Perceived parenting style, self-esteem and psychological distress in adolescents with heart disease

The aim of the study was to assess the relationships between perceived parenting style, depressed mood, anxiety and self-esteem in adolescents with heart disease compared with healthy adolescents. Forty-five adolescents, aged 12-18 with congenital or acquired heart disease and 50 healthy age-matched adolescents answered perceived parental behaviour, self-esteem, depressed mood and anxiety questionnaires. The study group reported higher perceived acceptance and lower perceived parental control than healthy adolescents, but similar levels of depressed mood, anxiety and self-esteem. Fischer's r-to-z transformation and regression analyses showed different associations between perceived parenting style and depressed mood, anxiety and self esteem. In the study group, higher perceived parental acceptance was associated with lower depressed mood and higher self-esteem, whereas these associations were not significant in the control group. In the control, but not the study group, higher perceived parental control was associated with lower depressed mood and lower anxiety. Parenting style proved to exert a differential effect on adolescents with and without heart disease. For the former, perceived parental acceptance had a more substantial effect on psychological well-being than perceived parental control. Professionals caring for these adolescents should be aware of the special importance of parenting style on the well-being of adolescents with heart disease, and address this issue in the clinical setting with the patients and their parents.     

Perceived parental warmth and adjustment among Ethiopian adolescents

This study aimed to investigate the relationship between adolescents’ perception of parental warmth and their self-esteem, school adjustment and depression symptoms. Data were collected from 809 adolescents (female=47%; mean age=16.8 years; SD=1.58) from four different high schools in Ethiopia. The data were analysed for differences in perceived parental warmth and adjustment by gender. Results suggest higher levels of parental warmth to be associated with comparatively lower school adjustment and depressive symptoms as well as higher self-esteem in girls rather than boys. A gendered effect seems to explain parent warmth influences of the personal and school adjustment of Ethiopian adolescents.     

The roles of sex, gender, and coping in adolescent depression

This study investigated the roles of coping and masculinity in higher rates of depressive symptoms among adolescent girls, as compared to boys. A model was designed and tested through path analysis, which involved the variables of sex, gender, problem-focused coping, rumination, and distraction. The Reynolds Adolescent Depression Scale and the Bem Sex Role Inventory, as well as a measure of coping with general stressors was completed by 246 adolescents. Results showed that adolescent girls were more depressed than boys, and that girls used more emotion-focused and ruminative coping than did boys. Greater degrees of ruminative coping were related to high levels of depressive symptoms. Problem-focused and distractive coping were positively correlated with masculinity and negatively associated with depression. Surprisingly, girls were more likely to use problem-focused coping. Problem-focused and distractive coping were found to mediate the negative relationship between masculinity and depression.     

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.     

Cognitive aspects of chronic depression

Previous research on chronic depression has focused on its link with other mood disorders and Axis II personality disorders. However, there are few data examining whether the cognitive perspective applies to this condition. In this cross-sectional study, 42 outpatients with chronic depression were compared with 27 outpatients with nonchronic major depressive disorder and 24 never psychiatrically ill controls on cognitive variables thought to be related to vulnerability to depression (e.g., dysfunctional attitudes, attributional style, a ruminative response style, and maladaptive core beliefs). Both depressed groups were more elevated than a never-ill comparison group. However, chronically depressed individuals were generally more elevated on measures of cognitive variables than those with major depressive disorders even after controlling for mood state and personality disorder symptoms.     

Protective and vulnerability factors of depression in normal adolescents

The present study investigated the role of various protective and vulnerability factors in the development of depressive symptoms. A sample of normal adolescents (N=373) completed the Children's Depression Inventory and measures of a negative attributional style, parental rearing behaviour, coping styles, and perceived self-efficacy. In addition to computing the correlations between depression and these protective and vulnerability factors, the present data were also subjected to structural equations modelling to examine the correlational structure of the data. Depression was accompanied by high levels of parental rejection, negative attributions, and passive coping, and by low levels of active coping and self-efficacy. Furthermore, a model in which negative parental rearing behaviour and a negative attributional style featured as the primary sources of depression, while coping styles and self-efficacy played a mediating role in the formation of depressive symptoms, provided a reasonable fit for the data.     

Children's coping with peer rejection: the role of depressive symptoms,social competence,and gender

The present study investigated children's anticipated emotional response and anticipated coping in response to peer rejection, as well as the qualifying effects of gender, depressive symptoms, and perceived social competence. Participants (N = 234), ranging in age between 10 and 13 years, were presented with two written vignettes depicting peer rejection. The most highly endorsed coping strategies were behavioural distraction, problem‐focused behaviour, and positive reappraisal. Results indicate that children higher in depressive symptoms reported a more negative anticipated mood impact. Moreover, children higher in depressive symptoms were less inclined to endorse behavioural and cognitive coping strategies typically associated with mood improvement (e.g., behavioural distraction, positive reappraisal). Independent of depression, children scoring higher on perceived social competence reported more active, problem‐oriented coping behaviour in response to the stressors. Types of coping were largely unaffected by gender, however girls reported higher levels of anticipated sadness than boys in response to the rejection vignettes. Theoretical and clinical implications are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

Gender differences in responses to depressed mood in a college sample

Two studies tested the hypothesis that women are more likely than men to focus on themselves and their mood when in a depressed mood, and that this leads them to experience longer periods of depressed mood. In both studies subjects were predominantly Caucasian college students. In our first study, a laboratory study, females chose to engage in an emotion-related task significantly more often than did males, even when this lead them to focus on an existing sad mood. In the second study, a prospective naturalistic study, females were more likely than males to evince an emotion-focused ruminative style of coping with their moods. A ruminative response style at Time 1 was a significant predictor of depression scores at Time 2, even after initial levels of depressed mood were taken into account. Furthermore, once rumination levels were controlled for, gender was no longer a potent predictor of depression outcome. The implications of these response styles for treatment are discussed.We thank Brandi Battistoni, Kim Bergquist, Rachel Carr, Lisa Lougee, and especially Ariel Lang for their invaluable help in data collection. We also thank Chuck Olson, Jannay Morrow, and Rose McDermott for their helpful comments on earlier drafts.     

Internalizing and Externalizing Problems as Correlates of Self-Reported Attachment Style and Perceived Parental Rearing in Normal Adolescents

The current study examined relationships between attachment style, parental rearing behaviors, and symptoms of internalizing and externalizing in a large sample of nonreferred adolescents (N = 742). Adolescents completed (a) a single-item measure of attachment style, (b) the child version of the EMBU, a questionnaire measuring perceptions of parental rearing behaviors, and (c) the Youth Self-Report, an index of severity of internalizing and externalizing symptoms. Results showed that attachment style was related to internalizing as well as externalizing symptoms. More specifically, adolescents who classified themselves as avoidantly or ambivalently attached displayed higher levels of internalizing and externalizing symptoms than adolescents who classified themselves as securely attached. Furthermore, perceived parental rearing behaviors were also associated with internalizing and externalizing symptoms. That is, low levels of emotional warmth and high levels of rejection and overprotection were accompanied by high levels of psychopathological symptoms. Finally, both attachment and parental rearing behaviors accounted for a unique proportion of the variance in internalizing symptoms. Yet, when predicting externalizing symptoms, only parental rearing behaviors declared a significant proportion of the variance.     

Reward Responsiveness and Ruminative Styles Interact to Predict Inflammation and Mood Symptomatology

Abnormal reward responsiveness and rumination each are associated with elevated inflammation and mood symptoms. Ruminating on positive and negative affect, or dampening positive affect, may amplify, or buffer, the associations of reward hyper/hyposensitivity with inflammation and mood symptoms. Young adults (N = 109) with high or moderate reward sensitivity completed reward responsiveness and ruminative style measures at the initial visit of a longitudinal study of mood symptoms, a blood draw to assess inflammatory biomarkers, and mood symptom measures at the study visits before and after the day of the blood draw. The interaction between high reward responsiveness and rumination on positive affect was associated with higher levels of an inflammatory composite measure and hypomanic symptoms. The interaction between lower reward responsiveness and high dampening of positive affect was associated with higher levels of the inflammatory composite measure and depressive symptoms. Lower reward responsiveness also interacted with low rumination on positive affect to predict increases in depressive symptoms and higher levels of the inflammatory composite. Thus, levels of reward responsiveness and ruminative response styles may synergistically influence the development of inflammatory phenotypes and both hypomanic and depressive mood symptoms.     

Understanding early-onset drug and alcohol outcomes among youth: the role of family structure, social factors, and interpersonal perceptions of use

Research on adolescents focuses increasingly on features of the family in predicting and preventing illicit substance use. Multivariate analyses of data from the National Survey of Parents and Youth (N=4173) revealed numerous significant differences on risk variables associated with family structure on adolescent drug-related perceptions and substance use. Youth from dual-parent households were least likely to use drugs and were monitored more closely than single-parent youth (p<0.001). A path analytic model estimated to illuminate linkages among theoretically implicated variables revealed that family income and child's gender (p<0.001), along with family structure (p<0.05), affected parental monitoring, but not parental warmth. Monitoring and warmth, in turn, predicted adolescents' social and interpersonal perceptions of drug use (p<0.001), and both variables anticipated adolescents' actual drug use one year later (p<0.001). Results reconfirm the importance of parental monitoring and warmth and demonstrate the link between these variables, adolescents' social and intrapersonal beliefs, and their use of illicit substances.     

A Kid-Friendly Tool to Assess Rumination in Children and Early Adolescents: Relationships with Mother Psychopathology and Family Functioning

The early identification of ruminative processes in children and early adolescents is particularly important to prevent the development of a stable ruminative style in later stages of development. The present study first aimed at validating a child-friendly tool, Kid Rumination Interview (KRI), to be used in a sample aged 7–12 years (n?=?100; 50% females). Second, we hypothesized that maternal depression, family functioning and participants’ emotion regulation skills would be associated with children’ levels of rumination. Factor analysis on KRI scores yielded two main factors: personal life-related rumination and school-related rumination. Older and female participants showed higher tendencies to ruminate about school issues compared to their younger and male counterparts. A low-to-moderate correlation emerged between school-related rumination and child/early adolescent’s emotion regulation capacities. Mothers’ depressive rumination and mothers’ depressive symptoms were positively associated with children/early adolescents’ rumination about personal life and rumination about school issues. Conversely, an adequate and positive family functioning was negatively correlated with both school-related rumination and rumination about personal life. Hierarchical regression analyses pointed to a crucial role of maternal rumination and familiar rigidity in both types of rumination. Personal life-related rumination was also specifically predicted by maternal depression and family enmeshment, whereas school-related rumination was significantly associated with children/early adolescents’ emotional control and gender. Overall, the KRI appears as a promising tool to assess rumination in children/early adolescents. Results suggests partially different pathways to specific forms of ruminative thoughts.     

The Mediating Roles of Adolescent Disclosure and Parental Knowledge in the Association Between Parental Warmth and Delinquency Among Korean Adolescents

The purpose of this study was to examine the association between parental warmth and adolescent delinquency, the potential mediating roles of adolescent disclosure and parental knowledge, and gender differences in such association among Korean adolescents. We hypothesized that (1) parental warmth would be significantly and negatively associated with delinquency, (2) adolescent disclosure and parental knowledge would mediate the association between parental warmth and adolescent delinquency, and (3) the association between parental warmth and adolescent delinquency mediated through adolescent disclosure and parental knowledge would be stronger for adolescent girls than boys. Using a sample of 3125 Korean adolescents from nationally representative and longitudinal data (Korea Youth Panel Survey), results from path analyses demonstrated that findings were consistent with US samples, suggesting a negative association between parental warmth and adolescent delinquency. Further, when Korean adolescents perceived parents to be warmer, they were more likely to disclose personal information to their parents. In turn, higher levels of disclosure were associated with higher levels of parental knowledge about their adolescent children’s activities. Finally, tests of gender differences suggested that parental warmth was more closely associated with adolescent disclosure among girls than boys. Results supported a process model through which parents may shape adolescent children’s delinquency.     

Depressed mood: The role of negative thoughts,self-consciousness,and sex role stereotypes

Research typically finds that depression is twice as common among women as among men. This may relate to differences in socialization that result in different emotions, cognitions, and coping reactions. Sex-role stereotypes, employment and marital status, and differential social pressures may also be significant in making women more vulnerable to the development of depression. Women may have less decision-making power, face more adverse life events, and have limited access to resources, which may lead to feelings of helplessness and low self-esteem. Low self-esteem and negative cognitions about the self in turn may be proximal factors predictive of negative mood. Additionally, women may be more prone to ruminative self-focus rather than active coping, a significant risk factor for depression. This study examined individual predictors of depressed mood for each sex, including coping, self-esteem, negative thoughts, self-consciousness (rumination), as well as social factors such as the endorsement of sex-role stereotypes and decision-making power in the family. Results indicated that social factors were not related to depressed mood in either sex, but were related to coping styles and self-esteem. Depressed mood was associated with individual characteristics, such as avoidant coping styles, social anxiety for women, and ruminative self-focus for men. Regression analysis showed that coping through denial and negative thoughts explained depressed mood, and the latter was particularly true for men. These results point to the significance of examining both individual and social factors when attempting to understand depression in men and women.     

Poverty and Depressed Mood Among Urban African-American Adolescents: A Family Stress Perspective

We examined the role of family stress as a mediator of the relationship between poverty and depressed mood among 1,704 low-income, inner-city African- American adolescents. Nearly half of participants (47%) reported clinically significant levels of depressive symptoms. Being female, reporting higher levels of family stress, and scoring higher on a poverty index were significantly associated with increased reports of depressed mood. Family stress significantly mediated the relationship between poverty and adolescent depressed mood, explaining 50% of the total effect. Sex-specific analyses revealed that this relationship only held for females, and there was no direct relationship between poverty and depressed mood for males. Results lend further support to family stress theory, although they suggest that the model may be more relevant for females than males. Implications for community-based preventive intervention and social policy are discussed.     

Suicidal ideation in Hispanic and mixed-ancestry adolescents.

This survey examined differences in suicidal ideation, depressive symptomatology, acculturation, and coping strategies based on ethnicity. The author gathered data from a self-report questionnaire administered to students in an ethnically diverse middle school (grades 6-8, N= 158). Hispanic (predominantly Mexican American) and mixed-ancestry adolescents displayed significantly higher risk of suicidal ideation compared to Anglo peers, even when socioeconomic status, age, and gender were controlled for. Suicidal ideation was associated with depressive symptoms, family problems, lower levels of acculturation, and various coping strategies. Using multivariate analysis, Hispanic ancestry, depressive symptoms, family problems, and the use of social coping remained in the model.     

Gender differences in emotional support and depressive symptoms among adolescents: A prospective analysis

Investigated components of perceived emotional support, including support from family members, nonfamily adults, and peers, as predictors of depressive symptoms in a sample of 333 high school students (age 14-18) using a prospective design. Analyses of panel questionnaire data at two points in time suggest there are significant gender differences both in the quality of perceived support reported by adolescents and in the importance of support variables as predictors of depressive symptoms. Although there are no gender differences in the magnitude of perceived support from family members, girls report higher emotional support from both nonfamily adults and peers than boys report. Simple correlations between family support and depression are significantly stronger for girls than for boys. Results of hierarchical regression analyses, controlling for initial level of symptoms, reveal that whereas both nonfamily adult and friend components of perceived support are significant predictors of changes in symptoms for girls, none of these variables significantly predicts changes in symptoms for boys in this sample. In addition, initial symptoms predict changes in family support for girls but not for boys.     

Parental, Behavioral, and Psychological Factors Associated with Cigarette Smoking among Secondary School Students in Nanjing, China

We designed this study to assess parental, behavioral, and psychological factors associated with tobacco use among Chinese adolescents. The data were collected from 995 middle school students in Nanjing, China. Both smoking experimentation and current smoking (smoking in the past 30 days) were assessed among the study sample. Psychosocial measures include family structure, problem behaviors, social influence of smoking (both parental and friends’ approval of smoking), depressive symptoms, social alienation, self-esteem, parental monitoring (social monitoring and academic monitoring) and parenting style (responsiveness and demandingness). Among the study sample (mean age 15.16 years and 50% females), 24% ever smoked and 15% smoked in the past 30 days. Advanced age, male gender, low family SES, low school performance and low educational aspiration were associated with both smoking experimentation and current smoking. Depressive symptoms, social alienation, low self-esteem, low social and academic monitoring, problem behaviors, low maternal and paternal responsiveness, peer smoking, parent smoking, and parental and friends’ approval of smoking were positively associated with current smoking among Chinese adolescents. Future tobacco use prevention efforts among Chinese adolescents need to consider the parental, behavioral, and psychological correlates identified in the current study.     

Depleted parental psychological resources as mediators of the association of income with adherence and metabolic control

For adolescents with Type 1 diabetes, lower family income may be associated with poorer diabetes management through depleted parental psychological resources (i.e., higher parental depressive symptoms, lower parental acceptance). Adolescents (N = 252; 46% male) aged 10-14 years with Type 1 diabetes assessed the acceptance of their mother and father (e.g., "gives me the feeling that she likes me as I am"; "she doesn't feel she has to make me over into someone else"). Mothers provided information on family income and demographics. Both mothers and fathers reported their depressive symptoms. HbA1c scores were indexed via medical records. Lower family income was associated with higher (i.e., worse) HbA1c, more mother and father depressive symptoms, and less acceptance from both parents. Mediation analyses revealed that the relationship of lower family income with metabolic control occurred indirectly through lower maternal and paternal acceptance and lower adherence. Lower family income may impair the quality of parent--adolescent relationships that are beneficial for good diabetes management.     

Dampening of positive affect prospectively predicts depressive symptoms in non-clinical samples

Past research has convincingly shown that a ruminative response style to negative affect (NA) predicts concurrent and prospective levels of depressive symptoms. Recent findings suggest that how people respond to positive affect (PA) might also be involved in the development of depressive symptoms, although this has heretofore not been tested prospectively. Participants from two non-clinical samples (total N=487) completed measures of depressive symptoms, response styles to NA (negative rumination) and response styles to PA (positive rumination and mood dampening) at two assessments separated by a 3-month (Sample 1) and 5-month period (Sample 2). Results in both samples showed that increased dampening responses to PA predict depressive symptoms at follow-up, even when taking into account baseline depressive symptoms and ruminative responses to NA. The results suggest that (dampening) responses to PA add useful information above and beyond (ruminative) responses to NA in predicting depression symptoms prospectively.