Depressive symptomatology in childhood and adolescence

Insights into child abuse and neglect: Findings from the Minnesota Longitudinal Study of Risk and Adaptation

The Minnesota Longitudinal Study of Risk and Adaptation (MLSRA) is a landmark prospective, longitudinal study of human development focused on a sample of mothers experiencing poverty and their firstborn children. Although the MLSRA pioneered a number of important topics in the area of social and emotional development, it began with the more specific goal of examining the antecedents of child maltreatment. From that foundation and for more than 40 years, the study has produced a significant body of research on the origins, sequelae, and measurement of childhood abuse and neglect. The principal objectives of this report are to document the early history of the MLSRA and its contributions to the study of child maltreatment and to review and summarize results from the recently updated childhood abuse and neglect coding of the cohort, with particular emphasis on findings related to adult adjustment. While doing so, we highlight key themes and contributions from Dr Dante Cicchetti's body of research and developmental psychopathology perspective to the MLSRA, a project launched during his tenure as a graduate student at the University of Minnesota.

Psychological treatments for temporomandibular disorder pain-A systematic review

OBJECTIVE

Temporomandibular disorders (TMD) are common. They affect abilities for carrying out daily tasks and influence different psychological aspects. In addition to standard treatment, psychological treatments have been suggested. The aim was to investigate the effects of psychological treatments on patients with painful TMD in a short- and long-term perspective.

MATERIALS AND METHODS

An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL), and Web of Science for randomized clinical trials (RCTs) reporting psychological interventions for TMD. Registered beforehand in PROSPERO (CRD42022320106). In total, 18 RCTs were included; six RCTs that could be used in the meta-analysis, and all 18 RCTs were used in the narrative synthesis. Risk of bias was assessed by the Cochrane's tool for assessing risk of bias and certainty of evidence by GRADE.

RESULTS

The narrative synthesis indicates that psychological treatment options seem equivalent to standard treatment for painful TMD. The meta-analysis showed that a combination of psychological treatment and standard treatment and manual treatment (very low-quality evidence) are significantly better in pain reduction than just counselling and standard treatments of TMD.

CONCLUSION

This study indicates that psychological treatments seem to reduce pain intensity in individuals with painful TMD, and that the effect seems to be equally good as standard treatment. However, a combination of psychological treatments and standard treatments seems to have an even better effect. This indicates that psychological treatments are promising as an additional treatment approach for painful TMDs.

Principles, policies, and practices: Thoughts on their integration over the rise of the developmental psychopathology perspective and into the future

Developmental psychopathology has, since the late 20th century, offered an influential integrative framework for conceptualizing psychological health, distress, and dysfunction across the lifespan. Leaders in the field have periodically generated predictions about its future and have proposed ways to increase the macroparadigm's impact. In this paper, we examine, using articles sampled from each decade of the journal Development and Psychopathology's existence as a rough guide, the degree to which the themes that earlier predictions have emphasized have come to fruition and the ways in which the field might further capitalize on the strengths of this approach to advance knowledge and practice in psychology. We focus in particular on two key themes first, we explore the degree to which researchers have capitalized on the framework's capacity for principled flexibility to generate novel work that integrates neurobiological and/or social-contextual factors measured at multiple levels and offer ideas for moving this kind of work forward. Second, we discuss how extensively articles have emphasized implications for intervention or prevention and how the field might amplify the voice of developmental psychopathology in applied settings.

Effects of Helicopter Parenting, Tiger Parenting and Inhibitory Control on the Development of Children's Anxiety and Depressive Symptoms

Helicopter parenting and tiger parenting may increase the risks of anxiety and depression in children. However, it is unclear how these parenting styles affect the developmental outcomes and trajectories of anxiety and depressive symptoms, and how children's internal inhibitory control (IC) moderates such effects. The present study aimed to examine this issue. A sample of 172 typically developing children (77 girls; Mage = 7.14, SDage = 0.33) and their parents participated in the study. Parents reported children's anxiety and depressive symptoms using the Child Behavior Checklist each year from the first measurement (T1) to the third measurement (T3) and reported their helicopter parenting and tiger parenting at T1. Children completed the Go/No-go task at T1 to measure their IC. Higher T1 helicopter parenting impeded the declines in anxiety and depression over time, and higher T1 tiger parenting predicted more anxiety and depressive symptoms at T3. However, such effects were only observed in children with low IC, and higher IC buffered the adverse impacts of both helicopter parenting and tiger parenting on children's anxiety and depressive symptoms. These findings revealed that helicopter parenting and tiger parenting had negative impacts on the developmental trajectories and outcomes of anxiety and depression in children and suggest that IC plays an important role in alleviating the risks of anxiety and depression among children in adverse environments.

Joint developmental trajectories of internalizing and externalizing problems from mid-childhood to late adolescence and childhood risk factors: Findings from a prospective pre-birth cohort

There is limited evidence on heterogenous co-developmental trajectories of internalizing (INT) and externalizing (EXT) problems from childhood to adolescence and predictors of these joint trajectories. We utilized longitudinal data from Raine Study participants (n = 2393) to identify these joint trajectories from 5 to 17 years using parallel-process latent class growth analysis and analyze childhood individual and family risk factors predicting these joint trajectories using multinomial logistic regression. Five trajectory classes were identified: Low-problems (Low-INT/Low-EXT, 29%), Moderate Externalizing (Moderate-EXT/Low-INT, 26.5%), Primary Internalizing (Moderate High-INT/Low-EXT, 17.5%), Co-occurring (High-INT/High-EXT, 17%), High Co-occurring (Very High-EXT/High-INT, 10%). Children classified in Co-occurring and High Co-occurring trajectories (27% of the sample) exhibited clinically meaningful co-occurring problem behaviors and experienced more adverse childhood risk-factors than other three trajectories. Compared with Low-problems: parental marital problems, low family income, and absent father predicted Co-occurring and High Co-occurring trajectories; maternal mental health problems commonly predicted Primary Internalizing, Co-occurring, and High Co-occurring trajectories; male sex and parental tobacco-smoking uniquely predicted High Co-occurring membership; other substance smoking uniquely predicted Co-occurring membership; speech difficulty uniquely predicted Primary Internalizing membership; child's temper-tantrums predicted all four trajectories, with increased odds ratios for High Co-occurring (OR = 8.95) and Co-occurring (OR = 6.07). Finding two co-occurring trajectories emphasizes the importance of early childhood interventions addressing comorbidity.

Bidirectional associations between parenting stress and child psychopathology: The moderating role of maternal affection

Parenting stress and child psychopathology are closely linked in parent-child dyads, but how the bidirectional association varies across childhood and adolescence, and shifts depending on maternal affection are not well understood. Guided by the transactional model of development, this longitudinal, prospective study examined the bidirectional relations between parenting stress and child internalizing and externalizing problems and investigated the moderating role of maternal affection from childhood to adolescence. Participants were from the Future of Families and Child Wellbeing Study, a diverse, nationally representative sample of 2,143 caregiving mothers who completed assessments at children ages 5, 9, and 15. Using cross-lagged panel modeling, we found bidirectional effects between parenting stress and child internalizing and externalizing problems. However, additional multigroup analyses showed that bidirectional associations depend on the levels of maternal affection. In the high maternal affection group, parenting stress at age 5 predicted higher internalizing and externalizing problems at age 9, and reverse child-to-parent paths were found from age 9 to age 15. In contrast, only one cross-lagged path was found in the low maternal affection group. Findings suggest that maternal affection can heighten the transactional associations between parenting stress and child psychopathology.

The Association between 24 h Movement Guidelines and Internalising and Externalising Behaviour Problems among Chinese Preschool Children

This study examined the relationship between adherence to 24 h movement guidelines (24 h MGs) and internalising and externalising behavioural problems in Chinese children aged 3-6 years, with a specific focus on the differences between weekdays and weekends. The guidelines include recommendations for physical activity (PA), screen time (ST), and sleep duration (SD). The results indicated a stronger association between adherence to these guidelines and behavioural problems on weekends compared to weekdays. Specifically, the odds of experiencing internalising problems were 1.33 higher (95% CI: 1.05-1.69) when not satisfying all three behaviours compared to not satisfying one or two. Moreover, on weekends, when ST was not fulfilled, there was a higher likelihood of externalising behaviour problems compared to when it was fulfilled (OR, 1.18, 95% CI, 1.01-1.38), and when all three behaviours were not met, the likelihood was even higher (OR, 1.50, 95% CI, 1.04-2.18). Children who met all three guidelines had fewer internalising and externalising behavioural problems, suggesting a potential beneficial effect on mental health. The study revealed that a higher adherence to these recommendations corresponded to a lower risk of mental health problems. Additionally, higher screen time was linked to an increase in externalising behavioural issues. These findings underscore the importance of adherence to 24 h MGs for optimal mental health in children. Future interventions should consider these behavioural factors and incorporate strategies to promote adherence to these guidelines, particularly on weekends.

Heterotypic and homotypic continuity in psychopathology: a narrative review

Psychopathology is a process: it unfolds over time and involves several different factors. To extend our knowledge of such process, it is vital to understand the trajectories that lead to developing and maintaining a specific disorder. The construct of continuity appears very useful to this aim. It refers to the consistency, similarity, and predictability of behaviors or internal states across different developmental phases. This paper aims to present a narrative review of the literature on homotypic and heterotypic continuity of psychopathology across the lifespan. A detailed search of the published literature was conducted using the PsycINFO Record and Medline (PubMed) databases. Articles were included in the review based on the following criteria: (1) publication dates ranging from January 1970 to October 2022; and (2) articles being written in the English language. To ensure a thorough investigation, multiple combinations of keywords such as "continuity," "psychopathology," "infancy," "childhood," "adolescence," "adulthood," "homotypic," and "heterotypic" were used. Articles were excluded if exclusively focused on epidemiologic data and if not specifically addressing the topic of psychopathology continuity. The literature yielded a total of 36 longitudinal studies and an additional 190 articles, spanning the research published between 1970 and 2022. Studies on continuity focus on the etiology of different forms of mental disorders and may represent a fundamental resource from both a theoretical and clinical perspective. Enhancing our understanding of the different trajectories beneath psychopathology may allow clinicians to implement more effective strategies, focusing both on prevention and intervention. Since literature highlights the importance of early detection of clinical signs of psychopathology, future research should focus more on infancy and pre-scholar age.

The role of paternal and maternal warmth and hostility on daughter's psychosocial outcomes: The insidious effects of father warmth combined with high paternal hostility

Introduction

Despite the well-accepted view on the importance of parental warmth and parental hostility for adolescent development, few studies have examined the joint interactive effects of these two key aspects of parenting. Furthermore, research comparing maternal and paternal parenting is limited, with the father-daughter relationship during adolescence remaining one of the more understudied familial contexts. Given that family processes are key for the intergenerational transmission of inequality, these parent-child relationships may be especially important for youth at risk for exposure to violence.

Objectives

Using a sample of juvenile female offenders, this study examined the associations between the perceived warmth and hostility in the father-daughter and mother-daughter relationships on daughters' depressive symptoms, anxiety symptoms, romantic partner warmth, romantic partner hostility, and the daughter's sense of agency. We hypothesized that high perceived parental warmth would moderate the effects of parental hostility by protecting daughters from the negative effects of parental hostility, with stronger effects for the father-daughter than the mother-daughter relationship.

Results

In contrast, our paternal relationship findings across four of the five outcomes suggest a moderation in the opposite direction - that is, high perceived father warmth exacerbates the deleterious effects of father hostility on daughters' depressive symptoms, anxiety, romantic partner warmth, and romantic partner hostility. Maternal warmth, and not hostility, had a direct association with these four outcomes, with stronger explanatory power shown for the father-daughter than the mother-daughter model. Higher agency was associated with maternal hostility only.

Conclusion

Our findings suggest that daughters might be modeling and internalizing the relationship with their fathers (for better or worse) when they perceive it as warm and supportive. Consequently, adolescent girls whose fathers exhibit hostile behavior may benefit from emotional distancing from their fathers.

Thriving despite Parental Physical Abuse in Adolescence: A Two-Wave Latent Transition Analysis on Hedonic and Eudaimonic Violence-Resilience Outcome Indicators

Internationally, about 25% of all children experience physical abuse by their parents. Despite the numerous odds against them, about 30% of adolescents who have experienced even the most serious forms of physical abuse by their parents escape the vicious family violence cycle. In this study, we analyzed longitudinally the data from a sample of N = 1767 seventh-grade high school students in Switzerland on physical abuse by their parents. We did this by conducting an online questionnaire twice within the school year. We found that in our sample, about 30% of the participating adolescents’ parents had physically abused them. We considered violence resilience a multi-systemic construct that included the absence of psychopathology on one hand and both forms of well-being (psychological and subjective) on the other. Our latent construct included both feeling good (hedonic indicators, such as high levels of self-esteem and low levels of depression/anxiety and dissociation) and doing well (eudaimonic indicators, such as high levels of self-determination and self-efficacy as well as low levels of aggression toward peers). By applying a person-oriented analytical approach via latent transition analysis with a sub-sample of students who experienced physical abuse (n_w2 = 523), we identified and compared longitudinally four distinct violence-resilience patterns and their respective trajectories. By applying to the field of resilience, one of the most compelling insights of well-being research (Deci & Ryan, 2001), we identified violence resilience as a complex, multidimensional latent construct that concerns hedonic and eudaimonic well-being and is not solely based on terms of psychopathology.

Affective Representation of Early Relationships with Parents and Current Anxiety and Depression

Research on the role of early relationships with parents on youth's anxiety and depression, especially in collectivist societies such as China, is limited. To fill this gap, we investigated the unique role of early relationship with mothers and fathers, respectively, in Chinese youth's anxiety and depression outcomes. The participants were 347 Chinese college students from 20 provinces. They first separately rated the frequency of experiencing 13 emotions (e.g., anger) from recalling early relationships with their mothers and fathers, then completed the Zung Self-Rating Anxiety Scale and the Zung Self-Rating Depression Scale. Logistic regression was performed to determine the unique contribution of early relationships with mothers and fathers, respectively, to the participants' clinical-level anxiety and depression. Based on the final model of our logistical regression, we found that an increase in negative affective representation of early relationship with the mother was associated with a higher likelihood of clinical level anxiety (OR = 3.58; 95% CI = 1.32-9.70), while an increase in positive affective representation of early relationship with the mother was associated with a lower likelihood of clinical-level depression (OR = 0.47; 95% CI = 0.25-0.87). Furthermore, an increase in negative affective representation of early relationship with the father was associated with a higher likelihood of clinical-level anxiety (OR = 3.36; 95% CI = 1.37-8.26) and depression (OR = 3.68; 95% CI = 1.59-8.52), above and beyond their affective representation of early relationship with the mother.

The Association Between Psychological Symptoms and Self-Reported Temporomandibular Disorders Pain Symptoms in Children and Adolescents

Background: Several studies have reported an association between temporomandibular disorder pain (TMD-P) and emotional disorders in children and adolescents. However, no studies have reported if self-reported TMD-P in Saudi Arabia is associated with psychosocial symptoms. Therefore, the current study aimed to evaluate the association between self-reported TMD-P with depression, anxiety and somatic problems in children and adolescents in Saudi Arabia. The hypothesis was that there is an association between self-reported TMD-P and psychological symptoms among children and adolescents.

Materials and Methods: The included participants were randomly selected boys and girls aged between 10 and 18 years, with a mean (SD) age of 14.0 (2.3) years. Out of 633 children and adolescents that were invited to participate, 509 voluntarily agreed to participate, and 466 completed all questionnaires. The questionnaires included items retrieved from the Youth Self Report (YSR) and Axis II of the Research Diagnostic Criteria for TMD (RDC/TMD) besides demographic data, medical history, and presence of oral parafunctions. To assess the presence of self-reported TMD-Pain, each participant was verbally asked two validated questions regarding the presence of TMD-P and dysfunction (2Q-TMD).

Results: Self-reported TMD-P in children and adolescents was significantly associated with anxiety, depression, somatic symptoms, and social problems (P < 0.0001). Further, the frequencies of anxiety, depression, and somatic disorders were more evident among children and adolescents who suffered from TMD-P (P < 0.0001). The odds of reporting TMD-P in children and adolescents was 1.4 times for border line and clinical diagnosis scores for anxiety and withdrawal depression domains, and 2.6 times for the somatic symptoms' domains. However, in the multiple regression model after controlling for possible confounders, only somatic symptoms and social scores were significant. Moreover, self-reported TMD-P was twice as prevalent among girls compared to boys.

Conclusion: This study reports a significant association between psychosocial burden and presence of self-reported TMD-Pain, with a stronger impact on girls than boys. There were significantly higher number of participants with self-reported TMD-P reporting a poor oral and general health. In addition, self-reported TMD-P was higher among those with borderline and clinically diagnosed anxiety/depression scores. Based on this finding, the current study supports that an early approach and recognition of children and adolescents with anxiety, depression, somatic symptoms, and TMD problems. This could result in a lesser burden for these children and adolescents both in regard to pain and psychosocial implications with increased quality of life.

Does secure base script knowledge mediate associations between observed parental caregiving during childhood and adult romantic relationship quality and health?

Increasingly, attachment representations are being assessed via secure base script knowledge - the degree to which individuals show awareness of the temporal-causal schema that summarizes the basic features of seeking and receiving effective support from caregivers during times of need. Limited research has assessed the links between secure base script knowledge and aspects of adult functioning and the role that secure base script knowledge may play in accounting for associations between early caregiving quality and adulthood functioning. We used follow-up assessments of the NICHD Study of Early Child Care and Youth Development cohort (N = 585) to examine whether secure base script knowledge at age 18 years: (a) is associated with later romantic relationship quality, depressive symptoms, and body mass index (BMI) at age 26 years, and (b) mediates expected associations between the quality of maternal and paternal sensitivity across the first 15 years of life and age-26 outcomes. More access to, and elaborated knowledge of the secure base script predicted less extreme hostility with romantic partners, and better emotional and physical health. Moreover, secure base script knowledge mediated the links between early maternal and paternal sensitivity and both later romantic partner hostility and depressive symptoms, but not BMI.

Insecure Attachment as a Risk Factor for the Development of Anxiety and Depression Symptoms in a Sample of Mexican Adults

PURPOSE

This study evaluated the risk posed by attachment type in the development of anxiety or depression symptomatology in Mexican adults.

DESIGN AND METHODS

This was case-control study in which anxiety and depression symptomatology levels were compared according to the attachment type reported by 3,666 participants.

FINDINGS

It was found that insecure attachment is a risk factor (p≤.001) for the development of severe levels of depression (OR = 2.12, CI 95%: 1.66-2.70) and anxiety symptomatology (OR = 1.52, 95% CI: 1.30-1.77). Findings are discussed based on their implications for psychiatric nursing practice.

PRACTICE IMPLICATIONS

The findings of this study enable nurses to consider the empirical validity of attachment theory for studying psychosocial aspects of mental health and to design intervention strategies that promote secure attachment in populations without psychiatric diagnoses to prevent anxiety and depression symptomatology.

Do risk factors for adolescent internalising difficulties differ depending on childhood internalising experiences?

PURPOSE

This study aimed to examine the continuity of internalising difficulties from childhood to adolescence, and determine if the influence of established risk factors on adolescent mental health differed depending on childhood internalising experiences.

METHODS

Data were used from the Kindergarten cohort of the Longitudinal Study of Australian Children (LSAC, N = 4983, est. 2004). Internalising difficulties were measured via parent report on the Strengths and Difficulties Questionnaire (SDQ) at each wave from 4-5 to 14-15 years of age, and defined as symptoms in the borderline or abnormal range (≥ 4). Logistic generalised estimating equations were used to characterise associations between childhood internalising problems (4-9 years) and previously identified risk factors with adolescent internalising difficulties at three time points (10-11, 12-13 and 14-15 years).

RESULTS

The risk of internalising problems was elevated at each adolescent age for those who previously experienced internalising symptoms in childhood compared to those who did not (10-11 years: OR 3.67, 95% CI 3.01-4.47, 12-13 years: OR 2.84, 95% CI 2.32-3.46, and 14-15 years: OR 2.33, 95% CI 1.90-2.87). Other known risk factors were found to be associated with adolescent internalising problems as expected. We found no statistical evidence that these associations differed for adolescents who previously experienced internalising symptoms in childhood.

CONCLUSION

Findings of this study confirm the continuity of childhood mental health problems and the role of individual and family characteristics in the aetiology of adolescent internalising difficulties. The same risk factors appear relevant to target for adolescents who first experienced internalising symptoms in childhood.

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.

[Supporting Children of Parents With a Mental Illness: State of Research and Two Practice Approaches and Claims for the Government]

Supporting Children of Parents With a Mental Illness: State of Research and Two Practice Approaches and Claims for the Government Children of parents with a mental illness (COPMI) are at an increased risk to develop (severe) mental disorders (SMI) themselves. Estimates for Germany result in about 25 % of COPMI. This is thus a large and high risk group. On the other hand, prevention programs for COPMI are still scarce, especially in Germany, and central features of the transgenerational transmission of mental disorders have not been studied in conjunction to shed light on potential transmission mechanisms. The current article presents two current research projects on COPMI focusing on preventive approaches. The BMBF funded project "Children of Parents with a Mental Illness At Risk Evaluation" (COMPARE) targets parents of children aged 1.5 to 16 years of age. Parents need to fulfil a current DSM-5 based diagnosis of a mental disorder and then receive either 25-45 sessions gold standard cognitive behavioural therapy (CBT) or CBT plus 10 sessions Positive Parenting Program (PPP) to test the effects of parental therapy on the children and whether an additional parent training results in incremental effects above and beyond CBT alone. The project "The Village" is a model project in the region Tyrol, Austria, targeting the improved identification and collaborative care of COPMI.

The unique effects of maternal and paternal depressive symptoms on youth's symptomatology: Moderation by family ethnicity, family structure, and child gender

Drawing on five waves of longitudinal data from 392 families (52% female; mean age of wave 1 [Mage_W1] = 12.89, standard deviation [SD] = .48; Mage_W5 = 21.95, SD = .77; 199 European American and 193 Mexican American families; 217 intact and 175 stepfather families), this study documented transactional relations of mothers' and fathers' depressive symptoms with youth's symptomatology from early adolescence to young adulthood. Trait and time-varying cross-lagged models revealed that both mothers' and fathers' between- and within-person differences in depressive symptoms were associated with youth's internalizing and externalizing symptoms. Whereas each parent's depressive symptoms uniquely contributed to youth's internalizing symptoms, however, only mothers' depressive symptoms influenced youth's externalizing symptoms. Although reciprocal effects of youth's internalizing symptoms on parents' depressive symptoms were not significant, youth's externalizing symptoms predicted changes in mothers' depressive symptoms over time. Moderation analyses revealed distinct transactional patterns by family ethnicity and child gender, but not by family structure. This study revealed dynamic transactions among family members' symptomatology that point to opportune times and targets for intervention efforts aimed at mitigating the negative impact of parents' depressive symptoms on youth's adjustment.

Depression and Depressive Symptoms in Pediatric Traumatic Brain Injury: A Scoping Review

OBJECTIVE

This scoping review aimed to summarize the existing knowledge base regarding depression and depressive symptoms in pediatric traumatic brain injury (TBI) and to identify gaps in the literature in an effort to guide future research.

METHODS

MEDLINE Ovid and PsycINFO Ovid databases were each searched by the authors using search terms intended to identify any original research study that examined depressive symptoms in children (ie, aged 0-18 years) with TBI.

RESULTS

A total of 14 published studies were included in the review. The studies included examined the prevalence of depression, risk factors associated with depression, and depression as a predictor of other TBI-related outcomes.

CONCLUSION

Existing research suggests that depressive symptoms are more common in a TBI population than in a healthy or orthopedically injured population. Injury-related factors such as lesions in the brain and the presence of pain, as well as noninjury factors such as older age at injury and low socioeconomic status, may be predictive of depressive symptoms. Depression is likely a secondary outcome of pediatric TBI rather than a direct result of the injury itself. Overall, a relative dearth of research exists on this topic; thus, the review concludes by proposing future research directions.

Adult attachment representations and depressive symptoms: A meta-analysis

BACKGROUND

Attachment theory has long argued that insecure and disorganized attachment representations are associated with vulnerability to psychopathology in general, and depressive symptoms in particular. However, studies assessing the link between insecure and disorganized attachment and depressive symptoms report inconsistent results. The primary aim of this meta-analysis was to examine the extent to which adult attachment representations are associated with depressive symptoms.

METHODS

We conducted a literature search for published studies using PsycINFO, MEDLINE, and ProQuest in March 2017, identifying 55 samples (N = 4,386). Eligible studies assessed depression using a well-validated self-report or clinical diagnostic measure of depression and attachment using the Adult Attachment Interview.

RESULTS

Results demonstrated that insecure individuals had higher levels of depression than secure-autonomous individuals (d = 0.21, 95% CI [0.08-0.33]). Specifically, insecure-preoccupied individuals (d = 0.48, 95% CI [0.30-0.65]), but not insecure-dismissing individuals (d = 0.09, 95% CI [-0.03-0.22]), exhibited significantly more depressive symptoms than the secure-autonomous individuals. Additionally, unresolved adults had higher levels of depression than adults with organized attachment classifications (d = 0.29, 95% CI [0.13-0.44]).

LIMITATIONS

Due to the nature of the studies reviewed, causal inferences regarding the links found between adult attachment representations and depressive symptoms may not be drawn. Further, the aggregate effect sizes do not solely reflect the magnitude of the association between attachment representations and clinically-diagnosed major depressive disorder.

CONCLUSIONS

The results of this meta-analysis have important conceptual and practical implications for attachment-based prevention and intervention efforts, as they suggest that attachment representations, specifically insecure-preoccupied and unresolved, are associated with depressive symptoms in adulthood. Future research using longitudinal and intervention-based designs should examine the extent to which insecure-preoccupied and unresolved attachment lead to increased depressive symptoms, as well as the mechanisms by which these attachment patterns across the life span may increase vulnerability to depressive symptoms in adulthood.

Long-term effects on adult attachment in German occupation children born after World War II in comparison with a birth-cohort-matched representative sample of the German general population

BACKGROUND

Children born of war are a phenomenon of every conflict. At the end of World War II and thereafter, approximately 400,000 children were fathered by foreign soldiers and born to local women in Germany. Quantitative research on psychosocial consequences of growing up as German occupation child (GOC) has been missing so far.

METHODS

This study examines adult attachment and its association with current depression in GOC (N = 146) using self-report instruments: Adult Attachment Scale, Patient Health Questionnaire. Data were compared to a birth-cohort-matched representative sample of the German population (BCMS; N = 786).

RESULTS

GOC differ in both attachment dimensions (less comfortable with closeness/intimacy, lowered ability to depend on others) and adult attachment (more dismissive and fearful) compared to BCMS. Insecure adult attachment is associated with current depression.

CONCLUSION

GOC grew up under difficult circumstances (e.g. poverty, adverse events, and stigmatization). Even decades later they display more insecure attachment in current relationships. Findings underline the complex and long-term impact of their developmental conditions on attachment and current mental health.

Attachment Representations and Brain Asymmetry during the Processing of Autobiographical Emotional Memories in Late Adolescence

Frontal and parietal asymmetries have repeatedly been shown to be related to specific functional mechanisms involved in emotion regulation. From a developmental perspective, attachment representations based on experiences with the caregiver are theorized to serve regulatory functions and influence how individuals deal with emotionally challenging situations throughout the life span. This study aimed to investigate neural substrates of emotion regulation by assessing state- and trait dependent EEG asymmetries in secure, insecure-dismissing and insecure-preoccupied subjects. The sample consisted of 40 late adolescents. The Adult Attachment Interview was administered and they were asked to report upon personally highly salient emotional memories related to anger, happiness and sadness. EEG was recorded at rest and during the retrieval of each of these emotional memories, and frontal and parietal hemispheric asymmetry were analyzed. We found attachment representations to differentially affect both the frontal and parietal organization of hemispheric asymmetry at rest and (for parietal region only) during the retrieval of emotional memories. During rest, insecure-dismissing subjects showed an elevated right-frontal brain activity and a reduced right-parietal brain activity. We interpret this finding in light of a disposition to use withdrawal strategies and low trait arousal in insecure-dismissing subjects. Emotional memory retrieval did not affect frontal asymmetry. However, both insecure groups showed an increase in right-sided parietal activity indicating increased arousal during the emotional task as compared to the resting state suggesting that their emotion regulation capability was especially challenged by the retrieval of emotional memories while securely attached subjects maintained a state of moderate arousal. The specific neurophysiological pattern of insecure-dismissing subjects is discussed with regard to a vulnerability to affective disorders.

Correlates of Childhood vs. Adolescence Internalizing Symptomatology from Infancy to Young Adulthood

In light of its associations with child and adolescent health and well-being, there remains a need to better understand the etiological underpinnings and developmental course of internalizing symptomatology in children and adolescents. This study leveraged intensive longitudinal data (N = 959; 49.6 % females) to test the hypothesis that internalizing symptoms in childhood may be driven more strongly by family experiences whereas internalizing symptoms in adolescence may derive more uniquely from familial loading for affective disorders (i.e., maternal depression). We evaluated the relative contributions of (a) family experiences (b) maternal depression, and (c) peer influences in testing this hypothesis. The results indicated that family predictors were more strongly correlated with childhood (relative to adolescent) internalizing symptoms. In contrast to previous findings, maternal depression also exhibited stronger associations with childhood internalizing symptoms. Although often overlooked in theories concerning potential differential origins of childhood vs. adolescent internalizing symptomatology, peer experiences explained unique variation in both childhood and adolescent internalizing problems.

Psychosocial Predictors and Correlates of Suicidality in Teenage Latino Males

Multiple ecodevelopmental factors were tested as they influence suicidality in a community sample of Latino adolescent males. Risk factors tested included childhood maltreatment, parental alcohol-related problems, and polysubstance problems. Protective factors included general self-efficacy, social conformity, and family bonding. Male participants (N = 349) were recruited from the Los Angeles area. About 80% of the sample reported some suicidal ideation, and 26% reported a history of at least one suicide attempt. The strongest protective factor for suicidality was problem-solving confidence, followed by a good relationship with parents and being law abiding. The strongest risk factor for suicidality was emotional abuse, followed by hard drug use, mother’s alcohol-related problems, and sexual abuse. Broad-based theories, research, treatment, and prevention efforts are critical to implement with this population.

Exposure to early adversity: Points of cross-species translation that can lead to improved understanding of depression

The relationship between developmental exposure to adversity and affective disorders is reviewed. Adversity discussed herein includes physical and sexual abuse, neglect, or loss of a caregiver in humans. While these stressors can occur at any point during development, the unique temporal relationship to specific depressive symptoms was the focus of discussion. Further influences of stress exposure during sensitive periods can vary by gender and duration of abuse as well. Data from animal studies are presented to provide greater translational and causal understanding of how sensitive periods, different types of psychosocial stressors, and sex interact to produce depressive-like behaviors. Findings from maternal separation, isolation rearing, chronic variable stress, and peer-peer rearing paradigms clarify interpretation about how various depressive behaviors are influenced by age of exposure. Depressive behaviors are broken down into the following categories: mood and affect, anhedonia, energy, working memory, sleep-wake, appetite changes, suicide, and general malaise. Cross-species evidence from humans, nonhuman primates, rats, and mice within each of these categories is discussed. In conclusion, sensitive periods for affective-related behaviors (anxiety, mood, and controllability) occur earlier in life, while other aspects of depression are associated with adversity later during adolescence.

Neural correlates of successful psychotherapy of depression in adolescents

BACKGROUND

While major effort has been put in investigating neural correlates of depression and its treatment in adults, less is known about the effects of psychotherapy in adolescents. Given the concordance of the ventral striatum, amygdala, hippocampus and the subgenual anterior cingulate cortex (sgACC) as correlates of depression and their involvement in reward processing, we used functional magnetic resonance imaging (fMRI) during performance of a monetary reward task in an intervention versus waitlist-control design to investigate the clinical and neural effects of cognitive behavioral group therapy (CBT-G).

METHODS

22 medication naïve adolescents with major depressive disorder were scanned before and after five sessions of CBT-G (PAT-I), or before and after five weeks of waiting (PAT-W). Changes in symptom scales were analyzed along with neural activation changes within the amygdala, hippocampus, sgACC and ventral striatum regions of interest (ROI).

RESULTS

Psychometric assessments and ROI activation remained unchanged in PAT-W. In PAT-I, significant reduction in clinical symptoms accompanied significant changes in brain activation within the left amygdala, left hippocampus and bilateral sgACC. In line with previous findings in adults, pre-to-post-activation changes in the bilateral sgACC correlated with pre-to-post and pre-to-follow-up symptom improvement, and individual expressions of sgACC activation before treatment were related to pre-to-follow-up therapeutic success.

LIMITATIONS

Future studies should include larger sample sizes.

CONCLUSIONS

Successful group psychotherapy of depression in adolescents was related to signal changes in brain regions previously demonstrated to be reliably linked with successful, particularly pharmacological treatment in adults.

Living with mentally ill parents during adolescence: a risk factor for future welfare dependence? A longitudinal, population-based study

Background

Living with parents suffering from mental illness can influence adolescents’ health and well-being, and adverse effects may persist into adulthood. The aim of this study was to investigate the relationship between parents’ mental health problems reported by their 15–16-year-old adolescents, the potential protective effect of social support and long-term dependence on public welfare assistance in young adulthood.

Methods

The study linked data from a youth health survey conducted during 1999–2004 among approximately 14 000 15–16-year-olds to data from high-quality, compulsory Norwegian registries that followed each participant through February 2010. Cox regression was used to compute hazard ratios for long-term welfare dependence in young adulthood based on several risk factors in 15–16-year-olds, including their parents’ mental health problems.

Results

Of the total study population, 10% (1397) reported having parents who suffered from some level of mental health problems during the 12 months prior to the baseline survey; 3% (420) reported that their parents had frequent mental health problems. Adolescent report of their parents’ mental health problems was associated with the adolescents’ long-term welfare dependence during follow-up, with hazard ratios (HRs) of 1.49 (CI 1.29–1.71), 1.82 (1.44–2.31) and 2.13 (CI 1.59–2.85) for some trouble, moderate trouble and frequent trouble, respectively, compared with report of no trouble with mental health problems. The associations remained significant after adjusting for socio-demographic factors, although additionally correcting for the adolescents’ own health status accounted for most of the effect. Perceived support from family, friends, classmates and teachers was analysed separately and each was associated with a lower risk of later welfare dependence. Family and classmate support remained a protective factor for welfare dependence after correcting for all study covariates (HR 0.84, CI 0.78–0.90 and 0.80, 0.75–0.85). We did not find evidence supporting a hypothesized buffering effect of social support.

Conclusions

Exposure to a parent’s mental health problem during adolescence may represent a risk for future welfare dependence in young adulthood. Perceived social support, from family and classmates in particular, may be a protective factor against future long-term welfare dependence.

Knowledge transfer in the field of parental mental illness: objectives, effective strategies, indicators of success, and sustainability

BACKGROUND

Mental health problems are often transmitted from one generation to the next. However, transferring knowledge about interventions that reduce intergenerational transmission of disease to the field of parental mental illness has been very difficult. One of the most critical issues in mental health services research is the gap between what is generally known about effective treatment and what is provided to consumers in routine care.

DISCUSSION

In this article we discuss several aspects of knowledge transfer in the field of parental mental illness. Effective strategies and implementation prerequisites are explored, and we also discuss indicators of success and sustainability.

SUMMARY

Altogether, this article presents a rationale for the importance of preventive strategies for children of mentally ill parents. Furthermore, the discussion shows how complex it is to change clinical practice.

Adult attachment style as a risk factor for maternal postnatal depression: a systematic review

Background

Postnatal depression (PND) is an important health problem of global relevance for maternal health and impacts on the health and wellbeing of the child over the life-course. Multinational data is hard to locate, the economic burden of PND on health care systems have been calculated in several countries, including Canada and in the UK. In Canada, health and social care costs for a mother with PND were found to be just over twice that of mothers with no mental illness. The extra community care cost for women with PND living in the UK was found to be £35.7 million per year.

Method

We carried out a systematic search to the literature to investigate the associations between attachment style and PND, using meta-narrative analysis methods, reporting statistical data and life narratives. The following databases were searched: PsycInfo, PsycExtra Web of Science, The Cochrane Library and Pubmed. We focused on research papers that examined adult attachment styles and PND, and published between 1991 and 2013. We included any papers showing relationship between maternal adult attachment and PND. Out of 353 papers, 20 met the study inclusion criteria, representing a total of 2306 participants. Data from these 20 studies was extracted by means of a data extraction table.

Results

We found that attachment and PND share a common aetiology and that ‘insecure adult attachment style’ is an additional risk factor for PND. Of the insecure adult attachment styles, anxious styles were found to be associated with PND symptoms more frequently than avoidant or dismissing styles of attachment.

Conclusion

More comprehensive longitudinal research would be crucial to examine possible cause-effect associations between adult attachment style (as an intergenerational construct and risk factor) and PND (as an important maternal mental health), with new screening and interventions being essential for alleviating the suffering and consequences of PND. If more is understood about the risk profile of a new or prospective mother, more can be done to prevent the illness trajectory (PND); as well as making existing screening measures and treatment options more widely available.

Electronic supplementary material

The online version of this article (doi:10.1186/s40359-014-0056-x) contains supplementary material, which is available to authorized users.

Integrating attachment and depression in the confluence model of sexual assault perpetration

This study sought to extend the confluence model of sexual assault perpetration by examining attachment insecurity and depression as additional predictors of sexual aggression. Male college students (N = 193) completed an online questionnaire assessing confluence model constructs in addition to attachment and history of depression. Overall, the model fit the data well, χ(2)(11, 193) = 19.43, p = ns; root mean square error of approximation = .063; comparative fit index = .94. Attachment and depression demonstrated both direct and indirect relationships with perpetration severity. The results contribute to elucidating the process by which certain men become susceptible to perpetrating sexual assault. Implications are discussed.

Early-life predictors of internalizing symptom trajectories in Canadian children

BACKGROUND

Previous research examining the development of anxious and depressive symptoms (i.e., internalizing symptoms) from childhood to adolescence has often assumed that trajectories of these symptoms do not vary across individuals. The purpose of this study was to identify distinct trajectories of internalizing symptoms from childhood to adolescence, and to identify risk factors for membership in these trajectory groups. In particular, we sought to identify risk factors associated with early appearing (i.e., child onset) symptoms versus symptoms that increase in adolescence (i.e., adolescent onset).

METHOD

Drawing on longitudinal data from the National Longitudinal Survey of Children and Youth, latent class growth modeling (LCGM) was used to identify distinct trajectories of internalizing symptoms for 6,337 individuals, from age 4-5 to 14-15. Multinomial regression was used to examine potential early-life risk factors for membership in a particular trajectory group.

RESULTS

Five trajectories were identified as follows: "low stable" (68%; reference group), "adolescent onset" (10%), "moderate stable" (12%), "high childhood" (6%), and "high stable" (4%). Membership in the "adolescent onset" group was predicted by child gender (greater odds for girls), stressful life events, hostile parenting, aggression, and hyperactivity. Membership in the "high stable" and "high childhood" trajectory groups (i.e., child-onset) was additionally predicted by maternal depression, family dysfunction, and difficult temperament. Also, several significant gender interactions were observed.

CONCLUSIONS

Causal mechanisms for child and adolescent depression and anxiety may differ according to time of onset, as well as child gender. Some early factors may put girls at greater risk for internalizing problems than boys.

Prevalence rates and risk factors for mental health difficulties in adolescents aged 16 and 17 years living in rural Ireland

OBJECTIVE

This study sought to ascertain the prevalence rates and risk factors for a range of mental health difficulties, including suicidal ideation/self-harm among 16 and 17-year-old rural Irish adolescents, a vulnerable group in transition from childhood to adulthood.

METHOD

Adolescents (n=237) took part in this cross-sectional study. Participants completed a questionnaire compendium consisting of generic questions on demographic information, use of mental health services and four normed questionnaires: The Youth Self-Report, the Children's Depression Inventory, the Coping Inventory for Stressful Situations-Adolescent and The Family Assessment Device.

RESULTS

We found that 16.9% of adolescents reported clinically significant mental health difficulties. Significant gender differences were found on internalising and externalising difficulties. There were no gender differences in suicidal ideation or self-harm. Only 3.4% of adolescents were receiving professional help for mental health difficulties. Multiple regression analyses revealed that family dysfunction, emotion-focussed coping and poor academic competence were significant predictors of poorer mental health difficulties in both genders. Family dysfunction was the strongest predictor of mental health difficulties in males. Among females, emotion-focussed coping was the strongest predictor of internalising difficulties and depression. Social diversion (social support) was predictive of less internalising difficulties and depression for females.

CONCLUSION

The study shows that a significant number of Irish 16 and 17 year olds have mental health difficulties, yet very few are receiving treatment. Emotion-focussed coping, family dysfunction, poor academic competence and less social support were important predictors of mental health difficulties. A new finding is the stronger association that family dysfunction has with poorer mental health in males than females, when controlling for academic competence and coping skills. The findings may have implications for psychological interventions.

Vulnerability to depression: a moderated mediation model of the roles of child maltreatment, peer victimization, and serotonin transporter linked polymorphic region genetic variation among children from low socioeconomic status backgrounds

Child maltreatment, peer victimization, and a polymorphism of the serotonin transporter gene (5-HTTLPR) were examined as predictors of depressive symptomatology. Children (M age = 11.26, SD = 1.65), including 156 maltreated and 145 nonmaltreated children from comparable low socioeconomic backgrounds, provided DNA samples and self-reports of relational peer victimization, overt peer victimization, and depressive symptoms. Path analysis showed that relational and overt victimization mediated the association between child maltreatment and depressive symptoms. Bootstrapping procedures were used to test moderated mediation and demonstrated that genotype moderated the indirect effects of relational and overt victimization on child depressive symptoms, such that victimized children with the long/long variation were at an increased risk for depressive symptoms compared to victimized children carrying a short allele. Results highlight the utility of examining process models that incorporate biological and psychological factors contributing to the development of depressive symptomatology and provide direction toward understanding and promoting resilience among high-risk youth from a multiple levels of analysis approach.

The promise of developmental psychopathology: Past and present

Progress in the field of developmental psychopathology is appraised in general and with regard to the particular lens of our understanding of the development of disorder. In general, the outpouring of research on various features of disorder and underlying processes could not have even been imagined 25 years ago. The progress is dazzling. At the same time, work on the development of disorders, beginning with antecedent patterns of adaptation, pales in comparison with work on the correlates of disorder. However, progress has been made. It is well established that the brain develops in the context of experience and that organism and environment continually interact over time. Something is now known about pathways leading to certain disorders and what initiates and impels individuals along them. If developmental psychopathology is to completely fulfill its promise of offering new ways of conceptualizing disorder and new guidance for prevention and intervention, much more work on developmental processes and a new way of exploring the development of disorder will be needed. Such a path is suggested.

Windows of vulnerability: maternal separation, age, and fluoxetine on adolescent depressive-like behavior in rats

Early exposure to stressful life events plays a significant role in adolescent depression. Clinical studies have identified a number of factors that increase the risk of depression, including sex of the subject, duration of the stressor, and genetic polymorphisms that elevate serotonin levels. In this study we used the maternal separation (MS) model to investigate to what extent these factors interacted during development to manifest in depressive-like behavior in male and female rats. The triadic model of learned helplessness parses depressive-like behavior into aspects of controllable, uncontrollable, and motivational behaviors. This model was used to investigate how the timing of MS between the ages of postnatal day (P) 2-9 and P9-16 interacted with either simultaneous vehicle (saline; 1ml/kg; i.p.) or fluoxetine (10mg/kg) exposure, which was used to enhance serotonin levels; these experiments also compared the effect of a vehicle injection during these developmental periods to a no injection control. Vehicle injections alone increased helplessness in the controllable condition in male rats when injected between P9-16 only, and did not interact further with MS. MS at both ages decreased controllability in male adolescents; females demonstrated an increase in controllability after MS. Elevated serotonin at P2-9 increased escape latencies in male and female control and MS subjects. Fluoxetine exposure at P9-16 increased helplessness in controls. Fluoxetine decreased helplessness in MS males independent of age, but increases helplessness in MS females. This study highlights the importance of age of MS (MS between P2-9 increases helplessness in males more than females), the duration of the stressor (previous results show females are effected by longer MS [P2-20], but not shorter [this study]), and that elevated serotonin increases escape latencies to a greater extent in females.

Mother-infant attachment and the intergenerational transmission of posttraumatic stress disorder

Evidence for the intergenerational transmission of posttraumatic stress disorder (PTSD) is documented in the literature, although the underlying mechanisms are poorly understood. Attachment theory provides a framework for elucidating the ways in which maternal PTSD may increase offspring PTSD vulnerability. The current study utilized two independent prospective data sets to test the hypotheses that (a) maternal PTSD increases the probability of developing an insecure mother-infant attachment relationship and (b) an insecure mother-infant attachment relationship increases the risk of developing PTSD following trauma exposure in later life. In the first study of urban, primarily low-income ethnic/racial minority mothers and infants (N = 45 dyads), elevated maternal PTSD symptoms at 6 months were associated with increased risk for an insecure, particularly disorganized, mother-infant attachment relationship at 13 months. In the second birth cohort of urban, low-income mothers and children (N = 96 dyads), insecure (avoidant or resistant) attachment in infancy was associated in a dose-response manner with increased lifetime risk for a diagnosis of PTSD by adolescence. A history of disorganized attachment in infancy predicted severity of PTSD symptoms, including reexperiencing, avoidance, hyperarousal, and total symptoms, at 17.5 years. In both studies, associations between attachment and PTSD were not attributable to numerous co-occurring risk factors. The findings suggest that promoting positive mother-child relationships in early development, particularly in populations at high risk for trauma exposure, may reduce the incidence of PTSD.

The distinctive role of romantic relationships in moderating the effects of early caregiving on adult anxious-depressed symptoms over 9 years

This study tests a model of young adult romantic quality as a moderator of the effects of early caregiving on anxious-depressed symptoms over a 9-year period in adulthood. Participants (n = 93) were a subsample from a longitudinal study of risk and adaptation. Quality of early caregiving was measured using observational data collected at five points in the first 4 years of life. Young adult romantic relationship quality was assessed from interviews with participants at age 23. Self-report anxious-depressed symptoms were measured at ages 23, 26, and 32. The results indicated that romantic quality moderated early caregiving to predict symptom levels across this period, with evidence for inoculation, amplification, and compensation effects. A discriminant analysis examining young adult work competence as a moderator provided further evidence for the distinctiveness of romantic relationships in changing the association between early caregiving and adult internalizing symptoms.

Contributions of maltreatment and serotonin transporter genotype to depression in childhood, adolescence, and early adulthood

BACKGROUND

Past findings on gene-by-environment (G×E) effects on depression have been mixed, leading to a debate of the plausibility of such mechanisms and methodological considerations that warrant attention. A developmental systems perspective postulates that complex, multi-level G×E effects are likely contributors to depression.

METHODS

Participants from families experiencing low-income status at birth were followed over 28 years. Maltreatment was recorded prospectively using multiple means and sources. Depression was measured repeatedly using well-validated interviews in middle childhood, through adolescence, and into adulthood.

RESULTS

Findings support a G×E effect where the less efficient form of the promoter region of the serotonin transporter gene (5-HTTLPR) contributes to a vulnerability to depressogenic aspects of maltreatment in childhood and adolescence. The presence of less efficient forms of the 5-HTTLPR polymorphism and maltreatment together raised risk for depression. This G×E effect was present generally and also among those who reported clinical levels of depression at only one point in time.

LIMITATIONS

This study used a low-income sample which limits generalizability to other populations. Sample size and rates of different forms of depression and depression at individual developmental stages supported general analyses, but limited the sorts of specific sub-analyses that were possible.

CONCLUSIONS

These findings support the plausibility of G×E effects on depression during childhood, adolescence, and early adulthood, key periods for the development of depression. Ongoing debates about the presence of G×E effects would be well served by additional work that was theoretically informed and employed prospective, longitudinal methodologies with well-validated measures of key constructs.

Korean American parental depressive symptoms and children's mental health: the mediating role of parental acceptance-rejection

This study explored the mediating role of parental acceptance-rejection in the relationship between parental depressive symptoms and children's mental health. Self-report data were gathered from 95 mothers and 91 fathers of children (ages 5-10 years) in Korean American families. For mothers and fathers, the relationship between parental depressive symptoms and child psychosocial problems was mediated by parenting behaviors, with parental rejection being a much stronger mediator than parental acceptance. For fathers, the relationship between fathers' depressive symptoms and child social competence was mediated by parenting, with fathers' parental rejection being a slightly stronger mediator than fathers' parental acceptance.

Validation of Children's Depression Scale in the Basque-speaking population

The aim of this study was to validate the Basque version of the CDS (Children's Depression Scale, Lang & Tisher, 1978), one of the most widely used questionnaires for the assessment of childhood depression, which has already been proved to be a valid and reliable tool in different cultures. The questionnaire was administered to a community sample of 886 participants (432 males and 454 females) aged between 8 and 16. A two-factor solution was obtained (Depressive dimension and Positive Dimension), which accounted for 29.86 % of the variance. Reliability with regard to internal consistency level and long-term stability was good (alpha = .95 and .79; and R = .73 and .59 for Depressive and Positive dimensions, respectively). Analysis of Differential Item Functioning with respect to age and gender showed that 91% and 88% of the items, respectively, did not present DIF. External validity evidence for the questionnaire was also obtained. We consider that the present work offers researchers and professionals interested in this area of study a valid and reliable tool for assessing depressive symptoms in Basque-speaking children and adolescents.

Unique system of care issues and challenges in serving children under age 3 and their families

This article addresses the primary modifications necessary for system change to better meet the mental health needs of children under the age of three. The role of risk and resiliency factors in the young child, family and community and the necessity for a comprehensive community infant-family mental health system with a focus on the whole family are addressed. Barriers to care within early childhood systems of care are examined, including stigma, community referral and collaboration, diagnostic concerns during infancy, issues around family engagement, empowerment and partnership, funding of comprehensive and well coordinated infant-family services, workforce capacity and evaluation. Recommendations for implementation of system changes at the community and federal levels are proposed.

Emotion regulation and depressive symptoms in preadolescence

This study examined associations among several measures of emotion regulation, and their links to depressive symptoms, in a sample of children ages 10-12 years old (N=87). Both temporal features of emotion regulation and regulation processes involved in the evaluation, monitoring, and modification of emotion were assessed through parent and child report and behavioral observation. Children also completed a self-report measure of depressive symptoms. Children with more depressive symptoms were reported by mothers and rated by observers as having higher levels of negative affect intensity. Regarding emotion regulation processes, children with more depressive symptoms reported more biased interpretations of emotionally charged situations, less awareness of their emotions, and their mothers reported that they utilized less problem-focused coping and positive reframing when coping with upsetting events. Findings suggest that children with depressive symptoms experience a wide range of difficulties with emotion regulation.

Evaluating workforce developments to support children of mentally ill parents: implementing new interventions in the adult mental healthcare in Northern Norway

BACKGROUND

According to new Norwegian laws, mental healthcare for adults are obligated to assess all patients who are parents and to act on their children's needs. This article describes the study protocol of implementing the interventions Family Assessment and Child Talks for children of patients in the adult psychiatry of the University Hospital of Northern Norway. The project is designed to evaluate the process of changes in clinical practice due to the implementation of two interventions. The interventions to be implemented are a standardised Family Assessment Form and the intervention called Child Talks. The family assessment form is an intervention to identify children of mentally ill parents and their needs. The intervention Child Talks is a health-promoting and preventive intervention where the mental health workers talk with the family about the situation of the children and their needs.

METHODS/DESIGN

There are two groups of participants in this study: (1) mental health workers in the clinic (N=220) and (2) patients who are parents (N=200) receiving treatment in the clinic. (1) In the evaluation of clinical practice, the authors use a pre-test, post-test and 1-year follow-up design. At pre-test, the authors evaluate status quo among mental health workers in the clinic regarding knowledge, attitudes, collaborative routines and clinical practice related to families with parental mental illness. After the pre-test is finished, the project move on to implement the interventions Family Assessment Form and Child Talks in the clinic. At post-test and 1-year follow-up, the authors evaluate the impact of implementing the Family Assessment Form in terms of how many children were identified and offered Child Talks in the clinic or referred to other services for additional support. (2) In the evaluation of parents/patients experience with the interventions, the authors use a pre-test post-test design. To identify children of mentally ill patients, the authors collect data on demographical variables for the patient and the child at pre-measures, as well as data on parental competence (PSOC) and parental concerns (PEDS) about their children. At post-measures, the authors evaluate the impact of the intervention in terms of user satisfaction, as well as changes between pre- and post-measures on parental competence (PSOC) and parental concerns (PEDS) about their children.

DISCUSSION

The implication of implementing new interventions to safeguard children of mentally ill patients and the limitation of not measuring child development directly are discussed.

Anxiety, depression and coping: CDI, MASC and CRI-Y for screening purposes in schools

This study used depression (CDI - Kovacs, 1981), anxiety (MASC - March, 1997) and coping strategy (CRI-Y - Moos, 1993) scales and studied the fitness and discriminant validity of reduced versions. The sample consisted of 916 Portuguese pupils, 54.3% feminine, aged 10 to 21 years old. The participants were selected from a set of public schools nation-wide. Two classes were chosen from the 5th to the 12th grades. A set of principal component analyses was carried out in a randomly chosen sample (n = 394) and all the three reduced measures were found to be strongly correlated with the previous. Confirmatory factor analyses (CFA) using the other part of the sample (n = 522) revealed adjustment indexes suggesting a good fit for both the whole model and gender and age groups separately. All scales revealed a good internal consistency. Globally, girls were more anxious and developed more coping strategies than boys. Older students tended to be less depressed, while younger adolescents present higher scores in depression and anxiety and less coping strategies. Reduced scales are sensitive to gender and age differences and can be used in school settings in order to establish a baseline and roadmaps for both universal and selective mental health school based programs.

A longitudinal study of maternal prenatal, postnatal and concurrent depressive symptoms and adolescent well-being

BACKGROUND

Maternal depression is known to be a risk for abnormal child development. Girls and boys have been found to respond differently to maternal depression. Although prenatal and postnatal depression has been widely studied, longitudinal studies of adolescent outcome are still rare.

METHODS

The original sample of 349 mothers in this longitudinal study was collected in 1989-1990 in Tampere, Finland. At the latest stage, of the 327 contacted in 2006, 191 mothers and 192 adolescents aged 16 to 17 years participated in the study. Maternal depressive symptoms were screened using the Edinburgh Postnatal Depression Scale (EPDS) prenatally, postnatally and at the latest stage. Adolescent outcome was examined using the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR).

RESULTS

Maternal concurrent depressive symptoms were associated with adolescent behavioral and emotional problems in both genders. Maternal prenatal depressive symptoms were associated with Externalizing Problems in the YSR and boys' lower Social Competence in both the CBCL and YSR. Maternal postnatal depressive symptoms were associated with boys' lower Social Competence both in the CBCL and YSR and Externalizing Problems in the YSR.

LIMITATIONS

Being a longitudinal normal population sample, the number of symptomatic mothers and adolescents is relatively small and the number of drop-outs is relatively high. Clinical evaluation of mothers and adolescents is also lacking.

CONCLUSIONS

Maternal prenatal and postnatal depressive symptoms are a risk to adolescent boys' wellbeing and concurrent depressive symptoms a risk for both girls' and boys' well-being. This long-term influence should be noted when treating women with depressive symptoms throughout motherhood.