Continuity, comorbidity and longitudinal associations between depression and antisocial behaviour in middle adolescence: a 2-year prospective follow-up study

The study investigated continuity, comorbidity and longitudinal associations between depression Beck depression inventory (RBDI) and antisocial behaviour Youth self-report (YSR) in middle adolescence. Data were used from a community sample of 2070 adolescents who participated in a 2-year prospective follow-up study. The results indicate that both depression and antisocial behaviour had considerable continuity, and concurrent comorbidity between these disorders was strong. In contrast to several previous studies, antisocial behaviour did not predict subsequent depression, but conversely, depression predicted subsequent antisocial behaviour among girls. Among boys history of depression seemed to protect from subsequent antisocial behaviour. Gender differences in longitudinal associations are discussed.     

Secrets from friends and parents: Longitudinal links with depression and antisocial behavior

Keeping secrets from parents is associated with depression and antisocial behavior. The current study tested whether keeping secrets from best friends is similarly linked to maladjustment, and whether associations between secrecy and maladjustment are moderated by the quality of the friendship. Adolescents (N = 181; 51% female, 48% white, non-Hispanic, 45% African American) reported their secrecy from parents and best friends, the quality of their parent–adolescent relationships and best friendships, and their depression and antisocial behavior at ages 12 and 13. Keeping more secrets from best friends was associated with more depression, but not with more antisocial behavior, when controlling for earlier adjustment, secrecy from parents, and the quality of the friendship. For girls associations between maladjustment and secrecy were conditioned by the quality of the relationships and whether secrets were kept from parents and friends. Discussion argues for expanding the study of secrecy in adolescence beyond the parent–child dyad.     

Maternal depression and children's antisocial behavior: nature and nurture effects

BACKGROUND: Children of depressed mothers have elevated conduct problems, presumably because maternal depression disrupts the caregiving environment. Alternatively, the association between maternal depression and children's antisocial behavior (ASB) may come about because (1) depressed women are likely to have comorbid antisocial personality traits, (2) depressed women are likely to mate and bear children with antisocial men, or (3) children of depressed mothers inherit a genetic liability for psychopathology. METHOD: We used data from the E-Risk Study, a representative British cohort of 1116 twin pairs assessed at 5 and 7 years of age. We tested for environmental mediation of the association between maternal depression during the children's first 5 years of life and children's ASB at age 7 years, free from familial liability for ASB. RESULTS: Maternal depression occurring after, but not before, the twins' birth was associated with child ASB and showed a significant dose-response relationship with child ASB at 7 years of age. Parental history of ASPD symptoms accounted for approximately one third of the observed association between maternal depression and children's ASB, but maternal depression continued to significantly predict children's ASB. Intraindividual change analyses indicated that children exposed to their mother's depression between ages 5 and 7 years showed a subsequent increase in ASB by age 7 years. The combination of depression and ASPD symptoms in mothers posed the greatest risk for children's ASB. CONCLUSIONS: Studies ignoring genetic transmission overestimate social transmission effects because both genetic and environmental processes are involved in creating risk for ASB in children of depressed mothers. Interventions for depressed mothers aiming to reduce conduct problems in their children should address parents' antisocial personality, as well as mothers' depression.     

Heart rate level and antisocial behavior in children and adolescents: a meta-analysis

OBJECTIVE: To assess whether antisocial children are characterized by low heart rate. METHOD: A meta-analysis was conducted on 45 independent effect sizes of the resting heart rate-antisocial behavior relationship obtained from 40 studies meeting inclusion and exclusion criteria. Studies were conducted between 1971 to 2002 using a total of 5,868 children. A secondary meta-analysis was also conducted on heart rate during a stressor. RESULTS: Significant overall effect sizes were found for both resting heart rate (d = -0.44, p <.0001) and heart during a stressor (d = -0.76, p <.0001). Gender, age, method of recording, use of psychiatric control group, recruitment source, concurrent versus prospective nature of testing, and source of behavioral rating all failed to moderate this relationship. CONCLUSIONS: Low resting heart rate appears to be the best-replicated biological correlate to date of antisocial behavior in children and adolescents. Several theoretical interpretations of this relationship are outlined that should be examined in future studies.     

24-hour cortisol measures in adolescents with major depression: a controlled study

Plasma cortisol levels were determined every 20 min for 24 hr in depressed adolescents (n = 27) meeting research diagnostic criteria (RDC) for major depressive disorder (MDD) and normal controls (n = 32). All subjects were between 12 and 18 years of age, at least Tanner Stage III of sexual development, medically healthy, and medication free at the time of the studies. The results showed that cortisol secretory patterns were very similar between the two groups with the exception that the depressed adolescents showed significantly elevated cortisol levels around sleep onset (a period when cortisol is usually suppressed). Subgroup analyses showed that most of these differences were contributed by the suicidal/inpatient depressed adolescents. The cause of the elevated cortisol during the normally quiescent period warrants further investigation and may be related to other biological disturbances around sleep onset (difficulty initiating sleep, reduced rapid eye movement (REM) latency, and alterations in sleep-stimulated growth hormone secretion).     

Responsiveness in psychotherapy with antisocial adolescents

Creating a "therapeutic situation" is a necessary condition for any type of psychotherapy. Antisocial adolescents often come from disturbed and chaotic backgrounds and present as behaviorally disturbed and deprived. One of the necessary ingredients in creating a therapeutic situation with them includes being responsive to them. The meaning of responsiveness, within a psychodynamic frame, is defined and its applications and limitations are explored.     

Suicidal ideation and attempts in adolescents: associations with depression and six domains of self-esteem

This study aimed to disentangle the influence of depression and self-esteem on suicidal behaviour in adolescence. Grades 8 and 11 students in Cape Town, South Africa (n = 939) completed questionnaires assessing suicidal ideation and behaviour, depression, and self-esteem with respect to family, peers, school, sports/athletics, body image and global self-worth. Data were analysed using a series of multinomial logistic regression models adjusted for gender, grade, race and the sampling strategy. Results indicated that depression and low self-esteem in the family context were independently associated with suicide ideation and attempts. Moreover, low family self-esteem significantly differentiated suicide attempters from ideators. Screening for depression and low self-esteem in the family context is discussed as a possible strategy for helping to identify adolescents at risk for suicide attempts.     

Longitudinal follow-up of adolescents with late-onset antisocial behavior: a pathological yet overlooked group

OBJECTIVE: Antisocial behavior that begins in mid- to late adolescence does not fit into commonly accepted taxonomies of antisocial behavior, yet it clearly exists. This study examined how this course of antisocial behavior compares with persisting (beginning by early adolescence and continuing through late adolescence) and desisting (stopping by mid-adolescence) antisocial behavior in terms of risk for later substance dependence and background risk factors (gender, IQ, socioeconomic status, parental antisocial behavior, and parental divorce). METHOD: A population-based sample of twins from the Minnesota Twin Family Study, evaluated at ages 17 and 20, was used. RESULTS: The results indicated that youths with late onsets were similar to those with persisting antisocial behavior and that both groups were at higher risk of later nicotine, alcohol, and cannabis dependence than controls; both also had similarly high levels of background risk factors. The late-onset group included a significant overrepresentation of females, whereas the persisting and desisting groups included more males. CONCLUSIONS: Late-onset antisocial behavior has many of the same negative correlates of persisting antisocial behavior but includes significantly more females. Although they are excluded from the diagnosis of antisocial personality disorder, these youths have clinically significant problems similar to those with this diagnosis.     

Case study: longitudinal treatment of adolescents with depression and inflammatory bowel disease

OBJECTIVE: To assess longitudinal maintenance of improvements in depression, anxiety, global functioning, and physical health perception in 11 adolescents at 6 and 12 months following completion of manual-based cognitive-behavioral therapy. METHOD: Standardized instruments assessed follow-up changes in depression, anxiety, physical health, and global psychological functioning. RESULTS: At both assessments, 10 adolescents did not meet criteria for mood disorders. Improvements in depression, anxiety, global functioning, and physical health perceptions at completion of the cognitive-behavioral therapy were maintained during the 12-month period. Additional cognitive-behavioral therapy sessions (mean = 4.36; SD = 4.37) and psychopharmacology (n = 5) were required during the follow-up period. CONCLUSIONS: CBT with maintenance sessions and medication offers promise to adolescents facing comorbid depressive and physical disorders.     

Predicting antisocial behavior among latino young adolescents: an ecological systems analysis

The authors used data from a national sample of 420 Latino young adolescents to examine multiple predictors of antisocial behavior within an ecological systems framework. They found that boys and youths who lived a higher proportion of their life in poverty exhibited higher levels of antisocial behavior, and mothers' acculturation was associated with lower levels. Neighborhood and school environments, exposure to deviant peer pressure, and 3 parenting practices--parent-youth attachment, physical punishment, and mothers' monitoring--were related to Latino youth antisocial behavior. Neighborhood quality and peer pressure explained the relation between poverty and an increased risk for antisocial behavior.     

Reciprocal longitudinal associations between substance use and child-to-parent violence in adolescents

Child-to-parent violence (CPV) is a type of violence that has received little attention despite its increasing rates in Western countries. Several models state that substance abuse constitutes a risk factor for aggressive behavior and that relationships among these variables can be reciprocal. In this study, the temporal relationships among substance use and physical and psychological CPV were examined. A sample of 981 adolescents (mean age = 15.22 years, SD = 1.2 years) completed measures of substance use and CPV at three time points (T1, T2, and T3) spaced 6 months apart. The results indicated that T1 levels of substance use predicted an increase in psychological CPV at T2 and that T2 levels of substance use predicted an increase in physical CPV at T3. Additionally, several mediational mechanisms emerged between substance use at T1 and CPV at T3. Neither physical nor psychological CPV predicted an increase in substance use at any time. Multiple comparisons indicated that the predictive association between substance use and physical aggression against parents was significant only in boys. These findings suggest that preventive programs for CPV should include specific components for reducing substance use.     

Cross-sectional and longitudinal associations between psychotic and depressive symptoms in depressed adolescents

Adults with major depressive disorder (MDD) with psychotic features (delusions and/or hallucinations) have more severe symptoms and a worse prognosis. Subclinical psychotic symptoms are more common in adolescents than adults. However, the effects of psychotic symptoms on outcome of depressive symptoms have not been well studied in adolescents. Depressed adolescents aged 11–17 with and without psychotic symptoms were compared on depression severity scores at baseline and at 28- or 42-week follow-up in two large UK cohorts. Psychotic symptoms were weakly associated with more severe depression at baseline in both cohorts. At follow-up, baseline psychotic symptoms were only associated with depressive symptoms in one sample; in the other, the effect size was close to zero. This supports the DSM5 system of psychotic symptoms being a separate code to severity rather than the ICD10 system which only allows the diagnosis of psychotic depression with severe depression. There was no clear support for psychotic symptoms being a baseline marker of treatment response.

     

Bullying perpetration and victimization associations to suicide behavior: a longitudinal study

Previous studies have reported a longitudinal association between cybervictimization and suicidal thoughts and behavior. However, the relationship between cyber-perpetration and prospective suicide risk remains unclear. The sample was composed of 2150 at-risk adolescents (mean age 15.42), enrolled in Vocational Education and Training high schools in Israel. Cyberbullying, traditional bullying, depression, hostility, serious suicidal ideations, and suicide attempts were assessed through self-report questionnaires at the beginning of the school year and one year later. All types of victimization and preparation were cross-sectionally associated with suicide ideation and attempts. Longitudinal associations were found between cyber-perpetration and suicidal ideation/attempts. Cyber-perpetrators were found to be over twice more likely to report serious suicidal ideation (OR = 2.04) or attempt suicide (OR = 2.64) in the subsequent year compared to noninvolved adolescents. These associations were significant even after adjusting for baseline depression, hostility, and traditional bullying. Traditional bullying perpetration was prospectively associated with suicide attempts. Traditional victimization was cross-sectionally associated with suicide ideation and attempts but not prospectively. Cybervictimization was prospectively associated with suicide ideation but not to suicide attempts. The findings demonstrate the prospective risk of involvement in bullying in regard to suicide ideation and behavior. Cyberbullying was found to be a somewhat differentiated phenomena from traditional bullying.

     

Nocturnal cortisol, thyroid stimulating hormone, and growth hormone secretory profiles in depressed adolescents

Twelve depressed adolescents and 12 controls matched for age, sex, Tanner stage, time of menstrual cycle (females), weight, and time of year assessed were studied over 3 nights. Measurements for cortisol, thyroid stimulating hormone, and growth hormone were made on serum collected at 10 P.M., 12 midnight, 1 A.M., 2 A.M., 3 A.M., 4 A.M., and 6 A.M. in eight pairs and every 20 minutes from 8 P.M. to 7 A.M. in four pairs. Cortisol secretion did not significantly differentiate the groups. Thyroid stimulating hormone secretion was significantly elevated in the depressed group at one time point. Growth hormone secretion significantly differentiated the two groups at most time points, and the depressed adolescents significantly hypersecreted growth hormone (area under the curve). Implications for the diagnosis, etiology, and treatment of adolescent depression are discussed.     

Parenting and adolescent antisocial behavior and depression: evidence of genotype x parenting environment interaction

BACKGROUND: Little is known about the interplay of genotypes and malleable risk factors in influencing adolescent psychiatric symptoms and disorders. Information on these processes is crucial in designing programs for the prevention of psychiatric disorders. OBJECTIVE: To assess whether latent genetic factors and measured parent-child relationships interact (G x E) in predicting adolescent antisocial behavior and depression. DESIGN: We characterized risk of antisocial behavior and depression in adolescents by means of a genetically informed design. We used in-home questionnaire and observational measures of adolescent outcomes and environmental moderators (parenting), and a latent variable behavior genetic analytic model. SETTING: A nationally distributed sample recruited from random-digit dialing and national market panels. PARTICIPANTS: A total of 720 families with at least 2 children, 9 through 18 years old, stratified by genetic relatedness (monozygotic and dizygotic twins, full biological siblings in nondivorced and stepfamilies, and half-siblings and biologically unrelated siblings in stepfamilies). MAIN OUTCOME MEASURES: Antisocial behavior and depressive symptoms. RESULTS: There was an interaction of genotype and both parental negativity and low warmth predicting overall antisocial behavior, as well as aggressive and nonaggressive forms of antisocial behavior, but not depression. Genetic influence was greater for adolescent antisocial behavior when parenting was more negative or less warm. Genotype-environment correlation was partialled out in the analysis and thus did not account for the results. CONCLUSION: This study demonstrates, on the basis of careful measurement and appropriate analytic methods, that a continuous measure of parenting in the normative range moderates the influence of genotype on antisocial behavior.     

Corticotropin-releasing hormone: possible role in eating disorders

It has been hypothesized that corticotropin-releasing hormone (CRH) is an integral mediator in the pathophysiology of anorexia nervosa. This hypothesis is based on a) studies on patients with eating disorders which found elevated CRH levels in the cerebrospinal fluid and an abnormal response of the hypothalamopituitary (HYPAC) axis to intravenous CRH, and b) the discovery that the central administration of CRH to rats causes an acute anorectic state. Human and animal data supporting this hypothesis are reviewed, and important problems with the data base and the interpretation of these data are discussed. Appropriate directions for future research are highlighted.