Affective and Autonomic Reactivity During Parent–Child Interactions in Depressed and Non-Depressed Mothers and Their Adolescent Offspring

Depression presents risks that are profound and intergenerational, yet research on the association of depression with the physiological processes that might be associated with impaired mental and physical health has only recently been contextualized within the family environment. Participants in this multi-method case–control study were 180 mother-adolescent dyads (50% mothers with a history of depression treatment and current depressive symptoms). In order to examine the association between maternal depression and affective and autonomic reactivity amongst these mothers and their adolescent offspring we collected self-reported measures of positive and negative affect, as well as measures of cardiovascular and electrodermal autonomic activity, during mother-adolescent interaction tasks. Findings indicated that depressed mothers and their adolescent offspring exhibited greater self-reported negative affect reactivity during a problem-solving interaction and blunted (i.e., low) sympathetic activity as measured via skin conductance level across both interaction tasks. These effects remained significant after controlling for a range of potential covariates, including medication use, sex, age, adolescents own mental health symptoms, and behavior of the other interactant, along with correcting for multiple comparisons. Findings indicate that depressed mothers and their adolescent offspring both exhibit patterns of affect and physiology during interactions that are different from those of non-depressed mothers and their offspring, including increased negative affect reactivity during negative interactions and blunted sympathetic activity across both positive and negative interactions. These findings have potential implications for understanding the role of family processes in the intergenerational transmission of risk for depressive disorders.

     

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.     

Facial expressions and vagal tone of infants of depressed and non-depressed mothers

Mothers classified as ‘depressed’, ‘non-depressed’ or ‘low scoring’ on the Beck Depression Inventory and their 3-month-old infants were videotaped during 3-minute face-to-face play interactions. Infants' facial expressions were coded using the AFFEX facial expression coding system and their EKG was recorded during the interactions to assess the relationship between cardiac measures and facial expressivity. Infants of both ‘depressed’ and ‘low scoring’ mothers showed significantly more sad and anger expressions and fewer interest expressions than infants of nondepressed mothers. Cardiac vagal tone, (quantified from the amplitude of respiratory sinus arrhythmia) was correlated with infants' joy and interest expressions and with self-comfort behaviours in the non-depressed and low scoring groups, but not in the depressed group. The results suggest that matermal depression affects infants' affective state and appearance as well as their biobehavioural emotional regulation systems.     

Childhood depression and conduct disorder: II. An analysis of family interaction patterns in the home.

Few researchers have assessed family interaction patterns associated with childhood depression, especially using observations in natural settings. We directly sampled the interaction patterns of families with depressed, conduct-disordered, mixed depressed-conduct-disordered, and comparison children ages 7-14 years in their homes during the evening meal. Observational measures were taken of positive and aversive behaviors and affect expression for both parents, the referred children, and their siblings. Results replicated previous research showing that conduct-disordered children express high levels of aversive behavior and anger and are part of a family system marked by conflict and aggression. The depressed children were exposed to maternal aversiveness but did not show any evidence of elevated levels of anger or aversiveness in their own behavior. Surprisingly, this was also true for the mixed-disorder children. High levels of depression in both groups of depressed children were associated with low levels of conflict and anger in family members. Overall, siblings showed very similar patterns of behavior, and were exposed to similar patterns of parental behavior, as the referred children. Results are discussed in terms of family models that emphasize the function of aggression and depression in the maintenance of child psychopathology.     

Prenatal paternal depression

Prenatal depressive symptoms, anxiety, anger and daily hassles were investigated in 156 depressed and non-depressed pregnant women and their depressed and non-depressed partners (fathers-to-be). Depressed versus non-depressed fathers had higher depression, anxiety and daily hassles scores. Although the pregnant women in general had lower anxiety, anger and daily hassles scores than the men, the scores on the measures for depressed fathers and depressed mothers did not differ. Paternal depression appeared to have less effect than maternal depression on their partners’ scores. However, the similarity between the scores of depressed mothers and depressed fathers highlights the importance of screening for depression in fathers-to-be as well as mothers-to-be during pregnancy.     

Assessment of mode of anger expression in adolescent psychiatric inpatients.

Anger can play an important role in depression and suicide risk among adolescents. The present study evaluated internalized and externalized anger in 92 adolescent psychiatric inpatients. Results indicated that adolescents who internalized their anger were more likely to be depressed and to experience feelings of hopelessness. In addition, adolescents who internalized their anger made more serious suicide attempts than did those who externalized their anger. In contrast, adolescents who externalized their anger were more likely to have alcohol-related problems. Thus, different modes of anger expression appear to be related to different manifestations of psychopathology. It was concluded that assessment of mode of anger expression in adolescents may enhance our understanding of suicide and its risk factors.     

Sleep disturbances in depressed pregnant women and their newborns

Pregnant women (N=253) were recruited during their second trimester of pregnancy (M=22.3 weeks gestation) and assigned to depressed (N=83) and non-depressed groups based on a SCID diagnosis of depression. They were then given self-report measures on sleep disturbance, depression, anxiety and anger, and their urine was assayed for norepinephrine and cortisol. These measures were repeated during their third trimester (M=32.4 weeks). Their newborns were then observed during sleep. During both the second and third trimesters, the depressed women had more sleep disturbances and higher depression, anxiety and anger scores. They also had higher norepinephrine and cortisol levels. The newborns of the depressed mothers also had more sleep disturbances including less time in deep sleep and more time in indeterminate (disorganized) sleep, and they were more active and cried/fussed more.     

Effects of maternal depression in the Still-Face Paradigm: A meta-analysis

The Still-Face Paradigm (SFP) enables researchers to examine the quality of mother-infant interactions. In typical infants, a classic still-face effect (SFE) has been confirmed whereby infants demonstrate reduced positive affect (PA), reduced gaze (GA), and increased negative affect (NA). Recently, the SFP has been used to examine the effect of maternal depression upon infant behaviour. However, the nature and consistency of the behavioural responses of infants of depressed mothers during the SFP remains unclear. In the current meta-analysis, we examined whether or not infants of depressed mothers demonstrate the classic SFE, as well as whether or not these infants display the same levels of PA, NA, and GA as their counterparts with non-depressed mothers. Results revealed that infants of depressed mothers display the classic SFE like infants of their non-depressed counterparts. However, infants of depressed mothers also demonstrated significantly higher levels of PA during the still-face episode. One potential interpretation of this finding is that infants prior experience of similar, depressed interactions with their mothers, encourages them to amplify their positive attachment signals in order to engage maternal attention and response. Alternatively, or additionally, infants of depressed mothers could be using PA in order to regulate their own NA.     

Depressed mothers' newborns show less discrimination of other newborns' cry sounds

Newborns' crying in response to the cry of another newborn has been called an empathetic response. The purpose of this study was to determine whether newborns of depressed mothers showed the same response. Newborns of depressed and non-depressed mothers were presented with cry sounds of themselves or other infants, and their sucking and heart rate were recorded. The newborns of non-depressed mothers responded to the cry sounds of other infants with reduced sucking and decreased heart rate. In contrast, the newborns of depressed mothers did not show a change in their sucking or heart rate to the cry sounds of other infants. This lesser attentiveness/responsiveness to other infants' cry sounds may predict their later lack of empathy.     

Responses to interpersonal conflict among young adults: Influence of family of origin

This study aimed to examine the role of family environment upon responses to interpersonal conflict in young adulthood, and to determine whether response patterns differed between men and women. Behavioral, affective, and cardiovascular responses of 17 young adults from families rated extreme (EXT) on scales of cohesion and flexibility were compared with those of 21 young adults from balanced (BAL) families. Participants engaged in 2 role‐play conflicts, 1 with a male confederate and 1 with a female confederate. Measures of positive and negative verbal and nonverbal behaviors, self‐reported anxiety and anger, and heart rate and blood pressure were obtained. Results showed EXT participants exhibited more negative verbal and less positive verbal behavior during both interactions than BAL participants. EXT men exhibited greater DBP, state anger, and negative nonverbal responses than BAL men, findings not observed for women. These findings indicate that exposure to a negative family environment influences how young adult men respond to interpersonal confrontation more than young adult women.     

Youth Depression in the Family Context: Familial Risk Factors and Models of Treatment

Research on parent risk factors, family environment, and familial involvement in the treatment of depression in children and adolescents is integrated, providing an update to prior reviews on the topic. First, the psychosocial parent and family factors associated with youth depression are examined. The literature indicates that a broad array of parent and family factors is associated with youth risk for depression, ranging from parental pathology to parental cognitive style to family emotional climate. Next, treatment approaches for youth depression that have been empirically tested are described and then summarized in terms of their level of parent inclusion, including cognitive–behavioral therapy, interpersonal therapy, and family systems approaches. Families have mostly not been incorporated into clinical treatment research with depressed adolescents, with only 32% of treatments including parents in treatment in any capacity. Nonetheless, the overall effectiveness of treatments that involve children and adolescents exclusively is very similar to that of treatments that include parents as agents or facilitators of change. The article concludes with a discussion of the implications of these findings and directions for further research.     

Therapist Interventions Associated with Productive Emotional Processing in the Context of Attachment-Based Family Therapy for Depressed and Suicidal Adolescents

Productive emotional processing is considered a key change mechanism in attachment-based family therapy (ABFT). This study examined the impact of attachment-based family therapy therapist interventions aimed to promote productive emotional processing of primary adaptive emotions in a sample of 30 depressed and suicidal adolescents who had participated in a larger randomized clinical trial. Results of sequential analyses revealed that relational reframes and therapists’ focus on primary adaptive emotions were associated with the subsequent initiation of adolescents’ productive emotional processing of primary adaptive emotions. In contrast, interpretations, reassurances, and therapists’ focus on adolescents’ rejecting anger toward their parents were all followed by the discontinuation of adolescents’ emotional processing that had already begun. Finally, therapists’ general encouragement of affect and focus on adolescents’ unmet attachment/identity needs were associated with both the initiation of adolescents’ productive emotional processing, and with the discontinuation of such processing once it had already begun. Theoretical and clinical implications are discussed.     

Staff and Boarders Perspectives of the Boarding Environment

This research provides support for a direct comparison between the home and boarding environments, the inference being that boarding staff who fulfil an in loco parentis role have an integral part to play in the developmental outcomes of adolescents (boarders). Research in the area of family functioning has found that adolescents tend to view the family environment more negatively than their parents and that these discrepant perceptions have been linked to both internalising and externalising disorders in adolescents. In an attempt to further clarify the influence of the parenting role of boarding staff and of the boarding environment in general, 121 staff and 415 boarders from schools in Queensland, Australia, were asked to rate the boarding environment on levels of conflict, social support and climate. It was found that boarders, like adolescents in the home environment, perceived significantly higher levels of conflict and lower levels of social support and positive climate than did staff. These findings lend further support to the conceptualisation of the boarding environment as a home away from home. The implications of these findings for boarders’ developmental outcomes are discussed.     

Parent–Teen Interactions as Predictors of Depressive Symptoms in Adolescents with Headache

This study investigated parent–adolescent conflict, family functioning, and adolescent autonomy as predictors of depressive symptoms in adolescents with primary headache. Frequent headaches during adolescence can have a negative impact on activity levels and psychological functioning. Depression is particularly prevalent in adolescents with headache but little research has examined the role of parent–teen interactions in predicting depressive symptoms. Thirty adolescents diagnosed with migraine or chronic daily headache completed self-report measures of pain intensity, parent–adolescent conflict, family functioning, and depression. Adolescents and their parents also participated in three videotaped interaction tasks, scored by independent raters to assess adolescent autonomy. Regression models revealed that pain intensity, parent–adolescent conflict, and autonomy predicted depressive symptoms. Higher levels of conflict, poorer family functioning and lower levels of autonomy were associated with more depressive symptoms. This study highlights the association between parent–teen interactions and psychological functioning in adolescents with primary headache. Implications for intervention are discussed.     

Depression is associated with the escalation of adolescents' dysphoric behavior during interactions with parents

Though much is known about the stable mood patterns that characterize depressive disorder, less attention has been directed to identifying and understanding the temporal dynamics of emotions. In the present study, we examined how depression affects the trajectory of dysphoric and angry adolescent emotional behavior during adolescent-parent interactions. Adolescents (72 depressed; 69 nondepressed) engaged in video recorded positive and negative interactions with their parents. Depressed adolescents showed a linear increase in dysphoric behaviors throughout the negative interactions, while the incidence of these behaviors remained relatively stable across the interactions among nondepressed adolescents. A similar linear increase was not found in angry behavior. These findings show that depression in adolescence is associated with greater escalation of dysphoria during conflictual interactions between adolescents and their parents. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Autonomy and Relatedness in Family Interactions with Depressed Adolescents

This study investigated family interaction patterns associated with adolescent depression. Twenty adolescent–mother dyads with clinically depressed adolescents participated in the study. Twenty dyads with externalizing youths and 20 nonclinic dyads were included as controls. Dimensions of autonomy and relatedness were rated during a videotaped mother–adolescent problem-solving task. Adolescent perceptions of parent attachment were also evaluated. Results indicated that depressed adolescents and their mothers did not differ in their behavior compared with nonclinic adolescents. Dyads with externalizing adolescents showed the highest impairment in autonomy and relatedness. Depressed adolescents perceived the quality of their relationships with their parents to be impaired relative to nonclinic dyads, as did externalizing adolescents.     

Modeling as an infant mental health intervention

Within the context of family therapy focused on the behavioral problems of a six year old, several observations of inappropriate interactions between the parents and their infant concerned the therapist. In consultation with an infant specialist it was decided that the therapist would avoid identifying parent-infant interactions as a further problem and would, instead, begin to model appropriate interactions during the on-going therapy sessions. The infant, initially passive, began to respond to the therapist and gradually the parents became more appropriate in their interactions with their infant. It was concluded that the modeling process minimized the stress and eliminated the need to process feelings of anger and guilt often associated with professional identification of family problems.     

Familial environment associated with type A behaviors and psychophysiological responses to stress in children

This study tested two major hypotheses regarding the characteristics of family environments associated with children's Type A behaviors, anger frequency and expression, hostile outlook, hostility displayed during an interview, and cardiovascular responses to laboratory stressors. Two measures of family environment, Positive Affiliation and Authoritarianism, were derived by a factor analysis of the Family Environment Scale completed by parents. The sample consisted of 66 girls and 48 boys enrolled in Grades 2 through 12 from 114 families residing in a predominantly White, upper-middle-class suburb of Pittsburgh. Analyses largely supported the first hypothesis--that a less supportive and positively involved family climate would be associated with attributes of potential coronary heart disease (CHD) risk in children. Families scoring low on Positive Affiliation had children who were assessed as more angry and hostile on the basis of questionnaires and interview. Boys from these families had a more pronounced heart rate response to all laboratory stressors. The second hypothesis--that authoritarianism, in the absence of positive involvement and supportiveness in the family, would be associated with attributes of potential CHD risk in children--received support in regard to boys' heart rate responses to the serial-subtraction and mirror-image-tracing tasks. High Authoritarianism scores in combination with low Positive Affiliation scores in families predicted a heightened heart rate response in boys. Sex differences in the pattern of associations among family and child characteristics were also found. Results suggest that factors in the family environment may be important influences in children's development of characteristics that may, in adulthood, place them at risk for CHD.     

Face Emotion Processing in Depressed Children and Adolescents with and without Comorbid Conduct Disorder

Studies of adults with depression point to characteristic neurocognitive deficits, including differences in processing facial expressions. Few studies have examined face processing in juvenile depression, or taken account of other comorbid disorders. Three groups were compared: depressed children and adolescents with conduct disorder (n = 23), depressed children and adolescents without conduct disorder (n = 29) and children and adolescents without disorder (n = 37). A novel face emotion processing experiment presented faces with ‘happy’, ‘sad’, ‘angry’, or ‘fearful’ expressions of varying emotional intensity using morphed stimuli. Those with depression showed no overall or specific deficits in facial expression recognition accuracy. Instead, they showed biases affecting processing of low-intensity expressions, more often perceiving these as sad. In contrast, non-depressed controls more often misperceived low intensity negative emotions as happy. There were no differences between depressed children and adolescents with and without conduct disorder, or between children with comorbid depression/conduct disorder and controls. Face emotion processing biases rather than deficits appear to distinguish depressed from non-depressed children and adolescents.     

Adolescents with attention deficit hyperactivity disorder: Mother-adolescent interactions,family beliefs and conflicts,and maternal psychopathology

A group of 83 adolescents with attention deficit hyperactivity disorder (ADHD) were subdivided into those with ADHD alone (n = 27) and those with ADHD and oppositional defiant disorder (ADHD/ODD, n = 56). They were compared to each other and a community control group (n = 77) on measures of family conflicts, family beliefs, maternal adjustment, and observations of mother-adolescent interactions during both a neutral and conflict discussion. Both ADHD groups had more topics on which there was conflict and more angry conflicts at home than control adolescents on parent reports. Only the ADHD/ODD adolescents reported more such conflicts, endorsed more extreme and unreasonable beliefs about their parent-teen relations, and demonstrated greater negative interactions during a neutral discussion than the control teenagers. Similarly, only mothers of the ADHD/ODD teens displayed greater negative interactions during a neutral discussion, more extreme and unreasonable beliefs about their parent-teen relations, greater personal distress, and less satisfaction in their marriages than the mothers in the control group. Most findings for the ADHD only group were between the control group and the group with mixed ADHD/ODD but did not differ from either group. Results imply that it is the combination of ODD symptoms with those of ADHD that is associated with the greater-than-normal conflicts, anger, poor communications, unreasonable beliefs, and negative interactive styles seen in ADHD adolescents. These same characteristics typify their mothers' interactions as well such that both the adolescents' ODD symptoms and maternal psychological distress (hostility) make unique contributions to the degree of conflict and anger in the parent-teen relations of ADHD adolescents.