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Van Schoors M, Van Lierde E, Steeman K, Verhofstadt LL, Lemmens GMD. Protective factors enhancing resilience in children of parents with a mental illness: a systematic review. Front Psychol 2023; 14:1243784. [PMID: 38192397 PMCID: PMC10773682 DOI: 10.3389/fpsyg.2023.1243784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/21/2023] [Indexed: 01/10/2024] Open
Abstract
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.
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Affiliation(s)
| | | | | | - Lesley L. Verhofstadt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Gilbert M. D. Lemmens
- Department of Head and Skin – Psychiatry, Ghent University, Ghent, Belgium
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
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2
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Ye B, Lau JTF, Lee HH, Yeung JCH, Mo PKH. The mediating role of resilience on the association between family satisfaction and lower levels of depression and anxiety among Chinese adolescents. PLoS One 2023; 18:e0283662. [PMID: 37228075 DOI: 10.1371/journal.pone.0283662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/14/2023] [Indexed: 05/27/2023] Open
Abstract
PURPOSE This study aimed to explore the association between family satisfaction, resilience, and anxiety and depression among adolescents, and the mediating role of resilience in these relationships. METHODS A cross-sectional study was conducted among grade 8 to 9 students from 4 secondary schools in Hong Kong. A total of 1,146 participants completed the survey. RESULTS Respectively 45.8% and 58.0% of students scored above the cut-off for mild anxiety and mild depression. Results from linear regression analyses showed that family satisfaction was positively associated with resilience, and both family satisfaction and resilience were and negatively associated with anxiety and depression. The mediating effects of resilience on the relationship between family satisfaction and anxiety/ depression (26.3% and 31.1% effects accounted for, respectively) were significant. CONCLUSIONS Both family satisfaction and resilience have important influence on adolescent mental health. Interventions that seek to promote positive family relationships and resilience of adolescents may be effective in preventing and reducing anxiety and depression symptoms among adolescents.
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Affiliation(s)
- Beizhu Ye
- Department of Social Medicine and Health Management, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Joseph T F Lau
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou, China
| | - Ho Hin Lee
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jason C H Yeung
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Phoenix K H Mo
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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3
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Vetri K, Piché G, Villatte A. An Evaluation of the Acceptability, Appropriateness, and Utility of a Bibliotherapy for Children of Parents With a Mental Illness. Front Psychiatry 2022; 13:815873. [PMID: 35492703 PMCID: PMC9046907 DOI: 10.3389/fpsyt.2022.815873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/14/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Children of parents with a mental illness are at higher risk for various psychiatric problems and adaptive difficulties compared to those of parents without mental health problems. Certain preventive psychoeducational interventions target these children to promote their well-being and resilience and prevent the emergence of adaptive difficulties. However, few such interventions have been developed and evaluated specifically for elementary school-aged children of parents with a mental illness. OBJECTIVES This study aims to evaluate an interpersonal psychotherapy-based book targeting children living with a parent with a mental illness. METHODS The study examines children, parents and psychosocial workers' perception of the acceptability, appropriateness and utility of the book. In total, 22 participants answered online open-ended questions after reading the book. RESULTS The book was highly appreciated and positively perceived by the families and psychosocial workers. Results suggest that children, parents and psychosocial workers viewed it as an appropriate and useful tool for supporting children with a parent with a mental illness. The present study reveals that the bibliotherapy appears well adapted to the developmental level of school-age children. DISCUSSION This study presents a book that shows promise for supporting the resilience of elementary school-aged children having a parent with a mental illness. Results highlight the importance of tailoring the content and modalities of interventions to the developmental level, needs and preferences of elementary school-aged children. The relevance of a collaborative method is also discussed, thus providing knowledge regarding this type of approach for the development of interventions targeting children.
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Affiliation(s)
- Kelly Vetri
- Laboratory LaPProche, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada.,Centre de recherche universitaire sur les jeunes et les familles (CRUJEF), Québec, QC, Canada.,Réseau de recherche en santé des populations du Québec (RRSPQ), Montréal, QC, Canada.,Réseau Intersectoriel de Recherche en Santé de l'Université du Québec (RISUQ), Québec, QC, Canada
| | - Geneviève Piché
- Laboratory LaPProche, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada.,Centre de recherche universitaire sur les jeunes et les familles (CRUJEF), Québec, QC, Canada.,Réseau de recherche en santé des populations du Québec (RRSPQ), Montréal, QC, Canada.,Réseau Intersectoriel de Recherche en Santé de l'Université du Québec (RISUQ), Québec, QC, Canada
| | - Aude Villatte
- Laboratory LaPProche, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada.,Centre de recherche universitaire sur les jeunes et les familles (CRUJEF), Québec, QC, Canada.,Réseau de recherche en santé des populations du Québec (RRSPQ), Montréal, QC, Canada.,Réseau Intersectoriel de Recherche en Santé de l'Université du Québec (RISUQ), Québec, QC, Canada
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4
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Shim JY, Lee S, Lee IH, Jeong YM. The Impact of Sleep Quality and Education Level on the Relationship between Depression and Suicidal Ideation in Parents of Adolescents. Healthcare (Basel) 2021; 9:healthcare9091171. [PMID: 34574945 PMCID: PMC8470521 DOI: 10.3390/healthcare9091171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to analyze the moderating effect of sleep quality and the moderated moderation effect of education level on the relationship between depression and suicidal ideations among middle-aged parents of adolescent children. This is a secondary analysis of a survey collected from a cross-sectional study. The inclusion criteria were middle-aged parents of adolescent children in D city, South Korea, who answered the survey questionnaires. A total of 178 completed questionnaires were used for the analysis. The moderating effect of sleep quality (B = -0.03, p = 0.736) and education level (B = -1.80, p = 0.029) on the relationship between depression and suicidal ideations was shown. It was confirmed that the moderating effect of sleep quality on the effect of depression on suicidal ideations differed according to the subject's education level. The findings have implications for mental healthcare providers who can be educated on sleep hygiene based on the subject's education level.
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Affiliation(s)
- Ji Yeon Shim
- College of Nursing, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si 31116, Korea; (J.Y.S.); (S.L.)
| | - Sook Lee
- College of Nursing, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si 31116, Korea; (J.Y.S.); (S.L.)
| | - Il Hyun Lee
- Knowledge Industry Center 174, StatEdu Institute of Statistics 514, Iksan-si 54630, Korea;
| | - Yoo Mi Jeong
- College of Nursing, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si 31116, Korea; (J.Y.S.); (S.L.)
- Correspondence: ; Tel.: +82-41-550-1458
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5
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Powell V, Riglin L, Ng-Knight T, Frederickson N, Woolf K, McManus C, Collishaw S, Shelton K, Thapar A, Rice F. Investigating Friendship Difficulties in the Pathway from ADHD to Depressive Symptoms. Can Parent-Child Relationships Compensate? Res Child Adolesc Psychopathol 2021; 49:1031-1041. [PMID: 33655375 PMCID: PMC8222013 DOI: 10.1007/s10802-021-00798-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2021] [Indexed: 01/13/2023]
Abstract
Attention deficit/hyperactivity disorder (ADHD) is associated with friendship difficulties. This may partly account for the increasingly recognised association between ADHD and subsequent depression. Little is known about the types of friendship difficulties that could contribute to the association between ADHD and depressive symptoms and whether other relationships, such as parent-child relationships, can mitigate against potential adverse effects of friendship difficulties. In a representative UK school sample (n = 1712), three main features of friendship (presence of friends, friendship quality and characteristics of the individual's classroom friendship group) were assessed in a longitudinal study with two assessment waves (W1, W2) during the first year of secondary school (children aged 11-12 years). These friendship features (W1) were investigated as potential mediators of the prospective association between teacher-rated ADHD symptoms (W1) and self-rated depressive symptoms (W2) seven months later. Parent-child relationship quality (W1) was tested as a moderator of any indirect effects of ADHD on depression via friendship. ADHD symptoms were inversely associated with friendship presence, friendship quality and positive characteristics of classroom friendship groups. Depressive symptoms were inversely associated with presence and quality of friendships. Friendship quality had indirect effects in the association between ADHD and subsequent depressive symptoms. There was some evidence of moderated mediation, whereby indirect effects via friendship quality attenuated slightly as children reported warmer parent-child relationships. This highlights the importance of considering the quality of friendships and parent-child relationships in children with ADHD symptoms. Fostering good quality relationships may help disrupt the link between ADHD symptomology and subsequent depression risk.
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Nix L, Nixon E, Quigley J, O'Keane V. Perinatal depression and children's developmental outcomes at 2 years postpartum. Early Hum Dev 2021; 156:105346. [PMID: 33744832 DOI: 10.1016/j.earlhumdev.2021.105346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Perinatal depression has been associated with a range of adverse outcomes for children's neurodevelopment. AIMS This study sought to examine the impact of maternal perinatal depression on 2-year-olds' social-emotional, cognitive, language, and adaptive behavioural development, using data collected at the fifth timepoint of a prospective longitudinal study, which followed participants from pregnancy through to toddlerhood. PARTICIPANTS 61 women and their children (M age = 26 months, SD = 1.83; 35 boys and 26 girls), of the original cohort of 98, who had been recruited during pregnancy, and stratified into three participant groups: 1. Depressed (those with a clinical diagnosis of Major Depressive Disorder [MDD]); 2. History (currently euthymic with a previous MDD episode); 3. Control (no history of psychiatric disorder). OUTCOME MEASURES Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D), and children's developmental outcomes were measured using the Bayley Scales of Infant and Toddler Development, 3rd Edition (BSID-III). RESULTS No direct associations between mothers' depression and children's social-emotional, cognitive or language development were observed. However, an unexpected positive association between maternal depression and children's social adaptive behaviour was found, which conferred an advantage on children whose mothers had suffered from depression. CONCLUSIONS The current findings contribute to the literature examining the impact of perinatal depression on early childhood outcomes. The unexpected positive association found between maternal depression and children's adaptive behaviour should prompt further research examining the adaptive resilience of young children exposed to maternal depression. This is discussed in the context of differential-susceptibility theory.
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Affiliation(s)
- Laura Nix
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland.
| | | | - Jean Quigley
- School of Psychology, Trinity College Dublin, Ireland
| | - Veronica O'Keane
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
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7
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Ellersgaard D, Gregersen M, Ranning A, Haspang TM, Christiani C, Hemager N, Burton BK, Spang KS, Søndergaard A, Greve A, Gantriis D, Jepsen JRM, Mors O, Plessen KJ, Nordentoft M, Thorup AAE. Quality of life and self-esteem in 7-year-old children with familial high risk of schizophrenia or bipolar disorder: the Danish High Risk and Resilience Study-VIA 7-a population-based cohort study. Eur Child Adolesc Psychiatry 2020; 29:849-860. [PMID: 31494772 DOI: 10.1007/s00787-019-01397-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 08/30/2019] [Indexed: 12/16/2022]
Abstract
It is well established that children with familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) have a higher risk of developing mental disorders, however, little is known of to what degree the genetic and environmental vulnerabilities affect the quality of life and self-esteem of these children. We aimed to compare the quality of life and self-esteem between children with FHR-SZ or FHR-BP and controls. We used Danish nationwide registers to retrieve a cohort of 522 7-year-old children with FHR-SZ or FHR-BP and controls. Quality of life was assessed with the 'Health-related Quality of Life Screening Instrument', KIDSCREEN-27, and the scale 'Social Acceptance (Bullying)' from the KIDSCREEN-52. Self-esteem was assessed with the self-report scale 'I think I am'. Assessors were blind to familial risk status of the children. Children with FHR-SZ displayed lower levels of the general quality of life, as well as lower scores on the 'Psychological Well-being' scale and the 'School Environment' scale of the KIDSCREEN-27 compared with controls. Both children with FHR-SZ and FHR-BP reported more bullying victimization compared with controls. Children with FHR-SZ reported lower self-esteem on the total scale of 'I think I am', as well as on the 'Skills and talents', the 'Psychological well-being', and the 'Relationships with others' subscales compared with controls. The findings of lower quality of life and self-esteem in children with FHR-SZ together with more bullying victimization in both familial high-risk groups call for studies on low risk, early intervention strategies towards this group of vulnerable children.
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Affiliation(s)
- Ditte Ellersgaard
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, 2900, Hellerup, Denmark. .,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.
| | - Maja Gregersen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Anne Ranning
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Thilde M Haspang
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, Copenhagen, Denmark
| | - Camilla Christiani
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Nicoline Hemager
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Birgitte Klee Burton
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Katrine Soeborg Spang
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Anne Søndergaard
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Jens R M Jepsen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services in the Capital Region of Denmark , Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Kerstin J Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital, Lausanne, Switzerland
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Kildegaardsvej 28, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne A E Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Steele EH, McKinney C. Relationships Among Emerging Adult Psychological Problems, Maltreatment, and Parental Psychopathology: Moderation by Parent-Child Relationship Quality. FAMILY PROCESS 2020; 59:257-272. [PMID: 30414327 DOI: 10.1111/famp.12407] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Current research supports clear relationships between parental psychopathology, parental maltreatment, and emerging adult child psychopathology. Less research has examined how the role of the parent-child relationship influences these existing associations. The current study tested two models that examined the moderating effect of parent-child relationship quality on parental psychopathology and emerging adult mental health as well as the effect on parental maltreatment and emerging adult mental health. It was expected that high parent-child relationship quality would buffer against the negative effects of parental psychopathology and maltreatment while enhancing the effects of functional parenting characteristics. Participants included 1,452 emerging adults, predominantly Caucasian (73.3%) college students who completed surveys on their mental health, recent experienced maltreatment, and their parents' mental health problems. Results suggested lowest rates of mental health problems for emerging adults were associated with higher parent-child relationship quality and lower parental psychological problems, whereas negative outcomes were associated with higher parental psychopathology, regardless of parent-child relationship quality. Additionally, physical maltreatment was associated with lower rates of mental health concerns in the context of higher mother-daughter relationship quality. Results emphasize the continuing impact of the parent-child relationship, particularly the mother-daughter relationship, on emerging adults' mental health. Moreover, the current study demonstrates the continuing influence of parents on their emerging adult children.
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Affiliation(s)
- Ellen H Steele
- College of Arts and Sciences, Mississippi State University, Mississippi State, MS
| | - Cliff McKinney
- College of Arts and Sciences, Mississippi State University, Mississippi State, MS
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Goodday SM, Bentall R, Jones S, Weir A, Duffy A. Coping strategies and self-esteem in the high-risk offspring of bipolar parents. Aust N Z J Psychiatry 2019. [PMID: 29536749 DOI: 10.1177/0004867418761577] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study investigated whether there were differences in coping strategies and self-esteem between offspring of parents with bipolar disorder (high-risk) and offspring of unaffected parents (control), and whether these psychological factors predicted the onset and recurrence of mood episodes. METHODS High-risk and control offspring were followed longitudinally as part of the Flourish Canadian high-risk bipolar offspring cohort study. Offspring were clinically assessed annually by a psychiatrist using semi-structured interviews and completed a measure of coping strategies and self-esteem. RESULTS In high-risk offspring, avoidant coping strategies significantly increased the hazard of a new onset Diagnostic and Statistical Manual of Mental Disorders, 4th Edition twice revised mood episode or recurrence (hazard ratio: 1.89, p = 0.04), while higher self-esteem significantly decreased this hazard (hazard ratio: 2.50, p < 0.01). Self-esteem and avoidant coping significantly interacted with one another ( p < 0.05), where the risk of a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition twice revised new onset mood episode or recurrence was only significantly increased among high-risk offspring with both high avoidant coping and low self-esteem. CONCLUSION A reduction of avoidant coping strategies in response to stress and improvement of self-esteem may be useful intervention targets for preventing the new onset or recurrence of a clinically significant mood disorder among individuals at high familial risk.
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Affiliation(s)
- Sarah M Goodday
- 1 Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Richard Bentall
- 2 Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Steven Jones
- 3 Spectrum Centre for Mental Health Research, Department of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Arielle Weir
- 4 Department of Epidemiology, School of Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Anne Duffy
- 5 Department of Psychiatry, Queen's University Student Wellness Services, Kingston, Ontario, Canada
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10
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Offspring of parents with mood disorders: time for more transgenerational research, screening and preventive intervention for this high-risk population. Curr Opin Psychiatry 2018; 31:349-357. [PMID: 29708895 DOI: 10.1097/yco.0000000000000423] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW Offspring of parents with mood disorders (major depressive and bipolar disorder) are at increased risk for developing mood disorders. In this review, an overview regarding the intergenerational transmission of mood disorders, screening, and preventive intervention is given for this vulnerable group. RECENT FINDINGS Offspring of parents with depression have a 40% chance of developing a depression, whereas offspring of parents with bipolar disorder have a 10% chance of developing a bipolar disorder by adulthood. Studies into the intergenerational transmission of mood disorders show that children of parents with mood disorders have increased biological dysregulation and neuropsychosocial impairments. Although there is a clear need for early identification of those at the highest risk, there are few systematic attempts in mental health care to screen children of parents with mood disorders. Lastly, preventive interventions seem to be effective in reducing depressive symptoms of children of parents with depression; however, those effects are small and short-lived. SUMMARY Offspring of parents with mood disorders constitute a vulnerable group at high risk of mood disorders. More research needs to be conducted regarding mechanisms of the intergenerational transmission. Moreover, screening and preventive interventions for these offspring should be systematically evaluated and implemented.
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11
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Plass-Christl A, Otto C, Klasen F, Wiegand-Grefe S, Barkmann C, Hölling H, Schulte-Markwort M, Ravens-Sieberer U. Trajectories of mental health problems in children of parents with mental health problems: results of the BELLA study. Eur Child Adolesc Psychiatry 2018; 27:867-876. [PMID: 29177564 DOI: 10.1007/s00787-017-1084-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 11/18/2017] [Indexed: 11/24/2022]
Abstract
Children of parents with mental health problems (CPM) have an increased risk for behavioral and psychological problems. This study investigated the age- and gender-specific course as well as predictors of mental health problems in CPM using the longitudinal data (baseline 1- and 2-year follow-ups) of a German general population sample from the BELLA study. Children and adolescents aged 11-17 years (at baseline) who had a parent with mental health problems (n = 325) were analyzed. The mental health problems of the children were assessed by the self-reported version of the strengths and difficulties questionnaire (SDQ). We used individual growth modeling to investigate the age- and gender-specific course, and the effects of risk as well as personal, familial and social protective factors on self-reported mental health problems in CPM. Additionally, data were examined differentiating internalizing and externalizing mental health problems in CPM. Results indicated that female compared to male CPM showed increasing mental health problems with increasing age. Mental health problems in CPM were associated with lower self-efficacy, worse family climate and less social competence over time. Internalizing problems were associated with lower self-efficacy, less social competence and more severe parental mental health problems. Externalizing problems were associated with lower self-efficacy, worse family climate and lower social competence. The main limitations of the study are the short time period (2 years) covered and the report of mental health problems by only one parent. Our findings should be considered in the development of treatment and prevention programs for mental health problems in CPM.
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Affiliation(s)
- Angela Plass-Christl
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christiane Otto
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fionna Klasen
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Wiegand-Grefe
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert-Koch-Institute, Berlin, Germany
| | - Michael Schulte-Markwort
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Mahedy L, Harold GT, Maughan B, Gardner F, Araya R, Bevan Jones R, Hammerton G, Sellers R, Thapar A, Collishaw S. Resilience in high-risk adolescents of mothers with recurrent depressive disorder: The contribution of fathers. J Adolesc 2018; 65:207-218. [DOI: 10.1016/j.adolescence.2018.03.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
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13
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Flouri E, Ruddy A, Midouhas E. Maternal depression and trajectories of child internalizing and externalizing problems: the roles of child decision making and working memory. Psychol Med 2017; 47:1138-1148. [PMID: 27995842 DOI: 10.1017/s0033291716003226] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Maternal depression may affect the emotional/behavioural outcomes of children with normal neurocognitive functioning less severely than it does those without. To guide prevention and intervention efforts, research must specify which aspects of a child's cognitive functioning both moderate the effect of maternal depression and are amenable to change. Working memory and decision making may be amenable to change and are so far unexplored as moderators of this effect. METHOD Our sample was 17 160 Millennium Cohort Study children. We analysed trajectories of externalizing (conduct and hyperactivity) and internalizing (emotional and peer) problems, measured with the Strengths and Difficulties Questionnaire at the ages 3, 5, 7 and 11 years, using growth curve models. We characterized maternal depression, also time-varying at these ages, by a high score on the K6. Working memory was measured with the Cambridge Neuropsychological Test Automated Battery Spatial Working Memory Task, and decision making (risk taking and quality of decision making) with the Cambridge Gambling Task, both at age 11 years. RESULTS Maternal depression predicted both the level and the growth of problems. Risk taking and poor-quality decision making were related positively to externalizing and non-significantly to internalizing problems. Poor working memory was related to both problem types. Neither decision making nor working memory explained the effect of maternal depression on child internalizing/externalizing problems. Importantly, risk taking amplified the effect of maternal depression on internalizing problems, and poor working memory that on internalizing and conduct problems. CONCLUSIONS Impaired decision making and working memory in children amplify the adverse effect of maternal depression on, particularly, internalizing problems.
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Affiliation(s)
- E Flouri
- Department of Psychology and Human Development,UCL Institute of Education, University College London,London,UK
| | - A Ruddy
- Department of Psychology and Human Development,UCL Institute of Education, University College London,London,UK
| | - E Midouhas
- Department of Psychology and Human Development,UCL Institute of Education, University College London,London,UK
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14
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Giallo R, Gartland D, Woolhouse H, Mensah F, Westrupp E, Nicholson J, Brown S. Emotional–behavioral resilience among children of first-time mothers with and without depression across the early childhood period. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2017. [DOI: 10.1177/0165025416687413] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The deleterious effects of maternal depression on child emotional and behavioral development are well documented, yet many children exposed to maternal depression experience positive outcomes. The aim of this study was to identify psychosocial factors associated with the emotional–behavioral resilience of four-year-old children of first-time mothers experiencing depressive symptoms across the early childhood period. Data were from 1085 mother–child dyads in the Maternal Health Study collected prospectively at five time-points from pregnancy to child age four. Longitudinal trajectories of maternal depressive symptoms were identified, and children were regarded as resilient or competent if they scored in the normal range on the Total Difficulties subscale of the Strengths and Difficulties Questionnaire. We found that 22% of women had a pattern of moderate to high depressive symptoms, and within this group 78% of their children were identified as resilient. Maternal tertiary education and maternal involvement in home learning activities were unique predictors of children’s resilience. Higher maternal age at the time of pregnancy and financial security were factors associated with positive outcomes for all children. The findings highlight the importance of policy and intervention efforts to strengthen the quality of maternal–child interactions and the home learning environment to promote the emotional and behavioral functioning of children whose mothers are experiencing mental health difficulties in the early years of parenting.
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Affiliation(s)
- Rebecca Giallo
- Murdoch Childrens Research Institute, Parkville, Australia
| | | | | | - Fiona Mensah
- Murdoch Childrens Research Institute, Parkville, Australia
| | | | - Jan Nicholson
- La Trobe University Judith Lumley Centre, Melbourne, Australia
| | - Stephanie Brown
- Murdoch Childrens Research Institute, Parkville, Australia
- Department of Paediatrics, Royal Children’s Hospital, The University of Melbourne, Melbourne, Australia
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15
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Reuben JD, Shaw DS. Resilience in the Offspring of Depressed Mothers: Variation Across Risk, Domains, and Time. Clin Child Fam Psychol Rev 2016; 18:300-27. [PMID: 26541559 DOI: 10.1007/s10567-015-0195-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Considerable research has demonstrated that maternal depression is a significant risk factor for emotional and behavioral problems in children and adolescents (Goodman and Gotlib in Psychol Rev 106:458-490, 1999). It is important to note, however, that most children of depressed parents do not develop problems. This review will examine studies of resilience as they relate to the degree to which positive adjustment occurs across different levels of risk (i.e., severity and chronicity of depression as well as in context of multiple risk factors), domains of adjustment, and time. Understanding the phenomenon of resilience to depression is of critical importance to prevention and intervention experts because it may provide insight into processes that can be enhanced and targeted in prevention approaches among high-risk populations.
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Affiliation(s)
- Julia D Reuben
- Department of Psychology, University of Pittsburgh, 210 South Bouquet Street, 4425 Sennott Square, Pittsburgh, PA, 15260-0001, USA.
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, 210 South Bouquet Street, 4425 Sennott Square, Pittsburgh, PA, 15260-0001, USA
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16
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Quality of life in youth with bipolar disorder and unaffected offspring of parents with bipolar disorder. J Affect Disord 2016; 202:53-7. [PMID: 27253217 DOI: 10.1016/j.jad.2016.05.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 05/22/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND There have been few studies investigating quality of life (QoL) in pediatric bipolar disorder (BD) patients and none comparing it with that observed in unaffected offspring of parents with BD and healthy controls. METHODS The self-report Youth Quality of Life Instrument-Research version (YQoL-R) was administered in 26 pediatric BD patients, 17 unaffected offspring of parents with BD, and 24 individuals with no history of DSM-IV Axis I psychiatric disorders. All diagnoses were determined through interviews based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. RESULTS There were statistical differences among the groups for all YQoL-R domains. Pairwise comparisons showed that perceived QoL was significantly worse in the BD group than in the unaffected offspring and healthy subjects, a difference that persisted even when only euthymic subjects were analyzed. There were no significant differences between the unaffected offspring and healthy subjects for any YQoL-R domain. LIMITATIONS Our sample was small. There was no QoL report from subjects parents nor data about family environment or BD parents' mood state. CONCLUSIONS There is a need for studies to investigate in greater detail the relationship between QoL and psychological resilience, particularly in the unaffected offspring of parents with BD.
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Plass A, Haller AC, Habermann K, Barkmann C, Petermann F, Schipper M, Wiegand-Grefe S, Hölling H, Ravens-Sieberer U, Klasen F. Faktoren der Gesunderhaltung bei Kindern psychisch belasteter Eltern. KINDHEIT UND ENTWICKLUNG 2016. [DOI: 10.1026/0942-5403/a000187] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
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.
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Affiliation(s)
- Angela Plass
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Anne-Catherine Haller
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Karoline Habermann
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Claus Barkmann
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Marc Schipper
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Silke Wiegand-Grefe
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Heike Hölling
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - Ulrike Ravens-Sieberer
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Fionna Klasen
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
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18
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Collishaw S, Hammerton G, Mahedy L, Sellers R, Owen MJ, Craddock N, Thapar AK, Harold GT, Rice F, Thapar A. Mental health resilience in the adolescent offspring of parents with depression: a prospective longitudinal study. Lancet Psychiatry 2016; 3:49-57. [PMID: 26654748 PMCID: PMC4703896 DOI: 10.1016/s2215-0366(15)00358-2] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 07/21/2015] [Accepted: 07/21/2015] [Indexed: 11/02/2022]
Abstract
BACKGROUND Young people whose parents have depression have a greatly increased risk of developing a psychiatric disorder, but poor outcomes are not inevitable. Identification of the contributors to mental health resilience in young people at high familial risk is an internationally recognised priority. Our objectives were to identify protective factors that predict sustained good mental health in adolescents with a parent with depression and to test whether these contribute beyond what is explained by parent illness severity. METHODS The Early Prediction of Adolescent Depression study (EPAD) is a prospective longitudinal study of offspring of parents with recurrent depression. Parents with recurrent major depressive disorder, co-parents, and offspring (aged 9-17 years at baseline) were assessed three times over 4 years in a community setting. Offspring outcomes were operationalised as absence of mental health disorder, subthreshold symptoms, or suicidality on all three study occasions (sustained good mental health); and better than expected mental health (mood and behavioural symptoms at follow-up lower than predicted given severity of parental depression). Family, social, cognitive, and health behaviour predictor variables were assessed using interview and questionnaire measures. FINDINGS Between February and June, 2007, we screened 337 families at baseline, of which 331 were eligible. Of these, 262 completed the three assessments and were included in the data for sustained mental health. Adolescent mental health problems were common, but 53 (20%) of the 262 adolescents showed sustained good mental health. Index parent positive expressed emotion (odds ratio 1·91 [95% CI 1·31-2·79]; p=0·001), co-parent support (1·90 [1·38-2·62]; p<0·0001), good-quality social relationships (2·07 [1·35-3·18]; p=0·001), self-efficacy (1·49 [1·05-2·11]; p=0·03), and frequent exercise (2·96 [1·26-6·92]; p=0·01) were associated with sustained good mental health. Analyses accounting for parent depression severity were consistent, but frequent exercise only predicted better than expected mood-related mental health (β=-0·22; p=0·0004) not behavioural mental health, whereas index parents' expression of positive emotions predicted better than expected behavioural mental health (β=-0·16; p=0·01) not mood-related mental health. Multiple protective factors were required for offspring to be free of mental health problems (zero or one protective factor, 4% sustained good mental health; two protective factors, 10%; three protective factors, 13%, four protective factors, 38%; five protective factors, 48%). INTERPRETATION Adolescent mental health problems are common, but not inevitable, even when parental depression is severe and recurrent. These findings suggest that prevention programmes will need to enhance multiple protective factors across different domains of functioning. FUNDING Sir Jules Thorn Charitable Trust, Economic and Social Research Council.
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Affiliation(s)
- Stephan Collishaw
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.
| | - Gemma Hammerton
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Liam Mahedy
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - Ruth Sellers
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK; Rudd Centre for Adoption Research and Practice, School of Psychology, University of Sussex, Brighton, UK
| | - Michael J Owen
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - Nicholas Craddock
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - Ajay K Thapar
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - Gordon T Harold
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK; Rudd Centre for Adoption Research and Practice, School of Psychology, University of Sussex, Brighton, UK; International Center for Research in Human Development, Tomsk State University, Tomsk, Russia; MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Frances Rice
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - Anita Thapar
- Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
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19
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Ranøyen I, Stenseng F, Klöckner CA, Wallander J, Jozefiak T. Familial aggregation of anxiety and depression in the community: the role of adolescents' self-esteem and physical activity level (the HUNT Study). BMC Public Health 2015; 15:78. [PMID: 25649024 PMCID: PMC4324879 DOI: 10.1186/s12889-015-1431-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 01/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Symptoms of anxiety and depression are significantly associated in parents and children, but few studies have examined associations between recurrent parental problems and offspring symptoms, and fathers have rarely been included in these studies. Additionally, few have investigated factors that may protect against familial aggregation of anxiety and depression. The aims of the present study are to examine the associations between recurrent parental anxiety/depression over a ten-year time span and offspring anxiety/depression in adolescence and to test whether two factors proposed to be inversely related to anxiety and depression, namely, adolescent self-esteem and physical activity, may moderate and mediate the transmission of anxiety/depression. METHODS This study used data from two waves of a Norwegian community study (the HUNT study) consisting of 5,732 adolescents, ages 13-18, (mean age = 15.8, 50.3% girls) who had one (N = 1,761 mothers; N = 742 fathers) or both parents (N = 3,229) participating in the second wave. In the first wave, 78% of the parents also participated. The adolescents completed self-reported questionnaires on self-esteem, physical activity, and symptoms of anxiety/depression, whereas parents reported on their own anxiety/depressive symptoms. The data were analysed with structural equation modeling. RESULTS The presence of parental anxiety/depression when offspring were of a preschool age predicted offspring anxiety/depression when they reached adolescence, but these associations were entirely mediated by current parental symptoms. Self-esteem partly mediated the associations between anxiety/depression in parents and offspring. No sex differences were found. Physical activity moderated the direct associations between anxiety/depression in mothers and offspring, whereas no moderating effect was evident with regard to paternal anxiety/depression. CONCLUSIONS These findings suggest that children of parents with anxiety/depression problems are at a sustained risk for mental health problems due to the apparent 10-year stability of both maternal and paternal anxiety/depression. Thus, preventing familial aggregation of these problems as early as possible seems vital. The associations between parental and offspring anxiety/depression were partially mediated by offspring self-esteem and were moderated by physical activity. Hence, prevention and treatment efforts could be aimed at increasing self-esteem and encouraging physical activity in vulnerable children of parents with anxiety/depression.
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Affiliation(s)
- Ingunn Ranøyen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Faculty of Medicine, Norwegian University of Science and Technology, Pb. 8905, Medisinsk teknisk forskningssenter (MTFS), NO-7491, Trondheim, Norway.
| | - Frode Stenseng
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Faculty of Medicine, Norwegian University of Science and Technology, Pb. 8905, Medisinsk teknisk forskningssenter (MTFS), NO-7491, Trondheim, Norway.
- NTNU Social Research, Trondheim, Norway.
| | - Christian A Klöckner
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Jan Wallander
- Psychological Sciences, School of Social Sciences, Humanities and Arts, and Health Sciences Research Institute, University of California, Merced, CA, US.
| | - Thomas Jozefiak
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Faculty of Medicine, Norwegian University of Science and Technology, Pb. 8905, Medisinsk teknisk forskningssenter (MTFS), NO-7491, Trondheim, Norway.
- Department of Child and Adolescent Psychiatry, St. Olav's Hospital, Trondheim, Norway.
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