Depression in 3/6-year-old children: clinical and psychosocial outcomes in later childhood and adolescence

Dimensions of Depressive Symptoms in Young Children: Factor Analysis of the Preschool Feelings Checklist-Scale

The current study is an investigation of the dimensionality of the Preschool Feelings Checklist-Scale (PFC-S), a caregiver-report questionnaire of early childhood depressive symptom severity. Caregivers of 450 young children, ages 3-8 years (M = 5.62, SD = 0.95; 49% female; 7% Hispanic; 66% White), completed the PFC-S and questionnaires on child emotion regulation and expression and self-reported depressive symptomatology. Confirmatory factor analyses indicated that a one-factor structure did not adequately fit the current PFC-S data. Using exploratory factor analysis, a three-factor structure emerged as interpretable and structurally sound, yielding reliable factors related to social and behavioral anhedonia, emotional and behavioral dysregulation, and excessive guilt and sadness. This factor structure showed configural and scalar invariance across preschool-aged and early middle childhood-aged children as well as children assigned male and female sex at birth. Correlations between the three factors and constructs related to depression suggested preliminary construct validity. The current study provides initial evidence for a multidimensional structure of the PFC-S and improves our understanding of early childhood depressive symptoms.

Comparison of Global and Daily Ratings of Associations between Anxiety and Depressive Behaviors and Impairment in Preschool-Aged Children

Anxiety and depressive difficulties can emerge during early childhood and cause impairment in functioning. Anxiety and depressive behaviors and impairment are typically assessed with global questionnaires that require recall of children's behavior over an extended period which could reduce the accuracy of parent report of children's behavior and functioning. The current study compared parents' report of children's anxiety and depressive behaviors and impairment when evaluated with global measures versus a daily diary measure. Participants (N = 901 parents of 3-5-year-old children) completed global and daily measures of children's behavior and impairment during enrollment to the study. Global measures were completed at baseline and the 14 daily diary measures were completed consecutively for two weeks. Across most measures, daily associations between parent-reported anxiety and depressive behaviors and impairment were stronger compared to associations with global measures. These results suggest that daily measures may better capture links between young children's typical behavior and functioning compared to global measures. In addition, daily assessment might be more effective for measuring mild to moderate yet still impairing behaviors that may be missed on global reports that require longer periods of recall.

Research, practice, and data informed investigations of child and youth suicide: A science to service and service to science approach

BACKGROUND

Suicide rates for children and adolescents have been increasing over the past 2 decades. In April 2023, the National Institute of Mental Health (NIMH) convened a two-day workshop to address child and youth suicide.

PURPOSE

The workshop focus was to discuss the state of the science and stimulate a collaborative response between researchers, death investigators, and data collection teams to build a science to service and service to science approach toward understanding - and ultimately preventing - this growing problem of child and youth suicide.

HIGHLIGHTS

Topics that meeting participants highlighted as worthy of further consideration for research and practice were: increasing awareness among death investigators, medical examiners, and coroners that child suicide deaths under age 10 years do occur and should be investigated and documented accordingly; emphasizing the value of science based protocols for child and youth death investigations to enhance consistency of approaches; and articulating needs for postvention services to suicide loss survivors.

OUTCOMES

The importance of collecting an accurate and complete cause and manner of death (i.e., unintentional, suicide, homicide, undetermined) among all child decedents, and demographic information such as race, ethnicity, and sexual/gender minority status was underscored as critical for enhanced surveillance. For prevention efforts, approaches to assessing and understanding suicidal thoughts and behaviors among diverse groups of children, and the variability in proximal and distal risk factors are needed to inform opportunities for preventive interventions for diverse communities. The need for consistent measures and processes to improve death investigations, fatality review committees, and coordination between data collection systems and agencies was also raised.

PRACTICAL APPLICATIONS

Collaborations among researchers, death investigators, and data collection teams can help to fully describe the child and youth suicide crisis and provide actionable information for new research, and prevention and response efforts.

Preschool-Onset Major Depressive Disorder as a Strong Predictor of Suicidal Ideation and Behaviors Into Preadolescence

OBJECTIVE

Suicidal thoughts and behaviors (STBs) in children are an escalating public health concern. This study focused on 1 understudied candidate risk factor, namely, preschool-onset major depressive disorder (PO-MDD), as a predictor of persistent and emerging STBs from early childhood into preadolescence.

METHOD

Participants were 137 children 8 to 12 years of age who met criteria for PO-MDD when they were 3 to 6 years of age, and a nondepressed sample of 53 age-, income-, and sex-matched peers. STBs were reported by caregivers (preschool, preadolescence) and children (preadolescence) using age-appropriate diagnostic interviews.

RESULTS

By preadolescence, children who had PO-MDD were 7.38 times more likely than their peers to have endorsed STBs after early childhood (p < .001; 67.9% vs 22.6%), including 6.71 times more likely to have engaged in suicide behaviors/attempts (p = .012; 21.9% vs 3.8%); they were also 8.98 times more likely to have endorsed STBs over the prior month (p = .005; 26.3% vs 3.8%). Similar findings emerged when limiting the PO-MDD group to children without preschool STBs, and when controlling for externalizing comorbidities, implicating PO-MDD as a unique diagnostic predictive risk factor. However, children who had PO-MDD with STBs were 3.46 times more likely than children who had PO-MDD without STBs to endorse later STBs (p = .018; 83.1% vs 54.2%), indicating substantial continuity of preschool STBs alongside strikingly high rates of emerging STBs into preadolescence.

CONCLUSION

PO-MDD is a strong risk factor for the emergence and persistence of STBs into preadolescence. Children with PO-MDD would likely benefit from increased suicide screening, proactive safety planning, and early interventions.

Effects of RhoA on depression-like behavior in prenatally stressed offspring rats

Depression is a common mental disease that can lead to suicide when severe. Exposure to prenatal stress (PS) can lead to depression-like behavior in offspring, but the mechanism is unclear. RhoA (Ras homology family member A) plays an important role in stress-induced changes in synaptic plasticity, participating in the development of depression by activating the downstream effector ROCK (Rho-associated protein kinase). This study explored the influence in the expression of RhoA and downstream molecules ROCK1/2 in prenatally stressed rats, and the effect of RhoA inhibitor simvastatin on depression-like behavior induced by PS. Depression-like behavior in offspring was detected by sucrose preference test, forced swimming test, and open-field test. The mRNA and protein expression of RhoA and ROCK1/2 in the hippocampus and prefrontal cortex of offspring rats were detected by qRT-PCR and western blotting, respectively. Our results showed that PS causes depression-like behavior in offspring rats, associated with elevated expression of RhoA, ROCK1/2 in the hippocampus and prefrontal cortex. After administration of simvastatin to PS rats, the expression of RhoA and ROCK2 was significantly reduced, alleviating depression-like behavior. Our study demonstrated that RhoA participates in the depression-like behavior in prenatally stressed offspring rats, which may be a potential target for antidepressant therapy.