Causal processes in development and psychopathology

The impact of childhood parental quality on mental health outcomes in older adults

OBJECTIVE

Parental bonding is cited as a determinant of mental health outcomes in childhood, adolescence and early-mid adulthood. Examination of the long-term impact for older adults is limited. We therefore examine the long-term risk of perceived poor parental bonding on mental health across the lifespan and into early-old age.

METHODS

Participants (N = 1255) were aged 60-64 years of age and drawn from the Australian Life Histories and Health study. Quality of parental bonding was assessed with the Parental Bonding Instrument (PBI). Self-reported history of doctors' mental health diagnoses and current treatment for each participant was recorded. Current depression was assessed with the Centre for Epidemiologic Studies Depression-8 (CESD-8). Due to known gender differences in mental health rates across the lifespan, analyses were stratified by sex.

RESULTS

A bi-factor analysis of the PBI in a structural equation framework indicated perceived Poor Parental Quality as a risk for both ever and current depression for both sexes. For males, Over-Protective Fathers were a risk for ever and current depression, whilst overall Poor Parental Quality was a risk for reporting current depression treatment. Whilst a number of the risks associated with current depression and treatment were attenuated when controlling for current mood, parental quality remained a significant risk for having reported a lifetime diagnosis for depression and anxiety for men.

CONCLUSION

Our results extend the existing literature base and demonstrate that mental health risk attributed to poor perceived parental quality continues across the life-course and into early-old age.

Pre-adoption adversity and self-reported behavior problems in 7 year-old international adoptees

To further investigate the long-term impact of pre-adoption adversity on international adoptees, externalizing and internalizing symptoms were assessed using a self-report measure at school-age in addition to mothers' reports. The sample consisted of 95 adopted children and their mothers. Children's health and developmental status were assessed soon after arrival in their adoptive family. At age 7, the Dominic Interactive, a self-report measure, was used to evaluate externalizing and internalizing symptoms while mothers completed the CBCL. Children's self-reports were compared to their non-adopted peers'. Adopted children reported more symptoms of specific phobia than their peers. A significant correlation was found between mothers' and children's reports but only for externalizing symptoms. Self-reported symptoms were related to indices of nutritional and psychosocial deprivation at arrival, such as low height/age and weight/height ratios. Our results emphasize the importance of considering international adoptees' perception of their psychological adjustment and the long-term impact of early risk factors.

Family relationships in childhood and common psychiatric disorders in later life: systematic review of prospective studies

BACKGROUND

Most evidence for associations between childhood adversity and adult mental illness is retrospective.

AIMS

To evaluate prospective evidence of associations between poor parent-child relationships and common psychiatric disorders in later life.

METHOD

Systematic review of studies published between 1970 and 2008 including: (a) more than 100 participants; (b) measures of relationships in the home during childhood; (c) at least 10 years between assessment of exposures; and (d) measures of anxiety, depression, suicide, suicidal ideation or post-traumatic stress disorder (PTSD). Analysis was by narrative synthesis.

RESULTS

Twenty-three papers were identified reporting data from 16 cohorts. Abusive relationships predicted depression, anxiety and PTSD. Maternal emotional unavailability in early life predicted suicide attempts in adolescence. Results of studies investigating less severe relationship problems were suggestive but not conclusive of causal association, due partly to methodological heterogeneity.

CONCLUSIONS

Given the prevalence and disabling nature of common psychiatric problems, these studies highlight the need to minimise harm associated with dysfunctional parent-child relationships.

Visualizing Multivariate Dependencies with Association Chain Graphs

In a recent paper, a new type of graph to visualize the results from graphical models was proposed. Association chain graphs (ACGs) provide a richer visualization than conventional graphs (directed acyclic and recursive regression graphs) if the data can be described with only a small number of parameters. ACGs display not only which associations reach statistical significance, but also the magnitude of associations (confidence intervals for statistical main effects) as the contrast color to the background color of the graph. In this paper, the ACG visualization is extended especially for the case where all variables are binary by illustrating their relative frequencies. This shows the degrees of associations not only on the individual (as expressed by odds ratios or other indexes of association) but also on the community level. We applied the approach to an extensive example of birth and childhood factors for the onset of affective mental disorders using data from the EDSP (Early Developmental Stages of Psychopathology) Study.

Correlations among socioeconomic and family factors and academic, behavioral, and emotional difficulties in Filipino adolescents in Hawai'i

BACKGROUND

Because of socioeconomic and acculturative challenges faced by immigrant families, Filipino adolescents in Hawai'i may be at risk for academic, behavioral and emotional difficulties.

AIM

To determine, among Filipino adolescents in Hawai'i, whether measures of economic hardship and lower socioeconomic status (SES) correlate positively with poor school performance, aggressive behavior, substance use, anxiety, and depression; and whether family support and cultural identification correlate negatively with these difficulties.

METHODS

216 Filipino adolescents from four public high schools in Hawai'i (1993-1994) were given surveys that assessed basic demographic information, measures of family support and other social variables, and measures of school performance, depression, anxiety, aggression and substance use.

RESULTS

In the total sample, low SES seemed to correlate with poor school performance and behavioral and emotional difficulties. In both the total sample and the sub-sample of adolescents with lower SES, family support was a universally strong protective factor. Learning genealogy was positively correlated with school performance, and speaking a language other than English was inversely correlated with substance use (in the whole sample) and depression (in the lower SES sub-sample).

CONCLUSIONS

For Filipino adolescents (in both the whole and lower-SES samples), family support was an important protective factor against academic, behavioral and emotional difficulties. The role of cultural identification as a risk or protective factor among Filipino adolescents deserves further investigation.

[Multiprofessional care and mental health in pregnant women]

OBJECTIVE

To identify non-psychotic affective disorders in pregnant women, to intervene by means of psychoprophylactic groups, and to evaluate possible alterations following intervention.

METHODS

One-hundred and three pregnant women (71 adults and 32 adolescents) were seen at a community program in the Paraisópolis neighborhood in the city of Sao Paulo, southeastern Brazil. We used the following instruments: Self Reporting Questionnaire and Beck Depression Inventory. Ten weekly two-hour meetings were held, addressing the link between mother and fetus and subjects related to mother and child, and answering mother's doubts. We used the chi-squared test (chi2) to compare mental health before and after the intervention, with a significance level of p<0.05.

RESULTS

Affective disorders were found in 45 pregnant women (43.7%) before the intervention and in 23 (22.3%) after the intervention. The impact of the intervention on affective disorders was statistically significant (p=0.001). Twenty-one women (20.4%) showed depression before the intervention, and 13 (12.6%) after the intervention, a non-significant difference (p=0.133).

CONCLUSIONS

Multiprofessional care can prevent, detect, and treat affective disorders during pregnancy in both adults and adolescents.

Prediction of behavioral problems in Chilean schoolchildren

Five hundred and thirty five Chilean schoolchildren were evaluated with a test-retest procedure using teacher and parent questionnaires in first and sixth grade, respectively, and a measure of self-esteem in sixth grade. According to teachers' ratings, disobedience/aggression, shyness and hyperactivity persisted. Cross-predictions were found: disobedience/aggression increased the risk of cognitive/concentration problems, which predicted emotional immaturity, while hyperactivity predicted disobedience/aggression. Teacher's global opinion of poor achievement predicted cognitive/concentration problems, and poor conduct predicted hyperactivity. Behavioral problems rated by parents in first grade predicted their persistence. Detection of problems in first grade predicts sixth grade outcomes, providing information for implementing preventive interventions.

Adverse effects of maternal antenatal anxiety on children: causal effect or developmental continuum?

There is much literature on the effects on the developing brain of adverse events in pregnancy and the sensitive period postpartum, both in humans and in animals (Perry &amp; Pollard, 1998). The study published by O'Connor etal(2002, this issue) contributes to this by suggesting that maternal antenatal anxiety increases the risk of behavioural problems in early childhood. They suggest that this could be due to the direct effect of maternal anxiety and stress on foetal brain development. This study also contributes to the longstanding and increasing evidence base that suggests that maternal mental ill health is related to childhood difficulties (Murray et al, 1996).