Is maternal depression related to mother and adolescent reports of family functioning?

The association between family cohesion and depression: A systematic review and meta-analysis

BACKGROUND

Many studies have analyzed the association between family cohesion and depression, but there are different views and the results are inconsistent. It is necessary to use meta-analysis to explore the association between family cohesion and depression and its influencing factors.

METHODS

Chinese database (China National Knowledge Infrastructure) and English databases (ERIC, MEDLINE, Web of Science Core Collection, Elsevier SD, PsycINFO, PsycArticles, and ProQuest dissertations and theses) were searched for articles published by November 2023. Measurements of family cohesion and depression, study design, age, gender, cultural background, and sampling year were analyzed as moderators. Meta-analysis was performed using the random effects model in CMA3.0 software.

RESULTS

A total of 71 studies (90,023 participants) were included in this study. The meta-analysis revealed a significant negative correlation between family cohesion and depression (r = -0.31, 95 % CI [-0.35, -0.27]). The association was moderated by measurements of family cohesion and depression, design type, and cultural background, but not by age, gender, or sampling year.

LIMITATIONS

The sample size included in this study is relatively small in European and African cultures, making it challenging to analyze cultural differences in the study results at present comprehensively.

CONCLUSIONS

The findings contribute to the ongoing debate between Social Support Theory and The Circumplex Model, showing that individuals with lower family cohesion tend to experience higher levels of depression.

Translation, Cultural Adaptation, and Psychometric Validation of the European Portuguese Version of the Iceland-Expressive Family Functioning Questionnaire (ICE-EFFQ)

A family's experience of mental illness can change the family's functioning. In clinical contexts, valid and reliable instruments that assess family functioning, therapeutic changes, and the effects of family nursing interventions are needed. This study focuses on the linguistic and cultural adaptation of the Iceland-Expressive Family Functioning Questionnaire (ICE-EFFQ) to European Portuguese and examines the psychometric properties of this instrument. A non-random sample of 121 Portuguese depressed patients and their relatives completed the questionnaire. Principal components analysis extracted 4 factors, explaining 55.58% of the total variance. Confirmatory factor analysis revealed acceptable adjustment quality indices. Cronbach's alpha coefficient was adequate for the global scale α = .86 and for the 4 subscales: communication α = .79, expression of emotions α = .68, problem-solving α = .71, and cooperation α = .61. The Portuguese version of ICE-EFFQ is a sensitive, valid, and reliable instrument for use with Portuguese families with adult members with depression and can be valuable in assessing these families' expressive functioning, before and after intervention.

Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study

BACKGROUND

This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents' cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers.

METHODS

The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children's Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews.

RESULTS

Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents' and mothers' perspectives as associated with adolescents' MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility.

CONCLUSIONS

This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence.

(In)Congruence in Perceived Mother-child Cohesion and Informants' Depressive Symptoms: A Dyadic Response Surface Analysis

Mother-child cohesion, reflecting the emotional connection between mothers and children, is a protective factor for individuals' mental health. The Modified Operations Triad Model suggests that children and mothers hold either congruent or incongruent views of their perceived cohesion, which reflects family functioning and is an indication of future mental health outcomes for family members. Despite increasing research on the impact of (in)congruence in perceived family functioning on children's mental health, few studies concurrently address the mental health of both mothers and children, overlooking their interdependence. This longitudinal study with multi-informant reports explored the long-term and developmental effects of (in)congruence in perceived mother-child cohesion on informants' depressive symptoms. A total of 577 families participated at the first time point, comprising 577 children (52.34% girls, Mage = 10.11 years) and 577 mothers (Mage = 37.32 years). The Dyadic Response Surface Analysis revealed that mother-child congruence at high levels of cohesion (versus low levels) predicted fewer depressive symptoms in mothers and children after three and nine months, as well as decreased depressive symptoms over nine months. Children who reported higher levels of cohesion than their mothers experienced fewer depressive symptoms after three months. Mothers with higher levels of cohesion than their children reported fewer depressive symptoms after three months. The current findings emphasize the importance of identifying and resolving discrepancies in perceived mother-child cohesion between mothers and children to promote a healthy family environment.

Maternal depression, parental attributions, and adolescent psychopathology: An evaluation using observational and video-mediated recall methods

Parenting styles associated with maternal depression are a risk factor for adolescent psychopathology, and maternal attributional styles may be a key mechanism in this relationship. Mother-adolescent dyads (N = 180; 96 male; ages 10-15) completed in-person interactions and then the mothers participated in a video-mediated recall procedure to assess maternal attributions. Maternal depression was associated with negative attributions. Negative attributions were associated with low parental acceptance, aggressive parenting, and low positive parenting. Positive maternal attributions were associated with less aggressive parenting, and more positive parenting during one interaction task. Adolescent externalizing behaviors were associated with negative attributions. Future research should evaluate whether maternal attributions mediate the association between maternal depression and both parenting behaviors and adolescent mental health.

Family Matters: The Effects of Multigenerational Community Violence Exposure on Family Functioning

Exposure to community violence is known to be associated with a host of maladaptive outcomes in both youth and adult populations. Though frequently examined in other interpersonal violence literature, family functioning has yet to be examined as an outcome in community violence literature. The current study begins to address this need by exploring the impact of parent and child's exposure to community violence on parents' perception of family functioning. Two hundred parent-child dyads (sons Mage =12.39, SD = 1.22 at baseline; mothers Mage = 42.79, SD = 9.21 at Wave 5) living in under-resourced, urban neighborhoods completed self-report questionnaires about their exposure (i.e., direct or indirect) to violent events in their community within the last year. The parents then completed an additional self-report questionnaire about their perception of family functioning at one year and three years post community violence exposure, respectively. Results of general linear modeling showed that at one- and three-years post-direct and indirect exposure, family cohesion and family communication was highest when 1) neither the parent nor child were exposed and when 2) only the child was exposed. Family functioning was at its lowest levels when the group included a parent who reported direct or indirect exposure to community violence. The results highlight a need to provide family-based psychosocial interventions to families exposed to violence to help preserve both individual and family functioning after exposure.

Depression in mothers at childhood: Direct and indirect association with problematic gaming in late adolescence/young adulthood

OBJECTIVES

Little is known about the relationship between depression in mothers and problematic gaming in their children. Therefore, we aimed to investigate the potential role of mothers' depression in childhood as a risk factor for problematic gaming in their offspring in late adolescence/young adulthood.

METHODS

We assessed data from 1557 participants on three waves (T0 collected in 2010/2011, T1 in 2013/2014, and T2 in 2018/2019) of a large Brazilian school-based cohort. Mother's depression at T0 was tested as a predictor of problematic gaming at T2 in a logistic regression model. In mediation analyses, we individually assessed internalizing or externalizing disorders at T1 as mediators in this association, with participants' sex being tested as a moderator in both models. Inverse probability weights were used to account for sample attrition at T2. All models were adjusted for maternal and participant-related covariates.

RESULTS

Mother's depression at T0 was significantly associated with problematic gaming at T2 (OR = 2.09, p < 0.001) even after adjusting for multiple confounding factors. The presence of any internalizing disorder at T1 was a partial mediator of this relationship, accounting for 8.18% (p = 0.032) of the total effect, while the presence of any externalizing disorder at T1 was not a significant mediator. Participants' sex was not a significant moderator in mediation models.

CONCLUSIONS

These findings suggest mother's depression in childhood as a risk factor for problematic gaming in later developmental stages, which may be partially mediated by internalizing psychopathology.

Longitudinal Linkages Between Parent-Child Discrepancies in Reports on Parental Autonomy Support and Informants' Depressive Symptoms

Although parent-child discrepancies in reports of parenting are known to be associated with child depressive symptoms, the direction of causality is unknown. To address this knowledge gap, this study contributes to existing literature by examining longitudinal within-family linkages between parent-child discrepancies in their reports on autonomy support and depressive symptoms of children, while also assessing these linkages with parents' depressive symptoms. In addition, this study explored whether these linkages differ for father- versus mother-child discrepancies. Longitudinal data (six annual waves) of 497 adolescents (56.9% boys, M_age at T₁ = 13.03, SD = 0.46), their mothers (N = 495), and their fathers (N = 446) of the Dutch study Research on Adolescent Development and Relationships (RADAR) were used. Counter to expectations, the results of a Random Intercept Cross-Lagged Panel Model provided no evidence for within-family cross-lagged effects. Instead, stable differences between families explained linkages; in families where children reported on average higher levels of depressive symptoms, children also reported lower levels of autonomy support relative to their parents. There were no associations between parent-child discrepancies and parents' depressive symptoms. Thus, the findings suggest that depressive symptoms are neither a consequence, nor a predictor of parent-child discrepancies in adolescence. The hypotheses and analytical plan of this study were preregistered in a project on the Open Science Framework.

Parental Psychological Control: Maternal, Adolescent, and Contextual Predictors

Parental psychological control (PC) hinders the development of autonomy, identity formation, and the attainment of self-determination and individuation of adolescents. The aim of this study was to deepen the understanding of which conditions increase the risk of the use of maternal PC by simultaneously considering the contribution of adolescent temperament, maternal separation anxiety, and adolescents’ perception of interparental conflict. A correlational study involving a sample of 106 Chilean adolescent-mother dyads was done. Adolescents were, on average, 15.42 years old (SD = 1.09) and 77% male. Mothers were, on average, 45.46 years old (SD = 6.39). We administered self-report questionnaires to the adolescent measuring effortful control and frustration as temperamental dimensions, along with the perception of interparental conflict. Mothers reported on their separation anxiety. Both the adolescents and their mothers reported on the use of maternal PC. Adolescents reported higher levels of maternal PC than their mothers did. All predictors were associated with PC reports. Higher levels of maternal anxiety about adolescent distancing, inter-parental conflict, and adolescent frustration were associated with higher reported levels of PC. In contrast, higher levels of adolescent effortful control were associated with lower levels of maternal PC. Finally, when maternal separation anxiety and inter-parental conflict were high there was a higher use of maternal PC. The present findings inform on how adolescent’s self-regulatory skills could reduce the risk of being exposed to maternal PC. And highlight the importance of using a systemic and interactional conceptualization when trying to understand their use.

Associations of childhood unintentional injuries with maternal emotional status during COVID-19

Background

To explore the characteristics of unintentional childhood-injury during the COVID-19 pandemic and assess the association of unintentional-injury with maternal emotional status.

Methods

A cross-sectional survey was conducted with a convenience sample of 1300 children under 12-years-old from 21 schools (including nurseries/ kindergartens/ primary schools) in Wuhan and Shanghai during March to April 2020, and the mothers completed questionnaires online. Self-rating Depression/Anxiety Scales were used to evaluate maternal emotional status, questions on child unintentional-injury were based on the International-Statistical-Classification-of-Diseases-and-Related-Health-Problems-version-10 (ICD-10), and a total of 11 kinds of unintentional injuries were inquired. Information on socio-demographic and family-background factors was also collected.

Results

The children of 0–4, 5–9, and 10–12 years accounted for 29.2, 55.2 and 15.6%, respectively, the unintentional-injury rates were 10.29, 4.18 and 3.45%, respectively (P < 0.001), and boys had higher rates than girls. The three leading causes included “being struck by/against”, falls and animal bites (traffic-injury accounted for a small proportion). Lower maternal educational, living in suburban/rural (vs. urban) areas, grandparents (vs. mothers) being main caregivers, more child exposure to secondhand smoke, close relatives being suspected/ confirmed COVID-19 cases were associated with a higher risk of child unintentional-injury. After adjusting for related confounders, higher maternal depression levels were associated with a higher risk of unintentional injury.

Conclusions

The characteristics of unintentional childhood injury were different from those in non-pandemic periods. The main causes, risk factors and the association of unintentional injury with maternal depression deserve attention for development of effective measures for preventing children from unintentional injury during COVID-19 pandemic.

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-021-02846-2.

Linking Foster Family Characteristics and Mental Health Symptoms of Youth in Care

Youth in foster care are disproportionately at risk for developing internalizing and externalizing problems (Lawrence et al., 2006); however, a history of maltreatment prior to foster care placement does not automatically result in poor mental health outcomes. Among non-foster care youth, the quality of family interactions has been related to adjustment outcomes, such that low family cohesion and high family conflict is associated with poor mental health symptoms (Caples & Barrera, 2006). While little is known about these constructs in foster care placements, they may help explain the variance in internalizing and externalizing problems for youth in foster care. The present study aimed to examine whether characteristics of the foster care environment (i.e., conflict, cohesion) across various placement types (i.e., traditional foster homes, group-care settings) could help explain the link between previous maltreatment exposure and mental health problems. The sample included 178 youth in foster care (M age  = 15.18, SD = 1.76) and their foster caregivers living in the Midwest. Youth participants completed self-report measures about prior maltreatment history, current family environment characteristics, and youth internalizing symptoms. Foster caregivers completed measures on current family environment and youth externalizing symptoms. Results indicated that caregiver report, but not youth report, of family cohesion was negatively associated with youth report of internalizing problems. When examining the indirect effects, youth report of family conflict partially accounted for the link between youth self-report of maltreatment and internalizing symptoms (B = 0.106, 95% CI = 0.026-0.186). Caregiver report of family conflict fully accounted for the association between youth self-report of maltreatment and caregiver report of youths' externalizing symptoms (B = 0.108, 95% CI = 0.005-0.211). Findings highlight the importance of utilizing multiple informants when measuring foster family environment and suggest that family conflict is particularly salient for the mental health of youth in foster care.

Family Functioning in Families Affected by Parental Mental Illness: Parent, Child, and Clinician Ratings

Family functioning is often impaired in families with a parent with mental illness and is linked to child mental health. This study aims to gain a better understanding of family functioning in affected families by comparing ratings among family members and by analyzing associations with clinician-rated family functioning. The cross-sectional sample comprised 210 families with ratings of 207 patients, 139 partners, and 100 children. Parents with a mental illness as well as their partners and children completed the German version of the Family Assessment Measure (FAM). Clinician ratings were obtained by the Global Assessment of Relational Functioning Scale (GARF). We conducted several mixed models to compare ratings of family functioning while accounting for family cluster. Family dysfunction was consistently elevated compared to a normative sample. On several domains, parents with a mental illness perceived family functioning to be worse compared to their partners and children. Partners and children did not differ in their perceptions of family functioning. Ratings of family members were moderately associated with clinician ratings. We discuss the importance of multi-informant assessment of family functioning and the implementation of family-based interventions for families with a parent with mental illness.

Perceived family adaptability and cohesion and depressive symptoms: A comparison of adolescents and parents during COVID-19 pandemic

OBJECTIVE

To compare the differences of depressive symptoms and perceived family cohesion and adaptability between adolescents and parents during the pandemic; to explore the association between depressive symptoms and family cohesion and adaptability.

METHODS

A total of 8,940 adolescents (45.77% males; Mean age=15.31±0.018 years old) and their parents (24.34% males; Mean age=40.78±0.60 years old) from Shenyang, Liaoning Province, China, participated in the survey and completed several questionnaires online. We used the Patient Health Questionnaire-9 (PHQ-9) and the Family Adaptability Cohesion Scale, Second Edition, Chinese version (FACES II-CV) to evaluate depressive symptoms and family cohesion and family adaptability from the perception of parents and adolescents.

RESULTS

Results indicated significant differences between adolescents' and parents' perspectives of family functions. Significant negative correlations exist between depressive symptoms and family cohesion and family adaptability from the perspectives of both adolescents and parents. In addition, regression models with demographic characteristics adjusted showed that the perceived family cohesion and adaptability of parents and adolescents and the agreements between them could be predicted by their depressive symptoms.

LIMITATION

Cross-sectional study and limited population-wide are limitations.

CONCLUSION

Detecting the depressive symptoms of adolescents and parents earlier and promptly providing family intervention are of great significance to promote their perceptions of family cohesion and adaptability, which contribute to the mental health development of adolescents and parents during the COVID-19 pandemic.

Associations between maternal depressive symptoms, children’s behavioral problems and perceptions regarding family interactions

Abstract The aim of this study was to verify possible associations between maternal depressive symptoms, children’s behavioral problems and perceptions regarding the family interactions, considering the reports of mothers and children. A total of 60 mothers and their school-age children were divided into two equal groups, according to the presence or absence of maternal depression indicators, and evaluated using the following instruments: Sociodemographic Questionnaire, Patient Health Questionnaire-9, Strengths and Difficulties Questionnaire, and scales of family interaction (Escalas de Qualidade nas Interações Familiares). The results indicate that maternal depressive symptoms were associated with children’s behavioral problems and with family interactions reported by mothers and children. Maternal depression and positive family interactions reported by the mothers predicted behavioral problems in children. Positive family interactions reported by the mothers also mediated the association between maternal depression and children’s behavioral problems, highlighting the relevance of interventions with mothers with depression indicators that have school-age children.

Adolescent psychopathology in times of change: Introduction to the special issue

The aim of this special issue is to understand better the many changes in adolescent psychopathology have taken place over the last decades. The factors associated with adjustment problems and psychopathology in adolescence today are not necessarily the same as the factors that predicted problems and psychopathology in the past. But the basic strategies for connecting negative experiences with adolescent psychopathology remain as important today as they were for understanding adolescent psychopathology decades ago. This is well exemplified in the studies included in this Special Issue. What all this studies have in common is that parenting and the family environment are assumed to play a key role in adolescents' adjustment and psychopathology. Finally, given that all papers in this special issue are based on conference presentations at the 15th Biennial Conference of the European Association for Research on Adolescence (EARA), some more information on that conference in included in this introduction.

Adolescent psychopathology in Times of Change: The need for integrating a developmental psychopathology perspective

In addition to the major physical, sexual and cognitive changes, as well as changes in relationships with parents and peers, in recent years adolescents also have to cope with many technological changes and increasing societal instabilities. Most of the existing research has examined the extent to which increasing uncertainties might impact expression of psychopathology and its magnitude. Emerging from a developmental psychopathology perspective, we are looking first for a better understanding of the meaning that adolescents give to these changes, which in turn is likely to affect their behavior. We are also looking for better understanding the importance of the role parents, and other societal systems/institutions (such as peers) play in ameliorating or enhancing the likelihood of maladaptive adolescent behavior under these circumstances.