Parent-reported Depressive Symptoms Research Articles

Transdiagnostic Attentional Deficits Are Associated with Depressive and Externalizing Symptoms in Children and Adolescents with Neuropsychiatric Disorders.

Although inattention, impulsivity, and impairments to vigilance are most associated with attention-deficit/hyperactivity disorder (ADHD), transdiagnostic attentional deficits are prevalent across all psychiatric disorders. To further elucidate this relationship, the present study investigated parent-reported neuropsychiatric symptom correlates of attention deficits using the factor structure of the Conners' Continuous Performance Test (CPT-II), a neuropsychological test of attention. Two-hundred and eighteen children and adolescents (7-21years old) completed the CPT-II as part of standard clinical protocol during outpatient pediatric neuropsychology visits. The factor structure of the CPT-II was determined with a principal component analysis (PCA) using Promax rotation. Pearson correlation analyses and regression models examined the relationship between the generated factor structure, parent-reported clinical symptoms, and pre-determined clinical diagnoses. Results from the PCA suggested a three-factor model best supported the structure of the CPT-II, and were subsequently defined as inattention, impulsivity, and vigilance. Performance-based inattention was significantly correlated with parent-reported hyperactivity, aggression, conduct problems, and depression. Parent-reported depressive symptoms and conduct problems were the strongest correlates of performance-based inattention, not hyperactivity or aggression. Performance-based inattention was significantly associated with an ADHD diagnosis but not a depression or anxiety diagnosis. Findings suggest attentional deficits are not specific to any one disorder. To enhance the identification, classification, and treatment of neuropsychiatric disorders, both researchers and clinicians alike must diminish the importance of categorical approaches to child/adolescent psychopathology and continue to consider the dimensionality of transdiagnostic characteristics such as inattention.

Mental Health during Medical Transition in a US and Canadian Sample of Early Socially Transitioned Transgender Youth

PurposeThis study aimed to shed light on the mental health of a unique group of medically transitioning transgender adolescents: those who had made a binary social transition during childhood and who, in general, had not experienced substantial gender-incongruent puberty. MethodsStudy participants were part of a broader longitudinal study comprising 3 groups: transgender youth, their cisgender siblings, and unrelated cisgender peers. Using multilevel models, we compared self-reported and parent-reported levels of anxiety and depressive symptoms among transgender youth at 3 stages: before youth had begun puberty blockers; after they had begun blockers; and after they had begun hormone therapy. We also compared age-based mental health trajectories in transgender and cisgender youth. ResultsIn this sample of transgender youth who sought and received gender-affirming medical care, participants experienced stable and relatively low levels of psychological distress across stages of medical transition and across time. There was one exception: transgender girls showed increased, followed by decreased, parent-reported depressive symptoms over time. In contrast, cisgender girls showed increases in internalizing symptomatology (with the exception of parent-reported anxiety) as they got older, and cisgender boys showed decreased self-reported anxiety and increased, followed by decreased, parent-reported depressive symptoms. By mid-adolescence, levels of anxiety and depressive symptoms among transgender girls and transgender boys generally fell between those of cisgender girls and cisgender boys. DiscussionResults demonstrate that transgender youth who are socially and medically supported in their gender identity can experience stable and positive mental health throughout the notoriously challenging developmental period of adolescence.

54 Exploring the Impact of Stria Terminalis Connectivity and Family Income on Depressive Symptoms Throughout Development

Objective:The stria terminalis (ST) is a white matter tract with connections to limbic and autonomic brain structures that is implicated in affective functioning. Recent works suggests that ST functional integrity and connectivity is associated with faster responses to emotional cues (Dzafic et al., 2019) and may be influenced by environmental factors including socioeconomic status (SES) and childhood adversity (Banihashemi et al., 2020). The role of the ST in the experience of more daily affective experiences, such as depressive symptoms, remains unexplored. Therefore, the present study examined the role of the ST and SES, as assessed by household income, in the relationship between age and depressive symptoms in typically developing children and adolescents.Participants and Methods:Participants include 64 typically developing children and adolescents age 8-21 (Mage=13.27, SD=3.15) who participated in an ongoing study of development of neurocognitive and social-cognitive skills. Participants completed imaging on a 3Tesla MR Siemens PRISMA scanner. Tractography was executed via ENIGMA tract-based spatial statistics to quantify WM integrity and provided values for mean fractional anisotropy (mFA) of the ST. Depressive symptoms were measured with the Behavior Assessment Scale for Children-Third Edition (BASC-3) parent report scale, and annual family income was obtained per parent report. Mediation and moderation analyses were conducted using Process version 4.1 (Hayes, 2022) in SPSS version 28. As depression symptoms are often higher in early adolescence than later, we examined the indirect effect of age on depressive symptoms through ST mFA and evaluated this relationship at different levels of family income.Results:Age was associated with lower levels of depressive symptoms (b=-.98, t=-2.18, p<.05), whereas greater right ST mFA was associated with higher levels of depressive symptoms (b=42.05, t=2.50, p<.05). Right ST mFA explained significant variance in the relationship between age and parent-reported depression (ab=.13, 95% CI [.02, .29]). The conditional indirect effect of family income was significant for children with annual family incomes between 25-50k (effect=.16, 95% CI [.01, .38]) and 75-100k (effect=.13, 95% CI [.001, .31]), but not for 100k+ (effect=.11, 95% CI [-.05, .33]).Conclusions:The present study revealed a significant, positive relationship between white matter integrity in the right ST and parent-reported depressive symptoms in healthy children and young adults. Finding extend on prior work implicating the ST in threat responsivity (Dzafic et al., 2019). Moreover,results suggest the role of the ST in the relationship between age and depression depends on level of family income, such that ST mFA explains more variance at lower income levels, and is no longer significant for children from families with income greater than 100k. These findings support the notion that environmental stressors (such as lower family income) may strengthen ST pathways via activity-dependent plasticity and repeated, coordinated activation (Rinaman et al., 2011). Future studies should examine these brain-behavior associations, as they may replicate in a larger sample, with more nuanced indicators of environmental stress.

Internalizing Symptoms in Adolescents With Sickle Cell Disease.

Sickle cell disease (SCD) is a genetic blood disorder that may affect patients' mood and behavior. However, measuring the prevalence of internalizing symptoms (anxiety and depression) in patients with SCD has been elusive. We assessed internalizing symptoms in adolescents with SCD to evaluate prevalence and to test whether neurocognitive performance and frequency of pain-related episodes were associated with internalizing concerns. One hundred eighty-five patients (57% HbSS/HbSß0-thalassemia, 43% HbSC/HbSß+-thalassemia), ages 12-18 years, received a neuropsychological evaluation as a part of a larger cohort study. Internalizing symptoms were measured using the Behavior Assessment System for Children, Second or Third Edition. Scores on the depression and anxiety scales were compared to normative values using Wilcoxon signed rank test. Spearman correlations examined associations between neurocognitive performances and internalizing symptoms. Robust multivariable regression models measured associations between internalizing symptoms and age, sex, sickle genotype, total hemoglobin, fetal hemoglobin, socioeconomic status, and frequency of pain episodes. Parent- and self-reported ratings of internalizing symptoms were not elevated compared to normative expectations. Overall, 1.8% and 6.3% of the sample displayed clinically elevated symptoms of anxiety and depression based on self-report, respectively. There were no associations between internalizing symptoms and neurocognitive performance (all p > .05). In multivariable analyses, the frequency of pain episodes was positively associated with self-reported anxiety (p = .006) and parent-reported depressive symptoms (p = .017). Adolescents with SCD do not report elevated internalizing symptoms compared to normative expectations. Further research is needed to examine the trajectory of internalizing symptoms and the bidirectional relationship between pain and psychosocial functioning in SCD.

0250 Greater Slow Wave Activity in Pre-pubertal Children Is Associated With Less Negative Emotional Responses the Following Day

Abstract Introduction Inadequate sleep quantity and/or quality in children is known to forecast development of emotional problems, but how sleep microstructure relates to children’s day-to-day emotional functioning remains unclear. Slow wave activity (SWA), or slow fluctuations of cortical activity during slow wave sleep (SWS) in the frequency range 0.75–4.5 Hz, is a marker of homeostatic sleep regulation and reflects synaptic reorganization of cortical areas early in life (Campbell & Feinberg, 2009). Findings regarding SWA among clinically depressed adolescents are mixed, with evidence of SWA reductions (Lopez et al., 2012) and increases (Tesler et al., 2016) compared to controls. Tesler et al. (2016) also showed SWA in frontal areas correlates positively with depressive thoughts. However, we are unaware of studies examining SWA in relation to depressive symptoms and next-day emotional responses among pre-pubertal children, before developmental declines in SWA (Jenni & Carskadon, 2004). Methods We examined relationships between N3 SWA, depressive symptoms, and next-day emotional responses among N=17 un-medicated, healthy children ages 7-11 years (Tanner 1/2). Children completed a baseline assessment and one night of at-home PSG monitoring (10-hour sleep opportunity) then an in-lab emotional assessment the next day where they provided arousal and valence ratings for negative affective images from the International Affective Picture System. Analyses controlled for PSG night total sleep time, and SWA did not differ by gender. Results Results indicated non-significant associations between SWA and child- and parent-reported depressive symptoms. Greater SWA density across frontal (r=-.66; p< .01), central (r=-.70; p< .001) and occipital regions (r=-.61; p< .01), along with frontal SWA amplitude (r=-.61; p< .01), significantly negatively related to valence ratings for negative images (images were rated as less negative). Conclusion While preliminary, findings suggest potential relationships between SWA and emotional functioning in pre-pubertal children. We have previously shown greater SWS corresponds with less same-week negative affect among pre-pubertal anxious children (Palmer & Alfano, 2017); additionally, in a longitudinal study of pre-pubertal children at risk for depression, greater SWS in childhood protected against later development of depression (Silk et al., 2007). Collectively, findings suggest greater SWA prior to pubertal transition may buffer against negative daytime emotional experiences and later depression. Support (If Any)

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Among Japanese Children: A Pilot Study.

At present, there is no established cognitive behavioral therapy (CBT) for treating emotional disorders in Japanese children. Therefore, we introduced the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) in Japan and adapted it to the Japanese context. We then examined its feasibility and preliminary efficacy using a single-arm pretest, posttest, follow-up design. Seventeen Japanese children aged between 8 and 12 years (female n = 11; male n = 6; M = 10.06 ± 0.97 years) with a principal diagnosis of anxiety, obsessive-compulsive, or depressive disorders, and their parents were enrolled in the study. The primary outcome was the overall severity of emotional disorders as assessed by psychiatrists using the Clinical Global Impression-Severity Scale. Secondary outcomes included child- and parent-reported anxiety symptoms, depressive symptoms, and functional status. No severe adverse events were observed. The feasibility was confirmed by the low dropout proportion (11.76%), high attendance proportion (children: 95.6%; parents: 94.6%), and sufficient participant satisfaction. Linear mixed models (LMMs) showed that the overall severity of emotional disorders and child- and parent-reported anxiety symptoms improved from pre-treatment to post-treatment, and that these treatment effects were maintained during the 3-month follow-up period. Additionally, child- and parent-reported functional status improved from pre-treatment to the 3-month follow-up. In contrast, child-reported depressive symptoms improved from pre-treatment to follow-up, but there was no significant change in parent-reported depressive symptoms between pre-treatment and other time points. These findings demonstrate the feasibility and preliminary efficacy of the Japanese version of the UP-C, suggesting that future randomized controlled trials (RCTs) are warranted (Clinical trial registration: UMIN000026911).

Are parental depressive symptoms related to the sleep quality and physical activity of their children with developmental disabilities?

BackgroundParenting young children with developmental disabilities presents unique opportunities and challenges. Parents can experience meaningful priority shifts in and appreciation for their lives, but they can also be at greater risk for diminished emotional health. Physiological child factors warrant further investigation as correlates for parent risk of or protection from depression. AimThis study examined the relations between parental depressive symptoms and the (1) sleep quality and (2) physical activity in their children with developmental disabilities adjusting for parent- and child-level factors. Methods and ProceduresChildren and parents were recruited for participation in this study from a university-based neurodevelopmental clinic. Parents completed questionnaires about themselves including measures of depressive symptoms and about their children including measures of sleep quality and physical activity. Researchers administered developmental measures to the children and physicians completed children’s diagnostic evaluations. Participants were 147 children (32 ± 4 months old) mostly with autism spectrum disorder (ASD) and their parents (mostly mothers). Factors associated with parent-reported depressive symptoms were analyzed with a generalized linear model. Outcomes and ResultsAn R2deviance value of 43 % confirmed that there was a substantial, moderate-to-large sized, improvement in the proportion of variance explained by the final model when compared with a null, or intercept-only, model. Depressive symptoms were approximately two times higher for parents of children with above average sleep disturbances and one and half times higher for parents whose children engaged in above average physical activity. Conclusion and ImplicationsOur study demonstrates the importance of considering children’s sleep and physical activity in supporting children’s developmental disabilities because they may offer pathways to enhanced family resilience and well-being.

Differences in Patient and Parent Informant Reports of Depression and Anxiety Symptoms in a Clinical Sample of Transgender and Gender Diverse Youth.

Purpose: We assessed characteristics of patients at a pediatric gender clinic and investigated if reports of mental health concerns provided by transgender and gender diverse (TGD) youth patients differed from reports provided by a parent informant on their behalf. Methods: This cross-sectional study included 259 TGD patients 8 to 22 years of age attending a pediatric gender clinic in the southeast United States from 2015 to 2020. Pearson correlations and paired sample t-tests compared patient-reported mental health concerns at patient intake with those provided by a parent informant. Clinical symptom severity was assessed with standardized T-scores. Level 2 Patient-Reported Outcomes Measurement Information System (PROMIS) Emotional Distress-Depression Scale and Level 2 PROMIS Emotional Distress-Anxiety Scale assessed depression and anxiety symptoms of patients. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Parent/Guardian-Rated Level 1 Cross-Cutting Symptom Measure was used with parents. Results: Patients had a mean age of 14.9 at first visit, with most identifying as White (85.5%), non-Hispanic (91.1%), and as a boy or man (63.6%). Half had moderate-to-severe depression (51.2%) or anxiety (47.9%) symptoms. There was a moderate, positive correlation between patient-reported and parent-reported depression symptoms, with no correlation for anxiety symptoms. Informant type differences were statistically significant (patients reporting greater depression and anxiety symptoms). Conclusions: TGD youth patients reported more severe depression and anxiety symptoms compared with parent informants. Despite moderate agreement on depression symptoms, parents did not accurately detect their child's anxiety symptoms. These discrepancies highlight a need for interventions which increase parental recognition of child mental health status.

In-person victimization, cyber victimization, and polyvictimization in relation to internalizing symptoms and self-esteem in adolescents with attention-deficit/hyperactivity disorder.

There is mixed evidence for whether in-person victimization and cyber victimization are differentially linked to internalizing symptoms and self-esteem among adolescents with attention-deficit/hyperactivity disorder (ADHD). The goals of the present study were to (1) evaluate in-person victimization and cyber victimization in relation to internalizing symptoms (i.e., anxiety and depression) and self-esteem and (2) examine differences in internalizing symptoms and self-esteem between in-person victimization, cyber victimization, and polyvictimization (i.e., both in-person victimization and cyber victimization). Participants were 78 adolescents (ages 13-17 years) diagnosed with ADHD who completed ratings of in-person victimization, cyber victimization, anxiety, depression, and self-esteem. Parents completed ratings of their adolescent's anxiety and depression. Adolescents with ADHD reported experiencing higher rates of in-person victimization (64%) than cyber victimization (23%) in the last 30 days. In addition, 22% reported that they experienced polyvictimization. In-person victimization was associated with higher adolescent-reported anxiety symptoms, whereas cyber victimization was associated with higher parent-reported depressive symptoms; both were associated with lower adolescent-reported self-esteem. Adolescents who reported polyvictimization reported the highest anxiety and depressive symptoms and the lowest self-esteem. Approximately one quarter of adolescents with ADHD report experiencing polyvictimization in the past month. Findings indicate that in-person victimization and cyber victimization are each uniquely associated with lower self-esteem and differentially associated with co-occurring internalizing symptoms among adolescents with ADHD. Polyvictimization is especially linked to higher internalizing symptoms and lower self-esteem. Longitudinal studies are needed to better understand the directionality of these associations.

Randomized control trial testing the effectiveness of implemented depression prevention in high-risk adolescents

BackgroundAdolescent depression is a global mental health concern. Identification and effective prevention in an early stage are necessary. The present randomized, controlled trial aimed to examine the effectiveness of Cognitive Behavioral Therapy (CBT)-based depression prevention in adolescents with elevated depressive symptoms. This prevention approach is implemented in school communities, which allows to examine effects under real-life circumstances.MethodsA total of 5222 adolescents were screened for elevated depressive symptoms in the second grade of secondary schools; 130 adolescents aged between 12 and 16 years old (M = 13.59; SD = 0.68; 63.8% girls) were randomly assigned to the experimental (OVK 2.0) or control condition (psycho-education). Self- and parent-reported depressive symptoms were assessed at pretest and post intervention, as well as 6- and 12-months follow-up. Clinical assessment of depression was assessed at pretest and 6-months follow-up.ResultsIntent-to-treat analyses revealed that the decrease in adolescent-rated depressive symptoms was significantly larger in the intervention condition than in the control condition. There was no significant difference in decrease of parent-rated depressive symptoms between both conditions.ConclusionsBased on the findings, we recommend the implementation of screening and prevention in schools, according the basics of this study design. Since this is a new step forward, we discuss the clinical impact and challenges, as well possibilities for future research.Trial registrationThe study is registered in the Dutch Trial Register for RCT’s (NTR5725). Date registered: 11 March 2016.

The development and validation of an algorithm to predict future depression onset in unselected youth.

Universal depression screening in youth typically focuses on strategies for identifying current distress and impairment. However, these protocols also play a critical role in primary prevention initiatives that depend on correctly estimating future depression risk. Thus, the present study aimed to identify the best screening approach for predicting depression onset in youth. Two multi-wave longitudinal studies (N = 591, AgeM = 11.74; N = 348, AgeM = 12.56) were used as the 'test' and 'validation' datasets among youth who did not present with a history of clinical depression. Youth and caregivers completed inventories for depressive symptoms, adversity exposure (including maternal depression), social/academic impairment, cognitive vulnerabilities (rumination, dysfunctional attitudes, and negative cognitive style), and emotional predispositions (negative and positive affect) at baseline. Subsequently, multi-informant diagnostic interviews were completed every 6 months for 2 years. Self-reported rumination, social/academic impairment, and negative affect best predicted first depression onsets in youth across both samples. Self- and parent-reported depressive symptoms did not consistently predict depression onset after controlling for other predictors. Youth with high scores on the three inventories were approximately twice as likely to experience a future first depressive episode compared to the sample average. Results suggested that one's likelihood of developing depression could be estimated based on subthreshold and threshold risk scores. Most pediatric depression screening protocols assess current manifestations of depressive symptoms. Screening for prospective first onsets of depressive episodes can be better accomplished via an algorithm incorporating rumination, negative affect, and impairment.

Depressive symptomatology in school-aged children with obstructive sleep apnea syndrome: incidence, demographic factors, and changes following a randomized controlled trial of adenotonsillectomy

Depressive symptoms following adenotonsillectomy (AT) relative to controls were examined in children with obstructive sleep apnea syndrome (OSAS). The Childhood Adenotonsillectomy Trial (CHAT) multisite study examined the impact of AT in 453 children aged 5 to 9.9 years with polysomnographic evidence of OSAS without prolonged desaturation, randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC). One hundred seventy-six children (eAT n = 83; WWSC n = 93) with complete evaluations for depressive symptomatology between baseline and after a 7-month intervention period were included in this secondary analysis. Exact binomial test assessed proportion of depressive symptomatology relative to norms, while effects of AT and OSAS resolution were assessed through linear quantile mixed-models. Treatment group assignment did not significantly impact depression symptoms, although self-reported depression symptoms improved over time (p < 0.001). Resolution of OSAS symptoms demonstrated a small interaction effect in an unexpected direction, with more improvement in parent ratings of anxious/depressed symptoms for children without resolution (p = 0.030). Black children reported more severe depressive symptoms (p = 0.026) and parents of overweight/obese children reported more withdrawn/depressed symptoms (p = 0.004). Desaturation nadir during sleep was associated with self-report depressed (r = -0.17, p = 0.028), parent-reported anxious/depressed (r = -0.15, p = 0.049), and withdrawn/depressed (r = -0.24, p = 0.002) symptoms. Increased risk for depressed and withdrawn/depressed symptoms was detected among children with OSAS, and different demographic variables contributed to risk in self-reported and parent-reported depression symptoms. Arterial oxygen desaturation nadir during sleep was strongly associated with depressed symptoms. However, despite improvements in child-reported depressed symptoms over time, changes were unrelated to either treatment group or OSAS resolution status. Childhood Adenotonsillectomy Study for Children with OSAS (CHAT), https://clinicaltrials.gov/show/NCT00560859, NCT00560859.

The cost of believing emotions are uncontrollable: Youths' beliefs about emotion predict emotion regulation and depressive symptoms.

As humans, we have a unique capacity to reflect on our experiences, including emotions. Over time, we develop beliefs about the nature of emotions, and these beliefs are consequential, guiding how we respond to emotions and how we feel as a consequence. One fundamental belief concerns the controllability of emotions: Believing emotions are uncontrollable (entity beliefs) should reduce the likelihood of trying to control emotional experiences using effective regulation strategies like reappraisal; this, in turn, could negatively affect core indices of psychological health, including depressive symptoms. This model holds particular relevance during youth, when emotion-related beliefs first develop and stabilize and when maladaptive beliefs could contribute to emerging risk for depression. In the present investigation, a pilot diary study (N = 223, aged 21-60) demonstrated that entity beliefs were associated with using reappraisal less in everyday life, even when controlling for possible confounds (i.e., self-efficacy, pessimism, stress exposure, stress reactivity). Then, two studies examined whether entity beliefs and associated impairments in reappraisal may set youths on a maladaptive trajectory: In a cross-sectional study (N = 136, aged 14-18), youths with stronger entity beliefs experienced greater depressive symptoms, and this link was mediated by lower reappraisal. This pattern was replicated and extended in a longitudinal study (N = 227, aged 10-18), wherein youth- and parent-reported depressive symptoms were assessed 18 months after assessing beliefs. These results suggest that entity beliefs about emotion constitute a risk factor for depression that acts via reappraisal, adding to the growing literature on emotion beliefs and their consequences for self-regulation and health. (PsycINFO Database Record

Self- and parent-reported depressive symptoms rated by the mood and feelings questionnaire

The Mood and Feelings Questionnaire (MFQ) was developed to measure depressive symptoms in children and adolescents. It includes a self-report and a parent-report part. This study set out to test the psychometric properties of the MFQ in a Danish population of children and adolescents.The study included a population-based sample of n = 992 individuals aged 9–17 years and n = 703 parents from five schools. The internal consistencies of both MFQ versions were excellent with high alpha coefficients. With few exceptions, correlation between items and the total score was moderate to high. Vegetative symptoms were among the lowest correlating items while cognitive symptoms were among the highest. Girls reported more depressive symptoms than boys, and reports from offspring indicated more depressive symptoms than reports from parents. There was no difference in depressive symptoms by respondents aged 9 to 11 compared to respondents aged 12 to 17 in schools where all pupils participated. However, in schools where pupils participated by choice, an increase in depressive symptoms by age was found. This study suggests that MFQ is reliable for evaluating depressive symptoms in a population of children and adolescents. Furthermore, it is of clinical relevance that parents tend to underreport depressive symptoms of their offspring.

Functional communication as a predictor of depression and anxiety symptoms among adolescents seeking bariatric surgery.

The purpose of the present study was to determine whether functional communication and parent-adolescent relations prospectively predict anxiety and depression symptoms among severely obese adolescents seeking bariatric surgery. Participants included 30 adolescents and their primary caregivers, who presented for enrolment in a study assessing the safety and efficacy of the laparoscopic adjustable gastric band. Adolescents and their caregivers completed questionnaires assessing anxiety and depression symptoms, functional communication, and parent-adolescent relations at baseline and immediately prior to having bariatric surgery. Regression analyses revealed that poorer parent reported functional communication at baseline predicted increases in adolescent reported anxiety and depression symptoms immediately prior to surgery (on average 8.8 months later), above and beyond baseline symptoms. Anxiety and depression symptoms did not predict functional communication over time. Parent-adolescent relations, as reported by the adolescent, were concurrently associated with adolescent reported depression symptoms at baseline, and were concurrently associated with adolescent reported anxiety and depression symptoms, as well as parent reported depression symptoms, immediately prior to surgery. Functional communication may be an important prospective risk factor for the development of anxiety and depression symptoms among severely obese adolescents seeking bariatric surgery, whereas adolescent report of the parent-adolescent relationship appears to be concurrently related to anxiety and depression symptoms. Future research should examine whether specifically targeting communication skills and family relationships within psychological treatment would improve psychosocial functioning among severely obese adolescents.

An Open Trial Investigation of a Transdiagnostic Group Treatment for Children With Anxiety and Depressive Symptoms

The current study investigates the feasibility and preliminary outcomes associated with a transdiagnostic emotion-focused group protocol for the treatment of anxiety disorders and depressive symptoms in youth. Twenty-two children (ages 7 to 12; M=9.79) with a principal anxiety disorder and varying levels of comorbid depressive symptoms were enrolled in an open trial of the Emotion Detectives Treatment Protocol (EDTP; Ehrenreich-May & Bilek, 2009), an intervention adapted from existent unified protocols for the treatment of emotional disorders among adults and adolescents. Results indicate that participants experienced significant improvements in clinician-rated severity of principal anxiety disorder diagnoses (d=1.38), the sum of all anxiety and depressive disorder severity ratings (d=1.07), and child-reported anxiety (d=0.47) and parent-reported depressive symptoms (d=0.54) at the posttreatment assessment. EDTP had good retention rates and reports of high satisfaction. Thus, preliminary evidence suggests that EDTP is a feasible and potentially efficacious treatment of youth anxiety disorders and co-occurring depressive symptoms. Children experiencing a range of internalizing symptoms may benefit from this more generalized, emotion-focused treatment modality, as it offers flexibility to families and the mental health clinician, while maintaining a concurrent focus on the provision of cognitive-behavioral treatment skills vital to the amelioration of anxiety and depressive disorder symptoms in youth.

Predictors of parental monitoring among families with a runaway adolescent.

Extensive research shows that parental monitoring is a critical factor in child adjustment. Using parent and adolescent reports, this study sought to examine predictors of parental monitoring among an understudied, high-risk sample of runaway adolescents. Parent-reported depressive symptoms, couple (romantic) relationship satisfaction, and adolescent-reported bonding with parents were used as predictors of both child- and parent-reported monitoring. Findings indicated that, among parents, the couple relationship was the primary predictor of monitoring, whereas among adolescents, the parent-child relationship was the primary predictor. Maternal depressive symptoms were unrelated to monitoring. These findings suggest the utility of considering monitoring as an interpersonal phenomenon rather than primarily a parent- or child-driven phenomenon.

Subgenual anterior cingulate responses to peer rejection: a marker of adolescents' risk for depression.

Extensive developmental research has linked peer rejection during adolescence with a host of psychopathological outcomes, including depression. Moreover, recent neuroimaging research has suggested that increased activity in the subgenual region of the anterior cingulate cortex (subACC), which has been consistently linked with depression, is related to heightened sensitivity to peer rejection among adolescents. The goal of the current study was to directly test the hypothesis that adolescents' subACC responses are predictive of their risk for future depression, by examining the relationship between subACC activity during peer rejection and increases in depressive symptoms during the following year. During a functional magnetic resonance imaging scan, 20 13-year-olds were ostensibly excluded by peers during an online social interaction. Participants' depressive symptoms were assessed via parental reports at the time of the scan and 1 year later. Region of interest and whole-brain analyses indicated that greater subACC activity during exclusion was associated with increases in parent-reported depressive symptoms during the following year. These findings suggest that subACC responsivity to social exclusion may serve as a neural marker of adolescents' risk for future depression and have implications for understanding the relationship between sensitivity to peer rejection and the increased risk of depression that occurs during adolescence.

The contribution of peers to monthly variation in adolescent depressed mood: A short-term longitudinal study with time-varying predictors

This study examined peer predictors of variation and growth in depressed mood among high-risk adolescents, using child and parent reports of monthly symptoms. One hundred seventy-six parents and their 10- to 14-year-old children separately took part in a series of up to nine monthly interviews. Multilevel growth models examined both time-varying peer predictors of parent and child reports of the child's depressive symptoms, controlling for age, gender, and treatment status. Deviant peer affiliation significantly predicted elevated depressive symptoms in the monthly child-report of depressed mood, especially for younger adolescents. Children's level of delinquency was significantly related to parent-reported depressive symptoms, and to child-reported symptoms in older adolescents only. As expected, depressed mood was higher for girls and more prevalent among older adolescents. The results suggest that peer processes may be linked in time to the development of depression, especially among high-risk adolescents.