Does supportive parenting mitigate the longitudinal effects of peer victimization on depressive thoughts and symptoms in children?

Cohen and Wills (Cohen, S., & Wills, T. A., 1985, Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310-357) described two broad models whereby social support could mitigate the deleterious effects of stress on health: a main effect model and stress-buffering model. A specific application of these models was tested in a three-wave, multimethod study of 1888 children to assess ways parental support (social support) mitigates the effects of peer victimization (stress) on children's depressive symptoms and depression-related cognitions (health-related outcomes). Results revealed that (a) both supportive parenting and peer victimization had main effects on depressive symptoms and cognitions; (b) supportive parenting and peer victimization did not interact in the prediction of depressive thoughts and symptoms; (c) these results generalized across age and gender; and (d) increases in depressive symptoms were related to later reduction of supportive parenting and later increase in peer victimization. Although supportive parenting did not moderate the adverse outcomes associated with peer victimization, results show that its main effect can counterbalance or offset these effects to some degree. Implications for practice and future research are discussed.

The influence of depressive symptoms on suicidal ideation among U.S. Vietnam-era and Afghanistan/Iraq-era veterans with posttraumatic stress disorder.

Major depressive disorder (MDD) co-occurs frequently with posttraumatic stress disorder (PTSD), and both disorders are linked to suicidal ideation. An emergent literature examines suicidal ideation in U.S. Afghanistan/Iraq-era veterans. Little research, however, has studied the role of PTSD and comorbid MDD on suicidal ideation across service eras. Therefore, this study aimed to examine the impact of depression on suicidal ideation in Afghanistan/Iraq-era and Vietnam-era veterans with PTSD. The sample included 164 Vietnam and 98 Afghanistan/Iraq veterans diagnosed with PTSD at a VA outpatient PTSD Clinic. Using structured interviews, 63% of the Vietnam sample and 45% of the Afghanistan/Iraq sample were diagnosed with comorbid current MDD. Measures included self-report assessments of PTSD and depressive symptoms and the Personality Assessment Inventory. Results of analyses suggested that in veterans of both eras, PTSD, MDD, and their interaction were significantly related to suicidal ideation (PTSD: η(2) = .01; MDD: η(2) = .10; PTSD × MDD: η(2) = .02). For veterans reporting greater depressive symptoms, there was a stronger relationship between PTSD symptoms and suicidal ideation. These results suggest that veterans from both eras display a similar clinical presentation and highlight the need to consider depressive symptoms when assessing veterans with PTSD. Future research should examine suicidal ideation and behaviors as they change over time in these two cohorts.

Impact of physical and relational peer victimization on depressive cognitions in children and adolescents.

The purpose of this study is to find longitudinal evidence of the effect of targeted peer victimization (TPV) on depressive cognitions as a function of victimization type and gender. Prospective relations of physical and relational peer victimization to positive and negative self-cognitions were examined in a 1-year, 2-wave longitudinal study. Self-reports of cognitions and both peer nomination and self-report measures of peer victimization experiences were obtained from 478 predominantly Caucasian children and young adolescents (Grades 3-6 at the beginning of the study) evenly split between genders. As a result, (a) peer victimization predicted increases in negative cognitions and decreases in positive cognitions over time; (b) relational victimization was more consistently related to changes in depressive cognitions than was physical victimization; (c) the prospective relation between victimization and depressive cognitions was stronger for boys than for girls; and (d) when the overlap between relational and physical TPV was statistically controlled, girls experienced more relational TPV than did boys, and boys experienced more physical TPV than did girls. Peer victimization, particularly relational TPV, has a significant impact on children's depressive cognitions. This relation seems particularly true for boys. Implications for future research, clinical work with victimized youth at risk for depression, and school policy to help both victims and bullies are discussed.

Are increased weight and appetite useful indicators of depression in children and adolescents?

During childhood and adolescence, physiological, psychological, and behavioral processes strongly promote weight gain and increased appetite while also inhibiting weight loss and decreased appetite. The Diagnostic and Statistical Manual-IV (DSM-IV) treats both weight-gain/increased-appetite and weight-loss/decreased-appetite as symptoms of major depression during these developmental periods, despite the fact that one complements typical development and the other opposes it. To disentangle the developmental versus pathological correlates of weight and appetite disturbance in younger age groups, the current study examined symptoms of depression in an aggregated sample of 2307 children and adolescents, 47.25% of whom met criteria for major depressive disorder. A multigroup, multidimensional item response theory model generated three key results. First, weight loss and decreased appetite loaded strongly onto a general depression dimension; in contrast, weight gain and increased appetite did not. Instead, weight gain and increased appetite loaded onto a separate dimension that did not correlate strongly with general depression. Second, inclusion or exclusion of weight gain and increased appetite affected neither the nature of the general depression dimension nor the fidelity of major depressive disorder diagnosis. Third, the general depression dimension and the weight-gain/increased-appetite dimension showed different patterns across age and gender. In child and adolescent populations, these results call into question the utility of weight gain and increased appetite as indicators of depression. This has serious implications for the diagnostic criteria of depression in children and adolescents. These findings inform a revision of the DSM, with implications for the diagnosis of depression in this age group and for research on depression.

Development and initial validation of the Adolescent Responses to Body Dissatisfaction measure.

One community sample (N = 607) of youths generated self-reported responses to body dissatisfaction, from which the Adolescent Responses to Body Dissatisfaction (ARBD) inventory was constructed. A 2nd, similar sample (N = 830) completed this measure as well as measures of coping, body dissatisfaction, body mass index, depressive symptoms, and disordered eating behaviors. Evidence of 6 ARBD factors emerged: Self-Acceptance, Compensatory Thinking, Diet/Exercise, Anxious Responding, Appearance Strategies, and Social Comparison. Subscales based on these factors provided evidence of convergent, discriminant, construct, and incremental validity. Sex and ethnic differences were also evident. Adolescents' use of Self-Acceptance and Compensatory Thinking strategies appeared to attenuate the relation between body dissatisfaction and psychopathology, whereas use of Diet/Exercise and Anxious Responding appeared to exacerbate this relation, especially in adolescents who were not overweight. The ARBD provides a window into potentially healthy and unhealthy ways in which adolescents cope with body dissatisfaction.

A Longitudinal Study of Cognitive Risks for Depressive Symptoms in Children and Young Adolescents.

Youths with high (N = 52) or low cognitive vulnerability (N = 48) for depression were selected from a larger sample (N = 515) of students (7-10 years old), based on their attributional style (AS), negative cognitions (NC), and/or self-competence (SC). Long-term effects of cognitive vulnerabilities on depressive symptoms were examined in a 3-year, three-wave, multiinformant, longitudinal design. Three findings emerged. First, some empirical overlap exists among these three types of cognitive diatheses, especially between NC and SC. Second, the combination of AS, NC, and SC had a significant (but diminishing) relationship to depressive symptoms at 6, 18, and 30 months, primarily due to NC and SC, not AS. Third, interactions between cognitive risk and life events were not significant, suggesting an additive type of diathesis-stress model for depression in young adolescents.

Targeted peer victimization and the construction of positive and negative self-cognitions: connections to depressive symptoms in children.

The goal was to examine the relation of covert/relational and overt/physical targeted peer victimization (TPV) to each other, to positive and negative self-cognitions, and to symptoms of depression. In a sample of elementary and middle school children, TPV was assessed by self-report, peer-nomination, and parent report in a multitrait-multimethod study. Positive and negative self-cognitions and depressive symptoms were assessed by self-report. Confirmatory factor analytic results support the convergent and discriminant validity of these two types of TPV. Both kinds of TPV were significantly related to positive and negative self-cognitions as well as self-reported depressive symptoms; however, structural equation modeling revealed that the effects of covert/relational TPV accounted for the effects of overt/physical TPV. In exploratory analyses, positive and negative self-cognitions explained the relation between TPV and depressive symptoms.

The relation of weight change to depressive symptoms in adolescence.

The Diagnostic and Statistical Manual of Mental Disorders lists weight gain or weight loss as a symptom of depression at all ages, but no study of adolescent depression has examined its relation to actual (not just self-reported) weight change. In the current longitudinal study, 215 adolescents provided physical and self-report measures of change in weight, body mass, and body fat over a 4-month time interval. They also completed psychological measures of body dissatisfaction, problematic eating attitudes, and depressive symptoms. The relation between physical measures of weight change and depressive symptoms varied with age. These relations were explained by individual differences in body dissatisfaction, eating attitudes, and behaviors, leading to questions about weight change as a symptom of depression in adolescence.

Gender differences in the longitudinal structure of cognitive diatheses for depression in children and adolescents.

In a school-based, four-wave, longitudinal study, children (grades 4-7) and young adolescents (grades 6-9) completed questionnaires measuring depressive symptoms and depressive cognitions, including positive and negative cognitions on the Cognitive Triad Inventory for Children (CTI-C; Kaslow, Stark, Printz, Livingston, & Tsai, 1992) and self-perceived competence on the Self-Perception Profile for Children (SPPC; Harter, 1985). Application of the Trait-State-Occasion model (Cole, Martin, & Steiger, 2005) revealed the existence of a time-invariant trait factor and a set of time-varying occasion factors. Gender differences emerged, indicating that some cognitive diatheses were more trait-like for girls than for boys (i.e., positive and negative cognitions on the CTI-C; self-perceived physical appearance and global self-worth on the SPPC). Implications focus on the emergent gender difference in depression, the design of longitudinal studies, and clinical decisions about the implementation of prevention versus intervention programs.

Weight change and appetite disturbance as symptoms of adolescent depression: toward an integrative biopsychosocial model.

The Diagnostic and Statistical Manual of Mental Disorders [American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.] lists weight change and appetite disturbance as a single compound symptom of depression at all ages. Nonetheless, assessment of these symptoms is complicated during adolescence by normative increases in body weight and appetitive drive as well as heightened rates of body dissatisfaction, dieting, and eating disorders. This review outlines biological and psychological mechanisms that may change the relation of weight change and appetite disturbance to depression during adolescence. We propose a developmental model of the relation of these symptoms to the disorder and use the model as a framework to summarize findings, limitations, and future directions of research. Although the literature suggests that weight change and appetite disturbance are related to adolescent depression, preliminary evidence suggests that interpretation of weight and appetite symptoms may depend on developmental level.

Assessment of hyperphagia in Prader-Willi syndrome.

OBJECTIVE: Prader-Willi syndrome (PWS), the leading known genetic cause of obesity, is characterized by intellectual disabilities, maladaptive and compulsive behaviors, and hyperphagia. Although complications of obesity resulting from hyperphagia are the leading cause of death in PWS, quantifying this drive for food has long been an unmet research need. This study provides factor-analytic and within-syndrome analyses of a new measure of hyperphagia in PWS. RESEARCH METHODS AND PROCEDURE: A 13-item informant measure, the Hyperphagia Questionnaire, was developed and administered to the parents of 153 persons with PWS, 4 to 51 years of age. The intelligence quotients, genetic subtypes of PWS, and BMIs of offspring were obtained, as were measures of their non-food problem behaviors. RESULTS: Factor analyses with varimax rotation produced three statistically and conceptually robust factors that accounted for 59% of the variance: Hyperphagic Behaviors, Drive, and Severity. Hyperphagic Behavior increased with age, whereas Drive remained stable, and Severity dipped in older adults. Hyperphagic Drive and Severity were positively correlated with non-food behavior problems, and Hyperphagic Drive differentiated the 36% of participants with extreme obesity from those who had overweight/obese (48%) or healthy (16%) BMI classifications. DISCUSSION: The Hyperphagia Questionnaire is a robust tool for relating breakthroughs in the neurobiology of hyperphagia to in vivo food-seeking behavior and for examining the psychological and developmental correlates of hyperphagia in PWS. The Hyperphagia Questionnaire also offers a nuanced, real-life outcome measure for future clinical trials aimed at curbing the life-threatening drive for food in PWS.