Interparental Conflict and Adolescent Depressed Mood: The Role of Family Functioning

Family functioning was investigated as a mediator between interparental conflict and adolescent depressed mood among adolescents living in two-parent and divorced families. Data were collected three times, with one year intervals. At the initial interview, adolescents were, on the average, 15.5 years old. Two types of interparental conflict were assessed: interparental conflict involving arguments about the adolescent, and arguments focused on the parents' behaviors. The results confirmed that family functioning mediated the effects of parent issue/interparental conflict, but not adolescent issue/interparental conflict. This was most evident for girls than boys. Implications of the findings for research and practice are discussed.     

Specificity in the Relationships Between Stressors and Depressed Mood Among Adolescents: The Roles of Gender and Self - Efficacy

The study's aim was to test for hypothesised specificity in the relationships of stressors (interpersonal stress and worries about daily living) with depressed mood among Romanian adolescents. Six hundred and thirty adolescents in grades 7, 9 and 11 in Bucharest schools participated. Structural equation models assessed the degree to which effects of stressors on depressed mood were mediated through social support and self-efficacy, and moderated by gender and self-efficacy. Neither social support nor self-efficacy had direct or mediating roles in predicting depressed mood among girls. Among boys, social support and self-efficacy played significant roles in the connection between interpersonal stress and depressed mood. Among girls, daily worries were associated with depressed mood only among those with low self-efficacy, and interpersonal stress was associated with depressed mood only among those with high self-efficacy. The data presented here show that different stressors have different relationships to a single outcome — depressed mood — conditioned by gender and self-efficacy.     

Suicidal ideations and attempts among adolescents subjected to childhood sexual abuse and family conflict/violence: The mediating role of anger and depressed mood

Based on a sample of 9085 16- to 19-year-old students attending all high schools in Iceland in 2004, the current study examines depressed mood and anger as potential mediators between family conflict/violence and sexual abuse, on the one hand, and suicidal ideations and suicide attempts on the other. Agnew's general strain theory provides the theoretical framework for the study. Structural equation modelling (SEM) was conducted allowing explicit modelling of both direct and mediating effects using observed and latent variables. The findings showed that both depressed mood and anger mediated the relationship between family conflict/violence and sexual abuse and suicidal attempts. However, when testing the mediating pathways between sexual abuse and family conflict/violence and suicidal ideations, only depressed mood but not anger turned out to be a significant mediator. The authors discuss how these finding may inform and facilitate the design and development of interventions to reduce the likelihood of suicide attempts among young people.     

Characteristics of adolescents with school refusal

OBJECTIVE: To describe the characteristics of young people presenting with school refusal to a child and adolescent psychiatric unit and examine differences between those admitted for inpatient treatment and the rest. METHOD: One hundred and ninety-two adolescents who had been assessed or treated for school refusal between 1994 and 1998 at the Rivendell Unit, Sydney, Australia were identified. An instrument was developed and used to gather data from files. Diagnoses were made by the consensus of two of the investigators using DSM IV criteria from all sources of information. RESULTS: The commencement of school refusal generally occurred in the first 2 years of high school. School refusers had a high prevalence not only of anxiety, but also of mood and disruptive behaviour disorders. A family history of psychiatric illness was present in over half the sample. There were no differences between those subsequently admitted as inpatients and the rest in terms of symptom scores, family composition, family conflict, family separation or history of abuse. Those admitted for inpatient treatment were more likely to have a diagnosis of mood disorders and comorbid diagnoses and to have a maternal history of psychiatric illness. CONCLUSIONS: School refusal in adolescence can be a symptom of a variety of disorders, particularly anxiety and mood disorder. Treatment programs need to be geared to the range of diagnoses which occur in this patient group and to the various circumstances associated with the onset of the problem.     

EEG asymmetry: relationship to mood and risk for alcoholism in Mission Indian youth.

BACKGROUND: Left frontal electroencephalogram (EEG) alpha dominance has been hypothesized to be related to depressed mood as well as aversive motivation and emotion. However, few studies have prospectively evaluated electroencephalogram asymmetry during development in high-risk adolescents and children. METHODS: EEG alpha asymmetry was investigated in 134 Mission Indian children who were between 7 and 13 years of age. The relationships between electroencephalogram alpha asymmetry and age, gender, parental history of alcohol dependence, Native American heritage, and mood/ approach behaviors were explored. RESULTS: No significant relationship was found between frontal alpha asymmetry and age, gender, or behavioral measures of depressed mood and/or approach behaviors. However, participants with > or = 50% Native American heritage were significantly more likely to have greater electroencephalogram alpha power in the left frontal cortex than in the right. CONCLUSIONS: The present findings suggest that the hypothesized relationship between EEG alpha asymmetry and measures of depressed mood, aversive motivation, and emotion may not be universal in all age or ethnic groups. Additionally, though the relationship between greater degrees of Native American heritage and alpha asymmetry are not as yet clear, we suggest it may be more related to substance abuse than depression in this population of Mission Indians.     

Depressive disorders in children and adolescents

Depressive disorders in children and adolescents are valid clinical entities which can be identified using adult diagnostic criteria. Recent research has resulted in significant progress in the areas of diagnosis, epidemiology, family pathology, pharmacokinetics and psychopharmacology. Many rating instruments have been developed to screen, diagnose and measure changes of depression in children and adolescents. The prevalence of depressive disorders in prepubertal children is about 2% and in adolescents about 5%. Depressive episodes are usually of long duration, with high rates of relapse. These relapses are usually associated with school, family and social failure. Follow-up studies of depressed adolescents indicated that about half of the patients continue to suffer from mood disturbances and psycho-social adaptational problems. In North America suicidal behaviour in adolescents has increased 300% in the past 30 years. However, its relationship to depression is more complex than in adults. There is a significant excess of affective illness and alcoholism in the families of depressed adolescents. Similarly, there is a high rate of impairment among children of parents with affective disorders. During depressive episodes, prepubertal children show abnormalities of growth hormone and cortisol secretion. However, DST findings are contradictory. Polysomnographic findings in childhood depression appear unremarkable. In adolescent depression these findings are similar to those in depressed adults. Biological manifestations of depressive disorders may be significantly affected by developmental and hormonal changes. Antidepressants have been effective in the therapy of several disorders in childhood. These include enuresis, school phobias, attention deficit, conduct disorders and obsessive-compulsive disorders. Open drug studies suggest that antidepressants are useful in depressed children.(ABSTRACT TRUNCATED AT 250 WORDS)     

Quarrelsome family environment as an enhanced factor on child suicidal ideation

Suicide is a leading cause of death in adolescents, and develops through a process leading from depression to suicidal ideation and self-injury. In this study, we analyzed and compared suicidal ideation among elementary school children from distinct families and school-related backgrounds. We conducted a cross-sectional study to investigate suicidal ideation in elementary school children in Miaoli County of Western Taiwan. Our study included 979 eligible participants and collected data, including suicidal ideation, depression scores, demographic characteristics, and family and school variables. The results revealed that 175 students (17.9%) exhibited depression, and 146 students (14.9%) had contemplated suicide. A quarrelsome family environment was found to be an important independent factor in child suicidal ideation after controlling for depression status. Children living in quarrelsome families showed a 3.7-fold risk of suicidal ideation compared with children in a harmonious family. Among boys living in quarrelsome family environments, suicidal ideation risk was 7.4-fold higher than for girls living in harmonious families. A 27-fold high increased suicidal ideation risk was also observed among the depressed children who living in the quarrelsome family environment, compared with the non-depressed in the harmonious family environment. This study provides novel evidence indicating the enhanced effects of a quarrelsome family environment combined with depression symptoms and among boys on suicidal ideation. These findings suggest of quarrels in a family environment playing an important role on elementary school children's psychological development, and may help parents in improving their mental health.     

Association between lifestyle activity and depressed mood among home-dwelling older people: a community-based study in Japan

In the community-based cross-sectional study, we investigated patterns of lifestyle activities among older people and examined the association between specific types of lifestyle activity and depressed mood status. The participants were 656 men and women aged 65 or older in 2004 who lived in a rural town in Japan, neither institutionalized nor hospitalized and who did not have symptoms of dementia. We found that less interaction with neighbors, society and friends was highly associated with depressed mood for men. Additionally, although they were physically active in gardening/farming, it did not necessarily mean that they were mentally healthy if they did not have close ties with friends, family and children/grandchildren. For women, it seemed important to engage in several types of activities relating to society, leisure and children/grandchildren to be in less depressed mood. Even if they were socially inactive, if they had frequent contact with family and children/grandchildren or going out for pleasure they were less likely to be depressed. Distinguishing gender differences in lifestyle activity patterns and the association of activities with depressed mood will help to guide the development of depression intervention programs.     

Autism spectrum disorder among first-visit depressed adult patients: diagnostic clues from backgrounds and past history

ObjectiveThe present study aimed to extract discriminating indicators for diagnosis of autism spectrum disorder (ASD) from personal backgrounds and past history among depressed adult outpatients.MethodsSubjects were 430 depressed adults, consisting of patients with ASD (n= 70) and those without ASD (n= 360). Group comparison and discriminant analysis was conducted with regard to backgrounds (age, gender, education, marriage, living alone, physical diseases and family history of mood disorders) and past history (school non-attendance, bullied experience, psychotic-like experiences, conduct problems, suicide-related behaviors and interpersonal friction).ResultsSix discriminating indicators (interpersonal friction, bullied experience, psychotic-like experiences, age under 32 years, school non-attendance and university educational level) were identified by stepwise discriminant analysis (P< .001). Absence of the first 4 indicators almost excluded ASD diagnosis with the highest negative predictive value (98%) and the least negative likelihood ratio (0.11) whereas one or more out of these 4 indicators showed low positive predictive value (32%) despite high sensitivity (93%).ConclusionsThe abovementioned 4 indicators may be useful clues to cover possible ASD subjects among depressed adults although further detailed ASD focused diagnostic procedure is absolutely necessary to specify true ASD subjects. Meanwhile, absence of these 4 indicators is probably helpful to rule out ASD diagnosis.     

Anhedonia and depressed mood in adolescence: course,stability, and reciprocal relation in the TRAILS study

Adolescence is marked by increases in the incidence of major depression (MDD), a disorder recognized as one of the leading causes of disability. Anhedonia and depressed mood predict both onset and chronicity of major depression (MDD), but have never been studied together longitudinally in the general adolescent population. The present study examined (1) the course and the stability of anhedonia and depressed mood and (2) their cross-sectional and longitudinal relations during adolescence. The study cohort consisted of 2,230 adolescents. Anhedonia and depressed mood were assessed with items of the YSR and ASR self-report forms at four measurement waves between ages 11 and 19. The proportion of adolescents reporting anhedonia decreased between ages 11 and 19, while the proportion of female adolescents reporting depressed mood increased. The stability of anhedonia and the cross-sectional association between anhedonia and depressed mood was larger at age 19 than at age 11. We found a mutual association between anhedonia and depressed mood without a clear temporal sequence. The presence of anhedonia at the end of adolescence might put adolescents at increased risk for MDD given the increasingly stronger stability and association with depressed mood. This suggests that it becomes more difficult to prevent MDD during late adolescence compared with early and middle adolescence.