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Objective To identify symptom dimensions of depression that predict recovery among SSRI-treatment resistant adolescents undergoing second-step treatment. Method The Treatment of Resistant Depression in Adolescents (TORDIA) trial included 334 SSRI-treatment resistant youth randomized to a medication switch, or a medication switch plus CBT. This study examined five established symptom dimensions (Child Depression Rating Scale-Revised) at baseline as they predicted recovery over 24 weeks of acute and continuation treatment. The two indices of recovery that were evaluated were time to remission and number of depression-free days. Results Multivariate analyses examining all five depression symptom dimensions simultaneously indicated that Anhedonia was the only dimension to predict a longer time to remission, and also the only dimension to predict fewer depression-free days. In addition, when Anhedonia and CDRS-total score were evaluated simultaneously, Anhedonia continued to uniquely predict longer time to remission and fewer depression-free days. Conclusions Anhedonia may represent an important negative prognostic indicator among treatment resistant depressed adolescents. Further research is needed to elucidate neurobehavioral underpinnings of anhedonia, and to test treatments that target anhedonia in the context of overall treatment of depression.

This article examined the effects of maternal depression during the postpartum period (Time 1) on the later behavior problems of toddlers (Time 3) and tested if this relationship was moderated by paternal psychopathology during toddlers’ lives and/or or mediated by maternal parenting behavior observed during mother–child interaction (Time 2). Of the 101 mothers who participated in this longitudinal study with their toddlers, 51 had never experienced an episode of Major Depressive Disorder (MDD) and 50 had experienced an episode of MDD during the first 18 months of their toddlers’ lives. Maternal depression at Time 1 was significantly associated with toddlers’ externalizing and internalizing behavior problems only when paternal psychopathology was present. As predicted, maternal negativity at Time 2 was found to mediate the relationship between maternal depression at Time 1 and toddlers’ externalizing behavior problems at Time 3.

Objective-To compare mother-child interactions and parenting styles in families of children with major depressive disorder, youths at high risk for depression, and healthy controls.Method-Currently depressed (n = 43), high-risk (n = 28), and healthy control (n = 41) youths and their mothers engaged in a standardized videotaped problem-solving interaction. Measures of affect and behavior for both mothers and children were obtained, in addition to global measures of parenting.Results-Depressed children demonstrated more negativity and less positivity in dyadic interactions than did children at high risk and control children. Mothers of depressed children were more disengaged than control mothers. Exploratory repeated-measures analyses in a subgroup of depressed children (n = 16) suggested mother-child interactions do not significantly change when children recover from depression. Children at high risk demonstrated less positivity in dyadic interactions than did controls. Mothers with a history of major depressive disorder and mothers with higher current depressive symptoms demonstrated patterns of disengagement and low control in interactions with children.Conclusions-Mother-child interactions in depressed youths are marked by maternal disengagement and low child positivity that may not improve when children recover. The bidirectional effects of maternal disengagement and low levels of child positivity may precede onset of major depressive disorder in children and serve as risk factors for recurrent depression in youths.Keywords major depressive disorder; high risk; mother-child interaction; parenting Family interactions provide a rich context for studying the bidirectional relationship between interpersonal environments and the onset and course of psychopathology in depressed children and adolescents. Depressed children and adolescents have discordant family relationships, marked by high rates of conflict, hostility, rejection, low support and cohesion, Copyright © 2008 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript and poor communication, [1][2][3][4][5] that may persist after children and adolescents recover from acute depressive episodes. 6,7 As such, maladaptive family interactions have been postulated to be one of the mechanisms by which depression develops and is maintained in at-risk children and adolescents. 4,8 Research on children of depressed mothers further indicates that poor family functioning, negative mother-child interactions and maladaptive parenting strategies may predate the development of depression in children with familial loading for depression. 9,10 Because of the bidirectional nature of child and parent factors that contribute overall discordant interactions in families of depressed children, it remains unclear whether negative family interactions precede depression in children and adolescents or whether negative family interactions are a consequence of children's depressive symptoms 1,11-13 or both. Two recently published studies sought to untangle ...