Youth Depression in the Family Context: Familial Risk Factors and Models of Treatment

Abstract

Research on parent risk factors, family environment, and familial involvement in the treatment of depression in children and adolescents is integrated, providing an update to prior reviews on the topic. First, the psychosocial parent and family factors associated with youth depression are examined. The literature indicates that a broad array of parent and family factors is associated with youth risk for depression, ranging from parental pathology to parental cognitive style to family emotional climate. Next, treatment approaches for youth depression that have been empirically tested are described and then summarized in terms of their level of parent inclusion, including cognitivebehavioral therapy, interpersonal therapy, and family systems approaches. Families have mostly not been incorporated into clinical treatment research with depressed adolescents, with only 32% of treatments including parents in treatment in any capacity. Nonetheless, the overall effectiveness of treatments that involve children and adolescents exclusively is very similar to that of treatments that include parents as agents or facilitators of change. The article concludes with a discussion of the implications of these findings and directions for further research. Keywordsdepression; adolescence; childhood; treatment; parent factors; family risk factors Developmentally, youth are known to have close ties to their families of origin (Diamond, Siqueland, & Diamond, 2003;Steinberg, 2005). As a result, there is a general belief in the field of psychology that it is important to include parents and families in the treatment of depressed youth (Clark, Beck, & Alford, 1999;Curry, 2001) however, empirical guidelines for how to do so are lacking. Consensus about the need for, and how to measure the effects of, parental involvement in treatment is elusive (Goodman & Gotlib, 1999). Still, achieving a better understanding of the multidimensional nature of risks for depression and how parent involvement in treatment relates to those risks are the priorities for the area of youth depression.Recently, a national group of experts was called to summarize and prioritize the state of research on risk and treatment for youth depression. Specifically, the National Institutes of Mental Health (NIMH) invited a workgroup of leaders in the field of depression to clarify the state of information about the risks for and treatment of depression, and to make recommendations on where the field needs to focus research endeavors (Costello et al., 2002). Regarding risks for depression, the workgroup recommended further research into both family environment and genetics. As summarized by Costello and the NIMH workgroup, multiple pathways to depression are evident. The workgroup emphasized the multidimensional NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript nature of depression, along with the paucity of research into the early pathways and interactions that cause depression. Although research has not identified all of the parent or family ...

Práticas alimentares parentais: a percepção de crianças acerca das estratégias educativas utilizadas no condicionamento do comportamento alimentar

“…As pesquisas que investigam as práticas educativas parentais apontam que elas estão relacionadas a diversos comportamentos, tais como: comportamentos antissociais dos filhos (Salvador & Weber, 2005); habilidades sociais dos filhos (Löhr, 2003;Weber, Flor, Viezzer, & Gusso, 2004); com maior facilidade do filho em enfrentar situações estressoras (Clark, Novak, & Dupree, 2002;Meesters & Murris, 2004;Wolfradt, Hempel, & Miles, 2003); sintomas depressivos nos filhos (Darling, 1999;Menegatti, 2002;Sander & McCarty, 2005); sintomas ansiosos (Hudson & Rapee, 2001;Weber, Biscaia, Pavei, & Brandenburg, 2003;Wolfradt, Hempel & Miles, 2003); comportamento agressivo (Alvarenga & Piccini, 2001;Ferreira & Marturano, 2002;Oliveira, Marin, Pires, Frizzo, Ravanello, & Rossato, 2002;Salvo, Silvares, & Toni, 2005); e com o uso de drogas e substâncias ilícitas (Cottrell, LI, Harris, D'alessandri, Atkins, Richardson, & Stanton, 2003;Sale, Sambrano, Springer, Peña, Pan, & Kasim, 2005).…”

Mood disorders in children and adolescents: update for pediatricians

“…Alguns estudos mostraram que, quando existe história familiar de qualquer tipo de TH, a criança tem um risco maior de desenvolver TDM 36 . Estudos de concordância entre gemelares também demonstram o peso do fator genético.…”

The Depression Impairment Scale for Parents (DISP): A new scale for the measurement of impairment in depressed parents

“…When examining this, it may be prudent to measure the parent′s impairment in areas that are more salient to offspring, such as family processes. A large corpus of research has implicated factors such as parent-offspring conflict (Rueter et al, 1999), adverse family environments (Eley et al, 2004;Sander and McCarty, 2005), parenting behaviour (Alloy et al, 2006), and marital difficulties (Cummings et al, 2005;Downey and Coyne, 1990) in the onset and maintenance of offspring depressive symptoms. Whilst time constraints of research and clinical protocols preclude the use of separate questionnaires to assess each domain of familial functioning, incorporating elements of this research into an impairment questionnaire for parents may be pertinent when assessing intergenerational transmission of depression.…”