Risk For Later Depression Research Articles

Early childhood household instability, adolescent structural neural network architecture, and young adulthood depression: A 21-year longitudinal study

Unstable and unpredictable environments are linked to risk for psychopathology, but the underlying neural mechanisms that explain how instability relate to subsequent mental health concerns remain unclear. In particular, few studies have focused on the association between instability and white matter structures despite white matter playing a crucial role for neural development. In a longitudinal sample recruited from a population-based study (N = 237), household instability (residential moves, changes in household composition, caregiver transitions in the first 5 years) was examined in association with adolescent structural network organization (network integration, segregation, and robustness of white matter connectomes; Mage = 15.87) and young adulthood anxiety and depression (six years later). Results indicate that greater instability related to greater global network efficiency, and this association remained after accounting for other types of adversity (e.g., harsh parenting, neglect, food insecurity). Moreover, instability predicted increased depressive symptoms via increased network efficiency even after controlling for previous levels of symptoms. Exploratory analyses showed that structural connectivity involving the left fronto-lateral and temporal regions were most strongly related to instability. Findings suggest that structural network efficiency relating to household instability may be a neural mechanism of risk for later depression and highlight the ways in which instability modulates neural development.

Infectious mononucleosis as a risk factor for depression: A nationwide cohort study

BackgroundInfectious mononucleosis is a clinical diagnosis characterized by fever, sore throat, lymph node enlargement and often prolonged fatigue, most commonly caused by Epstein-Barr virus infection. Previous studies have indicated that infectious mononucleosis can be followed by depression; however, large-scale studies are lacking. We used nationwide registry data to investigate the association between infectious mononucleosis and subsequent depression in this first large-scale study. MethodsProspective cohort study using nationwide Danish registers covering all 1,440,590 singletons born (1977–2005) in Denmark by Danish born parents (21,830,542 person-years’ follow-up until 2016); where 12,510 individuals had a hospital contact with infectious mononucleosis. The main outcome measures were a diagnosis of major depressive disorder (ICD-8: 296.09, 298.09, 300.4; ICD-10: F32) requiring hospital contact. ResultsInfectious mononucleosis was associated with a 40% increased hazard ratio (HR) for a subsequent depression diagnosis in the fully adjusted model (HR: 1.40, 95% CI: 1.26–1.56;n = 358), when compared to unexposed individuals. The increased risk of being diagnosed with depression was significant to the periods one to four years after the infectious mononucleosis diagnosis (HR: 1.40, 95% CI: 1.17–1.67;n = 121) and ≥ five years (HR: 1.40, 95% CI: 1.22–1.61;n = 207). We did not find any differences according to age (p = 0.61) nor sex (p = 0.30). ConclusionIn this largest study to date, infectious mononucleosis in childhood or adolescence was associated with an increased risk of a subsequent depression. Our findings have important clinical implications and identifies youth with infectious mononucleosis as a group at high risk of later depression in young adulthood.

What explains the link between childhood ADHD and adolescent depression? Investigating the role of peer relationships and academic attainment

There is increasing evidence that childhood Attention-Deficit Hyperactivity Disorder (ADHD) elevates risk of later depression, but the mechanisms behind this association are unclear. We investigated the relationship between childhood ADHD symptoms and late-adolescent depressive symptoms in a population cohort, and examined whether academic attainment and peer problems mediated this association. ALSPAC (Avon Longitudinal Study of Parents and Children) is an ongoing prospective longitudinal population-based UK cohort that has collected data since September 1990. 2950 individuals with data on parent-reported ADHD symptoms in childhood (7.5 years) and self-reported depressive symptoms in late adolescence (17.5 years) were included in analyses. 2161 individuals with additional data at age 16 years on parent-reported peer problems as an indicator of peer relationships and formal examination results (General Certificate of Secondary Education; GCSE) as an indicator of academic attainment were included in mediation analyses. Childhood ADHD symptoms were associated with higher depressive symptoms (b = 0.49, SE = 0.11, p < 0.001) and an increased odds of clinically significant depressive symptoms in adolescence (OR = 1.27, 95% CI 1.15–1.41, p < 0.001). The association with depressive symptoms was mediated in part by peer problems and academic attainment which accounted for 14.68% and 20.13% of the total effect, respectively. Childhood ADHD is associated with increased risk of later depression. The relationship is mediated in part by peer relationships and academic attainment. This highlights peer relationships and academic attainment as potential targets of depression prevention and intervention in those with ADHD. Future research should investigate which aspects of peer relationships are important in conferring later risk for depression.

The effect of maternal depression on mental representations and child negative affect

BackgroundMaternal depression is a widely recognized public health concern with significant implications for child functioning, including the development of negative child affect and risk for later depression. Negative mental representations may partially account for the association between maternal depression and child negative affect. MethodsThe effect of depression on low-income mothers’ representations of their child, self, and mother was assessed via Expressed Emotion (EE) during Five-Minute Speech Samples. Direct and indirect pathways between maternal depression, EE, and child negative affect were examined. Mothers (M = 24 years old) who had experienced a major depressive episode (n = 144) since child's birth, non-depressed comparison mothers (n = 62), and their children participated. ResultsExamination of between-group differences revealed that depressed mothers had higher levels of overall self EE. Trend results also suggest depressed mothers may have higher overall EE toward their children and their own mothers. Novel coding systems for EE toward self (Identity and Depressotypic Cognitions) and EE toward mother (Source of Concrete Support and Resolution of Past Adversity) were also developed and tested. A significant indirect relation was found between maternal baseline depression and child negative affect at 26 months via the mother's level of EE-Criticism of her mother. LimitationsCertain EE subcodes may need to be adapted for young children and high-risk, low-income participants. ConclusionsFindings highlights the importance of relational interventions that focus on maternal representations for women with depression and their children.

Profiles of psychosocial and clinical functioning in adolescence and risk for later depression and other outcomes

Most studies examining predictors of the onset of depression focus on variable centered regression methods that focus on the effects of multiple predictors. In contrast, person-centered approaches develop profiles of factors and these profiles can be examined as predictors of onset. Here, we developed profiles of adolescent psychosocial and clinical functioning among adolescents without a history of major depression. Data come from a subsample of participants from the Oregon Adolescent Depression Project who completed self-report measures of functioning in adolescence and completed diagnostic and self-report measures at follow-up assessments up to approximately 15 years after baseline. We identified four profiles of psychosocial and clinical functioning: Thriving; Average Functioning; Externalizing Vulnerability and Family Stress and Internalizing Vulnerability at the baseline assessment of participants without a history of depression at the initial assessment in mid-adolescence. Classes differed in the likelihood of onset and course of depressive disorders, experience of later anxiety and substance use disorders, and psychosocial functioning in adulthood. Moreover, the predictive utility of these classes was maintained when controlling for multiple other established risk factors for depressive disorders. This work highlights the utility of examining multiple factors simultaneously to understand risk for depression.

Depression among Mexican-origin mothers: Exploring the immigrant paradox.

Residential time in the United States appears to be a risk factor for mental health problems among Latinos, according to studies of the immigrant paradox, or a pattern of findings documenting better health for immigrants relative to U.S.-born Latinos. The present study used an acculturative stress model to examine the immigrant paradox with a sample of Mexican-origin mothers. Mothers [N = 175; age = 33.52 (10.75)], who were foreign- or U.S.-born, were categorized as more acculturated or less acculturated based on cluster analyses using demographic and language proficiency variables. The association between acculturative status and depressive symptoms approximately 9 months later was tested with two models: with both cultural stressors (i.e., perceived discrimination, acculturative stress) and cultural assets (i.e., familismo, ethnic identity) as mediators, and with the effects of cultural stressors moderated by cultural assets. Data provide some support for the validity of the mediation model. Less acculturated mothers reported (a) a stronger ethnic identity, which appears to have protected them from later depression, and (b) stronger familismo, which increased risk for later depression. In addition, discrimination was negatively related to later depression. We found support for the mediating role of cultural assets in the link between acculturation and depression, but some associations were in unexpected directions. These findings highlight the complexities of preserving core cultural characteristics among Mexican-origin mothers living in the United States, and the need to consider the context in which cultural processes unfold. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Irritability in ADHD: association with later depression symptoms

Attention-deficit/hyperactivity disorder (ADHD) and depression commonly co-occur. Identifying children with ADHD at risk for later depression may allow early intervention and prevention. Irritability is one possible mechanism linking these two disorders. It is common in ADHD and associated with later depression in the general population. Cross-sectional studies suggest an association between irritability and depression in ADHD, but longitudinal research is limited. This study followed up a clinical ADHD sample longitudinally to examine: (1) the association between childhood irritability and later depression symptoms, and (2) whether irritability persistence is important in this association. At baseline, parents (n = 696) completed semi-structured interviews about their child (mean age = 10.9), providing information on child psychopathology, including irritability. A subsample (n = 249) was followed up after a mean of 5.4 years. Parent-completed Mood and Feelings Questionnaires provided information on depressive symptoms at follow-up. Parent-rated structured diagnostic interviews provided information on ADHD diagnosis and irritability at follow-up. Regression analyses examined associations between (i) baseline irritability and depression symptoms at follow-up, and (ii) persistent (vs. remitted) irritability and depression symptoms at follow-up. Analyses controlled for age, gender, depression symptoms, anxiety, ADHD symptoms, and ADHD medication at baseline. Baseline irritability was associated with depression symptoms at follow-up, but the association attenuated after controlling for anxiety and ADHD symptoms. Persistent irritability was associated with depression symptoms at follow-up, after including all covariates. Children with ADHD with persistent irritability are at elevated risk of developing depression symptoms. They may be a target for early intervention and prevention of depression.

Irritability Trajectories, Cortical Thickness, and Clinical Outcomes in a Sample Enriched for Preschool Depression

Cross-sectional, longitudinal, and genetic associations exist between irritability and depression. Prior studies have examined developmental trajectories of irritability, clinical outcomes, and associations with child and familial depression. However, studies have not integrated neurobiological measures. The present study examined developmental trajectories of irritability, clinical outcomes, and cortical structure among preschoolers oversampled for depressive symptoms. Beginning at 3 to 5 years old, a sample of 271 children enriched for early depressive symptoms were assessed longitudinally by clinical interview. Latent class mixture models identified trajectories of irritability severity. Risk factors, clinical outcomes, and cortical thickness were compared across trajectory classes. Cortical thickness measures were extracted from 3 waves of magnetic resonance imaging at 7 to 12 years of age. Three trajectory classes were identified among these youth: 53.50% of children exhibited elevated irritability during preschool that decreased longitudinally, 30.26% exhibited consistently low irritability, and 16.24% exhibited consistently elevated irritability. Compared with other classes, the elevated irritability class exhibited higher rates of maternal depression, early life adversity, later psychiatric diagnoses, and functional impairment. Further, elevated baseline irritability predicted later depression beyond adversity and personal and maternal depression history. The elevated irritability class exhibited a thicker cortex in the left superior frontal and temporal gyri and the right inferior parietal lobule. Irritability manifested with specific developmental trajectories in this sample enriched for early depression. Persistently elevated irritability predicted poor psychiatric outcomes, higher risk for later depression, and decreased overall function later in development. Greater frontal, temporal, and parietal cortical thickness also was found, providing neural correlates of this risk trajectory.

Emotion dysregulation and functional connectivity in children with and without a history of major depressive disorder.

Recent interest has emerged in understanding the neural mechanisms by which deficits in emotion regulation (ER) early in development may relate to later depression. Corticolimbic alterations reported in emotion dysregulation and depression may be one possible link. We examined the relationships between emotion dysregulation in school age, corticolimbic resting-state functional connectivity (rs-FC) in preadolescence, and depressive symptoms in adolescence. Participants were 143 children from a longitudinal preschool onset depression study who completed the Children Sadness Management Scale (CSMS; measuring ER), Child Depression Inventory (CDI-C; measuring depressive symptoms), and two resting-state MRI scans. Rs-FC between four primary regions of interest (ROIs; bilateral dorsolateral prefrontal cortex [dlPFC] and amygdala) and six target ROIs thought to contribute to ER were examined. Findings showed that ER in school age did not predict depressive symptoms in adolescence, but did predict preadolescent increases in dlPFC-insula and dlPFC-ventromedial PFC rs-FC across diagnosis, as well as increased dlPFC-dorsal anterior cingulate cortex (dACC) rs-FC in children with a history of depression. Of these profiles, only dlPFC-dACC rs-FC in preadolescence predicted depressive symptoms in adolescence. However, dlPFC-dACC connectivity did not mediate the relationship between ER in school age and depressive symptoms in adolescence. Despite the absence of a direct relationship between ER and depressive symptoms and no significant rs-FC mediation, the rs-FC profiles predicted by ER are consistent with the hypothesis that emotion dysregulation is associated with abnormalities in top-down control functions. The extent to which these relationships might confer greater risk for later depression, however, remains unclear.

Childhood hunger and depressive symptoms in adulthood: Findings from a population-based study

BackgroundSeveral studies have linked childhood hunger to an increased risk for later depression. However, as yet, there has been little research on this relation in adults of all ages or whether there are sex differences in this association. The current study examined these issues using data from a national population-based sample. MethodsData were analyzed from 5095 adults aged 25–84 collected during the Estonian Health Interview Survey 2006. Information was obtained on the frequency of going to bed hungry in childhood and on depressive symptoms using the Emotional State Questionnaire (EST-Q). Logistic regression analysis was used to examine the association between hunger and depression while controlling for other demographic, socioeconomic and health-related variables. ResultsIn a fully adjusted model, going to bed hungry in childhood either sometimes or often was associated with significantly increased odds for depressive symptoms. When the analysis was stratified by sex the association was more evident in men where any frequency of childhood hunger was linked to adult depression while only women who had experienced hunger often had higher odds for depressive symptoms in the final model. LimitationsData on childhood hunger were retrospectively reported and may have been affected by recall bias. We also lacked information on potentially relevant variables such as other childhood adversities that might have been important for the observed associations. ConclusionChildhood hunger is associated with an increased risk for depressive symptoms among adults. Preventing hunger in childhood may be important for mental health across the life course.

Medication for Attention-Deficit/Hyperactivity Disorder and Risk for Depression: A Nationwide Longitudinal Cohort Study

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is associated with high rates of psychiatric comorbidity, including depression. However, it is unclear whether ADHD medication increases or decreases the risk for depression. MethodsWe studied all individuals with a diagnosis of ADHD born between 1960 and 1998 in Sweden (N = 38,752). We obtained data for prescription of ADHD medication, diagnosis of depression and other psychiatric disorders, and sociodemographic factors from population-based registers. The association between ADHD medication and depression was estimated with Cox proportional hazards regression. ResultsAfter adjustment for sociodemographic and clinical confounders, ADHD medication was associated with a reduced long-term risk (i.e., 3 years later) for depression (hazard ratio = 0.58; 95% confidence interval, 0.51–0.67). The risk was lower for longer duration of ADHD medication. Also, ADHD medication was associated with reduced rates of concurrent depression; within-individual analysis suggested that occurrence of depression was 20% less common during periods when patients received ADHD medication compared with periods when they did not (hazard ratio = 0.80; 95% confidence interval, 0.70–0.92). ConclusionsOur study suggests that ADHD medication does not increase the risk of later depression; rather, medication was associated with a reduced risk for subsequent and concurrent depression.

Development of Taking in the Good Based-Bibliotherapy Intervention Program in the Female Adolescent Depression Treatment

Adolescent depression is a severe mental health crisis and about 15% of adolescents are subject to a major depressive disorder (Young, Miller & Khan, 2010; Auerbach & Ho, 2012). Depression is related to remarkable hindrances in a person's overall functioning. Moreover, it enhances an increased risk of future serious depressive episodes and other related mental health confusion. The adverse outcomes, associated with adolescent depression (Ferguson & Woodward, 2002), are startling because of a direct pathway linking depression in adolescence to increased risk of later depression and anxiety'. Sex difference in depression is negligible prior to adolescence but there is a dramatic increase of depression in the prevalence, severity', and recurrence between the ages of 12 and 15 among girls (Hilt & Nolen-Hoeksema, 2009). It has been a question of interest among mental health professionals formally decades why girls are more affected than boys. Hyde and Mezulis (2008) proposed the Affect, Biology and Cognition (ABC) Model of Depression to identify depression in adolescent girls from a truly integrated developmental perspective in which affective, biological and cognitive vulnerabilities generate a form of cascade effect leading to adolescent depression and which should be a critical framework. Kerig, Ludlow, andWenar (2012) observed that biology comes back into play when early developing girls experience interpersonal stressors such as peer teasing and sexual harassment, which are the gender-specific forms of life stress that provoke a most recent element in this model. For girls with a basic propensity to depression, these negative experiences can upset the balance and act on their emotional and cognitive vulnerabilities to produce an ideal breeding ground for depression.World Health Organization (WHO) showed that the Philippines has the highest incidence of depression in South East Asia with 93 suicides for every 100,000 Filipinos. Department of Health (DOH) found that 15 out of 900 teenagers tried to commit suicide (DOH, 2015). Among the students surveyed in the Global School-based Health Survey in 2003-2004 (GSHS), 42% had felt sad or hopeless for two weeks or more during the past year; 17.15% had seriously considered committing suicide and 16.7% had actually made a plan about how they would do it. Moreover, females were more than twice as likely as males to have suicidal thoughts. CalmaBalderrama (2004) found that adolescents are at risk of major difficulty in the Philippines where Young people (aged 10-24) will number 32 million by 2025. Hindin and Gultiano (2006) stated that in the Philippines domestic violence is a major stressor causing the onset of depression among adolescents. Chakkyath (2012) emphasized the fact that the modem Filipino family undergoes various changes and transitions including marital separation and that the number of single parent families is increasing rapidly.Weisz, McCarty, and Valeri (2006) consider depression in children and adolescents tobe a significant, persistent, andrecurrent public health problem that undermines social and school functioning, generates severe family stress, and calls for significant assistance from the mental health services. In the psychotherapy treatment for depression, relevant models are found to be effective for adolescents and adults. The Behavioral Activation Model (BAM) is recurrently a top priority in treatment because depression is seen as a loss of response support. Interpersonal Psychotherapy (IP) offers a skill-building approach to specific forms of primary interpersonal issues such as grief, role disputes, role transitions and interpersonal deficits. Self-Management Therapy (SMT) addresses the six deficits in self control behavior of depressed persons or persons prone to depression (Rehm, 2010). According to Power (2013) Cognitive Behavioral Therapy (CBT) is a helpful intervention for depression and is the treatment of choice for many groups. …

Insulin-like growth factor 1 and risk of later depression in older people: prospective evidence from the English Longitudinal Study of Ageing

BackgroundDepressive disorders are a leading cause of mortality and morbidity. Whereas the role of psychosocial and behavioural predictors has been well examined, little is known about the biological origins of depression. In mice in which insulin-like growth factor 1 (IGF-1) was knocked out with viral vectors, there was evidence of increased signs of depression. In other studies, IGF-1 infusions in rodents had antidepressant properties. We tested the association of depression with IGF-1 in a large population-based study. MethodsIGF-1 concentrations were measured from serum taken at a nurse visit in 2008 from adults participating in the English Longitudinal Study of Ageing. Symptoms of depression were assessed in 2008 and 2012 with the eight item Center for Epidemiological Studies Depression Scale (CES-D) and diagnosis was based on self-report. Cross-sectional analyses were carried out on measures collected at baseline, in 2008. Outcome measures in longitudinal analyses were new reports of depression symptoms and physician-diagnosed depression in 2012. We used logistic regression to test both the cross-sectional and longitudinal associations, adjusted in a stepwise manner for age, anthropometric measures, comorbidities, psychosocial factors, and health behaviours. FindingsSamples from 6017 adults were included (mean age 65·7 years [SD 9·3], range 50–99; mean IGF-1 15·9 nmol/L [SD 5·7]). Mean CES-D score at baseline was 1·2 (SD 1·8). In cross-sectional and longitudinal analyses, the association between IGF-1 and symptoms of depression followed a U-shaped pattern—ie, lower and higher concentrations of IGF-1 were associated with an increased risk of depression, whereas the lowest risk was seen around median concentrations. In women, with the lowest quintile of IGF-1 as the referent, the age-adjusted odds ratios for increasing quintiles of IGF-1 in longitudinal analysis were 0·88 (95% CI 0·60–1·29), 0·77 (0·51–1·16), 0·84 (0·53–1·35), and 0·95 (0·60–1·50) (p for curve=0·027). Corresponding results in men were 0·51 (0·28–0·91), 0·50 (0·27–0·92), 0·63 (0·35–1·15), and 0·63 (0·35–1·13) (p for curve=0·002). These associations were partly attributable to comorbidities, adverse socioeconomic circumstances, and psychosocial and behavioural factors. Similar results were observed for the association between IGF-1 and physician-diagnosed depression. InterpretationIn the present study, which is the first to our knowledge to use validated measures of depression, there was some evidence that low and high concentrations of IGF-1 were associated with a slightly elevated risk of diagnosed depression and symptoms of depression. Further studies are needed to examine whether the observed association is causal and whether normalising IGF-1 concentrations with drugs or IGF-1 infusions could be useful and safe in the treatment of depression in older people. FundingThis work was supported by an Economic and Social Research Council–Medical Research Council studentship (awarded to SC).

Prenatal Stress as a Risk Factor for Major Depression: an Investigation On Therapeutic Intervention with Antipsychotics and the Role of Social Stimuli During Periadolescence

Introduction Children exposed to adverse psychosocial experiences, or early parental loss, are at an increased risk for later depression. Preclinical data indicate that epigenetic regulation of gene expression mediates the effects of early life stress (ELS) on adult behavior and health. In addition to stress-responsive systems (glucocorticoids), the expression of neurotrophic factors in the brain may be regulated epigenetically in the context of ELS contributing to mental health, or systemic disease at adulthood. Objectives In order to investigate epigenetic changes in target genes involved in the long-term effects of early adversity on psychopathology, we have set up an animal model (rat) of prenatal stress. Results show that ELS leads to a long-term down-regulation in the expression of target genes, such as the receptor for glucocorticoids and Brain derived neurotrophic factor (BDNF), thus mimicking adult conditions characterizing increased risk for psychopathology. Behavioral and neuroendocrine changes accompanying these differences in gene expression suggest increased stress responsivity, as well as impaired social behavior. Chronic treatment with the antipsychotic lurasidone during adolescence was able to counteract the changes in BDNF expression produced by ELS, preventing the down-regulation of long 3’-UTR BDNF levels that occurred from late adolescence into young adulthood. Furthermore, interaction with a non-stressed rat conspecific ameliorated behavioural dysfunction. Overall data indicate potential therapeutic targets to counteract prenatal stress and suggest that the perinatal environment can act as a potential buffer for stressful conditions occurring around birth. Support: ERA net-NEURON 'Poseidon” and Fondazione Cariplo 2012.

Developmental pathways from childhood conduct problems to early adult depression: findings from the ALSPAC cohort.

BackgroundPathways from early-life conduct problems to young adult depression remain poorly understood.AimsTo test developmental pathways from early-life conduct problems to depression at age 18.MethodData (n = 3542) came from the Avon Longitudinal Study of Parents and Children (ALSPAC). Previously derived conduct problem trajectories (ages 4-13 years) were used to examine associations with depression from ages 10 to 18 years, and the role of early childhood factors as potential confounders.ResultsOver 43% of young adults with depression in the ALSPAC cohort had a history of child or adolescent conduct problems, yielding a population attributable fraction of 0.15 (95% CI 0.08-0.22). The association between conduct problems and depression at age 18 was considerable even after adjusting for prior depression (odds ratio 1.55, 95% CI 1.24-1.94). Early-onset persistent conduct problems carried the highest risk for later depression. Irritability characterised depression for those with a history of conduct problems.ConclusionsEarly-life conduct problems are robustly associated with later depressive disorder and may be useful targets for early intervention.

Suicidal Adolescents’ Experiences With Bullying Perpetration and Victimization during High School as Risk Factors for Later Depression and Suicidality

This is the first study to examine the extent to which frequent involvement in high-school bullying (as a bullying perpetrator, victim of bullying, or bully-victim) increases the risk for later depression and suicidality beyond other well-established risk factors of suicide. The study included 96 students who reported being a bully, a victim, or a bully-victim, and also reported depression, suicidality, or substance problems during an initial suicide screen. These students were interviewed 2 years later and were compared with 142 youth identified during the initial screen as "suicide-at-risk" by virtue of their depression, suicidal ideation, attempts, and substance problems, but who did not report any involvement in bullying behavior. Students who reported both bullying others and other suicide-related behaviors at baseline had higher suicide ideation and were more functionally impaired at follow-up than students who reported suicide-related behaviors but were not involved in bullying. Preventive efforts in high school should target those children who are characterized by both psychological disturbance and bullying, especially the frequent bullies.

Maternal versus paternal physical and emotional abuse, affect regulation and risk for depression from adolescence to early adulthood

ObjectiveCurrent research has established that depression is a common outcome of child abuse. The current study extends previous research by examining the relationship between parental emotional and physical abuse and adolescents’ depressive symptoms using a prospective longitudinal design. We anticipated that this relationship would be mediated through problems in affect regulation, consistent with the view that the presence of abuse in the parent–child relationship would derail the development of adaptive affect regulation. Finally, we further examined gender-linked transmission of risk by considering both the gender of the parent perpetrating abuse and the gender of the adolescent. MethodsA sample of high-risk youth (N=179; 46% female) from juvenile justice and clinical settings completed assessments regarding maternal and paternal physical and emotional abuse, affect dysregulation and depressive symptoms during three time points over the course of five years. ResultsThe relationship between maternal abuse and depressive symptoms was partially mediated through affect dysregulation at Time 1 and fully mediated at Time 2. In addition, adolescents’ reports of maternal abuse at Time 1 predicted their depressive symptoms in early adulthood even after accounting for the partial mediating role of affect dysregulation at each of the three timepoints of the study. It was also found that paternal abuse was related to depressive symptoms through an indirect relationship with affect dysregulation for males, but not females. ConclusionThese findings suggest that adolescence may be a sensitive developmental period wherein abuse experiences have profound direct and mediated influences on the risk for later depression. Adolescents or young adults who have experienced abuse may benefit from interventions designed to build affect regulation skills.

High School Bullying as a Risk for Later Depression and Suicidality

This is the first study to examine whether high school students experiencing frequent bullying behaviors are at risk for later depression and suicidality. A total of 236 students who reported frequent bullying behavior without depression or suicidality during a suicide screening were interviewed 4 years later to reassess depression, suicidal ideation, attempts, substance problems, and functional impairment and were compared to at-risk youth identified during the screen, including 96 youth who also experienced bullying behavior. Youth who only reported frequent bullying behaviors (as bullies, victims, or both) did not develop later depression or suicidality and continued to have fewer psychiatric problems than students identified as at-risk for suicide. Students who experienced bullying behaviors and depression or suicidality were more impaired 4 years later than those who had only reported depression or suicidality. Thus, assessment of bullying behaviors in screening protocols is recommended.

Very Early Predictors of Adolescent Depression and Suicide Attempts in Children With Attention-Deficit/Hyperactivity Disorder

Major depression and dysthymia in adolescence are associated with substantial disability, need for mental health services, and risk for recurrence. Concrete suicidal ideation and attempts during adolescence are particularly associated with significant distress, morbidity, and risk for completed suicide. To test the hypothesis that young children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for depression and suicidal ideation and attempts during adolescence and to identify early predictors of which young children with ADHD are at greatest risk. Prospective follow-up study. Chicago, Illinois, and Pittsburgh, Pennsylvania. Patients A cohort of 125 children who met DSM-IV criteria for ADHD at 4 to 6 years of age and 123 demographically matched comparison children without ADHD were prospectively followed up in 7 structured diagnostic assessments of depression and suicidal behavior in assessment years 6 through 14, spanning 9 through 18 years of age. DSM-IV criteria for depressive disorders and suicidal behavior. Children with ADHD at 4 to 6 years of age were at greatly increased risk for meeting DSM-IV criteria for major depression or dysthymia (hazard ratio,4.32) and for attempting suicide (hazard ratio,3.60) through the age of 18 years relative to comparison children. There were marked variations in risk for these outcomes among children with ADHD, however. Within the ADHD group, children with each subtype of ADHD were at risk but for different adverse outcomes. Girls were at greater risk for depression and suicide attempts. Maternal depression and concurrent child emotional and behavior problems at 4 to 6 years of age predicted depression and suicidal behavior. All subtypes of ADHD in young children robustly predict adolescent depression and/or suicide attempts 5 to 13 years later. Furthermore, female sex, maternal depression, and concurrent symptoms at 4 to 6 years of age predict which children with ADHD are at greatest risk for these adverse outcomes. Identifying high-risk young children with ADHD sets the stage for early prevention trials to reduce risk for later depression and suicidal behavior.

Childhood Stimulant Treatment and Teen Depression: Is There a Relationship?

Recent preclinical data have raised the possibility that prepubertal treatment of attention-deficit/hyperactivity disorder (ADHD) with stimulant medication might increase risk for later depression. The current longitudinal study investigated whether children with ADHD who were treated with stimulant medication displayed heightened levels of adolescent depression. Adolescents diagnosed with ADHD during childhood who had received a minimum of 1 year of treatment with stimulant medication were compared to adolescents with a childhood history of ADHD who were never treated with stimulants and a demographically matched comparison group on self-reports of depressive symptoms and diagnoses of depressive disorders. Both subgroups with childhood ADHD reported significantly higher dimensional ratings of depression and categorical rates of depressive disorders relative to the comparison group (all p<0.05), yet those who were and were not medicated did not differ from one another. Results indicate that, while childhood ADHD increases risk for adolescent depression, stimulant treatment for ADHD neither heightens nor protects against such risk.