The effect of relational continuity of care in maternity and child health clinics on parenting self‐efficacy of mothers and fathers with loneliness and depressive symptoms

This study explored the parenting self‐efficacy of the parents of 18‐month‐old children in the context of Finnish maternity and child health clinics. This parenting self‐efficacy was observed in relation with the relational continuity of care and parents' experienced loneliness and depressive symptoms. The relational continuity of care was provided by a public health nurse in maternity and child health clinics. The participating parents were drawn from the STEPS study that is being carried out by the Institute for Child and Youth Research at the University of Turku. The results showed that relational continuity of care provided by the same public health nurse in the maternity and child health clinics was associated with mothers' higher emotional loneliness and with lower scores on three dimensions of parents' parenting self‐efficacy. Loneliness and depressive symptoms negatively influenced parents' parenting self‐efficacy – however, in the case where the family had experienced relational continuity of care, the parents' higher levels of depressive symptoms had not weakened their parenting self‐efficacy beliefs. These results are discussed in terms of organizing maternity and child health clinic services.     

A longitudinal study of children's depressive symptoms, self-perceptions, and cognitive distortions about the self

This longitudinal study examined how depressive symptoms relate to children's self-perceptions and to estimates of children's cognitive distortions about the self in a nonclinical sample of children who were followed from 4th grade (n = 248) through 6th grade (n = 227). Report card grades measured children's academic competence, and teachers' ratings of children's level of peer acceptance at school indicated social acceptance. Self-reported depressive symptoms predicted a change in children's negative views of the self. Moreover, the self-perceptions of children who exhibited more symptoms of depression appeared to reflect an underestimation of their actual competence. Children's negative self-perceptions and underestimations about the self were not associated with a subsequent change in depressive symptoms. The implications of the findings for cognitive theories of depression and future research with this population are discussed.     

Therapeutic Alliance,Interpersonal Relations,and Trauma Symptoms: Examining a Mediation Model of Women With Childhood Abuse Histories

The current study explored the dimensions of the early therapeutic alliance (tasks, goals, bonds, and other-therapist [people important to clients who support their involvement in therapy]) as mediators between clients’ interpersonal relations problems and outcome measures of trauma symptoms (dissociation and total trauma symptoms). Seventy-six female participants who were receiving treatment for posttraumatic stress due to child abuse (CA), were recruited from a university training clinic. The bond and other subscales mediated the association between interpersonal relations problems and dissociation. The element of client trust associated with the alliance bond, as well as clients’ sense that people who are important to them support their involvement in therapy, should be focal in treating CA survivors. Clinical implications revolve around developing, maintaining, and repairing the therapeutic relationship, especially the bond, within the context of dissociation, as well as exploring clients’ views of important others and its impact on their therapy.     

A Longitudinal Study of Parental Depressive Symptoms and Coparenting in the First 18 Months

Although the negative impact of postpartum depression on parenting behaviors has been well established—albeit separately—for mothers and fathers, the respective and joint impact of both parents' mood on family‐group interactive behaviors, such as coparenting support and conflict behaviors between the parents, have not yet been investigated. The aim of this study was to examine the association between parental depressive symptoms and coparenting behaviors in a low‐risk sample of families with infants, exploring reciprocity between the variables, as well as gender differences between mothers and fathers regarding these links. At 3 (T1), 9 (T2), and 18 months postpartum (T3), we assessed both parents' depressive symptoms with a self‐report questionnaire and observed coparenting support and conflict during triadic mother–father–child interactions. The results revealed that higher maternal depressive symptoms at T1 were associated with lower support at T1 and T2. Conflict at T3 was associated with higher maternal depressive symptoms at T3 and, more surprisingly, with less depressive symptoms in mothers at T2 and fathers at T3. Cross‐lagged associations suggested that parental depressive symptoms were more likely to influence coparenting than the reverse. Moreover, maternal depressive symptoms were more likely to be linked to coparenting behaviors than were paternal depressive symptoms. These results confirm that parental—mostly maternal—depressive symptoms, even of mild intensity, may jeopardize the development of healthy family‐level relations, which previous research has shown to be crucial for child development.     

Compassion‐Based Meditation in African Americans: Self‐Criticism Mediates Changes in Depression

This study examines self‐criticism as a mechanism through which compassion meditation reduces depressive symptoms in low‐income African American men and women (N  = 59) who had recently attempted suicide. After completing several measures, including the Levels of Self‐Criticism Scale and Beck Depression Inventory‐II , participants were randomly assigned to receive either a six‐session compassion meditation (CM ) group (Grady Compassion and Meditation Program) or a six‐session support group. As predicted, path analysis results showed that treatment condition led to changes in self‐criticism from pre‐ to posttreatment, with those receiving CM showing greater reductions in levels of self‐criticism than those randomized to the support group. Path analyses also revealed that changes in self‐criticism fully mediated the link between condition and changes in depressive symptoms. These findings highlight the importance and value of targeting levels of self‐criticism in compassion‐based interventions to reduce the depressive symptoms of suicidal African Americans.     

On the Integration of Need‐related Autobiographical Memories among Late Adolescents and Late Adults: The Role of Depressive Symptoms and Self‐congruence

Within self‐determination theory, integration denotes the process through which people accept past and present experiences and harmonize these experiences within their sense of self. We investigated associations between indicators of successful and poor integration of need‐related memories and memory‐related affect. We also examined the role of depressive symptoms and self‐congruence as antecedents of these indicators. Moreover, we investigated whether late adults, compared with late adolescents, were better capable of integrating need‐frustrating memories through higher levels of self‐congruence. Participants were 132 late adolescents (Mage = 17.83) and 147 late adults (Mage = 76.13), who reported on their level of depressive symptoms and self‐congruence. Next, participants generated a need‐satisfying and need‐frustrating memory and reported on the memories' integration (in terms of acceptance, connection and rumination) and associated affect. Whereas depressive symptoms related mainly to the poor integration of need‐frustrating memories, self‐congruence related positively to the integration of both need‐satisfying and need‐frustrating memories. In turn, integration was related to more positive and less negative affect. Late adults scored higher than late adolescents on the integration of need‐frustrating memories, an effect that was partly accounted for by late adults' elevated self‐congruence. Results suggest that self‐congruence, depressive symptoms and age play a role in the integration of need‐based autobiographical memories. Copyright © 2016 European Association of Personality Psychology     

在美国样本中母亲抑郁症状与儿童退缩的关系:教养行为的中介作用

本研究通过使用美国国家儿童健康与人类发育研究所的纵向研究数据建立分层线性模型,探究在儿童的早期发展中,母亲抑郁症状对儿童的社会性退缩的影响,以及母亲的教养行为在这一关系中的中介作用,结果发现：（1）在儿童24~54个月期间,随着母亲抑郁症状的升高,儿童的社会性退缩也随之升高;（2）母亲抑郁症对儿童社会性退缩的影响存在着性别差异,与女孩相比,男孩的社会性退缩更容易受到母亲抑郁症状的影响;（3）在男孩中,消极的教养行为在母亲抑郁症状与男孩的社会性退缩之间起到了中介作用,而在女孩中,这一中介作用并不显著。     

The role of perfectionism in cognitive behaviour therapy outcomes for clinically anxious children

The main aim of this study was to determine whether pre-treatment levels of child perfectionism impacted on anxiety treatment outcomes for school-aged children. In addition, it was investigated whether child perfectionism decreased following treatment for anxiety. Participants were sixty-seven clinically anxious children aged 6–13 years (female = 34; majority Caucasian) who were enrolled in a group-based cognitive behaviour therapy program, and their parents. They completed self-report questionnaires on anxiety and depressive symptoms and were administered a diagnostic interview to determine the type and clinician rated severity of anxiety and related disorders pre- and post-treatment and at 6-month follow-up. Self- and parent-rated perfectionism were also measured pre-treatment, while a subset of children completed perfectionism measures post-treatment as well. Self-Oriented Perfectionism, but not Socially Prescribed Perfectionism, predicted poorer self-reported treatment outcome (higher levels of anxiety symptoms) immediately following treatment and at 6-month follow-up when using a multi-informant approach. Additionally, both Self-Oriented and Socially Prescribed child perfectionism significantly reduced immediately following treatment. Despite reductions in child perfectionism following anxiety treatment, higher Self-Oriented Perfectionism may impact negatively on child anxiety treatment outcome.     

The affective structure of supportive parenting: depressive symptoms, immediate emotions, and child-oriented motivation

This study investigated the maternal concerns and emotions that may regulate one form of sensitive parenting, support for children's immediate desires or intentions. While reviewing a videotape of interactions with their 1-year-olds, mothers who varied on depressive symptoms reported concerns and emotions they had during the interaction. Emotions reflected outcomes either to children (child-oriented concerns) or to mothers themselves (parent-oriented concerns). Child-oriented concerns were associated with fewer negative emotions and more supportive behavior. Supportive parenting was high among mothers who experienced high joy and worry and low anger, sadness, and guilt. However, relations depended on whether emotions were child or parent oriented: Supportive behavior occurred more when emotions were child oriented. In addition, as depressive symptoms increased, mothers reported fewer child-oriented concerns, fewer child-oriented positive emotions, and more parent-oriented negative emotions. They also displayed less supportive behavior. Findings suggest that support for children's immediate intentions may be regulated by parents' concerns, immediate emotions, and depressive symptoms.     

Explaining the gender difference in depressive symptoms

It was hypothesized that women are more vulnerable to depressive symptoms than men because they are more likely to experience chronic negative circumstances (or strain), to have a low sense of mastery, and to engage in ruminative coping. The hypotheses were tested in a 2-wave study of approximately 1,100 community-based adults who were 25 to 75 years old. Chronic strain, low mastery, and rumination were each more common in women than in men and mediated the gender difference in depressive symptoms. Rumination amplified the effects of mastery and, to some extent, chronic strain on depressive symptoms. In addition, chronic strain and rumination had reciprocal effects on each other over time, and low mastery also contributed to more rumination. Finally, depressive symptoms contributed to more rumination and less mastery over time.     

Long-term effects of the death of a child on parents' adjustment in midlife.

The death of a child is a traumatic event that can have long-term effects on the lives of parents. This study examined bereaved parents of deceased children (infancy to age 34) and comparison parents with similar backgrounds (n = 428 per group) identified in the Wisconsin Longitudinal Study. An average of 18.05 years following the death, when parents were age 53, bereaved parents reported more depressive symptoms, poorer well-being, and more health problems and were more likely to have experienced a depressive episode and marital disruption than were comparison parents. Recovery from grief was associated with having a sense of life purpose and having additional children but was unrelated to the cause of death or the amount of time since the death. The results point to the need for detection and intervention to help those parents who are experiencing lasting grief.     

The Sexual Self-Perceptions of Young Women Experiencing Abuse in Dating Relationships

Though information about one's sexuality may be inferred from sexual interactions themselves, a sexual sense of self may also be derived from the quality of the intimate relationship more generally. In this study, we examined the sexual self-perceptions of young women in dating relationships (N=108) as a function of whether these relationships were characterized by abuse. Negative sexual self-perceptions were found to be more evident among women who were experiencing physical/psychological abuse or sexual coercion in their current relationships than among women who were not, even after controlling for self-esteem and depressive symptoms. However, positive sexual self-perceptions were unaffected by abuse, and hence may provide young women a basis for establishing healthier relationships in future.     

Tyler in the Labyrinth: A Young Child’s Journey from Chaos to Coherence

This paper describes the treatment of a young boy who was abused and neglected in infancy. It examines the challenges of working in the intimate territory of early trauma when a child is too fragmented to play. The therapist supported affect regulation to help the child experience a coherent sense of himself. As the boy became more integrated and related, the opening of transitional space became possible, and with it, the emergence of creativity. His growing capacity to play and his discovery of the rich utility of stories are discussed. A children’s book of Greek myths, in particular, the story of the Minotaur and the Labyrinth, held special meaning for him, and for the therapist too. As the child became increasingly related and symbolic, he eventually began to tell his own extraordinary story.     

Parental Depression and Child Externalizing and Internalizing Symptoms: Unique Effects of Fathers’ Symptoms and Perceived Conflict as a Mediator

Although a developing body of literature suggests that depressive symptoms in fathers are related to child psychopathology, little evidence suggests that paternal depression plays a unique role in children’s symptoms. We used a high-risk design involving children of mothers with and without histories of depression to test the unique mediating role of father–child conflict in the relations between fathers’ depressive symptoms and child externalizing and internalizing symptoms. In all regression analyses, mothers’ history of depression and current depressive symptoms were controlled. Depressive symptoms in fathers were associated with child externalizing and internalizing symptoms, and father–child conflict. Father–child conflict mediated relations between fathers’ depressive symptoms and child externalizing symptoms above and beyond the effects of maternal depression history and depressive symptoms. The results suggest that negative interpersonal consequences of parental depression on child psychopathology may not be limited to mothers.     

Cognitive Reappraisal and Depression in Children with a Parent History of Depression

Although decades of research have documented that children whose parents have a history of Major Depressive Disorder (MDD) are at a higher risk of developing depression themselves, not all of these children go on to develop depression themselves, thus highlighting the need to understand potential moderators of risk. The current study examined whether child emotion regulation, specifically, the use of cognitive reappraisal and suppression, moderated the link between parent and child depression. We recruited 458 parents and their children between the ages of 7–11 from the community. The majority of children were Caucasian (74.2%) and approximately half were girls (46.1%). Among children with a parent history of MDD, those who reported using cognitive reappraisal more frequently were less likely to have a history of depressive diagnoses themselves and had higher current levels of positive affect. Although children’s use of suppression was not associated with their levels of depressive symptoms among children with a parent history of MDD, higher levels of suppression were related to higher levels of depressive symptoms among children with no parent history of MDD. These findings suggest that, among children with a history of parent depression, children’s use of cognitive reappraisal may influence their own risk for developing depression and highlights the potential utility of early interventions that focus on improving the use of emotion regulation strategies like cognitive reappraisal among children of depressed parents.     

Longitudinal Model Predicting Self‐Concept in Pediatric Chronic Illness

Although self‐concept has been identified as salient to the psychosocial adjustment of adolescents dealing with a chronic illness (CI), little research has focused on its predictors it. Given that depression and parent–child attachment have been linked to self‐concept in the population at large, the goal of this study was to evaluate these relationships longitudinally in a sample of adolescents with CI. Using participant data from the Mastering Each New Direction (MEND) program, a 3‐month psychosocial, family based intensive outpatient program for adolescents with CI, we employed multilevel modeling to test longitudinal changes in self‐concept, as predicted by depressive symptoms and parent–child attachment, in a sample of 50 youths (M_age = 14.56, SD_age = 1.82) participating in MEND. Both “time spent in the program” and decreases in depressive symptoms were associated with increases in self‐concept over time. Higher baseline levels of avoidant attachment to both mother and father were also associated with greater initial levels of self‐concept. Targeting depressive symptoms and supporting adaptive changes in attachment may be key to promoting a healthy self‐concept in pediatric CI populations. The association between avoidant attachment and higher baseline self‐concept scores may reflect differences in participants’ autonomy, self‐confidence, or depression. Limitations of the study include variability in the amount of time spent in the program, attrition in final time point measures, and the inability to fully examine and model all potential covariates due to a small sample size (e.g. power).     

Infant Emotion Regulation Strategy Moderates Relations between Self‐Reported Maternal Depressive Symptoms and Infant HPA Activity

Children of mothers with depressive symptoms often have high cortisol levels. Research shows that various child characteristics (e.g., attachment pattern, internalizing behaviours, and temperament) moderate this association. We suggest that these characteristics share common variance with emotion regulation strategy. Therefore, we examine infant emotion regulation strategy as a moderator of the association between maternal depressive symptoms and infant hypothalamic–pituitary–adrenal (HPA) function. We hypothesize that infants who utilize more independent emotion regulation strategies and have mothers who report higher depressive symptoms will exhibit elevated cortisol levels. Participants were 193 mothers and infants (15 months old) recruited from the community. Self‐reported maternal depressive symptoms were assessed. Infant independent regulatory behaviours (withdrawal, wandering away, distraction, scanning, orienting to another object) were coded in the context of a Toy Frustration Task. Infant cortisol was collected via saliva samples at baseline, +20, and +40 minutes. Results indicate that infant emotion regulation strategy moderates the relation between mothers' self‐reported depressive symptoms and infant total cortisol output (AUC_G) and cortisol reactivity (AUC_I). Infants who employed more independent regulatory behaviours and have mothers with higher depressive symptoms experience greater cortisol secretion. We discuss the findings in relation to parent‐infant interactions and the adaptive nature of emotion regulation strategies, as they relate to HPA regulatory capacities. Copyright © 2015 John Wiley & Sons, Ltd.     

Depressive Symptoms and Conversational Self-Focus in Adolescents’ Friendships

This multi-method, longitudinal study considered the interplay among depressive symptoms, aversive interpersonal behavior, and interpersonal rejection in early and middle adolescents’ friendships. In particular, the study examined a newly identified interpersonal process, conversational self-focus (i.e., the tendency to redirect conversations about problems to focus on the self). Traditional interpersonal theories of depression suggest that individuals with depressive symptoms engage in aversive behaviors (such as conversational self-focus) and are rejected by others. However, in the current study, not all adolescents with depressive symptoms engaged in conversational self-focus and were rejected by friends. Instead, conversational self-focus moderated prospective relations of depressive symptoms and later friendship problems such that only adolescents with depressive symptoms who engaged in conversational self-focus were rejected by friends. These findings are consistent with current conceptualizations of the development of psychopathology that highlight heterogeneity among youth who share similar symptoms and the possibility of multifinality of outcomes.     

Comorbid social anxiety disorder in clients with depressive disorders: predicting changes in depressive symptoms, therapeutic relationships, and focus of attention in group treatment

The current study examined whether depressed outpatients with comorbid SAD respond differently to a cognitive-behavioral group intervention and if so, how and why. Using growth curve modeling, we found evidence that depressed clients with comorbid SAD had rapid improvement in depressive symptoms over the course of treatment and generally did not differ from those without comorbidity in developing close therapeutic relationships and modifying the direction of attentional focus away from the self. Non-linear effects demonstrated that rates of change in depressive symptoms, relationship variables, and focus of attention, were most rapid early in treatment. In contrast to hypotheses, trajectories of change in therapeutic relationships and attentional focus did not mediate the effect of SAD on treatment improvement in depressive symptoms. These findings suggest that comorbid SAD does not have a detrimental effect on the course of depression treatment and group-based treatments can be as beneficial for depressed individuals with comorbid SAD. It may be that group-based treatments for depression provide explicit opportunity for emotional processing in social situations (i.e., exposure) and hence mimic efficacious therapies for SAD.     

Family,friend, and neighbour child care providers and maternal well‐being in low‐income systems: An ecological social perspective

Integrating theory from the family ecological systems and social support literatures with findings from child care research, in this study we develop and test a model relating family, friend, and neighbour (FFN) child care provider characteristics to perceived child care quality (provider reports of caregiving behaviours, mother‐provider caregiving relationship) and maternal well‐being (work‐family conflict, depressive symptoms). Results from phone interviews with 187 FFN providers receiving public subsidies indicated that even after controlling for familial status or household income, caregiver perceptions of higher quality care were associated with higher education levels, greater attachment to child care as a job; and lower provider depressive symptoms. After controlling for familial status, data analysed from a subset of 51 mother‐provider pairs, indicated that mothers using care from providers who reported higher quality parent‐caregiver social relationships reported lower work‐family conflict and depressive symptoms. This study suggests mothers who have providers with whom they have good caregiving interactions may experience positive social support and psychological crossover dynamics associated with mother well‐being.