. Emerging research using advanced statistical methods has examined these theories, but further investigations are necessary. In this study, we utilised linked health data on maternal mental health disorders and explored their relationship with child problem behaviours via the Strengths and Difficulties Questionnaire for over 13 years. We accessed data from the Millennium Cohort Study, linked to anonymised individual-level population-scale health and administrative data within the Secure Anonymised Information Linkage (SAIL) Databank. We used Bayesian Structural Equation Modelling, specifically Random-Intercept Cross-Lagged Panel Models, to analyse the relationships between mothers and their children. We then explored these models with the addition of time-invariant covariates. We found that a mother's mental health was strongly associated over time, as were children's problem behaviours. We found mixed evidence for bi-directional relationships, with only emotional problems showing bi-directional associations in mid to late childhood. Only child-to-mother pathways were identified for the overall problem behaviour score and peer problems; no associations were found for conduct problems or hyperactivity. All models had strong between-effects and clear socioeconomic and sex differences. We encourage the use of whole family-based support for mental health and problem behaviours, and recommend that socioeconomic, sex and wider differences should be considered as factors in tailoring family-based interventions and support.

Turning to friends in preference to parents for support in early adolescence: does this contribute to the gender difference in depressive symptoms?

Introduction

Based on established evidence of gender differences in friendship patterns, and the vulnerability associated with early reliance on friends, we hypothesized that in 13-year-olds, a preference for turning to friends rather than parents for emotional support contributes to the gender difference in depressive symptoms.

Methods

Using a cross-sectional design, 671 adolescents (53.7% girls; mean age 13.11 ± 0.52 years) in a UK birth cohort [Wirral Child Health and Development Study (WCHADS)] reported turning to their parents and to their friends when distressed [Network of Relationships Inventory (NRI)] and depressed [Short Mood and Feelings Questionnaire (SMFQ)]. Preferentially turning to friends was assessed as turning to friends minus turning to parents for support. Analyses used path analysis using the gsem command in Stata.

Results

Girls had higher depressive symptoms than boys (p < .001). Consistent with the hypotheses, girls had higher scores than boys for preferentially turning to friends (p < .001). Preferentially turning to friends was associated with higher depressive symptoms (p < .001), and this mediated the gender difference in depressive symptoms (p < .001). The association between preferentially turning to friends and depressive symptoms was stronger for girls than for boys (p = .004).

Conclusions

In young adolescents, preferentially turning to friends over parents when distressed is common, and the association between preferentially turning and depressive symptoms is markedly higher in girls than in boys. This reflects either a gender difference in social vulnerability to depression or a greater impact of depression on the reliance on friends instead of parents in girls. While clarifying the directions of influence requires prospective study, these findings provide the first evidence that the assessment of depression in young adolescents should consider the degree of reliance on friends and parents.

Parent-Child Relationship Quality, Childhood Maltreatment, and Psychological Symptoms in Chinese Adolescent

This study aimed to examine the association between childhood maltreatment, parent-child relationship quality with psychological symptoms and to explore the moderating role of parent-child relationship quality in the association between childhood maltreatment and psychological symptoms among adolescents. It also probed to the role of gender differences in this effect. A representative sample of 14,500 middle school students in China were asked to complete a standard questionnaire on the details of childhood maltreatment, parent-child relationship quality, and psychological symptoms. All data were analyzed using SPSS 23.0. The PROCESS program was used to analyze whether parent-child relationship quality moderated the link between childhood maltreatment and psychological symptoms. The analyses revealed significant correlations between childhood maltreatment, parent-child relationship quality, and psychological symptoms (p < .001). Specifically, paternal relationship quality moderated the association between childhood maltreatment and psychological symptoms in the total sample (B = -0.01, p < .05) and the subgroup of girls (B = -0.01, p < .05), while maternal relationship quality moderated only the association between childhood maltreatment and psychological symptoms in the subgroup of boys (B = -0.01, p < .05). As the findings indicate, priority should be given to the quality of parent-child relationship and gender-specific methods employed to effectively reduce the psychological symptoms of adolescents with a history of childhood maltreatment.

Effect of Mothers' Parental Bonding Style on Their Maternal Attachment

Purpose: This study was aimed to investigate the relationship between mothers’ parental bonding styles and their maternal attachment levels. Methods: This descriptive and cross-sectional study involved 216 mothers. The data were collected using the Personal Information Form, the Maternal Attachment Inventory (MAI), and the Parental Bonding Instrument (PBI). Results: The mean MAI score of the mothers was found to be 96.72 ± 8.75 which indicated a high level of maternal attachment. The mean score from the PBI-mother form was found to be 49.13 ± 14.60 and PBI-father form was 46.12 ±14.90 which indicated that the mothers had a positive bonding with their parents.The relationship between an individual’s maternal attachment was found to be positive, moderate, and significant to her own parental bonding. Parental bonding with mother and parental bonding with father explained 35% and 23% of the total variance found in maternal attachment, respectively. Conclusion: Mothers’ parental bonding showed an effect on their maternal attachment as well. The families and couples should be trained on how positive or negative bonding with their children can affect their life cycles and future lives.

Association Between Social Participation and Cognitive Function in Community-Dwelling Adults

Social participation is associated with cognitive function; however, their causal relationships have not been reported yet. This study was designed to examine the autoregressive effects and bidirectional causal relationship between social participation and cognitive function. In this secondary longitudinal data analysis, we enrolled 4,834 Korean adults. A cross-lagged panel model with fixed effects was used to examine the causal relationships between social participation and cognitive function. Both participation (unstandardized coefficient = .370, p < .001) and cognitive function (unstandardized coefficient = .151, p < .001) had positive autoregressive effects over time. Participation had a cross-lagged effect on cognitive function (unstandardized coefficient = .061, p < .001). However, the cross-lagged effects of cognitive function on participation were not statistically significant (unstandardized coefficient = .051, p = .312). Various health-care programs that promote social participation and improve cognitive function must be established. Additional studies are required to confirm the causal effects of cognitive function on participation.

Child Psychological Functioning During the COVID-19 Lockdown: An Ecological, Family-Centered Approach

OBJECTIVE

To evaluate how sociodemographic characteristics and various aspects of parent well-being, family functioning, parent-child relationship, and child characteristics are related to psychological functioning in children aged 9 to 12 years during the COVID-19 lockdown.

METHOD

Participants included 144 children aged 9 to 12 years and their parents who lived in the province of Quebec, Canada, during the COVID-19 mandatory lockdown. Parents and children were administered a phone-based survey in which various child, parent, parent-child, and family characteristics were assessed.

RESULTS

Results showed that higher internalizing problems in children were related to greater depressive symptoms in parents, lower attachment security to parents, and greater aversion to aloneness in children. Results on externalizing behavior problems showed that more problems were associated with more family dysfunction and chaos and lower attachment security to parents. Finally, results on children's anxiety toward COVID-19 showed that more anxiety was associated with greater parental anxiety toward COVID-19 and more child aversion to aloneness.

CONCLUSION

Our findings showed that even during an unusual and stressful context such as a pandemic, proximal variables such as the attachment relationship that have been known to be closely associated with adaptation are significantly related to child psychological functioning. Such observations are important because they highlight factors that may accentuate child vulnerability in times of a pandemic and shed light on potential intervention targets.

Parent-Adolescent Communication and Early Adolescent Depressive Symptoms: The Roles of Gender and Adolescents' Age

Positive parent-adolescent communication has been found to be negatively related to adolescent depressive symptoms; however, few studies have investigated the moderating effects of adolescent gender and age on this relationship, especially during early adolescence in China. The present study investigated the joint moderating effects of adolescent gender and age on the linkage of father-adolescent and mother-adolescent communication with adolescents' depressive symptoms. A total of 11,455 Chinese junior high school students (M age = 14.15 years, SD = 1.22 years; 49.86% boys; N grade7 = 5712, N grade9 = 5743) completed ad hoc questionnaires of parent-adolescent communication and depressive symptoms. Multiple linear regression analyses were conducted. Results indicated that gender and age jointly moderated the association between parental communication and adolescent depressive symptoms. Specifically, for girls, the negative effects of both father-adolescent and mother-adolescent communication on depressive symptoms were stronger in 9th grade students than in 7th grade students, while for boys, the negative effects were not different between 7th grade students and 9th grade students. These findings suggest that in China, the protective effects of positive parent-adolescent communication on adolescents' depressive symptoms may be most salient among senior-grade girls in junior high school.

Mediating role of depressive symptoms linking insecure attachment and disordered eating in adolescents: A multiwave longitudinal study

Research has supported a link between insecure attachment and disordered eating in adolescents; however, how this influence is exerted remains unclear. This study explored whether depressive symptoms constitute a pathway through which insecure attachment to parents predicts subsequent development of disordered eating in the transition from childhood to adolescence. The study also examines whether there are differential effects regarding the attachment figure, child's gender, or reciprocity between variables. A community-based sample of Spanish youth (n = 904; 49.4% girls) was followed biennially from age 10 to 16 years. Attachment, depressive symptoms, and disordered eating were measured using the Inventory of Parental and Peer Attachment, Children's Depression Inventory, and Children's Eating Attitudes Test, respectively. Prospective data were analyzed using a dynamic panel model, which accounts for unmeasured time-invariant factors. Whereas insecure attachment to the father did not predict later depression or disordered eating, higher insecure attachment to the mother at ages 10 and 12 years predicted more disordered eating at ages 14 and 16 years via increased depressive symptoms at ages 12 and 14 years. No child's gender-specific or reverse mediational effects were found. This study suggests that an increase in depressive symptoms might be one mechanism by which insecure attachment exerts its influence on the development of eating disorders symptomatology in adolescence. Intervention efforts aimed at strengthening particularly the mother-child attachment relationship may reduce the vulnerability to develop depressive symptoms and disordered eating.

The role of relational support in the longitudinal links between adolescent sexual harassment victimization and psychological health

The links between sexual harassment victimization and aspects of psychopathology are well-established in adolescent research, but whether sexual harassment victimization undermines positive aspects of psychological health and the moderating role of relational support in the link between sexual harassment victimization and psychological ill-health remains unknown. Using a cross-lagged model, we examined (a) the bidirectional and longitudinal links between sexual harassment victimization and adolescent psychological health (emotional problems and well-being) and (b) the moderating role of relational support from parents, teachers, and peers (best friends and classmates) in the link between sexual harassment victimization and adolescent psychological health. We used two waves of self-reported data (separated by 1 year) from 676 Swedish adolescents (50% female; mean age = 13.85 years at the point of first data collection). Controlling for the effects of gender and subjective socioeconomic status, the cross-lagged model revealed that sexual harassment predicted emotional problems positively and well-being negatively. Moreover, well-being predicted sexual harassment negatively. Relational support from classmates moderated the link in the direction from sexual harassment victimization to emotional problems. Relational support did not moderate the link to well-being. The findings provide new and important insights into the role of sexual harassment victimization in adolescent psychological adjustment and potential approaches to intervention.