Family Resilience Progress from the Perspective of Parents of Adolescents with Depression: An Interpretative Phenomenological Analysis

Knowledge, attitudes, and practices of adolescent depression among parents of children diagnosed with depression in Ningbo City, eastern China

Objective

To investigate parental knowledge, attitudes, and practices (KAP) toward adolescent depression.

Methods

A cross-sectional survey was conducted between October 2022 and October 2023 at The First Affiliated Hospital of Ningbo University among parents of adolescents diagnosed with depression. A self-administered questionnaire was used to collect the parents' demographic characteristics and KAP toward adolescent depression.

Results

A total of 522 questionnaires were collected from parents of depressed adolescents. Among the participants, 383 (73.37%) were female. In addition, 426 participants (81.61%) had children aged 14-18. The mean knowledge, attitude, and practice scores were 9.09 ± 2.37 (possible range: 0-12), 37.04 ± 4.11 (possible range: 11-55), and 31.53 ± 3.84 (possible range: 8-40), respectively. There were significant positive correlations between knowledge and attitude (r = 0.225, p < 0.001), knowledge and practice (r = 0.240, p < 0.001), and attitude and practice (r = 0.381, p < 0.001). The path analysis showed significant direct effects of knowledge on attitude (β = 0.422, p < 0.001) and practice (β = 0.283, p < 0.001). There was an indirect effect of knowledge on practice through attitude (β = 0.131, p = 0.004). Attitude directly impacted practice (β = 0.311, p < 0.001).

Conclusion

Parents of adolescents diagnosed with depression exhibited moderate KAP regarding adolescent depression. The study underscored the importance of targeted interventions to improve parental KAP in supporting adolescents with depression. Moreover, future research should explore additional factors influencing parental attitudes and behaviors toward adolescent depression to develop more effective interventions.

The lived experience of mental disorders in adolescents: a bottom-up review co-designed, co-conducted and co-written by experts by experience and academics

We provide here the first bottom-up review of the lived experience of mental disorders in adolescents co-designed, co-conducted and co-written by experts by experience and academics. We screened first-person accounts within and outside the medical field, and discussed them in collaborative workshops involving numerous experts by experience - representing different genders, ethnic and cultural backgrounds, and continents - and their family members and carers. Subsequently, the material was enriched by phenomenologically informed perspectives and shared with all collaborators. The inner subjective experience of adolescents is described for mood disorders, psychotic disorders, attention-deficit/hyperactivity disorder, autism spectrum disorders, anxiety disorders, eating disorders, externalizing disorders, and self-harm behaviors. The recollection of individuals' past histories also indexes the prodromal (often transdiagnostic) features predating the psychiatric diagnosis. The experience of adolescents with mental disorders in the wider society is described with respect to their family, their school and peers, and the social and cultural context. Furthermore, their lived experience of mental health care is described with respect to receiving a diagnosis of mental disorder, accessing mental health support, receiving psychopharmacological treatment, receiving psychotherapy, experiencing peer support and mental health activism, and achieving recovery. These findings can impact clinical practice, research, and the whole society. We hope that this co-designed, co-conducted and co-written journey can help us maintain our commitment to protecting adolescents' fragile mental health, and can help them develop into a healthy, fulfilling and contributing adult life.

Parental Perception of Children's Mental Health During the Pandemic: Insights From an Italian Cross-Sectional Study

BACKGROUND

This study explores the impact of the pandemic on children's mental health. It examined the understanding of parents regarding their children's mental condition and their ability to identify issues, 2 years post the outbreak of the COVID-19 pandemic.

METHODS

Using a cross-sectional design, 507 Italian parents reported on their youngest child aged between 2 and 17, totaling 507 children. The outcomes focused on were parental perception of children's mental health deterioration, scores on the Strengths and Difficulties Questionnaire (SDQ) above the clinical cut-off, and parental under-recognition of mental health issues. Descriptive analyses and multivariable logistic regression models were executed (significance at p < .05).

RESULTS

Parents were 88.1% women (median age 41 years, interquartile range [IQR] = 36-47). Their children were 50.3% female [median age 6 years (IQR = 4-11)]. The data revealed 21.1% of parents perceived a deterioration in their children's mental health, while 44.2% had SDQ scores above the cut-off. Parental under-recognition of mental issues was found in 20.1% of cases. Significant correlations were found between parental perception of deterioration, SDQ scores, and factors like parental mental distress and children's sleep issues.

IMPLICATIONS

The findings suggest that schools and verified websites can serve as critical conduits for providing parents with reliable information. By promoting early identification and intervention, such mechanisms can help ensure mental health equity for children.

CONCLUSIONS

The research highlights the effect of the pandemic on children's mental health and the issue of parental under-recognition. The results underscore the importance of public health initiatives that enhance mental health information accessibility and reliability for parents.

The relationship between family communication and family resilience in Chinese parents of depressed adolescents: a serial multiple mediation of social support and psychological resilience

BACKGROUND

Family resilience plays a crucial role in helping depressed adolescents overcome challenges. However, studies examining family resilience in depressed adolescents are currently scarce. This study, guided by the family resilience framework, aimed to investigate the serial-multiple mediation of social support and psychological resilience between family communication and family resilience in Chinese families of depressed adolescents.

METHODS

In 229 parents of adolescents with major depressive disorder, 20.1% comprises of fathers, while 79.9% comprises of mothers. The mean age of depressed adolescents was 14.84 (±1.76) years, and the mean age of parents of these depressed adolescents was 43.24 (±4.67) years. The Family Resilience Assessment Scale (FRAS), the Psychological Resilience of Parents of Special Children Questionnaire, and the Social Support Rating Scale, Family Assessment Device (FAD) were used to collected data. Descriptive, univariate, and Pearson correlation analyses were used in preliminary analyses. To explore mediation, we employed a serial-multiple mediation model (PROCESS model 6).

RESULTS

Family communication was positively correlated with family resilience, social support, and psychological resilience. Mediation analysis revealed indirect effects of family communication on family resilience, which were mediated solely by either social support or psychological resilience, or through multiple mediation pathways involving both social support and psychological resilience.

CONCLUSIONS

Family communication positively and directly affects the family resilience of depressed adolescents, and a higher level of social support and psychological resilience can help improve family resilience. These findings not only provide empirical evidence supporting the family resilience framework but also have practical implications for future family interventions targeting depressed adolescents.