Tightly linked systems: reciprocal relations between maternal depressive symptoms and maternal reports of adolescent externalizing behavior

The frequently observed link between maternal depressive symptoms and heightened maternal reporting of adolescent externalizing behavior was examined from an integrative, systems perspective using a community sample of 180 adolescents, their mothers, fathers, and close peers, assessed twice over a 3-year period. Consistent with this perspective, the maternal depression-adolescent externalizing link was found to reflect not simply maternal reporting biases, but heightened maternal sensitivity to independently observable teen misbehavior as well as long-term, predictive links between maternal symptoms and teen behavior. Maternal depressive symptoms predicted relative increases over time in teen externalizing behavior. Child effects were also found, however, in which teen externalizing behavior predicted future relative increases in maternal depressive symptoms. Findings are interpreted as revealing a tightly linked behavioral-affective system in families with mothers experiencing depressive symptoms and teens engaged in externalizing behavior and further suggest that research on depressive symptoms in women with adolescent offspring should now consider offspring externalizing behaviors as a significant risk factor.     

The depressive personality disorder inventory and current depressive symptoms: implications for the assessment of depressive personality

The Depressive Personality Disorder Inventory (DPDI; Huprich, Margrett, Barthelemy, & Fine, 1996; see Appendix) was created to assess Depressive Personality Disorder in clinical and nonclinical samples. Since its creation, the DPDI has been used in multiple studies, and the psychometric properties of the measure have generally supported its reliability, convergent validity, and construct validity; however, evidence for the measure's discriminant validity has been mixed. Specifically, the DPDI tends to correlate highly with measures of current depressive symptoms, which limits its efficacy in differentiating current depressive symptoms from a depressive personality structure. A principal components analysis of 362 individuals who completed both the DPDI and Beck Depression Inventory (BDI-II; Beck, Steer, & Brown, 1996) found that 49% of the variance was accounted for in two components. Seven items from the DPDI loaded more strongly on the first component composed of many BDI-II items. These items were removed in order to create a measure believed to assess DPD without the confounding influence of current depressive symptomology. Principal components analysis of the revised measure yielded three components, accounting for 46% of the variance. The revised DPDI was used to calculate convergent, discriminant, and construct validity coefficients from measures used in former studies. Virtually no improvement in the validity coefficients was observed. It is concluded that assessing DPD via self-report is limited in its utility.     

Night waking in 6-month-old infants and maternal depressive symptoms

Relations between night waking in infants and depressive symptoms in their mothers at 6 months postpartum were examined using the data from the National Institute for Child Health and Human Development Study of Early Child Care. Although more depressive symptoms were only weakly correlated with a higher frequency of infant waking, longer wake times, and more total time awake, the rate of clinically significant depression scores was about double in mothers of chronically waking infants in comparison with mothers whose infants did not awaken during the night. The value of comparing subgroups to elucidate relations identified through correlations is discussed.     

Trajectories of maternal depressive symptoms, maternal sensitivity, and children's functioning at school entry

Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, the authors modeled trajectories of maternal depressive symptoms from infant age 1 month to 7 years. The authors identified 6 trajectories of maternal depressive symptoms: high-chronic, moderate-increasing, high-decreasing, intermittent, moderate-stable, and low-stable. Women on these depression trajectories varied in sociodemographic risk and in changes in observed maternal sensitivity over time. Maternal sensitivity was generally higher and increased when depressive symptoms were low; sensitivity was lower and decreased when depressive symptoms were either high or increasing. Child outcomes at 1st grade were examined by trajectory group. The authors discuss the complexity of disentangling maternal symptoms from maternal sensitivity and sociodemographic risk when predicting children's functioning.     

Maternal depressive symptoms and child temperament: Longitudinal associations with executive functioning

The present study investigated the contributions of maternal depressive symptoms and child temperament to youths' executive functioning (EF) across an 18-year longitudinal study. The primary hypothesis proposed that the association between youths' exposure to early maternal depressive symptoms (ages 3 & 5) and their EF (age 18) would be moderated by temperament in middle childhood (ages 8 & 10). Temperament was a significant moderator of the association between early maternal depressive symptoms and youth EF. Positive child temperament (high effortful control, EC, and low negative affectivity, NA) was associated with higher EF when maternal depressive symptoms during early childhood were low. In contrast, elevated maternal depressive symptoms overrode any associations between child temperament and later EF. Parallel analyses examining the interaction between child temperament and maternal depressive symptoms during middle childhood (controlling for earlier maternal depressive symptoms) revealed a different pattern of results. Clinical implications for prevention/intervention work on EF are discussed.     

Longitudinal relationships between depressive symptoms and health in normal older and middle-aged adults

Comorbidity between health and depression is salient in late life, when risk for physical illness rises. Other community studies have not distinguished between the effects of brief and long-standing depressive symptoms on excess morbidity and mortality. S. Cohen and M. S. Rodriguez's (1995) differential hypothesis of pathways between depression and health was used to examine the relationships between health and depression in a prospective probability sample of 1,479 community-resident middle-aged and older adults. Findings suggest that different durations of depressive symptoms have different relationships to health. Health had an impact on short-term increases in depressive symptoms but depressive symptoms had a weaker impact on health. The reciprocal impact was indistinguishable from the health influence on depression. In contrast, longer term depressive symptoms had a clear impact on health. The results imply that physical illness can affect depressive states; depressive traits but not states can affect illness.     

Interpersonal functioning and depressive symptoms in childhood: Addressing the issues of specificity and comorbidity

Research has supported linkages between depression and social impairment in youngsters, but has often focused on depressive symptoms in isolation. We collected data on depressive, anxiety, and externalizing symptoms in 161 school children. Information about interpersonal competence was gathered from several sources, including children, teachers, and behavioral observations. Depressive symptoms were found to be related to difficulties in multiple areas of competence, including maladaptive social problem-solving styles, conflict-negotiation and affect-regulation deficits, and peer rejection. Comparisons of the relative contributions made by depressive and anxiety symptoms to the prediction of functioning yielded some evidence for a specific relation between depressive symptoms and impairment. Children with cooccurring internalizing and externalizing symptoms generally suffered from the most social dysfunction. If replicated in clinical samples, findings such as these may help to guide intervention efforts with depressed children.We thank Daphne Isenberg, Margie Limon, Leslie Scher, and Jennifer Silverman for their assistance in various aspects of this study. We would also like to express our appreciation to the participating children and teachers and to the UCLA Bruin Kids Day Camp.     

Reliability of children's reports of depressive symptomatology

The use of self-report measures for the assessment of depression in children has gained wide popularity as a component in the evaluation of children's mental health and wellbeing. However, the extent to which children are reliable and consistent reporters of their depressive symptoms is sometimes called into question. This study examined the test-retest reliability of children's reports of depressive symptomatology on the Reynolds Child Depression Scale (RCDS;Reynolds, 1989a). The sample consisted of 220 children, in grades 3 through 6, representing a crosssection of ethnic groups. Children were tested twice, with a 4-week interval between testings. Results showed a high degree of stability in children's responses to the RCDS, with a test-retest reliability coefficient of 85 for the total sample, and a mean difference between testings of less than 2 points. Test-retest reliability coefficients were also computed for males and females, for each grade, and for white, black, Hispanic, and Asian children. Overall, the results lend strong support for the reliability and stability of children's self-reported depressive symptomatology as assessed by the RCDS.The authors wish to express their appreciation to Dr. Eleanor Chiang and Rovida Mott of the Sacramento Public Schools for their assistance in obtaining school and subject participation.     

Control-related beliefs and depressive symptoms in clinic-referred children and adolescents: developmental differences and model specificity

The contingency-competence-control (CCC) model links contingency and competence beliefs to perceived control and, in turn, to depression. However, a developmental perspective suggests that noncontingency may be too abstract a concept to be directly tied to depression before adolescence. We tested the CCC model and this developmental notion, using structural equation modeling, with 360 clinic-referred 8- to 17-year-olds. The CCC model fit the data well for the full sample accounting for 46% of the variance in depression. Separate analyses by age group placed perceived contingency in the best-fit model for adolescents (ages 12-17 years) but not for children (8-11 years). This suggests that abstract cause-effect concepts may have more direct affective impact after the cognitive changes of adolescence (e.g., formal operations) than before. Finally, the CCC model accounted for much more variance in depression than conduct problems, suggesting diagnostic specificity.     

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.     

Paternal/maternal attachment, peer support, social expectations of peer interaction, and depressive symptoms

The aim of this study was to investigate how paternal and maternal attachment might relate to adolescents' peer support, social expectations of peer interaction, and depressive symptoms; 1,144 8th graders in Taiwan participated in the study. The relationships were examined through a structural equating modeling. Consistent with theoretical formulations, adolescents with secure attachments to parents reported higher peer support, fewer negative expectations, and fewer depressive symptoms. Paternal and maternal attachment contribute almost equally to adolescents' social expectations of peer interaction and depressive symptoms. Attachment to the same-sex parent was related to adolescents' perceived peer support.     

Computerized speech recognition in psychological assessment: A Macintosh prototype for screening depressive symptoms

Computerized speech-recognition technology holds strong promise for psychological assessment. This paper focuses on a computerized speech recognition application for screening depressive symptomatology. A Macintosh-based prototype has been developed that uses the Center for Epidemiological Studies-Depression scale (CES-D). The prototype is a HyperCard stack interfaced with the Voice Navigator II speech recognition application. The “talking” program represents a viable depression screening tool that is fully voice operated by the respondent. A pilot study will assess the feasibility and acceptability of the computerized and written versions of the CES-D with a nonclinical adult population. A counterbalanced design will test for order effects and analyze the psychometric equivalence of the two methods. The limitations and future directions for speech-recognition applications in psychological assessment are discussed.     

Individual differences in the emergence of depressive symptoms in children and adolescents: a longitudinal investigation of parent and child reports

The authors address questions about the rate that depressive symptoms emerge, developmental and gender differences in this rate, and differences between parent and child estimates of this rate. In a 12-wave, cohort-sequential, longitudinal design, 1,570 children (Grades 4-11) and parents completed reports about children's depression. Cross-domain latent growth curve analysis revealed that (a) the rate of symptom growth varied with developmental level. (b) gender differences symptom growth preceded emergence of mean level gender differences, (c) the rate of symptom development varied with age, and (d) parent-child agreement about rate of symptom change was stronger than agreement about time-specific symptoms. The authors suggest that predictability of depressive symptoms varies with age and the dimension under investigation.     

Chronicity, severity, and timing of maternal depressive symptoms: relationships with child outcomes at age 5

The relationships between severity, chronicity, and timing of maternal depressive symptoms and child outcomes were examined in a cohort of 4,953 children. Mothers provided self-reports of depressive symptoms during pregnancy, immediately postpartum, and when the child was 6 months old and 5 years old. At the age 5 follow-up, mothers reported on children's behavior and children completed a receptive vocabulary test. Results suggest that both the severity and the chronicity of maternal depressive symptoms are related to more behavior problems and lower vocabulary scores in children. The interaction of severity and chronicity of maternal depressive symptoms was significantly related to higher levels of child behavior problems. Timing of maternal symptoms was not significantly related to child vocabulary scores, but more recent reports of maternal depressive symptoms were associated with higher rates of child behavior problems.     

Pramipexole: augmentation in the treatment of depressive symptoms

We describe a retrospective case series of three patients, two with bipolar depression and one with unipolar depression. Pramipexole is a Food and Drug Administration-approved antiparkinsonian agent, which, when used to augment antidepressants, would be considered an off-label use and should be discussed with the patient. These patients had robust responses to pramipexole augmentation of their treatment regimen. All three patients had been taking an atypical antipsychotic. The depressive symptoms were evaluated using the Hamilton Rating Scale for Depression.     

Prevention of depressive symptoms in school children

This paper describes the development and preliminary efficacy of a program designed to prevent depressive symptoms in at-risk 10–13 year-olds, and relates the findings to the current understanding of childhood depression. The treatment targets depressive symptoms and related difficulties such as conduct problems, low academic achievement, low social competence, and poor peer relations, by proactively teaching cognitive techniques. Children were identified as ‘at-risk’ based on depressive symptoms and their reports of parental conflict. Sixty-nine children participated in treatment groups and were compared to 73 children in control groups. Depressive symptoms were significantly reduced and classroom behavior was significantly improved in the treatment group as compared to controls at post-test. Six-month follow-up showed continued reduction in depressive symptoms, as well as significantly fewer externalizing conduct problems, as compared to controls. The reduction in symptoms was most pronounced in the children who were most at risk.     

Low-end specificity of childhood measures of emotional distress: consistent effects for anxiety and depressive symptoms in a nonclinical population

Previous research regarding the low-end specificity of self-report measures of affective distress in children suggests that defensiveness acts differentially to lower scores on self-report measures of depressive symptoms, but not on self-report measures of anxiety. This investigation examined this issue in a nonclinical sample of 442 children, ages 7 to 16. Participants completed measures of depressive symptoms (Children's Depression Inventory), anxiety symptoms (State-Trait Anxiety Inventory for Children) and defensiveness (Children's Social Desirability Scale). In contrast to previous research, the results in this study indicated similar effects of defensiveness on measures of depressive symptoms and anxiety. Low-end depression participants obtained significantly higher defensiveness scores, as did low-end anxious participants. In an attempt to circumvent the effects of defensiveness, we measured anhedonia (Pleasure Scale for Children, or PSC) as a proxy of depressive symptoms. We also found the PSC to be subject to the effects of defensiveness at approximately the same magnitude as the measures of anxiety and depressive symptoms.     

The role of rumination in depressive disorders and mixed anxiety/depressive symptoms

Several studies have shown that people who engage in ruminative responses to depressive symptoms have higher levels of depressive symptoms over time, after accounting for baseline levels of depressive symptoms. The analyses reported here showed that rumination also predicted depressive disorders, including new onsets of depressive episodes. Rumination predicted chronicity of depressive disorders before accounting for the effects of baseline depressive symptoms but not after accounting for the effects of baseline depressive symptoms. Rumination also predicted anxiety symptoms and may be particularly characteristic of people with mixed anxiety/depressive symptoms.     

Age differences and similarities in the correlates of depressive symptoms

The authors investigated whether several life events or concerns were differentially related to depressive symptoms across 3 adult age groups (young adults, middle-aged adults, and older adults). They examined the relationships of 2 measures of depressive symptoms to work status and satisfaction, relationship status and satisfaction, loneliness, recent losses, parenting strain, and caregiving. Some differences between age groups in these relationships were found. Yet, most results suggested that, although the frequency with which people experience specific life events or concerns varies across the adult life span, the relationships between these events or concerns and depressive symptoms are similar across age groups.     

A longitudinal analysis of anxiety and depressive symptoms

The authors modeled depressive and anxiety symptom data from 1,391 participants in a longitudinal study of middle-aged and older Swedish twins (M age = 60.9 years, SD = 13.3). Although anxiety and depression were highly correlated, a model with distinct Anxiety and Depression factors fit the data better than models with Positive and Negative Affect factors or a single Mental Health factor. Lack of well-being was associated with anxiety rather than depression. Over two 3-year intervals, anxiety symptoms led to depressive symptoms, but the relationship was not reciprocal. Anxiety symptoms were more stable than depression. These findings provide additional support for the idea that anxiety symptoms may reflect a personality trait such as neuroticism more than do depressive symptoms and suggest that low positive affect may not be as specific to depression among older adults as in younger people.