Pathways to prevention for children of depressed mothers: a review of the literature and recommendations for practice

Targeting positive valence systems function in children of mothers with depressive symptoms: A pilot randomized trial of an RDoC-Informed preventive intervention

Reduced activation of the Research Domain Criteria (RDoC) positive valence systems (PVS) is observed in high-risk (HR) children of depressed mothers and predictive of future psychopathologies. We developed a dyadic, neuroscience-informed preventive intervention, Family Promoting Positive Emotions (FPPE), designed to prevent psychopathology in HR children by targeting PVS processes. We evaluated the initial efficacy of FPPE compared to written information (WI) psychoeducation in engaging PVS-related targets and reducing perceived stress and emotional distress symptoms in HR youth. Participants included 74 children ages 8-12 years and their biological mothers reporting elevated depressive symptoms. Following random assignment, 55 dyads completed FPPE (n = 29) or WI (n = 26) and pre-post assessments of child clinical symptoms. Youth completed a reinforcement learning task and 10 days of positive affect ratings to assess PVS-related targets. Results revealed a small within-subjects increase in child daily positive affect in FPPE, but not WI. Further, FPPE resulted in reductions in mother-reported child perceived stress and symptoms of anger, anxiety, and depression with medium-to-large within-subjects effects. Intervention effects on reinforcement learning and child-rated clinical symptoms were not observed. This study suggests FPPE shows promise in enhancing positive affect and reducing the emergence of clinical symptoms in HR children. CLINICALTRIALS.GOV IDENTIFIER: NCT05223842.

Stressors and Coping Methods of Turkish Adolescents With High and Low Risk of Depression: A Qualitative Study

BACKGROUND

Stress and coping skills are essential factors in the etiology of depression. Understanding the stressors and coping strategies of adolescents in Turkey may help determine the content of the country-specific depression prevention program.

AIMS

The purpose of this study was to understand the stressors of adolescents with a high or low risk of depression and how they coped with these stressors.

METHOD

This descriptive qualitative study was conducted in a high school in western Turkey. The data were collected via semistructured individual interviews. Eleven adolescents with high risk of depression and 10 adolescents with low risk of depression were included in the study. Content analysis technique was used to analyze the data.

RESULTS

The stressors of adolescents and their coping were grouped into three themes: stressors, factors affecting coping strategies of adolescents, and coping. Stressors theme consists of three subthemes: family relationship, peer relationship, and telephone/internet usage. The factors affecting coping strategies of adolescents theme consists of four subthemes: cognitive distortions, self-perception, family relationships, and peer relationships. The coping theme consists of two subthemes: engagement coping and disengagement coping.

CONCLUSIONS

It was determined that adolescents with a high risk of depression had more stressors and used more disengagement-coping techniques. It is recommended that to prevent depression among adolescents, school nurses should take initiatives to strengthen the coping strategies of adolescents with high risk of depression.

Socio-Demographic and Coping Correlates and Predictors of Depressive Symptoms Among Low-Income and Ethnic Minority Mothers At-Risk

This study identified coping and sociodemographic correlates and predictors of depressive symptoms in mothers at risk for clinical depression. A descriptive, cross-sectional design was employed. A convenience sample of 88 low-income or ethnic-minority mothers aged 21 to 45 completed a depression scale, demographic data sheet, and responded to an open-ended question. Content analysis, descriptive, and inferential statistics was used for data analysis. Exactly 42.5% of mothers reported high depressive symptoms (>16). Lower income levels (r = .342, p = .01) and head-of-household status (r = .220, p = .04) were significantly associated with higher depressive symptoms. Those who used social support coping had lower depressive symptoms than those who did not (t = 2.50, p = .014). Those using emotion-focused coping only had higher depressive symptoms than those using a mix of coping strategies (t = 2.60, p = .011). Healthcare providers can employ vigilant depression screening and encourage utilization of a mix of problem and emotion-focused coping strategies to reduce depressive symptoms and prevent clinical depression.

Temporal effects of maternal psychological distress on child mental health problems at ages 3, 5, 7 and 11: analysis from the UK Millennium Cohort Study

BACKGROUND

Psychological distress is common among women of childbearing age, and limited longitudinal research suggests prolonged exposure to maternal distress is linked to child mental health problems. Estimating effects of maternal distress over time is difficult due to potential influences of child mental health problems on maternal distress and time-varying confounding by family circumstances.

METHODS

We analysed the UK Millennium Cohort Study, a nationally representative sample with data collected throughout childhood. Adopting a marginal structural modelling framework, we investigated effects of exposure to medium/high levels of maternal psychological distress (Kessler-6 score 8+) on child mental health problems (Strengths and Difficulties Questionnaire borderline/abnormal behaviour cut-off) using maternal and child mental health data at 3, 5, 7 and 11 years, accounting for the influence of child mental health on subsequent maternal distress, and baseline and time-varying confounding.

RESULTS

Prior and concurrent exposures to maternal distress were associated with higher levels of child mental health problems at ages 3, 5, 7 and 11 years. For example, elevated risks of child mental health problems at 11 years were associated with exposure to maternal distress from 3 years [risk ratio (RR) 1.27 (95% confidence interval (CI) 1.08-1.49)] to 11 years [RR 2.15 (95% CI 1.89-2.45)]. Prolonged exposure to maternal distress at ages 3, 5, 7 and 11 resulted in an almost fivefold increased risk of child mental health problems.

CONCLUSIONS

Prior, concurrent and, particularly, prolonged exposure to maternal distress raises risks for child mental health problems. Greater support for mothers experiencing distress is likely to benefit the mental health of their children.