Intergenerational transmission of depression: test of an interpersonal stress model in a community sample

An interpersonal stress model of depression transmission was tested in a community sample of nearly 800 depressed and never-depressed women and their 15-year-old children. It was hypothesized that maternal depression (and depression in the maternal grandmother) contributed to chronic interpersonal stress in the mothers, affecting quality of parenting and youths' social competence. In turn, poor social functioning and interpersonal life events caused at least in part by the youths were predicted to be the proximal predictors of current depressive symptoms and diagnoses. Structural equation modeling confirmed the predicted associations among variables and the link between youth chronic and episodic interpersonal stress and depression. Additionally, the association between maternal and child depression was entirely mediated by the predicted family and interpersonal stress effects.     

Intergenerational transmission of partner violence: a 20-year prospective study

An unselected sample of 543 children was followed over 20 years to test the independent effects of parenting, exposure to domestic violence between parents (ETDV), maltreatment, adolescent disruptive behavior disorders, and emerging adult substance abuse disorders (SUDs) on the risk of violence to and from an adult partner. Conduct disorder (CD) was the strongest risk for perpetrating partner violence for both sexes, followed by ETDV, and power assertive punishment. The effect of child abuse was attributable to these 3 risks. ETDV conferred the greatest risk of receiving partner violence; CD increased the odds of receiving partner violence but did not mediate this effect. Child physical abuse and CD in adolescence were strong independent risks for injury to a partner. SUD mediated the effect of adolescent CD on injury to a partner but not on injury by a partner. Prevention implications are highlighted.     

Intergenerational transmission of somatization behaviour: a study of chronic somatizers and their children

BACKGROUND: Exposure to an ill parent in childhood may be a risk factor for adult somatization. This study examines the hypothesis that somatizing adults are more likely to have been exposed to illness as a child and that in turn, their children are more likely to report ill health and to have more contact with medical services than children of other mothers. METHOD: A cross-sectional comparative investigation of three groups of mothers and their children of 4-8 years of age: (i) 48 mothers suffering from chronic somatization; (ii) 51 mothers with chronic 'organic' illness; and (iii) 52 healthy mothers was carried out. RESULTS: Somatizing mothers were more likely than other women to report exposure to childhood neglect and to physical illness in a parent (OR 2.9; 95% CI 1.4-6.1). The children of these somatizing mothers were more likely to have health problems than were the children of organically ill or healthy women and had more consultations with family doctors (average annual rates: somatizers 4.9 (S.D. 3.8), organic 3.0 (S.D. 3.5) and healthy 2.8 (S.D. 2.6)). Multivariate modelling of consultation rates among children found significant main effects for maternal somatization, maternal childhood adversity, the child's tendency to worry about health and a two-way interaction of maternal childhood adversity and her somatization status. CONCLUSIONS: The hypotheses are broadly supported. However, it is important to emphasize the extent to which these findings are based on maternal reports.     

Intergenerational transmission of traumatization: Theoretical framework and implications for prevention

Intergenerational transmission of traumatization (ITT) occurs when traumatized parents have offspring with increased risk for emotional and behavioral problems. Although fetal exposure to the maternal biological milieu is known to be one factor in ITT, PTSD-driven parent–child interactions represent an additional important and potentially modifiable contributor. The Perinatal Interactional Model of ITT presented herein proposes that PTSD leads to social learning and suboptimal parent–child interactions, which undermine child regulatory capacity and increase distress, largely explaining poor social-emotional outcomes for offspring of parents with PTSD. Psychosocial intervention, particularly when delivered early in pregnancy, holds the possibility of disrupting ITT.     

抑郁症小鼠模型的神经免疫改变

目的 建立慢性束缚应激（CRS）和慢性不可预见性应激（CUMS）模型,观察C57BL/6小鼠行为学指标,海马区及脾脏结构及相关因子基因表达的差异,探讨不同慢性应激造模手段对小鼠神经免疫系统的影响,为抑郁症发病机制及抗抑郁药初筛选提供实验依据。方法 建立6周的对照组、CRS及CUMS小鼠模型共45只,通过行为学评价测定小鼠行为学指标;运用HE染色观察小鼠大脑海马区及脾脏组织形态;运用尼氏染色观察海马区神经元受损情况;Real-time PCR检测海马区抑郁相关基因脑源性神经营养因子(BDNF)、五羟色胺转运体(5-HTT),吲哚胺2,3加双氧酶1（IDO1）及脾脏炎症因子白细胞介素（IL）-1β、IL-6的表达情况。结果 慢性应激6周后, CRS组小鼠的水平穿格数及直立数无显著变化而CUMS组极显著下降;CRS组与CUMS组小鼠悬尾及强迫游泳试验累计不动时间均显著增加（P<0.05）;同时两种应激均能引起海马和脾脏结构的损伤,但CUMS组海马区的神经元损伤更严重;仅有CUMS组海马区相关基因显著改变;CUMS组脾脏IL-1β,IL-6的基因表达水平显著升高,而CRS组IL-6水平无显著变化。结论 应激6周后,CRS和CUMS均可不同程度地引起抑郁样症状;从神经免疫学角度观察,CUMS模型的抑郁样症状明显。提示,与CRS模型相比,CUMS模型更能反映机体的抑郁症状。     

Minor depression in adolescence: phenomenology and clinical correlates

BACKGROUND: Depressions that fail to meet the diagnostic criteria for major depressive disorder (MDD) may be underdiagnosed and undertreated in adolescent population. Traditionally, they are not considered as serious conditions and the phenomenological nature and clinical correlates of these disorders are largely unknown. In the present study, we used a large, representative and age-standardized sample of adolescents to examine the phenomenology and clinical correlates of minor depression, a poorly understood condition included in the category of Depressive Disorder Not Otherwise Specified in Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revised (DSM-IV-TR). METHODS: 909 girls and 945 boys, with mean age of 14, were interviewed by professionals using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). RESULTS: Although clearly milder condition than MDD, minor depression was associated with marked suicidal thoughts, plans and attempts, recurrences and a high degree of comorbidity. At this early age, despite that 14% of adolescents under 15 had suffered from depressive conditions with severe clinical implications, most of them failing to meet the diagnostic threshold for MDD, only 1.7% had received any psychiatric treatment. 40% of depressive adolescents who had attempted suicide had no contact with mental health services. LIMITATIONS: Analyzed in a cross-sectional setting, no conclusions about long-term implications could be made. CONCLUSIONS: The results highlight the clinical and public health significance of non-MDD depressions, e.g. minor depression, which need to be more carefully identified and treated at early age.     

The neuroscience of depression in adolescence

The neuroscience of depression in children and adolescents has only recently become a focus of research. Initially, techniques previously used for adult investigations were employed, such as endocrine studies and sleep studies. Endocrine studies have indicated that, as in adult depression, a dysregulation of the serotonin (5-HT) axis is involved in childhood depression. However, both of these techniques are difficult to perform in children and have yielded some inconsistent results. The more recently developed neuroimaging techniques should enable the greatest advances in our understanding of the pathophysiology of depression. These techniques have already implicated the frontal lobes in the pathogenesis of depression in children and adolescents, and further research is ongoing.     

Developmental origins of cognitive vulnerabilities to depression: review of processes contributing to stability and change across time

Cognitive theories of depression have been shown to be potent predictors of future increases in depressive symptoms and disorder in children, adolescents, and adults. This article focuses on potential developmental origins of the main cognitive vulnerabilities, including dysfunctional attitudes, negative cognitive style, and rumination. We selectively review processes and factors that have been hypothesized to contribute to the emergence and stabilization of these cognitive risk factors. This review focuses on genetic factors, temperament, parents and peers as salient interpersonal influences, and stressful life events. We end with suggestions for future theory development and research. In particular, we emphasize the need for additional conceptual and empirical work integrating these disparate processes together into a coherent, developmental psychopathological model, and we highlight the coexistence of both stability and change in the development of cognitive vulnerabilities to depression across the lifespan. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1–12, 2009.     

Aging and depression: Vulnerability and stress across adulthood

This paper reviews research on the relationship between age and depression in adulthood, with a focus on depression in late life. Age differences in prevalence rates of major depression and depressive symptomatology raise questions about presentation and measurement of depression across adulthood, and suggest a changing salience of risk factors for depression from young adulthood through old age as well as to cohort differences in risk for depression. Applying a developmental perspective on biological change, psychological adaptation, and stress processes throughout adulthood shows that risk for depression onset in young adults is typified more through psychological vulnerability and stress, as well as genetic factors, while risk for depression in older adults typified more through comorbid medical and neurological disorder. Implications for research and clinical practice are discussed. This review of the relationship of age to depression shows that the study of psychopathology and adult development can inform each other.     

Sympathetic and parasympathetic responses to social stress across adolescence

Many transformations that occur in adolescence are related to emotion and emotion regulation, yet very little is known about the autonomic underpinnings of these changes. The aim of the study was to document age-related differences in autonomic responses to social stress and relations to emotion regulation. Ninety-nine female adolescents engaged in a paced breathing and a spontaneous speech task while electrocardiography measurements were taken. Spectral decomposition of the heart period data was used to create measures of sympathetic and parasympathetic activity. Results revealed a positive correlation between age and sympathetic activity and a negative correlation between age and parasympathetic activity. These findings contribute to a better understanding of the age-related norms of cardiac variability across adolescence.     

Predictors of future depression in early and late adolescence

BACKGROUND: This study examined whether the possibility to predict future DSM-IV depressive disorder can be increased with recurrent screening for depression in community adolescents, compared to single screening in early or in late adolescence. In addition, it examined which depressive symptoms in early and late adolescence predicted future depressive disorder most accurately. METHODS: Participants from an ongoing longitudinal cohort study were assessed when they were aged between 10 and 15 (early adolescence), and between 14 and 19 (late adolescence), and were followed until they were 20-25 (young adulthood). The Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) were used to screen for depression in early and late adolescence, and CIDI/DSM-IV diagnoses of depressive disorder were used as the outcome measure during follow-up. RESULTS: Recurrent screening only slightly improved the prediction of future depression, and cognitive and physical symptoms in late adolescence predicted future depression accurately in boys. Sleeping problems in early adolescence predicted future depression in girls. LIMITATIONS: The main limitation was the retrospective recall of the age of onset of a depressive disorder. CONCLUSIONS: Recurrent screening for depression did not predict future depressive disorder better than single screening in late adolescence. However, depressive symptoms like sleeping problems predicted future depression quite accurately in adolescent boys and girls. This indicates that it may be useful to screen adolescents for the presence of such symptoms, for instance in school settings, to predict which adolescents are at risk to develop DSM-IV depressive disorder in early adulthood.     

The challenge of diagnosing depression in childhood and adolescence

Depression is a significant psychiatric disorder in children and adolescents which can result in serious consequences such as school absenteeism and decreased educational attainment. Recent studies have shown that children and adolescents present with a different spectrum of symptoms than adults with depression. Furthermore, depression in the young is more frequently comorbid with other psychiatric disorders than in adult patients, further complicating diagnosis. Once the condition is diagnosed, it is clear that treatment is necessary. Although early clinical data suggest that selective serotonin reuptake inhibitors (SSRIs) or psychotherapy may provide effective treatment, further clinical trials are required in young patients.     

Weight change and appetite disturbance as symptoms of adolescent depression: Toward an integrative biopsychosocial model

The Diagnostic and Statistical Manual of Mental Disorders [American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.] lists weight change and appetite disturbance as a single compound symptom of depression at all ages. Nonetheless, assessment of these symptoms is complicated during adolescence by normative increases in body weight and appetitive drive as well as heightened rates of body dissatisfaction, dieting, and eating disorders. This review outlines biological and psychological mechanisms that may change the relation of weight change and appetite disturbance to depression during adolescence. We propose a developmental model of the relation of these symptoms to the disorder and use the model as a framework to summarize findings, limitations, and future directions of research. Although the literature suggests that weight change and appetite disturbance are related to adolescent depression, preliminary evidence suggests that interpretation of weight and appetite symptoms may depend on developmental level.     

Hypothalamo-pituitary-adrenal axis abnormalities in depression: a review and a model

A wide range of abnormalities of the hypothalamo-pituitary-adrenal (HPA) axis has been described in depression. This paper reviews recent advances in the understanding of this system, and draws them together to construct a model for the purposes of further research and discussion. It is proposed that there are two fundamental changes which both originate in the hypothalamus: an increased secretion of corticotropin-releasing hormone, and a neurally mediated adrenal hyper-responsivity to ACTH. The resulting changes in hormone regulation would be expected to produce all the characteristic HPA axis abnormalities commonly seen in depression. The model makes several predictions which could be tested by future experiment.     

Intergenerational transmission of maternal behavior in rhesus macaques and its underlying mechanisms

Thirteen group-living rhesus macaque females that were crossfostered shortly after birth were followed longitudinally until they gave birth for the first time. Their maternal behavior was compared to the behavior of both their foster and their biological mothers, and analyzed in relation to the cerebrospinal fluid (CSF) concentrations of serotonin, dopamine, and norepinephrine metabolites (5-HIAA, HVA, and MHPG) measured in their second year of life. Crossfostered females were similar to their foster mothers in their rates of maternal rejection and grooming, whereas their contact-making behavior was more similar to that of their biological mothers. Crossfostered females with lower CSF concentrations of 5-HIAA exhibited higher rates of maternal rejection than females with higher CSF 5-HIAA. In a related article (Maestripieri et al., 2006), we reported that rhesus infants reared by highly rejecting mothers had lower CSF 5-HIAA in their first 3 years of life. Taken together, these findings suggest that early social experience and experience-related long-term changes in serotonergic function may play a role in the intergenerational transmission of maternal rejection from mothers to daughters.     

Epigenetic canalization and phenotypic change: a minimax model

A selectionist model of phylogenic behaviour is presented in which epigenetic canalization fulfills the pivotal r?le. It is shown that directional selection will result in stress induce creodal destabilization and in genetic unmasking. Both processes will in turn result in a rapid increase in phenotypic variance for natural selection to act on, and hence a sudden increase in the rate of phylogenic change. Acting on the epigenome via internal selection and on phenotypic peripherals via stabilizing selection, natural selection will also assure phenotypic stasis by means of increased genetic concealment, deepened canalization and developmental constraints. The latter two factors allow for the application of a minimax rule of phenotypic change: that part of an organism with the minimum potential for phenotypic change (hence the maximum canalization) will govern the direction of the maximum phenotypic change of the other parts. The hierarchialization of phenotypic change predicted by the minimax rule explains the coexistence of gradualistic and punctuational changes within lineages of the same species.     

Intergenerational transmission of somatization behaviour: 2. Observations of joint attention and bids for attention

BACKGROUND: Somatoform disorders may have their roots in childhood through processes that involve an enhanced parental focus on health. The aim of this study was to test the hypothesis that somatizing mothers will show less joint involvement than other mothers during play but greater responsiveness when this play involves a 'medical' theme. METHOD: Cross-sectional observational study of 42 chronic somatizers, 44 organically ill and 50 healthy mothers and their 4-8 year-old children during structured play and a meal. Tasks comprised boxes containing tea-set items, 'medical' items and a light snack. RESULTS: Somatizing mothers were emotionally flatter and showed lower rates of joint attention than other mothers during both play tasks. While the three groups had similar rate of bids for attention, somatizing mothers were more responsive to their child's bids during play with the medical box than at other times. In contrast, the children of somatizing mothers ignored a greater proportion of their mother's bids during play with the medical box than did children of other mothers or during play with a non-medical theme. CONCLUSION: The study has demonstrated tentative evidence in support of the hypothesis.