Parent-child interaction in the etiology of dependent and self-critical depression

Abstract

The role of caring parent-child relationships in the development of depression has been investigated in three types of research strategies: (a) the study of secure and insecure attachment patterns in infants and young children; (b) the study of depressed mother-child interactions based on the assumption that the caring patterns in these families of children at risk for depression could contribute to the understanding of the etiology of depression; and (c) the study of normal and depressed adults' retrospective accounts of early caring experiences with their parents. A major conclusion from all three research methodologies is that mental representations or internal working models of attachment of care-giving relationships are central constructs in understanding the development of a vulnerability to depression. Secure and disturbed patterns of caring relationships are internalized by the child as mental representations; impaired mental representations based on disturbed relationships can create a vulnerability to later depression. There are suggestions that an anxious or ambivalent insecure attachment may lead to a depression focused on issues of dependency, loss, and abandonment, whereas an avoidant insecure attachment may result in a depression focused on issues of self-worth and self-criticism, with angry feelings directed toward both the caregiver and toward the self. Indications of possible critical periods in the development of vulnerability to depression are also considered.