Child-reported Depression Research Articles

Stress and child internalizing symptoms: Examining the moderating role of Latino fathers' warmth and support.

Latino immigrants within the United States experience various stressors, which have been linked to the development and exacerbation of internalizing symptoms among Latino youth. Therefore, it is crucial to explore factors that may buffer the impact of stress among immigrant families. Fathers may influence child outcomes through positive parenting behaviors, yet Latino fathers have been underrepresented in research. This study examined how paternal warmth and support may moderate the association between the accumulation of stress and child internalizing symptoms among low-income, Latino immigrant families. Participants included 62 children between the ages of 6 and 10, and their paternal caregivers (94% fathers; 90% born in Mexico). This study utilized a multi-method approach including parent-report, child-report and observational measures. Participants completed questionnaires and video-recorded family interaction tasks during home visits. Stress was positively associated with child-reported depression. Self-reported paternal warmth was associated with fewer parent-reported child internalizing symptoms and moderated the effects of stress on symptoms. Analyses showed a significant positive association between paternal stress and child internalizing symptoms for children with the lowest levels of parental warmth. However, when paternal warmth was high, accumulation of stress and child internalizing symptoms were not related. Thus, high levels of warmth buffered the impact of stress on internalizing symptoms. This study highlights the importance of Latino fathers' parenting behaviors on child internalizing symptoms.

Brain structural associations with depression in a large early adolescent sample (the ABCD study®)

BackgroundDepression is the leading cause of disability worldwide with > 50% of cases emerging before the age of 25 years. Large-scale neuroimaging studies in depression implicate robust structural brain differences in the disorder. However, most studies have been conducted in adults and therefore, the temporal origins of depression-related imaging features remain largely unknown. This has important implications for understanding aetiology and informing timings of potential intervention.MethodsHere, we examine associations between brain structure (cortical metrics and white matter microstructural integrity) and depression ratings (from caregiver and child), in a large sample (N = 8634) of early adolescents (9 to 11 years old) from the US-based, Adolescent Brain and Cognitive Development (ABCD) Study®. Data was collected from 2016 to 2018.FindingsWe report significantly decreased global cortical and white matter metrics, and regionally in frontal, limbic and temporal areas in adolescent depression (Cohen's d = -0⋅018 to -0⋅041, β = -0·019 to -0⋅057). Further, we report consistently stronger imaging associations for caregiver-reported compared to child-reported depression ratings. Divergences between reports (caregiver vs child) were found to significantly relate to negative socio-environmental factors (e.g., family conflict, absolute β = 0⋅048 to 0⋅169).InterpretationDepression ratings in early adolescence were associated with similar imaging findings to those seen in adult depression samples, suggesting neuroanatomical abnormalities may be present early in the disease course, arguing for the importance of early intervention. Associations between socio-environmental factors and reporter discrepancy warrant further consideration, both in the wider context of the assessment of adolescent psychopathology, and in relation to their role in aetiology.FundingWellcome Trust

Contributions From Resting State Functional Connectivity and Familial Risk to Early Adolescent-Onset MDD: Results From the Adolescent Brain Cognitive Development Study

Abstract Background Family history of Major Depressive Disorder (MDD) is a robust predictor of MDD onset, especially in early adolescence. We examined the relationships between familial risk for depression and alterations to resting state functional connectivity (rsFC) within the default mode network (wDMN) and between the DMN and the left/right hippocampus (DMN-LHIPP/DMN-RHIPP) to the risk for early adolescent MDD onset. Methods We examined 9403 youth aged nine to eleven from the Adolescent Brain Cognitive Development study. Depressive symptoms were measured with the parent-reported Child Behavior Checklist. Both youth and their parents completed the Kiddie Schedule for Affective Disorders and Schizophrenia, which provided MDD diagnoses. A family history screen was administered to determine familial risk for depression. Youth underwent a resting state functional magnetic resonance imaging scan, providing us with rsFC data. Results Negative wDMN rsFC was associated with child-reported current depression, both child- and parent-reported past depression, and parent-reported current depressive symptoms. No difference was found in wDMN, DMN-LHIPP or DMN-RHIPP rsFC in children with or without familial risk for depression. Familial risk for depression interacted with wDMN rsFC in association with child-reported past MDD diagnosis and parent-reported current depressive symptoms. Limitations Information such as length of depressive episodes and age of onset of depression was not collected. Conclusions Altered wDMN rsFC in youth at familial risk for depression may be associated with increased risk for MDD onset in adolescence, but longitudinal studies are needed to test this hypothesis.

Maternal control and children’s internalizing and externalizing symptoms in the context of neighbourhood safety: moderating and mediating models

ABSTRACT While there are strong associations between parenting and children’s well-being, it is important to understand these relations in different home environments. This study examined relations of two parenting dimensions previously examined as parental control, controllingness and structure, and child symptomatology with regard to neighbourhood safety. It explored the dangerous neighbourhood hypothesis, suggesting that parents should exert more control in less safe and less control in safer contexts, and a neighbourhood stress hypothesis in which less safe neighbourhoods undermine adaptive parenting and increase child symptomatology. 213 mothers and their sixth-grade children (Mean age = 11 years) participated. Mothers completed questionnaires measuring neighbourhood safety and children’s internalizing and externalizing symptoms, and children completed measures of maternal controllingness and structure provision, and their own internalizing and externalizing symptoms. Maternal controllingness was associated with more and maternal structure with fewer child symptoms. Controllingness was associated with greater child-reported depression in less but not more safe neighbourhoods. Mediation analyses suggested that lower neighbourhood safety was associated with more controllingness which was associated with children’s reports of depression and hostility. Results did not support the dangerous neighbourhood hypothesis, but suggest that less safe neighbourhoods may challenge mothers’ abilities to parent in a way that prevents symptomatology in children.

Brain Structural Associations with Depression in a Large Early Adolescent Sample (The ABCD Cohort)

Background: Depression is the leading cause of disability worldwide with >50% of cases emerging before the age of 25yrs. Large-scale neuroimaging studies in depression implicate robust structural brain differences in the disorder. However most studies have been conducted in adults and therefore, the temporal origins of depression-related imaging features remain unknown. This has important implications for understanding aetiology and informing timings of potential intervention. Methods: Here, we examine associations between brain structure (cortical metrics and white matter microstructural integrity) and depression ratings (from caregiver and child), in a large sample of early adolescents from the Adolescent Brain and Cognitive Development (ABCD) Study (N=9981, 9-11-year olds). Findings: We report significantly decreased global cortical and white matter metrics, and regionally in frontal, limbic and temporal areas in adolescent depression (Cohen’s d = -0.018 to -0.041, β = -0.019 to -0.057). Further, we report consistently stronger imaging associations for caregiver-reported compared to child-reported depression ratings. Divergences between reports (caregiver vs child) were found to significantly relate to negative socio-environmental factors (e.g., family conflict, absolute β=0.048 to 0.169). Interpretation: Depression ratings in early adolescence were associated with similar imaging findings to those seen in adult depression samples, suggesting neuroanatomical abnormalities may be present early in the disease course, arguing for the importance of early intervention. Associations between socio-environmental factors and reporter discrepancy warrant further consideration, both in the wider context of the assessment of adolescent psychopathology, and in relation to their role in aetiology. Funding: The study is funded by Wellcome Trust Strategic Award “Stratifying Resilience and Depression Longitudinally” (STRADL) (Reference 104036/Z/14/Z) and MRC Mental Health Data Pathfinder Award (Reference MC_PC_17209). HCW is supported by a JMAS SIM fellowship from the Royal College of Physicians of Edinburgh and by an ESAT College Fellowship from the University of Edinburgh. AMM receives the Wellcome Trust Strategic Award (Reference 104036/Z/14/Z). Declaration of Interests: AMM has received research funding from The Sackler Trust, Eli Lilly and Janssen. No other conflicts of interest declared by other authors. Ethics Approval Statement: The study was approved by the National Institute of Mental Health Data Archive, United States (NIMH). Data was accessed through the NDA data base (http://nda.nih.gov/abcd, Federal-Wide Assurance: FWA00018101).

Associations between infant and toddler regulatory problems, childhood co-developing internalising and externalising trajectories, and adolescent depression, psychotic and borderline personality disorder symptoms.

Early regulatory problems (RPs) are associated with childhood internalising and externalising symptoms. Internalising and externalising symptoms, in turn, are associated with adolescent psychopathology (e.g. personality disorders, depression). We examined whether RPs are directly associated with adolescent psychopathology, or whether associations are indirect via childhood internalising and externalising symptoms. We used data from the Avon Longitudinal Study of Parents and Children. Mothers reported on their child's RPs at 6, 15-18 and 24-30months, and internalising and externalising symptoms at 4, 7, 8 and 9.5years. Adolescent psychotic, depression and BPD symptoms were assessed at 11-12years. Children were grouped by their patterns of co-developing internalising and externalising symptoms using parallel process latent class growth analysis (PP-LCGA). Path analysis was used to examine direct and indirect associations from RPs to the three adolescent outcomes. There were four groups of children with distinct patterns of co-developing internalising and externalising (INT/EXT) symptoms. Most children (53%) demonstrated low-moderate and stable levels of INT/EXT symptoms. A small proportion (7.7%) evidenced moderate and increasing INT and high stable EXT symptoms: this pattern was strongly predictive of adolescent psychopathology (e.g. depression at 11years: unadjusted odds ratio=5.62; 95% confidence intervals=3.82, 8.27). The other two groups were differentially associated with adolescent outcomes (i.e. moderate-high increasing INT/moderate decreasing EXT predicted mother-reported depression at 12, while low stable INT/moderate-high stable EXT predicted child-reported depression at 11). In path analysis, RPs at each time-point were significantly indirectly associated with symptoms of BPD and child- and mother-reported depression symptoms via the most severe class of INT/EXT symptoms. Consistent with a cascade model of development, RPs are predictive of higher levels of co-developing INT/EXT symptoms, which in turn increase risk of adolescent psychopathology. Clinicians should be aware of, and treat, early RPs to prevent chronic psychopathology.

Fatigue, Physical and Functional Mobility, and Obesity in Pediatric Cancer Survivors.

Survivors of childhood cancer are prone to an increased risk of chronic issues such as cardiovascular disease, fatigue, weight-related problems, and emotional disturbances. This study utilized the biopsychosocial model to examine the hypothesis that greater depression and lower mobility would be significantly associated with greater fatigue and higher body mass index in survivors of childhood cancer. Data were analyzed for 144 children treated and followed up for an oncology condition at a southeastern academic medical center. Voluntarily, children completed the Patient-Reported Outcomes Measurement Information System 1.0, and parents completed the Family Symptom Inventory as part of a brief annual psychosocial screening battery. Height and weight were collected by a clinic nurse prior to questionnaire completion. Hierarchical linear regression showed that shorter time since diagnosis (β = -.154, P < .05), greater child-reported depression (β = .396, P < .01), and lower mobility (β = .427, P < .01) significantly predicted greater fatigue (adjusted R = 0.54). Older age (β = .262, P < .01) and not receiving chemotherapy (β = -.209, P < .05) significantly predicted higher body mass index (adjusted R = 0.051). Findings showed that fatigue tends to improve over time after treatment but may be predicted by greater depression symptoms and lower mobility in recent survivors of childhood cancer. For survivors of childhood cancer with higher levels of fatigue, treating symptoms of depression and maximizing physical and mobility may be of clinical value. With the impact of psychological and social factors not yet understood in pediatric cancer survivors, weight status in recent survivors of childhood cancer is likely a complex interaction between biological and treatment factors.

Classroom racial/ethnic diversity and upper elementary children’s social-emotional development

Research has shown that racial/ethnic diversity in elementary schools and classrooms benefits children’s academic achievement and feelings of safety and belonging. The current study aimed to expand on existing research by examining associations between classroom racial/ethnic composition and upper elementary children’s social-emotional development and whether these associations differed based on overall quality of classroom interactions. Data were collected from 526 third- through fifth-grade children in 35 urban public elementary school classrooms. Measures included teacher-reported child social competence, teacher-child relationship quality, and aggression; child self-reported depression and anxiety; and observed classroom interactions. Hierarchical linear modeling revealed that classroom diversity was positively related to teachers’ reports of child social competence and teacher-child closeness and negatively related to child-reported depression. The relationship between classroom diversity and child social-emotional development did not differ based on classroom interactional quality, indicating that these associations may be robust to differences in classroom environments.

Lifetime exposure to traffic-related air pollution and symptoms of depression and anxiety at age 12 years

BackgroundWhile air pollution has been associated with depression and anxiety in adults, its impact on childhood mental health is understudied. ObjectiveWe examined lifetime exposure to traffic-related air pollution (TRAP) and symptoms of depression and anxiety at age 12 years in the Cincinnati Childhood Allergy and Air Pollution Study cohort. MethodsWe estimated exposure to elemental carbon attributable to traffic (ECAT), a surrogate of diesel exhaust, at birth, age 12 years, and average exposure throughout childhood, using a validated land use regression model. We assessed depression and anxiety at age 12 years by parent report with the Behavior Assessment System for Children-2, and by child report with the Child Depression Inventory-2 (CDI-2) and the Spence Children's Anxiety Scale (SCAS). Associations between TRAP at birth, age 12 years, and childhood average and mental health outcomes were estimated using linear regression models adjusting for covariates including parent depression, secondhand smoke exposure, race, household income, and others. ResultsExposure to ECAT was not significantly associated with parent-reported depression or anxiety. However, exposure to ECAT at birth was associated with increased child-reported depression and anxiety. Each 0.25 µg/m3 increase in ECAT was associated with a 3.5 point increase (95% CI 1.6–5.5) in CDI-2 scores and 2.3 point increase (95% CI 0.8–3.9) in SCAS total anxiety scores. We observed similar associations between average childhood ECAT exposures but not for concurrent exposures at age 12. ConclusionsTRAP exposure during early life and across childhood was significantly associated with self-reported depression and anxiety symptoms in children. The negative impact of air pollution on mental health previously reported among adults may also be present during childhood.

Feasibility of an emotional health curriculum for elementary school students in an underserved Hispanic community.

Hispanic children have greater mental health challenges but fewer received mental health services than other ethnic groups. A classroom-based Emotional Health Curriculum (EHC) was developed to address mental health disparities in an underserved Hispanic community. A quasi-experimental design with one group pre- and post-intervention was used to test the feasibility of an 8-week EHC for one hundred 3rd and 4th grade children in a dual-immersion Spanish-English elementary school. Limited efficacy was measured by changes in depression and anxiety scores reported by children and teachers. Acceptance was evaluated by a child-reported satisfaction survey and a focus group in which the four teachers shared their experiences. Implementation was measured by participation, retention, and fidelity rates. The child-reported depression and anxiety and teacher-reported depression were significantly decreased in at-risk children with the effect size ranging from 0.60 to 1.16 (ps<0.05). The majority of children (89.7%) enjoyed the EHC and teachers observed that children had acquired skills to manage their emotional distress. The participation, retention, and fidelity rates were 98%, 94%, and 99.13%, respectively. The results provide promising evidence that the EHC has the potential to improve depression and anxiety symptoms in at-risk children.

Children’s Attitudes toward Aggression: Associations with Depression, Aggression, and Perceived Maternal/Peer Responses to Anger

Little is known about factors that influence children’s attitudes toward aggression, despite evidence that these attitudes are influential in promoting violent behaviors. The purpose of the present research was to examine the relation of self, peer, and parent social factors to school-age children’s maladaptive attitudes toward aggression. Specifically, symptoms of depression, peer overt aggression behaviors, and perceptions of maternal and peer responses to anger were evaluated as important factors associated with the use of aggression. These factors were examined separately for boys and girls, as research has consistently documented gender differences in the form and use of aggression. Hierarchical regression models were computed separately for boys and girls in grades three through five (N = 167), with child-reported depression, peer-nominated overt aggression, and child-reported maternal and best friend responses to anger examined as predictors of maladaptive attitudes toward aggression. For girls, depressive symptoms positively predicted maladaptive attitudes toward aggression. For boys, the extent of peer-reported overt aggression (positively) and child-reported supportive maternal responses to the child’s anger (negatively) predicted maladaptive attitudes toward aggression. The value of examining social factors that relate to attitudes toward aggression is discussed as well as consideration of gender differences in these relations. In addition, discussion includes how these results highlight important targets for interventions that may be especially relevant for school-age girls and boys.

Observed Mother and Father Rejection and Control: Association With Child Social Anxiety, General Anxiety, and Depression

The parent–child relationship has been recognized as an important micro-ecological context that is thought to influence child anxiety and depression. Much contemporary research has examined child-reports of broad parenting behaviors (e.g., rejection, overprotection) and has overwhelmingly focused on the mother–child relationship. Little research has examined specific parenting behaviors that may be associated with child anxiety and depression, and whether these processes are similar for mothers and fathers and boys and girls. Using a parent–child interaction task, we examined associations among specific mother and father behaviors and child-reported general anxiety, social anxiety, and depression, and explored whether these associations were moderated by child gender. Participants were 90 children (50 % female) aged 9–12 years (Mage = 10.28, SD = 1.22), 90 fathers (Mage = 43.78, SD = 6.31) and 90 mothers (Mage = 40.67, SD = 4.97). Children completed measures of social anxiety, general anxiety, and depression. Families participated in a video-recorded blindly rated interaction task that provided indices of verbal and nonverbal rejection and controlling behaviors. Mothers’ physical takeovers (unsolicited physical assistance) were associated with greater child social anxiety and mothers’ denial of requests for reassurance were associated with greater child general anxiety. Fathers’ critical statements were associated with child-reported depression. Several child gender differences were noted. Findings from our study suggest that mothers’ and fathers’ specific parenting behaviors are differentially associated with children’s social anxiety, general anxiety and depression—and these processes may vary by child gender.

Overweight during childhood and internalizing symptoms in early adolescence: The mediating role of peer victimization and the desire to be thinner

BackgroundOverweight is associated with depression and anxiety among adults. It is unclear whether this association begins in childhood. Overweight among children is associated with a higher risk of peer victimization, and may mediate an association between overweight and internalizing symptoms. No study has tested this hypothesis in a longitudinal population-based sample using developmental trajectories of overweight in middle childhood. MethodsData was drawn from the population-based Quebec Longitudinal Study of Child Development. A three-group trajectory model of overweight development (6–12 years) was previously identified using a semi-parametric group-based approach (n=1678): “early-onset” (11.0%), “late-onset” (16.6%) and “never overweight” (72.5%). Mediation models tested the link between overweight status and child-reported depression and anxiety at 13 years via peer victimization and body dissatisfaction. ResultsChildren on an early-onset overweight trajectory were at increased risk for both depression (B=.318, 95% CI=.141;.496) and anxiety (B=.262, 95% CI=.09;.44) at 13 years. These direct associations were mediated by peer victimization and subsequent desire to be thinner. Children on a late-onset childhood overweight trajectory were at increased risk for both depression (B=.332, 95% CI=.187;.477) and anxiety (B=.215; 95% CI=.072;.358) at 13 years, mediated by the desire to be thinner. LimitationsWe were unable to control for previous levels of body dissatisfaction. Our measure of peer victimization was not specific to weight-based teasing. ConclusionsOverweight during middle childhood increases risk of early adolescence internalizing symptoms. Peer victimization and body dissatisfaction are partly responsible for this link.

Family-Based Interpersonal Psychotherapy for Depressed Preadolescents: Examining Efficacy and Potential Treatment Mechanisms

To conduct a randomized controlled trial to evaluate the preliminary efficacy of family-based interpersonal psychotherapy (FB-IPT) for treating depression in preadolescents (aged 7-12 years) as compared to child-centered therapy (CCT), a supportive and nondirective treatment that closely approximates the standard of care for pediatric depression in community mental health. Preadolescents with depression (N= 42) were randomly assigned FB-IPT or CCT. Pre- and posttreatment assessments included clinician-administered measures of depression, parent- and child-reported depression and anxiety symptoms, and parent-child conflict and interpersonal impairment with peers. Preadolescents receiving FB-IPT had higher rates of remission (66.0% versus 31%), a greater decrease in depressive symptoms from pre- to posttreatment, and lower depressive symptoms at posttreatment (R(2)= 0.35, ΔR(2)= 0.22; B=-8.15, SE= 2.61, t[37]=-3.13, p= .002, F(2)= 0.28) than did preadolescents with depression receiving CCT. Furthermore, preadolescents in the FB-IPT condition reported significant reductions in anxiety and interpersonal impairment compared with preadolescents in the CCT condition. Changes in social and peer impairment from pre- to posttreatment were associated with preadolescents' posttreatment depressive symptoms. There was a significant indirect effect for decreased social impairment accounting for the association between the FB-IPT and preadolescents' posttreatment depressive symptoms. Findings indicate FB-IPT is an effective treatment for preadolescent depression and support further investigation of interpersonal mechanisms by which FB-IPT may reduce preadolescent depression. Clinical trial registration information-Phase II Study ofFamily Based Interpersonal Psychotherapy (FB-IPT) forDepressed Preadolescents; http://clinicaltrials.gov; NCT02054312.

Risk, Resilience, and the Rorschach: A Longitudinal Study of Children Who Experienced Sexual Abuse

Experiencing sexual abuse increases the risk that children will report or otherwise demonstrate problems with emotion, behavior, and health. This longitudinal study of 44 children who experienced sexual abuse examined whether information processing as assessed via the Rorschach Inkblot Test was associated with child-reported depression symptoms assessed via the Children's Depression Inventory (Kovacs, 1992) concurrently and an average of 15 months later. Children whose Rorschach protocols were relatively free of scores suggesting intense distress, complex processing, and sexual content were more likely to experience remission of depression symptoms at follow-up. Findings provide incremental validity for certain Rorschach indexes to inform prognosis regarding depression symptoms and perhaps their treatment.

Predictors and consequences of developmental changes in adolescent girls' self-reported quality of attachment to their primary caregiver

In an at-risk community sample of 2101 girls, we examined trajectories, predictors, and consequences of changes in a central aspect of adolescents' perceived quality of attachment (QOA), i.e., their reported trust in the availability and supportiveness of the primary caregiver. Results demonstrated two distinct epochs of change in this aspect of girls' perceived QOA, with a significant linear decrease in early adolescence (ages 11–14) followed by a plateau from 14 to 16. Baseline parent-reported harsh punishment, low parental involvement, single parent status, and child-reported depression symptoms predicted steeper decreases in attachment during early adolescence, which in turn predicted greater child-reported depression and conduct disorder symptoms in later adolescence. Results suggest that both parent and child factors contribute to trajectories of self-reported QOA in adolescence, and a faster rate of decrease in girls' perceived QOA to caregivers during early adolescence may increase risk for both internalizing and externalizing symptoms.

The Prevalence of Depression in Pediatric Oncology Patients Undergoing Chemotherapy Treatment in Jordan

The aim of this study was to investigate the prevalence of depression in pediatric oncology patients in Jordan, comparing them with peers who suffered from chronic conditions or were healthy. The authors investigated 58 children with cancer, 56 with chronic illnesses, and 64 healthy controls using the Arabic version of the Children's Depression Inventory (CDI). There was no significant difference in CDI scores between children with cancer, children with chronic illnesses, and healthy controls. Using the conventional cutoff point of a score of 20 gives a prevalence of 20.68% for child-reported depression in the cancer group. This is toward the high end of the range for similar studies in other countries. The results suggest that children with cancer undergoing chemotherapy are no more likely to be depressed than children with chronic illnesses or healthy controls, although further research is warranted.

Do parents know best? Parent-reported vs. child-reported depression symptoms as predictors of future child mood disorder in a high-risk sample

Parents with depression are thought to be unreliable reporters of children's depression symptoms, but findings are contradictory and primarily focus on discrepancies between parent and child reports rather than on the predictive validity of informants. Using a sample of parents with recurrent depression, our analyses utilised data from a prospective high-risk longitudinal study (the Early Prediction of Adolescent Depression study) to investigate whether baseline parental reports of child depression symptoms predicted new onset mood disorder (NOMD) in children. The sample included 287 parents with a history of recurrent depression and their adolescent offspring (aged 9-17 at baseline). Families were assessed at three time points. The Child and Adolescent Psychiatric assessment (parent and child versions) was used to assess the number of child depression symptoms (computed separately by informant at baseline) and NOMD at follow-up. All DSM-IV diagnoses were confirmed by two child psychiatrists. Parent reports of child depression symptoms at baseline significantly predicted NOMD in children. Secondary analyses stratifying the sample according to child age showed that, for younger children, parent reports were significantly better at predicting NOMD compared to child reports. For children aged 12 or older, there were no significant differences between parent and child reports in predicting NOMD. The pattern of association remained the same once we controlled for baseline levels of parental depression. Not all parents were currently experiencing an episode of depression at the baseline assessments; the sample consisted predominantly of mothers, thus findings may not be applicable to fathers or families without a history of parental depression. In this high risk sample, child and parent ratings of depression predict new onset child mood disorder to a similar degree. Clinicians and researchers should give due consideration to parent ratings of their children's depression symptoms, regardless of whether the parent suffers with depression.

Validation of the Pediatric Symptom Checklist in HIV-infected Batswana

Objective: To determine the validity of the Pediatric Symptom Checklist (PSC), a brief measure of psychosocial health, for screening HIV+ Batswana children. Method: Setswana versions of the parent and child PSC were administered to 509 HIV+ Batswana children (age 8–16) and their parents/guardians. Test properties were evaluated and cut-off scores were derived using receiver operating characteristic curve analysis. Scores on the parent-completed PSC and the child-completed PSC-Y were compared to parental and clinic staff reports of concern about the child's psychosocial health and to scores on the Children's Depression Inventory and the Revised Children's Manifest Anxiety Scale. Results: The Setswana PSC has high internal consistency (Cronbach's alpha 0.87 for the parent-completed version). Comparing PSC scores to parental reports of concern and child-reported depression symptoms, a cut-off score of 20 on the PSC and PSC-Y maximised the sensitivity and specificity. Conclusions: The PSC performed well in Setswana-speaking children and is a promising screening tool for paediatric psychosocial problems in busy clinical settings. Screening with the PSC may allow for early detection and treatment of psychosocial problems. This is likely to be of particular value for HIV+ children for whom HIV treatment non-adherence may result from untreated psychosocial dysfunction.

Peer Victimization in Children With Obsessive–Compulsive Disorder: Relations With Symptoms of Psychopathology

This study examined the frequency of peer victimization and psychological symptom correlates among youth with obsessive-compulsive disorder (OCD). The Schwartz Peer Victimization Scale, Children's Depression Inventory, and Asher Loneliness Scale were administered to 52 children and adolescents diagnosed with OCD. The child's parent or guardian completed the Child Behavior Checklist, and a trained clinician administered the Children's Yale-Brown Obsessive–Compulsive Scale (CY– BOCS). Fifty-two healthy controls and 52 children with Type 1 diabetes (T1D) who were administered the Schwartz Peer Victimization Scale as part of another study were included for comparison purposes. Greater rates of peer victimization were reported in youth with OCD relative to healthy controls and children with Type 1 diabetes (T1D). Peer victimization in the OCD sample was positively related to loneliness, child-reported depression, parent-reported internalizing and externalizing symptoms, and clinician-rated OCD severity. Peer victimization fully mediated the relation between OCD severity and both depression and parent reports of child externalizing behaviors and partially mediated the relation between OCD severity and loneliness. Recognition of the magnitude of the problem and contribution problematic peer relations may play in comorbid psychological conditions is important for clinicians who see children with OCD.