Protective Factors for Depression among African American Children of Predominantly Low-Income Mothers with Depression

Protective factors enhancing resilience in children of parents with a mental illness: a systematic review

Objectives

A systematic review was conducted to (1) investigate protective factors enhancing resilience in children of parents with a mental illness (COPMI), and (2) examine theoretical and methodological issues in the existing literature.

Method

Following guidelines for systematic reviews, searches were performed using Web of Science, Pubmed and Embase. After screening 5,073 articles 37 fulfilled inclusion criteria and were extracted for review. Results of the present review indicate that there are several ways to help build resilience in COPMI. More specifically, five protective factors emerged from the reviewed literature: Information, Support, Family functioning and Connectedness, Child coping, and Parenting.

Discussion

Research on protective factors in children confronted with parental mental illness is still scarce and for some factors no clear conclusions can be drawn based on the available evidence. To further our understanding of the building blocks and underlying mechanisms of resilience in COPMI, additional rigorously designed studies are needed.

Protective factors for suicidal ideation among Black adolescents indirectly exposed to community violence

OBJECTIVE

Community violence exposure has been identified as a risk factor for Black youth suicide ideation. However, little is known about factors that protect community violence exposed youth against suicide ideation. The current study examined associations between knowledge of family member and peers' community violence exposure and Black youth's subsequent suicidal ideation, and investigated self-worth and social support as protective factors.

METHOD

Participants were a community sample of Black youth (N = 447, 47.4% female; Mage = 11.77, SD = 0.35) who reported about community violence exposure, self-worth, social support, and suicide ideation in grades 6 and 7.

RESULTS

Regression analyses revealed that grade 6 knowledge of family member and peers' community violence exposure was associated with increases in suicide ideation assessed in grade 7. Self-worth attenuated the association between knowledge of others' community violence exposure and suicide ideation for male adolescents. For female adolescents, social support attenuated the association between knowledge of others' community violence and suicide ideation.

CONCLUSIONS

Findings highlight the consequential impact of knowledge about community violence for Black youth's suicidal ideation. Enhancing protective factors for Black youth is an important target for intervening with exposure to violence and reducing suicide ideation.

Tracking Stress, Mental Health, and Resilience Factors in Medical Students Before, During, and After a Stress-Inducing Exam Period: Protocol and Proof-of-Principle Analyses for the RESIST Cohort Study

Background

Knowledge of mental distress and resilience factors over the time span from before to after a stressor is important to be able to leverage the most promising resilience factors and promote mental health at the right time. To shed light on this topic, we designed the RESIST (Resilience Study) study, in which we assessed medical students before, during, and after their yearly exam period. Exam time is generally a period of notable stress among medical students, and it has been suggested that exam time triggers mental distress.

Objective

In this paper, we aim to describe the study protocol and to examine whether the exam period indeed induces higher perceived stress and mental distress. We also aim to explore whether perceived stress and mental distress coevolve in response to exams.

Methods

RESIST is a cohort study in which exam stress functions as a within-subject natural stress manipulation. In this paper, we outline the sample (N=451), procedure, assessed measures (including demographics, perceived stress, mental distress, 13 resilience factors, and adversity), and ethical considerations. Moreover, we conducted a series of latent growth models and bivariate latent change score models to analyze perceived stress and mental distress changes over the 3 time points.

Results

We found that perceived stress and mental distress increased from the time before the exams to the exam period and decreased after the exams to a lower level than before the exams. Our findings further suggest that higher mental distress before exams increased the risk of developing more perceived stress during exams. Higher perceived stress during exams, in turn, increased the risk of experiencing a less successful (or quick) recovery of mental distress after exams.

Conclusions

As expected, the exam period caused a temporary increase in perceived stress and mental distress. Therefore, the RESIST study lends itself well to exploring resilience factors in response to naturally occurring exam stress. Such knowledge will eventually help researchers to find out which resilience factors lend themselves best as prevention targets and which lend themselves best as treatment targets for the mitigation of mental health problems that are triggered or accelerated by natural exam stress. The findings from the RESIST study may therefore inform student support services, mental health services, and resilience theory.

Association between caregiver depression and child after-school program participation

Depressive symptoms in parents and caregivers to children are associated with adverse biopsychosocial outcomes for caregivers themselves and the children in their custody. Higher overall and parenting-related stress, including stress over children's unsupervised after-school time, is associated with increased caregiver depression risk. Child after-school program participation is a form of social support that may mitigate parenting-related stress and reduce caregiver depression risk. This study tested for the association between child after-school program participation and caregiver depression in a sample of 486 caregivers in Richmond, Virginia. Child after-school program participation was associated with a significant reduction in the likelihood of a past caregiver depression diagnosis (OR = 0.58, 95% CI = 0.39 - 0.86, p = 0.007). This relationship remained significant after adjusting for the influence of caregiver anxiety, stress, financial hardship, and sociodemographic characteristics (OR = 0.49, 95% CI = 0.27 - 0.86, p = 0.015). Child after-school program participation may function as a protective factor that reduces caregiver depression risk. More research is needed to determine whether the observed association is causal in nature and dosage dependent. Findings from this and future studies may be used to inform evaluation of the impact of after-school programs at the family-level.

Responsive Parenting Buffers the Impact of Maternal PTSD on Young Children

OBJECTIVE

This study investigates maternal responsive parenting behaviors as a theorized buffer to the detrimental impact of maternal PTSD symptoms on young children's depression and anxiety symptoms, disruptive behavior, and stress-related symptoms.

DESIGN

A multi-ethnic sample of 242 trauma-exposed mothers and their preschool-aged children was assessed. Maternal responsive parenting behaviors were observed during standardized parent-child interactions. Maternal and child mental health symptoms were reported by mothers.

RESULTS

Maternal PTSD symptoms were associated with their responsive parenting behaviors and predicted children's mental health symptoms. Responsive parenting was inversely associated with children's depression and stress-related symptoms. Moderation analyses revealed an interactive effect of maternal symptoms and responsive parenting on preschool children's disruptive behavior and stress-related symptoms.

CONCLUSIONS

Responsive parenting behaviors can mitigate the ill effects of maternal PTSD symptoms. Nurturing relationships buffer the impact of maternal PTSD. Helping parents' to sensitively respond to their young children's distress can support positive outcomes in children.

ASSOCIATIONS BETWEEN EARLY MATERNAL DEPRESSIVE SYMPTOM TRAJECTORIES AND TODDLERS' FELT SECURITY AT 18 MONTHS: ARE BOYS AND GIRLS AT DIFFERENTIAL RISK?

The goal of this study was to evaluate whether there are sex differences in children's vulnerability to caregiving risk, as indexed by trajectories of maternal depressive symptoms assessed from 2 to 18 months' postpartum, and children's rated attachment security in toddlerhood, adjusting for maternal social support and demographic risk. Analyses utilized longitudinal data collected for 182 African American mother-child dyads from economically diverse backgrounds. Participants were recruited at the time of the child's birth and followed to 18 months' postpartum. Results of conditional latent growth models indicated that an increasing rate of change in level of maternal depressive symptoms over time negatively predicted toddlers' felt attachment security. Higher social support was associated with decreasing levels of maternal depressive symptoms over time whereas higher demographic risk was associated with increasing levels of maternal depressive symptoms. A subsequent multigroup conditional latent growth model revealed that child sex moderated these associations. For male (but not female) children, a rapid increase in maternal depressive symptoms was associated with lower felt attachment security at 18 months. These findings suggest that boys, as compared to girls, may be more vulnerable to early caregiving risks such as maternal depression, with negative consequences for mother-child attachment security in toddlerhood.

Faktoren der Gesunderhaltung bei Kindern psychisch belasteter Eltern

Zusammenfassung. Kinder psychisch belasteter Eltern bilden eine Hochrisikogruppe für die Entwicklung psychischer Auffälligkeiten und weisen im Vergleich zur Gesamtbevölkerung eine geringere gesundheitsbezogene Lebensqualität auf. Für die Entwicklung spezifischer präventiver und therapeutischer Unterstützungsprogramme wurden veränderungssensitive Faktoren der psychischen Gesunderhaltung in einer Stichprobe von psychisch belasteten Eltern und ihren 13- bis 17-jährigen Kindern untersucht. Es wurden signifikante Prädiktoren aus den drei Bereichen personale, familiäre und soziale Ressourcen sowohl für die psychische Gesundheit als auch für die gesundheitsbezogene Lebensqualität identifiziert. Für psychische Gesundheit waren dies soziale Kompetenz, familiäre Unterstützung und Schulklima, für Lebensqualität Selbstwirksamkeitserwartung, Optimismus, Familienklima und Schulklima. Die Ergebnisse machen deutlich, dass personale, familiäre und soziale Ressourcen für Kinder psychisch belasteter Eltern von großer Bedeutung sind für die psychische Gesunderhaltung. Sie profitieren insbesondere von Ressourcen, die außerhalb der Familie angesiedelt sind, wie einer guten schulischen Integration. Spezifische Interventionsprogramme für Kinder psychisch belasteter Eltern sollten neben der persönlichen und familiären deshalb unbedingt auch die schulische Situation berücksichtigen.

Psychosocial challenges of young people affected by HIV: experiences from Hamilton County, Chattanooga, Tennessee

The number of young people affected by HIV and AIDS in Tennessee has steadily grown over the last few years. As a response to this situation, several organizations are working hard to address the needs of families impacted by HIV and AIDS. However, a close examination of some of the services provided suggests that young people within these families are ignored. Most of the services are geared toward HIV and AIDS-infected adult members of these families. Young people within these household are not targeted, and little is known about psychosocial challenges they experience in living with HIV-positive parents or guardians. In an attempt to address this gap, this small-scale qualitative study investigated the psychosocial challenges of young people affected by HIV and AIDS as a result of living with HIV-positive parents or guardians. Perceived sense of depression, experiencing stigma, self-blame, and lack of communication and loneliness were challenges that young people faced regularly.

Parental Strain, Mental Health Problems, and Parenting Practices: A Longitudinal Study

Although poor parenting practices place youth living in under resourced communities at heightened risk for adjustment difficulties, less is known about what influences parenting practices in those communities. The present study examines prospective linkages between three latent constructs: parental strain, mental health problems and parenting practices. Parental victimization by community violence and life stressors were indicative of parental strain; depressive, anxious, and hostile symptoms were indicators of parental mental health; and parental knowledge of their child's activities and child disclosure were indicators of parenting practices. Interviews were conducted annually for 3 waves with 316 female caregivers (92% African American) parenting youth in low-income inner-city communities. Structural equation modeling revealed that parental strain, assessed at Wave 1, predicted changes in mental health problems one year later, which in turn predicted parenting practices at Wave 3. These results suggest that parental strain can compromise a caregiver's ability to parent effectively by impacting their mental health. Opportunities for intervention include helping caregivers process trauma and mental health problems associated with parental strain.

Moderators of Mother's Problems on Middle-Aged Offspring Depressive Symptoms

OBJECTIVES

Conservation of Resources (COR) theory postulates that individuals utilize various resources to manage stressful circumstances. Children employ many resources to cope with the problems of parents who suffer from disabilities, cognitive impairment, and functional limitations. This phenomenon is rarely explored among middle-aged offspring and their aging parents.

METHOD

Drawing from the Family Exchanges Study, we focus on a sample (N = 308) of middle-aged adults (mean age = 51) whose only living parent was their mother. We use multiple regression to examine maternal support and self-reported health as moderators of maternal problems on offspring depressive symptoms.

RESULTS

Participants whose mothers had few problems generally reported low levels of depressive symptoms. When mothers had high problems, results indicate a negative association between depressive symptoms and physical health. When maternal problems were high, the amount of support offspring receive from their mother had a negative association with offspring depressive symptoms. When mothers had low problems, receiving more maternal support was associated with lower depressive symptoms and receiving low support was associated with increased depressive symptoms.

DISCUSSION

Middle-aged offspring use both personal and family-based resources to buffer the psychological ramifications of their mother's problems. Our results provide a unique extension of COR theory.