Childhood depression and conduct disorder: I. Behavioral, affective, and cognitive aspects of family problem-solving interactions.

We assessed the family interactions of depressed, conduct-disordered, mixed depressed-conduct-disordered, and nonclinic children, ages 7-14 years, during a standardized family problem-solving discussion in the clinic. The child's and the mother's problem-solving proficiency, aversive behavior, and associated affective behavior (depressed and angry-hostile) were observed. The child and mother also rated each other's affect during the interaction for the dimensions sad, angry, critical, and happy on Likert-type scales. The child's and mother's cognitive constructions about the interaction were assessed using video-mediated recall. Although all clinic groups had lower levels of effective problem solving than did nonclinic children, their deficiencies were somewhat different. Mixed and depressed children displayed high levels of depressed affect and low levels of angry affect, whereas conduct-disordered children displayed both angry and depressed affect. In addition, conduct-disordered children had lower levels of positive problem solving and higher levels of aversive content than did non-conduct-disordered children. Depressed and conduct-disordered children had higher levels of self-referent negative cognitions than did mixed and comparison children, and depressed children also had higher other-referent negative cognitions than did all other groups. The study provides support for theories and treatment that stress the importance of family problem-solving and conflict resolution skills in child psychopathology.     

Sex differences in anger expression,depressed mood,and aggression in children and adolescents

The current study examined anger expression styles and their relationship to levels of depressed mood and aggressive behavior in male and female children and adolescents. Measures of anger, anger expression, and depressed mood were collected from both children and their parents. Hierarchical multiple regressions revealed that anger expression significantly predicted sadness but not aggression for females, after accounting for age and anger level. Among males, anger expression was important in predicting aggression but not sadness, whereas age and anger level best predicted sadness. These results suggest that age, anger level, and anger expression may be risk factors for depression and aggression among children and adolescents. Sex appears to be an important factor in anger expression styles and related depression and aggressive behavior.     

Marital interaction and depression

In this article, patterns of marital interaction as a function of depression and marital satisfaction are examined. The purpose of the study was to separate dysfunctional marital interaction patterns that were unique to depression from those that were associated with marital distress. The presence or absence of a depressed wife was crossed with level of marital satisfaction (distressed or nondistressed) to produce four groups of subject couples. Couples in which the wife was depressed exhibited more depressive behavior than did nondepressed couples, but only during discussion of a high conflict (as opposed to neutral) topic. Sex X Depression Level X Marital Satisfaction interactions were found for aggressive behavior: Depressed women in nondistressed relationships exhibited behavior that was characteristic of maritally distressed couples (high rates of aggression). In contrast, the husbands of these women exhibited behavior that one would expect in happily married couples (low rates of aggression). We failed to replicate previous findings that depressive behavior served a coercive function, although distressed couples, regardless of depression status, exhibited all the usual signs of negative dysfunctional interaction. In general, the findings suggested that marital distress rather than depression per se may be responsible for the dysfunctional interaction patterns frequently observed in depressed couples.     

Ruminating on Rumination: are Rumination on Anger and Sadness Differentially Related to Aggression and Depressed Mood?

Rumination is a risk factor for aggression and depression, yet few studies have incorporated both aggression and depression in a unitary model that reflects how rumination predicts these distinct conditions. The current study examined rumination on anger and sadness to assess their unique relations with aggression and depressed mood, respectively. Analogous anger rumination and sadness rumination questionnaires were used to minimize measurement variance, and were completed by 226 undergraduate students. Factor analysis suggested one general rumination factor comprised of two distinct sub-factors of anger rumination and sadness rumination. Path analysis confirmed unique relations between anger rumination and aggression, and sadness rumination and depressed mood. Further, anger rumination and anger were independent predictors of aggression. Results supported the conceptualization of anger rumination and sadness rumination as distinct constructs and underscore the importance of pursuing research that incorporates both forms of rumination to better understand how they impact development, mental health, and behavior.     

Family interaction and child psychopathology: A comparison of two observation strategies

We examined two systems of assessing family interactions that are in common usage: a home based observation of free parent-child interaction and a clinic based observation of a structured mother-child problem solving discussion. Participants were 18 depressed, 27 conduct disordered and 16 comparison children and their mothers. Results indicated that: 1) these observations may yield very different data about child, and to a lesser extent, parent behavior, 2) parental affect in the clinic was related to their level of aversive behaviour in the home, 3) levels of both aversive and positive behavior for children and their mothers were correlated within each setting, 4) accuracy of diagnostic classifications made on the basis of the observational data were highest for comparison and conduct disordered children, but lowest for depressed children observed in the clinic, and 5) the inclusion of data on mothers' behavior increased classification accuracy for conduct disordered children only.     

An Initial Look at Sibling Reports on Children's Behavior: Comparisons with Children's Self-Reports and Relations with Siblings' Self-Reports and Sibling Relationships

The authors examined siblings' reports of children's depression, anxiety, and aggression, and their reports of the sibling relationship, and compared them with children's self-reports. In two samples, including 169 sibling pairs (age M = 9.98 years, SD = 1.51), no significant differences emerged in the levels of depression and anxiety found in siblings' reports of children's behavior and children's self-reports, although siblings reported children to have significantly higher levels of aggression than the children self-reported. Age, the difference in ages between siblings, sex, and sibling sex were not related to siblings' reports of children's behavior. The relations between children's and siblings' reports of children's behavior were significant, yet moderate (average r = .22). Both siblings' self-reports of internalizing behavior and their perceptions of aspects of the sibling relationship (affection, rivalry, hostility, and satisfaction with the sibling relationship) explained significant, and unique, variance in siblings' reports of children's internalizing behavior. The findings for aggressive behavior were similar, although siblings' perceptions of affection in the sibling relationship were not significantly related to their reports of children's aggression. The potential uses and benefits of sibling reports of children's behavior, and sibling and family relationships, are discussed.     

Destructive sibling conflict and the development of conduct problems in young boys

Little empirical work has explored the relation between destructive sibling conflict and conduct problems in children. This study used a measure of observed sibling conflict to examine its relations with maternal and teacher report of conduct problems in a low-income sample of 180 five-year-old boys and their close-age siblings. Early report of behavior problems and rejecting parenting were added to the analyses to control for these predictors and to examine interactive effects. The interaction between destructive sibling conflict and rejecting parenting predicted aggressive behavior problems across time and informants such that a rise in aggression scores was evident for children who had high levels of both sibling conflict and rejecting parenting. Sibling conflict was also directly related longitudinally to the Child Behavior Checklist Delinquency factor. Results are discussed in terms of additive risk models and G. R. Patterson's (1984, 1986) theory of coercion.     

The Significance of Family Structure in Internalizing (Anxious/Depressed) and Externalizing (Aggressive/Delinquent) Problems among Chinese Adolescents

The present pioneering study investigated the differences across various types of family structure among Chinese adolescents with proactive and reactive aggression. It aimed at providing frontline social workers and family therapists with inspirations for designing suitable interventions for adolescents with specific subtypes of aggressive behavior from different family structure backgrounds. After completing an online survey including the Reactive and Proactive Aggression Questionnaire (RPQ) and the subscales of the Child Behavior Checklist – Youth Self-report (CBCL-YSR) on aggressive behavior, delinquent behavior, and anxious/depressed symptom, 520 out of 13,338 Chinese adolescents aged 11 to 18 were randomly selected and stratified based on the types of family structure (intact family, single father family, single mother family, stepfather family, and stepmother family). Expectedly, boys elicited more proactive aggression, delinquent behaviors, and aggressive behaviors than girls. Besides, significant cross-structural differences were found between children from stepmother family, who showed more proactive aggression, anxious/depressed symptoms, aggressive behaviors, and delinquent behaviors, and those from intact family regardless of gender. The interaction effects between gender and family structure were significant for reactive aggression, anxious/depressed behavior, and aggressive behavior. An interaction effect showed boys from stepmother families were more reactively aggressive than those from intact families. In addition, more anxious/depressed symptoms were found in boys from stepmother family than those from intact and single mother families. In conclusion, the impacts of family structure on proactive aggression and delinquent behavior are not gender specific, but the impacts on reactive aggression and anxious/depressed behavior are only specific to boys.

     

Expression of Anger in Depressed Adolescents: The Role of the Family Environment

The expression of anger is considered to be abnormal in depression, yet its role is only poorly understood. In the present study we sought to clarify this role by examining the moderating influence of the family environment on overall levels of anger expression and anger reactivity in depressed and non-depressed adolescents during conflictual interactions with their parents. One hundred and forty one depressed and non-depressed adolescent participants engaged in a problem-solving task with their parents during which their behavioral expression of anger and heart rate were recorded. The results demonstrate that general levels of parental anger in the family environment (as indicated by the overall level of expressed anger by the parents during the interactions) strongly moderates how depressed differ from non-depressed adolescents in terms of their anger, heart rate and reactivity. Overall, the findings suggest that in depressed adolescents anger is much less adaptively attuned to the environment, consistent with models that predict dysfunction in the regulation of anger that prevents depressed individuals responding adaptively to their social environment.     

Indirect influence of maternal social contacts on mother-child interactions: A setting event analysis

Fourteen mother-child dyads who had sought psychological help for severe interaction problems took part in a study that investigated the relationship between maternal social interactions with adults outside the family and mother-child interactions in the home. Social interactions outside the family were based on maternal self-reports; mother-child interactions in the home were based on direct observations and included both base-rate and sequential measures. Results indicated that mothers were significantly more aversive toward their children on days in which they had themselves experienced a high proportion of aversive interactions with adults than on days in which they had not. This higher level of aversiveness was evident in their responses to both aversive and nonaversive child behavior and could not be attributed to any corresponding change in child behavior. Implications for research and clinical practice are discussed.This work appeared first as a paper presented at the 92nd Annual Convention of the American Psychological Association, Toronto, August 1984. The research data reported in this article were generated by support from the National Institute of Mental Health, Crime and Delinquency Section, Grant No. R01-1068-58, to Robert G. Wahler. His permission to use these data is gratefully acknowledged.     

Adolescents' emotion expectancies regarding aggressive and nonaggressive events: connections with behavior problems

A total of 50 behaviorally disruptive (conduct-disordered or oppositional defiant-disordered) adolescents and 50 comparison adolescents assessed how they expected to feel following both aggressive and nonaggressive situations. Compared with their peers, behaviorally disruptive adolescents expected fewer normative emotions and exhibited somewhat more of an anger emphasis in their nonaggressive emotion attributions, and they expected to feel happier following acts of instrumental/proactive aggression. These patterns of emotion expectancies were linked more closely with teacher ratings of adolescents' proactive aggression than with ratings of reactive aggression. Regression analyses indicated that both nonaggression emotion expectancies and proactive aggression happiness made independent contributions to predicting adolescents' externalizing tendencies. Discussion focused on the contributions of different types of self-attributed emotion expectancies to adolescents' social understanding and behavior.     

ADHD and aggression as correlates of suicidal behavior in assaultive prepubertal psychiatric inpatients

Forty-three psychiatrically hospitalized prepubertal children were assessed regarding their assaultive and suicidal behaviors. These children were subsequently classified into two groups, assaultive/suicidal (AS) and assaultive-only (AO). AS children had higher aggression and suicidal-scale scores, but not higher depression scores, and were more likely to be diagnosed with ADHD. ADHD, child's aggression, and maternal depression and state anger accounted for 33% of the variance in suicidal-scale scores. Aggression mediated the relation between ADHD and suicidal behavior. Differences in symptom pattern between these two subtypes of assaultive inpatient children are interpreted as a basis for distinctive screening procedures.     

Multilevel Correlates of Childhood Physical Aggression and Prosocial Behavior

The study identified independent individual, family, and neighborhood correlates of children's physical aggression and prosocial behavior. Participants were 2,745 2–11-year olds nested in 1,982 families, which were themselves nested in 96 Canadian neighborhoods. Hierarchical linear modeling showed that the total variation explained by the three-level model was 28.03% for physical aggression and 17.57% for prosocial behavior. For both childhood behaviors, approximately 66% of this explained variance was between individuals and up to 30% was between families. The smallest amount of observed variation was between neighborhoods. Significant individual-level predictors common to both childhood behaviors were child's sex and maternal hostility toward the target child. Specifically, boys had more mother-reported physical aggression and less prosocial behavior. Children who experienced greater-than-average maternal hostility (compared to siblings) were more physically aggressive and less prosocial. At the family level, significant common predictors were mother depressed mood and punitive parenting. Children had higher levels of physical aggression and lower levels of prosocial behavior in families where mothers had greater depressed mood and used more punitive parenting practices. At the neighborhood level, greater perceived problems and lower poverty level were associated with higher levels of physical aggression. Results are discussed with reference to past and future studies of multilevel effects on children's socialization.     

Mothers' attributions and expectancies regarding their conduct-disordered children

As an extension of Patterson's family coercion model, we hypothesized that parental attributions about the causes of child misbehavior and parental expectancies concerning the effectiveness of parenting techniques are involved in the establishment and maintenance of coercive exchanges. Mothers of 40 conduct-disordered children and 40 matched control children completed questionnaires measuring their attributions regarding the causes of their children's misbehavior and their expectations concerning the general and personal effectiveness of parenting techniques. Results supported the hypotheses: parents of conduct-disordered children were more likely to regard their children's misbehavior as intentional and to attribute it to stable, global causes beyond the parents' control. They also were less likely to see their own parenting as effective. We speculate that these parents hold cognitive stances of blame and helplessness that contribute to aversive parent behavior as well as to parent withdrawal in the face of escalating child aggressiveness.This article is based on a doctoral dissertation conducted by Anne Davison Baden while at Peabody College of Vanderbilt University, and was presented in part at the annual meeting of the American Psychological Association, New Orleans, August 1989.     

Family interaction patterns and childhood depression

Rehm's (1977) self-control model for depression and Bandura's (1977) concept that children internalize external controls placed upon them are united to predict family interaction patterns that may contribute to the etiology or maintenance of depression in children. Families of depressed, nondepressed, and nonclinic children were compared on rates of, and criteria for, parental and self-reinforcement. Mother-father-child interactions were sequentially coded to reveal that mothers of depressed and nonclinic children both set very high criteria for rewarding their children, compared to mothers of clinic/nondepressed children. However, mothers of depressed children rewarded their depressed children at much lower rates than mothers of either clinic/nondepressed or nonclinic children. These factors, taken together, are discussed in terms of their possible etiological role in childhood depression.     

Social problem-solving in depressed,conduct-disordered,and normal adolescents

Although past theory and research implicate social problem-solving deficits in both depression and aggressive disorders, research examining carefully diagnosed groups of adolescent depressed and conduct-disordered groups had not previously been conducted. In the current study three groups of adolescents (major depression, conduct-disordered, and normal) were studied using two social problem-solving measures. Both the Means-Ends Problem-Solving task (MEPS) and the Social Situations Analysis measure (SSA) failed to show social problem-solving problem deficits in the depressed group relative to their normal age peers, but did provide corroborative evidence for social problem-solving deficits in the conduct-disordered sample. Relative to the other two groups, the conduct-disordered adolescents were found to generate fewer means to a social end, to anticipate fewer obstacles in the pursuit of solutions to interpersonal situations, and to generate fewer assertive behavioral solutions to difficult social situations. The results are discussed in relation to other work with depressed and aggressive youth, and directions for future research are given.     

Does Neighborhood Social Capital Buffer the Effects of Maternal Depression on Adolescent Behavior Problems?

Neighborhood characteristics have been shown to impact child well-being. However, it remains unclear how these factors combine with family characteristics to influence child development. The current study helps develop that understanding by investigating how neighborhoods directly impact child and adolescent behavior problems as well as moderate the influence of family characteristics on behavior. Using multilevel linear models, we examined the relationship among neighborhood conditions (poverty and social capital) and maternal depression on child and adolescent behavior problems. The sample included 741 children, age 5–11, and 564 adolescents, age 12–17. Outcomes were internalizing (e.g. anxious/depressed) and externalizing (e.g. aggressive/hyperactive) behavior problems. Neighborhood poverty and maternal depression were both positively associated with behavior problems for children and adolescents. However, while neighborhood social capital was not directly associated with behavior problems, the interaction of social capital and maternal depression was significantly related to behavior problems for adolescents. This interaction showed that living in neighborhoods with higher levels of social capital attenuated the relationship between maternal depression and adolescent behavior problems and confirmed the expectation that raising healthy well-adjusted children depends not only on the family, but also the context in which the family lives.     

Emotional congruence in older couples coping with wives' osteoarthritis: exacerbating effects of pain behavior

The authors examined congruence in the negative emotions (depression, anger) of 101 female osteoarthritis patients (M age = 69 years) and their caregiving husbands (M age = 71 years) and the extent to which patients' pain behavior (e.g., limping, rubbing joints) exacerbated linkages between partners' negative emotions. Associations between patients' and husbands' emotions were examined within domains (e.g., depression-depression) and across domains (e.g., depression-anger) over a 6-month interval. Regression analyses revealed that patients' initial levels of depressive symptoms and anger were related to increases in their husbands' anger over time. The associations between patients' depressive symptoms and their husbands' depressive symptoms and anger were conditioned by pain behaviors. Patients who were more depressed and who engaged in high levels of pain behavior had husbands who became more depressed and angry.     

The Relationship between Anger Rumination and Aggression in Typically Developing Children and High-Risk Adolescents

This paper examines anger rumination as a risk factor of aggression in typically developing children and high-risk adolescents. Study 1 developed and evaluated the psychometric properties of a self-report measure of children’s anger rumination (Children’s Anger Rumination Scale; CARS) and its association with teacher- and peer-rated overt and relational aggression in school-aged children (n = 254, M age = 10.62). Findings offered support for the reliability and validity of the CARS as well as support for the hypothesis that children who ruminate to anger exhibit elevated levels of overt and relational aggression. Study 2 examined concurrent and prospective relationships between anger rumination and aggression and the moderating effects of trait anger in a sample of male juvenile offenders (n = 119, M age = 16.74). Latent growth curve analyses revealed that the interaction between trait anger and anger rumination predicted initial levels of aggression (i.e., intercept) and changes in aggression over time (i.e., slope). Juvenile offenders who were high in trait anger and ruminated in response to anger exhibited the highest initial levels of aggression. Contrary to our hypothesis, this group did not exhibit greater increases in aggression over time relative to others, but instead they had stably high levels of aggression at each time point. These findings suggest that cognitive-behavioral treatment strategies for aggression may be improved by educating youths about the contributory role of anger rumination in the development of aggression and providing them with adaptive alternatives to coping with feelings of anger.     

Coping and Positive Affect in Adolescents of Mothers With and Without a History of Depression

The adolescent children of depressed mothers are at increased risk for depression, but little is known about protective factors for these children. Maintenance of positive affect in a stressful context may be an important marker of resilience. Mothers with (n = 34) and without (n = 38) a history of depression and their adolescent children completed questionnaires regarding adolescents’ coping and depressive symptoms and engaged in a 15 min videotaped interaction about family stress. Adolescents’ observed behaviors were coded using the Iowa Family Interaction Rating Scales. No significant differences emerged in observed behavior between adolescents of mothers with and without a history of depression. Higher levels of primary and secondary control coping and lower levels of disengagement coping were related to higher levels of observed positive mood and fewer depressive symptoms in adolescents. Observed positive mood was related to fewer depressive symptoms in adolescents, even after accounting for maternal history of depression and current maternal depressive symptoms. Results suggest the importance of considering positive affect in the context of family stress as a marker of resilience in adolescents at risk for depression. The current study provides evidence for coping as a protective factor, related to higher levels of positive affect and fewer depressive symptoms, in adolescents exposed to maternal depressive symptoms.