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Israel ES, Gibb BE. A transactional mediation model of risk for the intergenerational transmission of depression: The role of maternal criticism. Dev Psychopathol 2024; 36:92-100. [PMID: 36097809 DOI: 10.1017/s0954579422000992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In this study, we sought to combine two lines of research to better understand risk for the intergenerational transmission of depression. The first focuses on the role of maternal criticism as a potential mechanism of risk for depression in youth while the second builds from interpersonal and stress generation models regarding the potential impact of youth depression on future escalations in maternal criticism. Specifically, we examined the role of maternal criticism within a transactional mediation model using data from a multi-wave study. Participants were 251 mother-offspring pairs consisting of mothers with (n = 129) and without (n = 122) a history of major depressive disorder (MDD) during their child's lifetime who completed assessments every 6 months for 2 years. We found support for the hypothesized transactional mediational model in which maternal expressed emotion-criticism (EE-Crit) mediated the link between maternal history of MDD and residual change in youth's depressive symptoms over the previous 6 months and, reciprocally, youth depressive symptoms mediated the relation between maternal MDD history and residual change in EE-Crit 6 months later. These results indicate that maternal criticism and offspring depressive symptoms may contribute to a vicious cycle of depression risk, which should be considered for interventions targeted toward youth at risk of developing MDD.
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Affiliation(s)
- Elana S Israel
- Department of Psychology, Binghamton University, State University of New York, Binghamton, NY, USA
| | - Brandon E Gibb
- Department of Psychology, Binghamton University, State University of New York, Binghamton, NY, USA
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2
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Fischer AS, Holt-Gosselin B, Hagan KE, Fleming SL, Nimarko AF, Gotlib IH, Singh MK. Intrinsic Connectivity and Family Dynamics: Striatolimbic Markers of Risk and Resilience in Youth at Familial Risk for Mood Disorders. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:855-866. [PMID: 35272095 PMCID: PMC9452604 DOI: 10.1016/j.bpsc.2022.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 02/04/2022] [Accepted: 02/22/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Few studies to date have characterized functional connectivity (FC) within emotion and reward networks in relation to family dynamics in youth at high familial risk for bipolar disorder (HR-BD) and major depressive disorder (HR-MDD) relative to low-risk youth (LR). Such characterization may advance our understanding of the neural underpinnings of mood disorders and lead to more effective interventions. METHODS A total of 139 youth (43 HR-BD, 46 HR-MDD, and 50 LR) aged 12.9 ± 2.7 years were longitudinally followed for 4.5 ± 2.4 years. We characterized differences in striatolimbic FC that distinguished between HR-BD, HR-MDD, and LR and between resilience and conversion to psychopathology. We then examined whether risk status moderated FC-family dynamic associations. Finally, we examined whether baseline between-group FC differences predicted resilence versus conversion to psychopathology. RESULTS HR-BD had greater amygdala-middle frontal gyrus and dorsal striatum-middle frontal gyrus FC relative to HR-MDD and LR, and HR-MDD had lower amygdala-fusiform gyrus and dorsal striatum-precentral gyrus FC relative to HR-BD and LR (voxel-level p < .001, cluster-level false discovery rate-corrected p < .05). Resilient youth had greater amygdala-orbitofrontal cortex and ventral striatum-dorsal anterior cingulate cortex FC relative to youth with conversion to psychopathology (voxel-level p < .001, cluster-level false discovery rate-corrected p < .05). Greater family rigidity was inversely associated with amygdala-fusiform gyrus FC across all groups (false discovery rate-corrected p = .017), with a moderating effect of bipolar risk status (HR-BD vs. HR-MDD p < .001; HR-BD vs. LR p = .005). Baseline FC differences did not predict resilence versus conversion to psychopathology. CONCLUSIONS Findings represent neural signatures of risk and resilience in emotion and reward processing networks in youth at familial risk for mood disorders that may be targets for novel interventions tailored to the family context.
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Affiliation(s)
- Adina S Fischer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
| | | | - Kelsey E Hagan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Scott L Fleming
- Department of Biomedical Data Science, Stanford University, Stanford, California
| | - Akua F Nimarko
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, California
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
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3
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Uçar HN, Çetin FH, Türkoğlu S. Perceived Expressed Emotion and Irritability in Adolescents With Attention-Deficit/Hyperactivity Disorder Inattentive Type: The Moderating Effect of Subtype. J Psychosoc Nurs Ment Health Serv 2022; 60:11-20. [PMID: 35522933 DOI: 10.3928/02793695-20220429-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study aimed to investigate perceived expressed emotion (EE) and irritability among adolescents with inattentive and combined type attention-deficit/hyperactivity disorder (ADHD-I and ADHD-C, respectively), and to assess whether the subtype plays a moderating role in the relationship between perceived EE and irritability. The current cross-sectional, case-control study comprised 37 adolescents with ADHD-I, 62 adolescents with ADHD-C, and 58 age- and sex-matched adolescents without ADHD. After controlling for confounding factors, adolescents with ADHD-C were found to exhibit significantly higher levels of perceived lack of emotional support than adolescents with ADHD-I (p = 0.029). Results of moderation analysis showed ADHD subtype to be a moderating factor in the relationship between perceived EE and irritability. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Ahmadzadeh YI, Eley TC, Hannigan L, Creswell C, Lichtenstein P, Spotts E, Ganiban J, Neiderhiser J, Rijsdijk F, McAdams TA. Parental criticism and adolescent internalising symptoms: using a Children-of-Twins design with power calculations to account for genetic influence. J Child Psychol Psychiatry 2022; 63:599-607. [PMID: 34374994 PMCID: PMC8828800 DOI: 10.1111/jcpp.13498] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Parental criticism is correlated with internalising symptoms in adolescent offspring. This correlation could in part reflect their genetic relatedness, if the same genes influence behaviours in both parents and offspring. We use a Children-of-Twins design to assess whether parent-reported criticism and offspring internalising symptoms remain associated after controlling for shared genes. To aid interpretation of our results and those of previous Children-of-Twins studies, we examine statistical power for the detection of genetic effects and explore the direction of possible causal effects between generations. METHODS Data were drawn from two Swedish twin samples, comprising 876 adult twin pairs with adolescent offspring and 1,030 adolescent twin pairs with parents. Parent reports of criticism towards their offspring were collected concurrently with parent and offspring reports of adolescent internalising symptoms. Children-of-Twins structural equation models were used to control for genetic influence on the intergenerational association between parental criticism and adolescent internalising. RESULTS Parental criticism was associated with adolescent internalising symptoms after controlling for genetic influence. No significant role was found for shared genes influencing phenotypes in both generations, although power analyses suggested that some genetic effects may have gone undetected. Models could not distinguish directionality for nongenetic, causal effects between generations. CONCLUSIONS Parental criticism may be involved in psychosocial family processes in the context of adolescent internalising. Future studies should seek to identify these processes and provide clarity on the direction of potential causal effects.
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Affiliation(s)
- Yasmin I Ahmadzadeh
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Thalia C Eley
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Laurie Hannigan
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Cathy Creswell
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erica Spotts
- Office of Behavioral and Social Science Research, National Institutes of Health, Bethesda, MD, USA
| | - Jody Ganiban
- Department of Psychology, George Washington University, Washington, DC, USA
| | - Jenae Neiderhiser
- Department of Psychology, Pennsylvania State University, University Park, PA, USA
| | - Fruhling Rijsdijk
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tom A McAdams
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Promenta Research Centre, University of Oslo, Oslo, Norway
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5
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Parental Expressed Emotion, Parenting Stress, and Behavioral Problems of Young Children with 22q11.2 Deletion Syndrome and Idiopathic Autism Spectrum Disorder. Child Psychiatry Hum Dev 2022:10.1007/s10578-021-01310-7. [PMID: 35083589 DOI: 10.1007/s10578-021-01310-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/03/2022]
Abstract
This study examined the associations of parents' expressed emotion (EE) and parenting stress, with behavioral problems of children with 22q11.2 deletion syndrome, idiopathic autism (iASD) and typically developing (TD) children. Parents of children aged 3-8 years completed the five-minute-speech-sample (FMSS), parental stress index and children behavioral checklist. Parents' FMSS-EE-criticism was higher among parents of children with 22q11DS and iASD compared to parents of TD children. FMSS-EE scores predicted children's behavioral problems, above and beyond parenting stress. The associations between FMSS-EE, parenting stress and children's behavioral problems were consistent across 22q11DS, iASD and TD children. These findings highlight the need for targeting parents' EE and parenting stress as integral elements in the screening and prevention of behavioral problems of young children with 22q11DS and iASD.
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James KM, Foster CE, Tsypes A, Owens M, Gibb BE. Maternal criticism and children's neural responses to reward and loss. J Exp Child Psychol 2021; 211:105226. [PMID: 34252754 PMCID: PMC9887476 DOI: 10.1016/j.jecp.2021.105226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 02/02/2023]
Abstract
Parental criticism is linked to a number of detrimental child outcomes. One mechanism by which parental criticism may increase risk for negative outcomes in children is through children's neural responses to valenced information in the environment. The goal of the current study, therefore, was to examine the relation between maternal criticism and children's neural responses to monetary gains and losses. To represent daily environmental experiences of reward and punishment, we focused on reactivity to monetary gains versus losses in a guessing task. Participants were 202 children and their mothers recruited from the community. The average age of the children was 9.71 years (SD = 1.38, range = 7-11), with 52.0% of them male and 72.8% Caucasian. Mothers completed the Five Minute Speech Sample to assess expressed emotion-criticism, and of these dyads 51 mothers were rated as highly critical. In addition, children completed a simple guessing game during which electroencephalography was recorded. Children of critical mothers displayed less neural reactivity to both monetary gain and loss than children without critical mothers. Our results were at least partially independent of children's and mothers' current levels of internalizing psychopathology. These findings suggest that children exposed to maternal criticism may exhibit disruptions in adaptive responses to environmental experiences regardless of valence. Targeted interventions aimed at reducing expressed emotion-criticism may lead to changes in a child's reward responsiveness and risk for psychopathology.
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Affiliation(s)
| | | | | | - Max Owens
- University of South Florida, St. Petersburg
| | - Brandon E Gibb
- Binghamton University (State University of New York), Binghamton, NY 13902, USA
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7
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All in the Family: How Parental Criticism Impacts Depressive Symptoms in Youth. Res Child Adolesc Psychopathol 2021; 50:27-35. [PMID: 33743095 DOI: 10.1007/s10802-021-00809-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
Despite a strong connection between family environment and mood symptoms in youth, little research to date has examined potential underlying mechanisms. We propose an etiological model investigating how parenting (i.e., expressed emotion, or EE) affects youth depression by shaping their emotion regulation abilities. Forty-six youth and caregivers participated in this cross-sectional study. Family environment was assessed using the Five-Minute Speech Sample (FMSS) and the Levels of Expressed Emotion Scale (LEE). The Difficulties in Emotion Regulation Scale (DERS) and the Children's Depression Rating Scale-Revised (CDRS-R) were used to assess youth emotion regulation and depressive symptoms, respectively. Analyses demonstrated no significant relationships between type of reporter (i.e., independent rater, parent, youth) of parental EE and criticism. Mediation analyses suggested that youth-reported parental EE predicted greater levels of youth depressive symptoms, and that this association was mediated by emotion regulation. This study has direct clinical implications, elucidating the importance of strengthening positive parent-child communication to support the development of emotion regulation skills and psychological well-being for youth.
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8
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Multiple domains of risk factors for first onset of depression in adolescent girls. J Affect Disord 2021; 283:20-29. [PMID: 33516083 PMCID: PMC7954924 DOI: 10.1016/j.jad.2021.01.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 12/26/2020] [Accepted: 01/09/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND First onsets of depression are especially common in adolescent females and often develop into chronic/recurrent illness. Surprisingly few studies have comprehensively evaluated multiple domains of etiologically-informative risk factors for first onset in adolescents from the community. We investigated whether clinical, cognitive, personality, interpersonal, and biological risk factors prospectively predict a first onset of depressive disorder (DD), and of DD with a chronic/recurrent course, in a community sample of adolescent girls. METHODS 479 girls (13.5-15.5 years) with no history of DD completed baseline assessments of risk factors and five diagnostic assessments over 3 years. Baseline measures were analyzed separately and jointly to prospectively predict first-onset DD and first-onset chronic/recurrent DD. RESULTS Most risk factors predicted first-onset DD (n = 93), including depressive symptoms, anxiety disorders, rumination, personality traits, blunted neural response (late positive potential [LPP]) to unpleasant pictures, peer victimization, parental criticism, and parental mood disorder. Depressive symptoms, rumination, parental mood disorder, and parental criticism were independently associated with first onsets. Nearly all measures, including a blunted neural response to rewards (reward positivity [RewP]), also predicted first-onset chronic/recurrent DD (n = 52), with depressive symptoms, low extraversion, poor peer relationships, and blunted RewP emerging as independent risk factors. LIMITATIONS This study focused on adolescent females and therefore does not provide information on males. CONCLUSIONS Multiple domains of risk factors in early adolescence are prospectively associated with first-onset DD and chronic/recurrent DD. A smaller subset of risk factors uniquely contributing to first onsets may represent core vulnerabilities for adolescent-onset depression and promising prevention targets.
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Rapp AM, Chavira DA, Sugar CA, Asarnow JR. Incorporating family factors into treatment planning for adolescent depression: Perceived parental criticism predicts longitudinal symptom trajectory in the Youth Partners in Care trial. J Affect Disord 2021; 278:46-53. [PMID: 32949872 PMCID: PMC7704900 DOI: 10.1016/j.jad.2020.09.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study aimed to clarify the predictive significance of youth perceptions of parental criticism assessed using a brief measure designed to enhance clinical utility. We hypothesized that high perceived parental criticism would be associated with more severe depression over 18-months of follow-up. METHODS The study involved secondary analyses from the Youth Partners in Care trial, which demonstrated that a quality improvement intervention aimed at increasing access to evidence-based depression treatment in primary care led to improved depression outcomes at post-treatment compared to usual care enhanced by provider education regarding depression evaluation/management. Patients (N = 418; ages 13-21) were assessed at four time points: baseline; post-treatment (six-month follow-up); 12- and 18-month follow-ups. The primary analysis estimated the effect of perceived parental criticism on likelihood of severe depression (i.e., Center for Epidemiological Studies-Depression Scale ≥ 24) over post-intervention follow-ups using a repeated-measures logistic regression model. Secondarily, a linear mixed-effects growth model examined symptom trajectories from baseline through 18-months using the Mental Health Index-5, a measure of emotional distress available at all time-points. RESULTS High perceived parental criticism emerged as a robust predictor of clinically-elevated depression (OR=1.66, p=.02) and a more pernicious symptom trajectory over 18-months (β =-1.89, p<.0001). LIMITATIONS The association between the self-report perceived criticism and traditional expressed emotion measures derived from verbal and nonverbal parental behaviors was not evaluated. CONCLUSIONS Results support perceived parental criticism as a predictor of youth depression outcomes over 18-months. This brief measure can be feasibly integrated within clinical assessment to assist clinicians in optimizing treatment benefits.
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Affiliation(s)
- Amy M Rapp
- Department of Psychology, University of California, Los Angeles; Department of Psychiatry, Columbia University; New York State Psychiatric Institute
| | | | - Catherine A Sugar
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Department of Biostatistics, University of California, Los Angeles
| | - Joan R Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles.
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10
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Hamilton JL, Chand S, Reinhardt L, Ladouceur CD, Silk JS, Moreno M, Franzen PL, Bylsma LM. Social media use predicts later sleep timing and greater sleep variability: An ecological momentary assessment study of youth at high and low familial risk for depression. J Adolesc 2020; 83:122-130. [PMID: 32771847 DOI: 10.1016/j.adolescence.2020.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Social media (SM) use has been increasingly recognized as a potential contributor to poor sleep. Few studies have examined SM use and sleep using ecological momentary assessment (EMA), compared different types of media use (SM, television, gaming), or examined whether youth at high and low familial risk for depression are differentially affected by SM use. METHODS The current study included 76 youth (46% female; Mean age = 11.28 years) who were recruited based on parental history of recurrent depression (N = 35 high risk; N = 41 low risk) in the United States. Youth completed a 9-day EMA protocol, which included current activity at time of prompt and daily sleep onset and offset times. Regression and multilevel models were conducted to examine the effects of media use on sleep. RESULTS Results indicated that youth who used more SM (mean and number of days) went to sleep later, but did not have shorter sleep duration. Youth with more SM use also had higher levels of variability of both sleep timing and sleep duration across the 9-day period. There were no effects of gaming or TV on sleep, and youth at high risk for depression did not have differences in SM use or its effects on sleep compared to low-risk youth. CONCLUSIONS These findings indicate a unique impact of SM use on sleep timing and variability for youth (regardless of risk status), which may suggest a unique and modifiable pathway through which SM use contributes to poor health.
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Affiliation(s)
| | - Shannon Chand
- Department of Psychiatry, University of Pittsburgh, USA
| | | | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh, USA; Department of Psychology, University of Pittsburgh, USA
| | - Jennifer S Silk
- Department of Psychiatry, University of Pittsburgh, USA; Department of Psychology, University of Pittsburgh, USA
| | - Megan Moreno
- Department of Pediatrics, University of Wisconsin School of Medicine, USA
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11
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Kline ER. Commentary: Expressed emotion as a mechanistic target in psychosis early intervention. Schizophr Res 2020; 222:8-9. [PMID: 32446702 PMCID: PMC7572555 DOI: 10.1016/j.schres.2020.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/05/2020] [Accepted: 05/05/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Emily R. Kline
- 75 Fenwood Road, Boston, MA 02115, United States of America.
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12
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Butterfield RD, Siegle GJ, Lee KH, Ladouceur CD, Forbes EE, Dahl RE, Ryan ND, Sheeber L, Silk JS. Parental coping socialization is associated with healthy and anxious early-adolescents' neural and real-world response to threat. Dev Sci 2019; 22:e12812. [PMID: 30746855 DOI: 10.1111/desc.12812] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 02/04/2019] [Indexed: 01/14/2023]
Abstract
The ways parents socialize their adolescents to cope with anxiety (i.e., coping socialization) may be instrumental in the development of threat processing and coping responses. Coping socialization may be important for anxious adolescents, as they show altered neural threat processing and over reliance on disengaged coping (e.g., avoidance and distraction), which can maintain anxiety. We investigated whether coping socialization was associated with anxious and healthy adolescents' neural response to threat, and whether neural activation was associated with disengaged coping. Healthy and clinically anxious early adolescents (N = 120; M = 11.46 years; 71 girls) and a parent engaged in interactions designed to elicit adolescents' anxiety and parents' response to adolescents' anxiety. Parents' use of reframing and problem solving statements was coded to measure coping socialization. In a subsequent visit, we assessed adolescents' neural response to threat words during a neuroimaging task. Adolescents' disengaged coping was measured using ecological momentary assessment. Greater coping socialization was associated with lower anterior insula and perigenual cingulate activation in healthy adolescents and higher activation in anxious adolescents. Coping socialization was indirectly associated with less disengaged coping for anxious adolescents through neural activation. Findings suggest that associations between coping socialization and early adolescents' neural response to threat differ depending on clinical status and have implications for anxious adolescents' coping.
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Affiliation(s)
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kyung Hwa Lee
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ronald E Dahl
- School of Public Health, University of California, Berkeley, California
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
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Maternal criticism and non-suicidal self-injury in school-aged children. Psychiatry Res 2019; 273:89-93. [PMID: 30640056 PMCID: PMC9912120 DOI: 10.1016/j.psychres.2019.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 11/20/2022]
Abstract
Although non-suicidal self-injury (NSSI) is a significant public health concern in youth, most of the extant research on NSSI has focused on adults and, to a lesser extent, adolescents. Therefore, little is known about the correlates and potential risk factors for NSSI in school-aged children. One factor that may be particularly important to children is their exposure to maternal criticism. Thus, the goal of this study was to examine the association between maternal expressed emotion-criticism (EE-Criticism) and NSSI in children, and to determine whether this relation is similar for girls and boys. Participants were 204 children (ages 7-11; 39.7% female, 81.9% Caucasian) and their mothers. Participants completed interviews assessing the child's history of NSSI. Mothers completed the Five-Minute Speech Sample to determine levels of EE-Criticism toward their child. We found that girls exposed to high levels of EE-Criticism were more likely to have a lifetime history of NSSI than girls of mothers exhibiting low levels of EE-Criticism; however, the relation between EE-Criticism and NSSI was not significant for boys. These results are consistent with interpersonal models of risk for NSSI, but suggest that one interpersonal factor, maternal criticism, is more strongly related to NSSI in girls than in boys.
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Olino TM, Bufferd SJ, Dougherty LR, Dyson MW, Carlson GA, Klein DN. The Development of Latent Dimensions of Psychopathology across Early Childhood: Stability of Dimensions and Moderators of Change. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 46:1373-1383. [PMID: 29359267 PMCID: PMC6056348 DOI: 10.1007/s10802-018-0398-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Recent research has described the structure of psychopathology as including one general and multiple specific factors, and this structure has been found in samples across development. However, little work has examined whether this structure is consistent across time, particularly in young children, within the same sample. Further, few studies have examined factors that influence the magnitude of the stability of latent dimensions of psychopathology. In the present study, we examine these issues in a community sample of 545 children assessed at ages 3 and 6. In addition, we explored child temperament, parental history of psychopathology, and parenting behaviors as potential moderators of the longitudinal stability of latent dimensions of psychopathology. We found that the same bifactor model structure identified at age 3 provided an adequate fit to the data at age 6. Further, our model revealed significant homotypic stability of the general, internalizing, and externalizing specific factors. We also found evidence of differentiation of psychopathology over time with the general factor at age 3 predicting the externalizing factor at age 6. However, we failed to identify moderators of the longitudinal associations between psychopathology latent factors. Overall, our results bolster support for the bifactor structure of psychopathology, particularly in early childhood.
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Affiliation(s)
- Thomas M Olino
- Department of Psychology, Temple University, 1701 N. 13th St, Philadelphia, PA, 19122, USA.
| | - Sara J Bufferd
- California State University San Marcos, San Marcos, CA, USA
| | | | - Margaret W Dyson
- University of California San Diego School of Medicine, San Diego, CA, USA
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15
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Shepherd M, Merry S, Lambie I, Thompson A. Indigenous Adolescents' Perception of an eMental Health Program (SPARX): Exploratory Qualitative Assessment. JMIR Serious Games 2018; 6:e13. [PMID: 29980495 PMCID: PMC6053605 DOI: 10.2196/games.8752] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 04/05/2018] [Accepted: 04/09/2018] [Indexed: 12/03/2022] Open
Abstract
Background Depression is a major health issue for indigenous adolescents, yet there is little research conducted about the efficacy and development of psychological interventions for these populations. In New Zealand there is little known about taitamariki (Māori adolescent) opinions regarding the development and effectiveness of psychological interventions, let alone computerized cognitive behavioral therapy. SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) is a computerized intervention developed in New Zealand to treat mild-to-moderate depression in young people. Users are engaged in a virtual 3D environment where they must complete missions to progress to the next level. In each level there are challenges and puzzles to completeIt was designed to appeal to all young people in New Zealand and incorporates several images and concepts that are specifically Māori. Objective The aim was to conduct an exploratory qualitative study of Māori adolescents’ opinions about the SPARX program. This is a follow-up to an earlier study where taitamariki opinions were gathered to inform the design of a computerized cognitive behavior therapy program. Methods Taitamariki were interviewed using a semistructured interview once they had completed work with the SPARX resource. Six participants agreed to complete the interview; the interviews ranged from 10 to 30 minutes. Results Taitamariki participating in the interviews found SPARX to be helpful. The Māori designs from the SPARX game were appropriate and useful, and the ability to customize the SPARX characters with Māori designs was beneficial and appeared to enhance cultural identity. These helped young people to feel engaged with SPARX which, in turn, assisted with the acquisition of relaxation and cognitive restructuring skills. Overall, using SPARX led to improved mood and increased levels of hope for the participants. In some instances, SPARX was used by wider whānau (Māori word for family) members with reported beneficial effect. Conclusions Overall, this small group of Māori adolescents reported that cultural designs made it easier for them to engage with SPARX, which, in turn, led to an improvement in their mood and gave them hope. Further research is needed about how SPARX could be best used to support the families of these young people.
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Affiliation(s)
- Matthew Shepherd
- School of Counselling, Human Services and Social Work, Faculty of Education, The University of Auckland, Auckland, New Zealand.,Ngāti Tama, Māori tribe, Taranaki area, New Zealand
| | - Sally Merry
- Department of Psychological Medicine, School of Medicine, The University of Auckland, Auckland, New Zealand
| | - Ian Lambie
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - Andrew Thompson
- School of Counselling, Human Services and Social Work, Faculty of Education, The University of Auckland, Auckland, New Zealand
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16
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Ahun MN, Consoli A, Pingault JB, Falissard B, Battaglia M, Boivin M, Tremblay RE, Côté SM. Maternal depression symptoms and internalising problems in the offspring: the role of maternal and family factors. Eur Child Adolesc Psychiatry 2018; 27:921-932. [PMID: 29273860 DOI: 10.1007/s00787-017-1096-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 12/02/2017] [Indexed: 11/28/2022]
Abstract
Maternal depression symptoms (MDS) are a robust risk factor for internalising problems (IP) in the offspring. However, the relative importance of MDS and other factors associated with it (i.e. other types of maternal psychopathology, maternal parenting practices, family characteristics) is not well understood. To (a) identify a group of children with high levels of IP between 6 and 12 years using combined maternal and teacher assessments and (b) to quantify the associations between trajectories of MDS during early childhood and children's IP trajectories before and after controlling for family factors associated with MDS. MDS and family factors were assessed in a population-based sample in Canada (n = 1537) between 5 months and 5 years. The outcome variable was membership in trajectories of teacher- and mother-rated IP between ages 6 and 12 years. Family factors were included as covariates in a multinomial logistic regression model. There was a strong association between MDS and children's atypically high levels of IP in unadjusted analyses [OR 4.14 (95% CI 2.60; 6.61)]. The association was reduced, but remained strong [2.60 (1.55; 4.36)] when maternal psychopathology, maternal parenting, and family socioeconomic status were entered in the model. MDS, maternal anxiety, and low parental self-efficacy were associated with offspring's high IP trajectories. MDS is associated with high levels of children's IP independently of other maternal and family characteristics. Intervention targeting maternal psychopathology and parenting self-efficacy and testing the impact on children's IP would provide information on the putative causal pathways between maternal and offspring's symptomatology.
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Affiliation(s)
- Marilyn N Ahun
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal and Sainte-Justine Hospital, Montreal, Quebec, Canada
| | - Angele Consoli
- Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie, GH Pitié-Salpêtrière, Paris, France.,INSERM U669, Universities of Paris-Descartes and Paris-Sud, Paris, France
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, University College London and Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, United Kingdom.,CESP, INSERM U1018 University of Paris-Sud, University of Paris-Saclay, UVSQ, Paris, France
| | - Bruno Falissard
- CESP, INSERM U1018 University of Paris-Sud, University of Paris-Saclay, UVSQ, Paris, France
| | - Marco Battaglia
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Division of Child, Youth and Emerging Adulthood, Centre for Addiction and Mental Health, Toronto, Canada
| | - Michel Boivin
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal and Sainte-Justine Hospital, Montreal, Quebec, Canada.,Tomsk State University, Siberia, Russia.,École de psychologie, Université Laval, Quebec, Canada
| | - Richard E Tremblay
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal and Sainte-Justine Hospital, Montreal, Quebec, Canada.,International Laboratory for Child and Adolescent Mental Health Development, University of Montreal, Montreal, Quebec, Canada.,University College Dublin, Dublin, Ireland
| | - Sylvana M Côté
- Research Unit on Children's Psychosocial Maladjustment, University of Montreal and Sainte-Justine Hospital, Montreal, Quebec, Canada. .,Tomsk State University, Siberia, Russia. .,International Laboratory for Child and Adolescent Mental Health Development, University of Montreal, Montreal, Quebec, Canada.
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17
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Abstract
I have been given a priceless opportunity to reflect on my career in the remarkably productive field of risk factors for depression. Psychological research on depression exploded in the early years of my work. I try to give an account of the choices and challenges, and reflect on the influences, some calculated and some serendipitous, that determined the paths I have followed. I focus mostly on the robust depression risk factors that have influenced my research, including dysfunctional cognitions, stressful life events and circumstances, parental depression, interpersonal dysfunction, and being female, and I cover some of what I did but also the influential work of others. This is a selective review of depression research in the past 40 or so years, noting some of the big developments that set the stage for the remarkable activity that continues today. In the conclusion, there is a brief statement of aspirations for future developments in our field.
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Affiliation(s)
- Constance Hammen
- Department of Psychology, University of California, Los Angeles, California 90095, USA;
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18
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James KM, Owens M, Woody ML, Hall NT, Gibb BE. Parental Expressed Emotion-Criticism and Neural Markers of Sustained Attention to Emotional Faces in Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2018; 47:S520-S529. [PMID: 29718731 PMCID: PMC6214793 DOI: 10.1080/15374416.2018.1453365] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
There is growing evidence for the role of environmental influences on children's information-processing biases for affectively salient stimuli. The goal of this study was to extend this research by examining the relation between parental criticism (expressed emotion-criticism, or EE-Crit) and children's processing of facial displays of emotion. Specifically, we examined the relation between EE-Crit and children's sensitivity in detecting facial displays of emotion. We also examined a neural marker of sustained attention, the late positive potential (LPP) event-related potential component (ERP). Participants were 87 children (ages 7-11 years; 53.3% female, 77.8% Caucasian) and their parents (ages 24-71; 90% female, 88.9% Caucasian). Parents completed the Five-Minute Speech Sample to determine levels of EE-Crit toward their child. Children completed a morphed faces task during which behavioral and ERP responses were assessed. Although there were no group differences in sensitivity in detecting facial displays of emotion, we found that children of parents exhibiting high, compared to low, EE-Crit displayed less attention (smaller LPP magnitudes) to all facial displays of emotion (fearful, happy, sad). These results suggest that children of critical parents may exhibit an avoidant pattern of attention to affectively-salient interpersonal stimuli.
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Affiliation(s)
- Kiera M. James
- Center for Affective Science, Binghamton University (SUNY), Binghamton, NY 13902
| | - Max Owens
- University of South Florida St. Petersburg, St. Petersburg, FL 33701
| | - Mary L. Woody
- Center for Affective Science, Binghamton University (SUNY), Binghamton, NY 13902
| | - Nathan T. Hall
- Pennsylvania State University, University Park, PA 16802
| | - Brandon E. Gibb
- Center for Affective Science, Binghamton University (SUNY), Binghamton, NY 13902
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19
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James KM, Woody ML, Feurer C, Kudinova AY, Gibb BE. Disrupted physiological reactivity among children with a history of suicidal ideation: Moderation by parental expressed emotion-criticism. Biol Psychol 2017; 130:22-29. [PMID: 29030216 DOI: 10.1016/j.biopsycho.2017.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 10/09/2017] [Accepted: 10/09/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The goal of this study was to examine physiological reactivity during parent-child interactions in children with and without a history of suicidal ideation (SI), a group known to be at increased risk for suicidal thoughts and behaviors in the future. We also examined the potential moderating role of parental expressed emotion-criticism (EE-Crit) to determine whether the presence of parental criticism may help to identify a subgroup of children with a history of SI most at risk for physiological dysregulation. METHOD Participants were 396 children (age 7-11; 54% male, 71.7% Caucasian) and their biological parent. Children's levels of high frequency heart rate variability (HF-HRV) were assessed during a resting baseline period followed by a positive and negative discussion with their parent. Additionally, parents completed the Five-Minute Speech Sample to determine levels of EE-Crit toward their child, and children completed an interview assessing their history of SI. RESULTS Consistent with our hypothesis, we found that exposure to parental criticism moderated the relation between a child's history of SI and their HF-HRV reactivity to the discussions. Specifically, while most children exhibited the typical pattern of HF-HRV suppression from baseline to both interactions, the highest risk children (i.e., children with a history of SI who also had highly critical parents) did not display any change in HF-HRV across the tasks, suggesting a failure to engage a typical psychophysiological response during emotional contexts. CONCLUSIONS These results suggest a specific physiological mechanism that may place these children at risk for suicidal thoughts and behaviors in the future.
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Affiliation(s)
- Kiera M James
- Center for Affective Science, Binghamton University (SUNY), USA.
| | - Mary L Woody
- Center for Affective Science, Binghamton University (SUNY), USA
| | - Cope Feurer
- Center for Affective Science, Binghamton University (SUNY), USA
| | | | - Brandon E Gibb
- Center for Affective Science, Binghamton University (SUNY), USA
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20
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Family-Focused Treatment for Childhood Depression: Model and Case Illustrations. COGNITIVE AND BEHAVIORAL PRACTICE 2017; 24:269-287. [PMID: 28966545 DOI: 10.1016/j.cbpra.2016.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Although the evidence base for treatment of depressive disorders in adolescents has strengthened in recent years, less is known about the treatment of depression in middle to late childhood. A family-based treatment may be optimal in addressing the interpersonal problems and symptoms frequently evident among depressed children during this developmental phase, particularly given data indicating that attributes of the family environment predict recovery versus continuing depression among depressed children. Family-Focused Treatment for Childhood Depression (FFT-CD) is designed as a 15-session family treatment with both the youth and parents targeting two putative mechanisms involved in recovery: (a) enhancing family support, specifically decreasing criticism and increasing supportive interactions; and (b) strengthening specific cognitive-behavioral skills within a family context that have been central to CBT for depression, specifically behavioral activation, communication, and problem solving. This article describes in detail the FFT-CD protocol and illustrates its implementation with three depressed children and their families. Common themes/challenges in treatment included family stressors, comorbidity, parental mental health challenges, and inclusion/integration of siblings into sessions. These three children experienced positive changes from pre- to posttreatment on assessor-rated depressive symptoms, parent- and child-rated depressive symptoms, and parent-rated internalizing and externalizing symptoms. These changes were maintained at follow-up evaluations 4 and 9 months following treatment completion.
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21
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Mellick W, Sharp C, Wilkinson A. The Moderating Role of Maternal Depression in the Relation Between Adolescent Behavioral Inhibition and Maternal Critical Expressed Emotion. Child Psychiatry Hum Dev 2017; 48:546-553. [PMID: 27541604 DOI: 10.1007/s10578-016-0680-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Behavioral inhibition is associated with a range of negative affective states and behaviors in adolescents which may elicit critical expressed emotion (EE-Crit) among mothers. Whether the relation between adolescent behavioral inhibition and maternal EE-Crit may depend on the presence of maternal depression is unknown. Therefore, a total of N = 81 biological mother/adolescent daughter dyads were recruited: mothers with a history of major depressive disorder (n = 45) and never-depressed mothers (non-depressed: n = 36). Structured clinical interviews were administered, daughters reported their behavioral inhibition and mothers reported daughter-directed maternal EE-Crit. Maternal depression was a moderator such that higher daughter behavioral inhibition was associated with greater EE-Crit among depressed mothers, specifically. There were no group differences for daughter behavioral inhibition or maternal EE-Crit. These findings highlight the significant role that maternal depression may play in relation to adolescent behavioral inhibition, EE-Crit, and risk for the development of adolescent psychopathology.
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Affiliation(s)
- William Mellick
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, USA.
| | - Carla Sharp
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, USA
| | - Anna Wilkinson
- University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6300, Austin, TX, 78701, USA
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22
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Rienecke RD, Sim L, Lock J, Le Grange D. Patterns of expressed emotion in adolescent eating disorders. J Child Psychol Psychiatry 2016; 57:1407-1413. [PMID: 27377705 PMCID: PMC5115973 DOI: 10.1111/jcpp.12594] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND This goal of this study was to understand the patterns of expressed emotions (EEs) in adolescent eating disorders. As such, this study compared EE among families of adolescents with anorexia nervosa (AN), bulimia nervosa (BN), and a psychiatric control group, major depressive disorder (MDD). This study also examined the influence of family status (intact vs. nonintact) and the presence of siblings on EE. METHODS Two-hundred and fifteen adolescents (ages 12-19) and their families were recruited for this study including 121 adolescents with AN, 54 adolescents with BN, and 40 adolescents with MDD. Adolescents with at least one parent completed the Standardized Clinical Family Interview. Adolescents completed structured diagnostic interviews to assess eligibility for the study, as well as a standardized questionnaire to assess depression. RESULTS Analyses revealed that fathers showed higher levels of critical comments to adolescents with BN or MDD than those with AN, whereas mothers made more critical comments toward patients with BN. Mothers made the least number of positive remarks toward patients with MDD. In terms of the influence of family status, fathers from intact families showed more expressions of warmth and were less critical than fathers from nonintact families, whereas mothers from intact families were less critical but also made fewer positive remarks than mothers from nonintact families. The presence of siblings appeared to reduce mothers' expression of warmth and emotional overinvolvement. CONCLUSIONS Unique patterns of EE were found to characterize AN, BN, and MDD. Family status and the presence of siblings exert an influence on EE that should be taken into consideration in future research.
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Affiliation(s)
- Renee D. Rienecke
- Department of Pediatrics at Medical University of South Carolina, Charleston, SC,Department of Psychiatry at the University of Michigan, Ann Arbor, MI
| | - Leslie Sim
- Department of Psychiatry and Psychology at the Mayo Clinic, Rochester, MN
| | - James Lock
- Department of Psychiatry & Behavioral Sciences at Stanford University, Stanford, CA
| | - Daniel Le Grange
- Department of Psychiatry at the University of California, San Francisco, San Francisco, CA, USA
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23
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McCann TV, Songprakun W, Stephenson J. Efficacy of a self-help manual in increasing resilience in carers of adults with depression in Thailand. Int J Ment Health Nurs 2016; 25:62-70. [PMID: 26666688 DOI: 10.1111/inm.12178] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/19/2015] [Accepted: 08/17/2015] [Indexed: 12/16/2022]
Abstract
Caring for a person with a mental illness can have adverse effects on caregivers; however, little is known about how best to help such caregivers. The aim of the present study was to examine the efficacy of a cognitive behaviour therapy-guided self-help manual in increasing resilience in caregivers of individuals with depression, in comparison to caregivers who receive routine support only. A randomized, controlled trial was conducted, following CONSORT guidelines, with 54 caregivers allocated to parallel intervention (self-help manual) (n = 27) or control (standard support) (n = 27) groups. Resilience was assessed at baseline, post-test (week 8), and follow up (week 12). Intention-to-treat analyses were undertaken. Repeated-measures ANOVA indicated a significant difference in resilience scores between the three time points, showing a large effect. Pairwise comparisons between intervention and control groups indicated resilience to be significantly different between baseline and post-test, and between baseline and follow up, but not between post-test and follow up. Overall, the intervention group showed a slightly greater increase in resilience over time than the control group; however, the time-group interaction was not significant. Guided self-help is helpful in improving caregivers' resilience and could be used as an adjunct to the limited support provided to carers by mental health nurses and other clinicians.
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Affiliation(s)
- Terence V McCann
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
| | | | - John Stephenson
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, West Yorkshire, UK
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24
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Tompson MC, O Connor EE, Kemp GN, Langer DA, Asarnow JR. Depression in Childhood and Early Adolescence: Parental Expressed Emotion and Family Functioning. ANNALS OF DEPRESSION AND ANXIETY 2015; 2:1070. [PMID: 27347564 PMCID: PMC4917222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Across development depression is associated with impairments in interpersonal and family functioning. In turn, these impairments may predict a more negative depression course and outcome. This study examined family functioning and parental Expressed Emotion (EE) among depressed youth during middle childhood and early adolescence and their relationship to demographic and clinical factors. Data were drawn from pretreatment evaluations of 132 depressed youth ages 7-14 and their families enrolled in a randomized clinical trial comparing family to individual treatment for youth depressive disorders. Families completed semi-structured diagnostic interviews, self-report measures of family functioning, and the Five Minute Speech Sample EE measure. High parental EE was more common in one-parent, as opposed to two-parent families, and early adolescent youth were more likely than pre-adolescent youth to have high critical EE parents. Severity and chronicity of child depression, child comorbidity, functional impairment, and maternal depressive symptoms were not associated with parental EE. Parental high EE overall and critical EE in particular were associated with reports of higher conflict and lower cohesion by both parents and children when compared to low parental EE. Similar patterns of associations were evident for youth across pre-adolescent and early adolescent developmental periods. Single parent status may be an indicator of greater family stress; and higher levels of critical EE may reflect the higher levels of parent-child conflict characteristic of the transition from late childhood to early adolescence. Among youth with depression parental EE appears to reflect potentially important impairments in family functioning.
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Affiliation(s)
- M C Tompson
- Department of Psychological and Brain Sciences, Boston University, USA
| | - E E O Connor
- Department of Psychological and Brain Sciences, Boston University, USA
| | - G N Kemp
- Department of Psychological and Brain Sciences, Boston University, USA
| | - D A Langer
- Department of Psychological and Brain Sciences, Boston University, USA
| | - J R Asarnow
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, USA
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25
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Peris TS, Miklowitz DJ. Parental Expressed Emotion and Youth Psychopathology: New Directions for an Old Construct. Child Psychiatry Hum Dev 2015; 46:863-73. [PMID: 25552241 PMCID: PMC4618702 DOI: 10.1007/s10578-014-0526-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Levels of parental expressed emotion (EE) are prospectively associated with the symptomatic course of a range of childhood psychiatric disorders. This article reviews the literature linking parental EE to youth psychopathology and proposes a novel framework for understanding its mechanisms of action. We find that, despite noteworthy methodological limitations, parental EE is linked consistently to a more deleterious course of mood, anxiety, and psychotic disorders in youth. Its mechanism of action is unknown. Models of "toxic family stress" (referring to frequent, sustained, and uncontrollable stress without protective influences) provide one framework for understanding how high EE environments interact with individual biological vulnerabilities to promote illness onset and recurrence. Research aimed at understanding biological responses (e.g., stress reactivity, arousal) to familial EE is needed. Such work may inform efforts to understand how EE affects the course of psychiatric disorders and may guide the development of novel interventions emphasizing emotion regulation strategies.
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Affiliation(s)
- Tara S Peris
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Rm. 67-439, Los Angeles, CA, 90095, USA.
| | - David J Miklowitz
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Rm. 67-439, Los Angeles, CA, 90095, USA
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26
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Khafi TY, Yates TM, Sher-Censor E. The Meaning of Emotional Overinvolvement in Early Development: Prospective Relations With Child Behavior Problems. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2015; 29:585-594. [PMID: 26147935 PMCID: PMC4670280 DOI: 10.1037/fam0000111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Emotional overinvolvement (EOI) in parents’ Five Minute Speech Samples (FMSSs; Magaña-Amato, 1993) is thought to measure overconcern and enmeshment with one’s child. Although related to maladaptive outcomes in studies of adult children, FMSS EOI evidences varied relations with behavior problems in studies with young children. These mixed findings may indicate that certain FMSS EOI criteria reflect inappropriate and excessive involvement with adult children, but do not indicate maladaptive processes when parenting younger children. Thus, this study evaluated relations of each FMSS EOI criterion with changes in child behavior problems from preschool to first grade in a community sample of 223 child–mother dyads (47.98% female; Wave 1 M(age) 49.08 months; 56.50% Hispanic/Latina). Maternal FMSS EOI ratings were obtained at Wave 1, and independent examiners rated child externalizing and internalizing behavior problems at Wave 1 and again 2 years later. Path analyses indicated that both the self-sacrifice/overprotection (SSOP) and statements of attitude (SOAs) FMSS EOI criteria predicted increased externalizing problems. In contrast, excessive detail and exaggerated praise were not related to child externalizing behavior problems, and Emotional Display was not evident in this sample. None of the FMSS EOI criteria evidenced significant relations with internalizing behavior problems. Multigroup comparisons indicated that the effect of SOAs on externalizing behavior problems was significant for boys but not for girls, and there were no significant group differences by race/ethnicity. These findings point to the salience of SSOP and SOAs for understanding the developmental significance of EOI in early development.
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Scheeringa MS, Myers L, Putnam FW, Zeanah CH. Maternal Factors as Moderators or Mediators of PTSD Symptoms in Very Young Children: A Two-Year Prospective Study. JOURNAL OF FAMILY VIOLENCE 2015; 30:633-642. [PMID: 26120248 PMCID: PMC4479421 DOI: 10.1007/s10896-015-9695-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Research has suggested that parenting behaviors and other parental factors impact the long-term outcome of children's posttraumatic stress disorder (PTSD) symptoms. In a sample of 62 children between the ages of one and six who experienced life-threatening traumas, PTSD was measured prospectively two years apart. Seven maternal factors were measured in a multi-method, multi-informant design. Both moderation and mediation models, with different theoretical and mechanism implications, were tested. Moderation models were not significant. Mediation models were significant when the mediator variable was maternal symptoms of PTSD or depression (measured at Time 1), self-report of maternal escape/avoidance coping (measured at Time 2), or self-report emotional sensitivity (measured at Time 2). Greater maternal emotional sensitivity was associated with greater Time 2 PTSD symptoms among children. Observational measures of emotional sensitivity as the mediator were not supported. Correlation of parents' and children's symptoms is a robust finding, however caution is warranted in attributing children's PTSD symptoms to insensitive parenting.
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Affiliation(s)
| | - Leann Myers
- Tulane University School of Public Health and Tropical Medicine
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28
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Mellick W, Kalpakci A, Sharp C. Current maternal depression moderates the relation between critical expressed emotion in mothers and depressive symptoms in their adolescent daughters. Psychiatry Res 2015; 227:224-9. [PMID: 25908266 DOI: 10.1016/j.psychres.2015.03.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 02/21/2015] [Accepted: 03/08/2015] [Indexed: 10/23/2022]
Abstract
Prior studies have examined critical expressed emotion (EE-Crit) in mothers in the intergenerational transmission of depression. However, the potential moderating effect of maternal depression diagnostic status in relation to EE-Crit and youth depressive symptoms has yet to be determined. A total of N=121 biological mother/daughter dyads that differed in maternal depression diagnostic status were recruited for the present study: (1) currently depressed mothers (current depression, n=29); (2) formerly depressed mothers (past depression, n=39); and (3) mothers free from any psychiatric history (healthy controls, n=53). Mothers were administered structured clinical interviews and completed self-report measures of EE-Crit and psychopathology, and daughters self-reported depressive symptoms. Results indicated no significant group differences in EE-Crit; however, current maternal depression status moderated EE-Crit such that the magnitude of the relation between EE-Crit and adolescent depressive symptoms was significantly greater in daughters of currently depressed mothers. These findings highlight the importance of considering current maternal depression, rather than a history of maternal depression, in relation to EE-Crit and adolescent depressive symptoms, providing impetus for future investigations.
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Affiliation(s)
- William Mellick
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204, United States
| | - Allison Kalpakci
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204, United States
| | - Carla Sharp
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204, United States.
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Whalen DJ, Malkin ML, Freeman MJ, Young J, Gratz KL. Brief report: Borderline personality symptoms and perceived caregiver criticism in adolescents. J Adolesc 2015; 41:157-61. [PMID: 25889821 DOI: 10.1016/j.adolescence.2015.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 01/20/2015] [Accepted: 03/18/2015] [Indexed: 12/27/2022]
Abstract
Despite findings of an association between adolescent psychopathology and perceived parental criticism, the relation between adolescent borderline personality disorder (BPD) symptoms and perceived parental criticism has not been examined. Given the centrality of interpersonal sensitivity to BPD (relative to other forms of psychopathology), we hypothesized that adolescent BPD symptoms would be uniquely related to perceived caregiver criticism, above and beyond other forms of psychopathology and general emotion dysregulation. Adolescents (N = 109) in a residential psychiatric treatment facility completed self-report measures of BPD symptoms, perceived caregiver criticism, emotion dysregulation, and symptoms of depression, anxiety, and posttraumatic stress disorder. Results revealed a unique relation of adolescent BPD symptoms to perceived caregiver criticism, above and beyond age, gender, and other forms of psychopathology. Findings suggest that adolescent BPD symptoms may have unique relevance for adolescents' perceptions of caregivers' attitudes and behaviors, increasing the likelihood of negative perceptions.
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Affiliation(s)
| | | | | | | | - Kim L Gratz
- University of Mississippi Medical Center, USA.
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Ensink K, Biberdzic M, Normandin L, Clarkin J. A Developmental Psychopathology and Neurobiological Model of Borderline Personality Disorder in Adolescence. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/15289168.2015.1007715] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Nelemans SA, Hale WW, Branje SJT, Hawk ST, Meeus WHJ. Maternal criticism and adolescent depressive and generalized anxiety disorder symptoms: a 6-year longitudinal community study. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 42:755-66. [PMID: 24154713 DOI: 10.1007/s10802-013-9817-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This 6-year longitudinal study examined the direction of effects (i.e., parent effects, child effects, or reciprocal effects) between maternal criticism and adolescent depressive and Generalized Anxiety Disorder (GAD) symptoms, including adolescents' perceptions of criticism as a potential mediator. Consistent with recent empirical findings on associations between parenting and adolescent internalizing symptoms, we hypothesized stronger child effects than parent effects. A community sample of 497 adolescents (M age = 13.03 at T1, 57 % boys) reported annually on their depressive and GAD symptoms as well as their perceptions of parental criticism. Their mothers (M age = 44.41 at T1) also reported annually on their own critical behavior toward their adolescent. As expected, cross-lagged panel models demonstrated stronger child effects (i.e., adolescent psychopathology predicting maternal criticism) than parent effects (i.e., maternal criticism predicting adolescent psychopathology) for both adolescent depressive and GAD symptoms, including adolescent perceived criticism as a significant mediator. Our results emphasize the importance of considering (1) potential bidirectional influences over time, contrary to a focus on parent effects on adolescent mental health, as well as (2) adolescent perceptions of parenting as an important potential mediator in associations between aspects of the parent-adolescent relationship and adolescent internalizing psychopathological symptoms.
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Affiliation(s)
- Stefanie A Nelemans
- Research Centre Adolescent Development, Utrecht University, PO Box 80.140, 3508 TC, Utrecht, The Netherlands,
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Li CY, Lewis FM. Expressed emotion and depression in caregivers of older adults with dementia: results from Taiwan. Aging Ment Health 2014; 17:924-9. [PMID: 23826863 DOI: 10.1080/13607863.2013.814098] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The purpose of this study was to examine the relationship between (1) expressed emotion (EE) and characteristics of Taiwanese dementia patients and their family caregivers and (2) EE and depressed mood, burden, and perception of health in Taiwanese caregivers of elderly persons with dementia. METHODS Sixty-five primary caregivers of elderly persons with mild to severe dementia were recruited from institutions in Taiwan and they completed four standardized questionnaires: Level of Expressed Emotion (LEE) scale, Center for Epidemiologic Studies Depression (CES-D) scale, Zarit Burden Inventory (ZBI), and General Health Perceptions subscale of the Medical Outcomes Study Short Form 36 Health Survey (MOS SF-36). RESULTS EE was positively associated with caregiver depression (r = .543; p < .001) and burden (r = .532; p < .001), and negatively associated with caregivers' perceived health (r = -.316; p = .010). The higher the caregivers' depression and burden, the greater was their EE and the lower the caregivers' perceived health, the higher was their EE. EE was negatively associated with caregiver education (r = -.279; p = .024) and income (r = -.261; p = .036). The lower the caregivers' education and income, the higher was their EE. CONCLUSION The significant relationship between EE and caregivers' mood and perceived burden suggests that caregivers with elevated mood or burden may put persons with dementia at greater risk for toxic, negative interactions from them. Although this study's design precludes attributing directionality, more depressed caregivers are at a greater risk of higher EE which may affect care of their elderly demented family members. Additional research is warranted with a larger sample size and/or a longitudinal design.
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Affiliation(s)
- Chao-Yin Li
- a School of Nursing , Fooyin University , Kaohsiung , Taiwan, Republic of China
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Stepp SD, Whalen DJ, Scott LN, Zalewski M, Loeber R, Hipwell AE. Reciprocal effects of parenting and borderline personality disorder symptoms in adolescent girls. Dev Psychopathol 2014; 26:361-78. [PMID: 24443951 PMCID: PMC4103652 DOI: 10.1017/s0954579413001041] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Theories of borderline personality disorder (BPD) postulate that high-risk transactions between caregiver and child are important for the development and maintenance of the disorder. Little empirical evidence exists regarding the reciprocal effects of parenting on the development of BPD symptoms in adolescence. The impact of child and caregiver characteristics on this reciprocal relationship is also unknown. Thus, the current study examines bidirectional effects of parenting, specifically harsh punishment practices and caregiver low warmth, and BPD symptoms in girls aged 14-17 years based on annual, longitudinal data from the Pittsburgh Girls Study (N = 2,451) in the context of child and caregiver characteristics. We examined these associations through the use of autoregressive latent trajectory models to differentiate time-specific variations in BPD symptoms and parenting from the stable processes that steadily influence repeated measures within an individual. The developmental trajectories of BPD symptoms and parenting were moderately associated, suggesting a reciprocal relationship. There was some support for time-specific elevations in BPD symptoms predicting subsequent increases in harsh punishment and caregiver low warmth. There was little support for increases in harsh punishment and caregiver low warmth predicting subsequent elevations in BPD symptoms. Child impulsivity and negative affectivity, and caregiver psychopathology were related to parenting trajectories, while only child characteristics predicted BPD trajectories. The results highlight the stability of the reciprocal associations between parenting and BPD trajectories in adolescent girls and add to our understanding of the longitudinal course of BPD in youth.
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Dietz LJ, Marshal MP, Burton CM, Bridge JA, Birmaher B, Kolko D, Duffy JN, Brent DA. Social problem solving among depressed adolescents is enhanced by structured psychotherapies. J Consult Clin Psychol 2014; 82:202-11. [PMID: 24491077 DOI: 10.1037/a0035718] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Changes in adolescent interpersonal behavior before and after an acute course of psychotherapy were investigated as outcomes and mediators of remission status in a previously described treatment study of depressed adolescents. Maternal depressive symptoms were examined as moderators of the association between psychotherapy condition and changes in adolescents' interpersonal behavior. METHOD Adolescents (n = 63, mean age = 15.6 years, 77.8% female, 84.1% White) engaged in videotaped interactions with their mothers before randomization to cognitive behavior therapy (CBT), systemic behavior family therapy (SBFT), or nondirective supportive therapy (NST) and after 12-16 weeks of treatment. Adolescent involvement, problem solving, and dyadic conflict were examined. RESULTS Improvements in adolescent problem solving were significantly associated with CBT and SBFT. Maternal depressive symptoms moderated the effect of CBT, but not SBFT, on adolescents' problem solving; adolescents experienced increases in problem solving only when their mothers had low or moderate levels of depressive symptoms. Improvements in adolescents' problem solving were associated with higher rates of remission across treatment conditions, but there were no significant indirect effects of SBFT on remission status through problem solving. Exploratory analyses revealed a significant indirect effect of CBT on remission status through changes in adolescent problem solving, but only when maternal depressive symptoms at study entry were low. CONCLUSIONS Findings provide preliminary support for problem solving as an active treatment component of structured psychotherapies for depressed adolescents and suggest one pathway by which maternal depression may disrupt treatment efficacy for depressed adolescents treated with CBT.
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Affiliation(s)
- Laura J Dietz
- Western Psychiatric Institute and Clinic, University of Pittsburgh
| | | | - Chad M Burton
- Western Psychiatric Institute and Clinic, University of Pittsburgh
| | | | - Boris Birmaher
- Western Psychiatric Institute and Clinic, University of Pittsburgh
| | - David Kolko
- Western Psychiatric Institute and Clinic, University of Pittsburgh
| | | | - David A Brent
- Western Psychiatric Institute and Clinic, University of Pittsburgh
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Sullivan AE, Judd CM, Axelson DA, Miklowitz DJ. Family functioning and the course of adolescent bipolar disorder. Behav Ther 2012; 43:837-47. [PMID: 23046785 PMCID: PMC3500638 DOI: 10.1016/j.beth.2012.04.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 04/11/2012] [Accepted: 04/14/2012] [Indexed: 11/28/2022]
Abstract
The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder, using longitudinal measures of family cohesion, adaptability, and conflict. Parent- and adolescent-reported symptom and family functioning data were collected from 58 families of adolescents with bipolar disorder (mean age =14.48±1.60; 33 female, 25 male) who participated in a 2-year randomized trial of family-focused treatment for adolescents (FFT-A). Cohesion and adaptability scores did not significantly change over the course of the study. Parent-reported conflict prior to psychosocial treatment moderated the treatment responses of families, such that high-conflict families participating in FFT-A demonstrated greater reductions in conflict over time than low-conflict families. Moreover, adolescent mania symptoms improved more rapidly in low-conflict than in high-conflict families. For all respondents, cohesion, adaptability, and conflict were longitudinally correlated with adolescents' depression scores. Finally, decreases in parent-reported conflict also predicted decreases in adolescents' manic symptoms over the 2-year study. Findings suggest that family cohesion, adaptability, and conflict may be useful predictors of the course of adolescent mood symptoms. Family conflict may be an important target for family intervention in early onset bipolar disorder.
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Affiliation(s)
- Aimee E. Sullivan
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Muenzinger D244, 345 UCB, Boulder, CO, 80309-0345, USA; ;
| | - Charles M. Judd
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Muenzinger D244, 345 UCB, Boulder, CO, 80309-0345, USA; ;
| | - David A. Axelson
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Pittsburgh, PA 15213, USA;
| | - David J. Miklowitz
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Muenzinger D244, 345 UCB, Boulder, CO, 80309-0345, USA; ; ,University of California, Los Angeles, UCLA Semel Institute for Neuroscience and Human Behavior, Division of Child and Adolescent Psychiatry, 760 Westwood Plaza, Rm 58-217 David Geffen School of Medicine at UCLA, Los Angeles, CA 90024-1759, USA;
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37
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McCann TV, Lubman DI, Clark E. Views of young people with depression about family and significant other support: interpretative phenomenological analysis study. Int J Ment Health Nurs 2012; 21:453-61. [PMID: 22616999 DOI: 10.1111/j.1447-0349.2012.00812.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Families and significant others have an important role in helping young people cope with depression, but lack of support undermines coping. In this paper, we present the views of young people with depression about the role of family and significant others in assisting them to cope with their illness. An interpretative phenomenological analysis study was undertaken using semistructured, audio-recorded interviews with 26 young people diagnosed with depression. The findings present two contrasting themes in the data, which reflect the young people's views about the influence of families and significant others in helping them cope with depression. The first, being supportive, highlighted how families and significant others helped through patience, tolerance, understanding, and encouragement; all of which strengthened young people's resilience as they attempted to cope with depression. The second theme, being unsupportive, showed how, in the young people's view, family conflict and change, and living in an unsupportive environment, compromised their ability to cope with depression. The findings suggest that mental health nurses, other clinicians, and primary care practitioners need to increase families' and significant others' understandings of depression and their capacity to support young people in these circumstances.
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Affiliation(s)
- Terence V McCann
- School of Nursing and Midwifery, Victoria University, Australia.
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38
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Gravener JA, Rogosch FA, Oshri A, Narayan AJ, Cicchetti D, Toth SL. The relations among maternal depressive disorder, maternal expressed emotion, and toddler behavior problems and attachment. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 40:803-13. [PMID: 22146899 DOI: 10.1007/s10802-011-9598-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Direct and indirect relations among maternal depression, maternal Expressed Emotion (EE: Self- and Child-Criticism), child internalizing and externalizing symptoms, and child attachment were examined. Participants were mothers with depression (n = 130) and comparison mothers (n = 68) and their toddlers (M age = 20 mo.; 53% male). Assessments included the Diagnostic Interview Schedule (maternal depression); the Five Minute Speech Sample (EE); the Child Behavior Checklist (toddler behavior problems); the Strange Situation (child attachment). Direct relations were significant linking: 1) maternal depression with both EE and child functioning; 2) Child-Criticism with child internalizing and externalizing symptoms; 3) Self-Criticism with child attachment. Significant indirect relations were found linking maternal depression with: 1) child externalizing behaviors via Child-Criticism; 2) child internalizing behaviors via Self- and Child-Criticism; and 3) child attachment via Self-Criticism. Findings are consistent with a conceptual model in which maternal EE mediates relations between maternal depression and toddler socio-emotional functioning.
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Affiliation(s)
- Julie A Gravener
- Clinical and Social Sciences in Psychology, University of Rochester, Mt. Hope Family Center, Rochester, NY, USA.
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Gibb BE, Beevers CG, McGeary JE. Toward an integration of cognitive and genetic models of risk for depression. Cogn Emot 2012; 27:193-216. [PMID: 22920216 PMCID: PMC3509244 DOI: 10.1080/02699931.2012.712950] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
There is growing interest in integrating cognitive and genetic models of depression risk. We review two ways in which these models can be meaningfully integrated. First, information-processing biases may represent intermediate phenotypes for specific genetic influences. These genetic influences may represent main effects on specific cognitive processes or may moderate the impact of environmental influences on information-processing biases. Second, cognitive and genetic influences may combine to increase reactivity to environmental stressors, increasing risk for depression in a gene×cognition×environment model of risk. There is now growing support for both of these ways of integrating cognitive and genetic models of depression risk. Specifically, there is support for genetic influences on information-processing biases, particularly the link between 5-HTTLPR and attentional biases, from both genetic association and gene×environment (G×E) studies. There is also initial support for gene×cognition×environment models of risk in which specific genetic influences contribute to increased reactivity to environmental influences. We review this research and discuss important areas of future research, particularly the need for larger samples that allow for a broader examination of genetic and epigenetic influences as well as the combined influence of variability across a number of genes.
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Affiliation(s)
- Brandon E Gibb
- Psychology Department, Binghamton University-SUNY, Binghamton, NY 13902-6000, USA.
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Burkhouse KL, Uhrlass DJ, Stone LB, Knopik VS, Gibb BE. Expressed emotion-criticism and risk of depression onset in children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2012; 41:771-7. [PMID: 22838507 DOI: 10.1080/15374416.2012.703122] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The primary goal of the current study was to examine the impact of maternal criticism (expressed emotion-criticism; EE-Crit) on the prospective development of depressive episodes in children. In addition to examining baseline levels of EE-Crit, we also sought to determine whether distinct subgroups (latent classes) of mothers could be identified based on the levels of EE-Crit they exhibited over a multiwave assessment and whether that latent class membership would predict depression onset in children. Finally, we examined whether EE-Crit and maternal depression would independently predict children's depression risk or whether EE-Crit would moderate the link between maternal depression and children's depression onset. Children of mothers with or without a history of major depression (N = 100) were assessed 5 times over 20 months. Children completed the Children's Depression Inventory and mothers completed the Five Minute Speech Sample and the Beck Depression Inventory at the baseline assessment, and at 2-, 4-, and 6-month follow-up assessments. Children and mothers completed diagnostic interviews assessing children's onsets of depressive episodes at the 20-month follow-up. Latent class analysis of the 4 waves of EE-Crit assessments revealed two distinct groups, exhibiting relatively lower versus higher levels of EE-Crit across the first 6 months of follow-up. EE-Crit latent class membership predicted children's depression onset over the subsequent 14 months. This finding was maintained after controlling for mother's and children's depressive symptoms during the initial 6 months of follow-up. Finally, maternal depression did not moderate the link between EE-Crit and childhood depression onset. Continued exposure to maternal criticism appears to be an important risk factor for depression in children, risk that is at least partially independent of the risk conveyed by maternal depression. These results highlight the importance of a modifiable risk factor for depression-repeated exposure to maternal criticism.
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Affiliation(s)
- Katie L Burkhouse
- Department of Psychology, Binghamton University (SUNY), NY 13902, USA.
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Mendes AV, Loureiro SR, Crippa JA, de Meneses Gaya C, García-Esteve L, Martín-Santos R. Mothers with depression, school-age children with depression? A systematic review. Perspect Psychiatr Care 2012; 48:138-48. [PMID: 22724399 DOI: 10.1111/j.1744-6163.2011.00318.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To carry out a systematic review of the association between maternal and school-age children depression and covariate factors. DESIGN AND METHODS The key words maternal depression, depressed children, and school-age key words were searched in Medline, Lilacs, Scielo, IndexPsi, and PsycInfo (2004-2010). Clinical and community cross-sectional and longitudinal studies were included. A qualitative checklist was used. FINDINGS Thirty studies were included (21.926 dyads). The results supported the association, showing several modulators: family environment, marital adjustment, social support, depression symptoms, and children-related variables. Limitations were nonrandom samples, single informants, and nondepression diagnosis. PRACTICE IMPLICATIONS Identifying mothers with depression may be useful for prevention and early detection of school-age children's depression.
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Affiliation(s)
- Ana Vilela Mendes
- Department of Neurosciences and Behavior, Division of Psychiatry, Ribeirão Preto School of Medicine, University of São Paulo (FMRP-USP), Brazil.
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Silk JS, Shaw DS, Prout JT, O'Rourke F, Lane TJ, Kovacs M. Socialization of Emotion and Offspring Internalizing Symptoms in Mothers with Childhood-Onset Depression. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2011; 32:127-136. [PMID: 21607196 DOI: 10.1016/j.appdev.2011.02.001] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This study examines how mothers with and without a history of childhood-onset depression respond to their 3-9 year-old children's emotions. Mother-child dyads included 55 offspring of mothers with a history of childhood-onset depressive disorders and 57 offspring of never-depressed mothers. Mothers with a history of childhood depression were less likely than were control mothers to respond in supportive ways to their children's negative emotions and were more likely to magnify, punish, or neglect their children's negative emotions. Magnification, neglect, and punishment of children's negative emotions were concurrently associated with children's internalizing symptoms, and neglect and punishment were associated with internalizing over a one year follow-up. Maternal neglect of children's negative emotion was positively associated with later internalizing symptoms for children who already had higher internalizing symptoms at the initial assessment. Findings suggest that atypical socialization of emotion may be one mechanism in the development of internalizing disorders.
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Affiliation(s)
- Jennifer S Silk
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Laghezza L, Delvecchio E, Salcuni S, Riso DD, Chessa D, Lis A, Tompson MC. Five-Minute Speech Sample Measure of Expressed Emotion among Parents of Typically Developing Italian Children: A Pilot Study. Percept Mot Skills 2011; 112:382-92. [DOI: 10.2466/07.10.21.28.pms.112.2.382-392] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although community samples have been used for comparison with at-risk and disturbed children, very few studies have examined parental Expressed Emotion in family members of typically developing children. This descriptive study reports Expressed Emotion for a community-based Italian sample of mothers and fathers of children without clinical mental health problems ( N = 101) ages 6 to 11 years ( M = 8.2, SD = 1.4). Children were drawn from regular elementary schools in Italy. Expressed Emotion was measured using the Five-minute Speech Sample. Mothers', fathers', and families' Expressed Emotion frequencies and percents were calculated, as well as frequencies and percents of Expressed Emotion subcomponents of Criticism and Emotional Over-involvement. As expected, low rates were found. There were no significant differences between fathers' and mothers' Expressed Emotion categories.
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Affiliation(s)
- Loredana Laghezza
- Dipartimento di Scienze Umane e della Formazione, Università di Perugia
| | - Elisa Delvecchio
- Dipartimento di Psicologia dello Sviluppo e delta Socializzazione, Università di Padova
| | - Silvia Salcuni
- Dipartimento di Psicologia dello Sviluppo e delta Socializzazione, Università di Padova
| | - Daniela Di Riso
- Dipartimento di Psicologia dello Sviluppo e delta Socializzazione, Università di Padova
| | - Daphne Chessa
- Dipartimento di Scienze, Umane e delta Formazione, Università di Perugia
| | - Adriana Lis
- Dipartimento di Psicologia dello, Sviluppo e delta Socializzazione, Università di Padova
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Olié E, Courtet P. Dépression récurrente : facteurs de risque, facteurs de vulnérabilité. Encephale 2010; 36 Suppl 5:S117-22. [DOI: 10.1016/s0013-7006(10)70042-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Although there have been advances in our ability to treat child and adolescent depression, use of evidence-based treatments still results in many patients with residual symptoms. Advances in our understanding of cognitive, emotional, and ecological aspects of early-onset depression have the potential to lead to improvements in the assessment and treatment of depression. A search for endophenotypes, i.e., traits that are related to depression, mediate the familial transmission of depression, and are genetically determined, may help in understanding etiology and in personalizing treatment. However, advances in treatment may also come from the identification of biomarkers, i.e., modifiable neurocognitive, physiological, or biochemical indices that are correlated with, or mediate, treatment outcome. More effective treatments may emerge from being able to personalize interventions to the patient's cognitive, emotional, and developmental profile.
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Affiliation(s)
- David A Brent
- University of Pittsburgh Medical Center, 200 Lothrop St., Pittsburgh, PA 15213-2582, USA.
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