Adolescent Developmental Pathways Among Depression, Conduct Problems, and Rejection: Integrative Data Analysis Across Three Samples.

OBJECTIVE: The current study investigated sex differences in longitudinal associations among youth depression, conduct problems, and peer rejection from ages 11 to 16. We hypothesized that girls would follow the irritable depression model, which posits that depression leads to conduct problems, and that peer rejection would mediate this relationship. We hypothesized that boys would follow the cumulative failure model, which suggests that conduct problems predict future depression, mediated by peer rejection. METHOD: We used integrative data analysis to combine three datasets, creating an aggregate sample of 2,322 adolescents, 58.4% of an ethnic minority group, and 51.3% boys. Using random-intercept cross-lagged panel modeling with data from ages 11-16, we conducted a nested model comparison. RESULTS: Results indicated that a model which allowed paths to differ by sex demonstrated better model fit than a constrained model. While depression, conduct problems, and peer rejection were relatively stable over time and had correlated random intercepts, there were few crossover paths between these domains for either sex. When the strengths of individual crossover pathways were compared based on sex, only the path from conduct problems at age 13 to depression at age 14 was significantly different, with this path being stronger for girls. CONCLUSIONS: These results suggest that stable, between-person effects largely drive relationships between depression, conduct problems, and peer rejection during adolescence, whereas there are few transactional, within-person pathways between these domains. This pattern of findings demonstrates the utility of random intercept cross-lagged panel modeling for disentangling between- and within-person effects.

Disrupting Maternal Transmission of Depression: Using Integrative Data Analysis (IDA) to Examine Indirect Effects of the Family Check-Up (FCU) Across Three Randomized Trials.

Maternal depression is a well-established risk factor for the development of depression in offspring. As such, reducing maternal depression may be key to effective prevention efforts to reduce offspring's depression. Based on the broad risk represented by maternal depression, examining cross-over effects of parent-focused interventions on maternal depression is important. The present study examined improvements in maternal depression as a mediator of the long-term effects of the Family Check-Up (FCU) prevention program on youth depression across three randomized controlled trials. The FCU is a family-focused intervention originally designed to reduce youth problem behaviors, particularly conduct problems and substance use, but has also been found to have cross-over effects on other youth problem behaviors, including internalizing symptoms. We utilized integrative data analysis that allows for powerful tests of prevention effects across trials, specifically moderated nonlinear factor analysis, to integrate data across three trials: one trial initiated in early childhood and two in early adolescence. Using a latent growth modeling approach, we first examined direct effects of the FCU on changes in maternal depression. Then we examined the mediating effect of maternal depression on changes in both parent and youth reports of youth depression. A significant intervention effect on maternal depression was observed across the three trials, with the FCU predicting improvements in maternal depression. In turn, such improvements predicted a reduction in the growth in both parent and youth reports of youth depressive symptoms across 10 years post baseline. These results demonstrate the utility in addressing cross-over effects of family-focused interventions in reducing the long-term development of depression in youth through mediating pathways.

Long-term Effects of the Family Check-Up on Suicidality in Childhood and Adolescence: Integrative Data Analysis of Three Randomized Trials.

This study employed integrative data analysis techniques to examine the long-term effects of the family check-up (FCU) on changes in youth suicide risk using three randomized prevention trials, including one trial initiated in early childhood and two initiated in early adolescence. Data were harmonized across studies using moderated nonlinear factor analysis, and intervention effects were tested using an autoregressive latent trajectory model examining changes in suicide risk across long-term follow-up. Across trials, significant long-term effects of the FCU on reductions in suicide risk were observed, although differences between intervention and control group trajectories declined over time. No moderation of intervention effects was observed by youth gender or race/ethnicity or across samples. While results offer further support for the benefits of the FCU for suicide risk reduction, they also suggest that such effects may wane over time, underscoring the need for continued development of the FCU to enhance longer-term durability of effects on suicide-related behaviors.

Developmental Models of Depression, Externalizing Problems, and Self-regulatory Processes: Integrated Data Analysis Across Four Longitudinal Studies of Youth.

Integrative data analysis (IDA) was used to derive developmental models of depression, externalizing problems, and self-regulatory processes in three prevention trials of the Family Check-Up and one longitudinal, community-based study of girls over a 10-year span covering early to late adolescence (N = 4,773; 74.9% female, 41.7% white). We used moderated nonlinear factor analysis to create harmonized scores based on all available items for a given participant in the pooled dataset while accounting for potential differences in both the latent factor and the individual items as a function of observed covariates. We also conducted latent growth model analyses to examine developmental trajectories of risk. Results indicated a bidirectional relationship between depression and externalizing problems, with greater baseline externalizing problems and depression predicting growth in inhibitory control difficulties. Furthermore, initial level of inhibitory control difficulties was associated with growth in depression. We did not, however, find a relationship between early inhibitory control difficulties and growth in externalizing problems. This work illustrates the utility of IDA techniques to harmonize data across multiple studies to identify risk factors for the development of depression and externalizing problems that can be targeted by prevention efforts.

Depressive Symptoms and Trust of Healthcare Provider in Rural Adolescents: Relationships and Predictors.

The purpose of this study was to evaluate associations among depressive symptoms, trust of healthcare provider, and health behavior in adolescents who live in a rural area. Two hundred twenty-four adolescents aged 14-19 years old attending public high school in the Midwestern United States were surveyed. Results showed a diagnosis of depression, trust of healthcare provider, health awareness, and stress management predicted depressive symptoms in adolescents living in a rural area. Healthcare providers should take extra care to promote trust in the healthcare provider-patient relationship with adolescents and to follow guidelines for annual screening of adolescents for depressive symptoms. Nursing implications include adolescent psychoeducation to improve health awareness and stress management.

Rumination in Early Adolescent Girls: An EEG Study of Cognitive Control and Emotional Responding in an Emotional Go/NoGo Task.

Although there is a substantial literature on rumination and depression, research examining neurocognitive processes related to rumination is just emerging, and few studies have examined such processes in relation to depression-risk in early adolescence. This study examined the associations between neurocognitive processes and trait-rumination in relation to familial risk for depression in nondepressed girls in early adolescence. Neurocognitive processes were assessed via EEG recording during an emotional Go/NoGo task, and analyses examined two Event-Related Potential components, including the Go and NoGo N2, reflecting attentional engagement and cognitive control processes respectively, and the Go and NoGo P3, reflecting motivated attention and inhibitory motor processes. In higher-risk youth, rumination was associated with specific alterations in both N2 and P3 amplitudes to nonemotional faces when required to enact a response, suggesting disrupted behavioral flexibility in adjusting responses to meet task demands. In lower-risk youth, however, greater rumination was associated with diminished engagement of top-down attention and cognitive control resources (i.e., attenuated N2 amplitudes), and enhanced activation of inhibitory motor control processes (i.e., enhanced P3 amplitudes). Results provide novel information regarding the association between depression-risk, rumination, and emotional processing in early adolescence that may have implications for risk-identification and prevention.

Indirect effects of the early childhood Family Check-Up on adolescent suicide risk: The mediating role of inhibitory control.

This study investigates suicide risk in late childhood and early adolescence in relation to a family-centered intervention, the Family Check-Up, for problem behavior delivered in early childhood. At age 2, 731 low-income families receiving nutritional services from Women, Infants, and Children programs were randomized to the Family Check-Up intervention or to a control group. Trend-level main effects were observed on endorsement of suicide risk by parents or teachers from ages 7.5 to 14, with higher rates of suicide risk endorsement in youth in the control versus intervention condition. A significant indirect effect of intervention was also observed, with treatment-related improvements in inhibitory control across childhood predicting reductions in suicide-related risk both at age 10.5, assessed via diagnostic interviews with parents and youth, and at age 14, assessed via parent and teacher reports. Results add to the emerging body of work demonstrating long-term reductions in suicide risk related to family-focused preventive interventions, and highlight improvements in youth self-regulatory skills as an important mechanism of such reductions in risk.

Physiological linkage and affective dynamics in dyadic interactions between adolescents and their mothers.

This study examined physiological linkage (specifically, linkage in respiratory sinus arrhythmia; RSA) between parents and youth (aged 11-17) across conflict and fun activity discussion tasks. We also examined whether observed, momentary negative affect or parental depressive symptoms, would moderate patterns of RSA linkage across the interaction tasks. RSA linkage was assessed using a multilevel actor-partner interdependence model (APIM). Participants were 59 mother-adolescent dyads, including mothers with or without clinically significant depressive symptoms. Both mothers and teens evidenced stable RSA over time (actor effect), although the stability of maternal RSA was moderated by maternal depression, with maternal depressive symptoms related to slower RSA return to baseline. There was a significant partner influence on youth RSA, with maternal RSA positively related to subsequent youth RSA. However, this effect was moderated by maternal depression and maternal negative affect (NA), with low maternal depression/low maternal NA related to dyadic synchrony, whereas high depression or high NA led to attenuation of this relationship. Results demonstrate the importance of understanding the dynamic and complex nature of family interactions in the context of depression.

The Family Check Up and Adolescent Depression: An Examination of Treatment Responders and Non-Responders.

The Family Check Up (FCU) is a family-centered intervention for reducing children's problem behavior through improving parenting skills and family interactions. Although the FCU was designed to prevent conduct problems, we have also found the program to be effective in preventing escalating symptoms of depression in early adolescence. The current analyses examine heterogeneous patterns of response to treatment in an effort to identify factors associated with differential response to family intervention. We examined heterogeneity in trajectories of youth-reported depressive symptoms from grades 6 to 9, using a Latent Growth Mixture Modeling framework to identify patterns of treatment response and non-response. Three symptom trajectories were identified, including the following: (1) a large class exhibiting stable, low symptom levels, (2) a class exhibiting high and stable depressive symptoms, and (3) a class exhibiting low initial symptoms that increased over time. Significant intervention effects were identified only among the third class, as a preventive effect on depression from 7th to 9th grade for youth with low initial symptoms. No effect of intervention was observed in the other two classes. Comparisons of classes 2 and 3 suggested that class 3 members were more likely to be females with high baseline antisocial behavior, but lower initial levels of depression. The findings suggest the importance of exploring heterogeneity within a prevention design, as well as the importance of tailored approaches to the prevention of adolescent depression.

Effects of depression and past-year binge drinking on cognitive control processes during a flanker task in college-aged adults.

BACKGROUND: Recent but largely separate literatures have examined neurocognitive alterations related to both depression and binge drinking, suggesting similar patterns of impairments in attention control and decisional processes. However, depression and problematic alcohol use tend to co-occur, and few studies have examined whether cognitive processing effects of depression and binge drinking are independent or interacting. OBJECTIVE: The current study examined joint effects of depressive symptoms and past-year binge drinking on cognitive processing (measured via EEG assessment). METHODS: University students aged 18 and over (N = 46; 63.4% female) were recruited based on self-reported depressive symptoms and also provided reports of alcohol use (51% reported significant depression; 46% reported at-least one past-year binge-drinking episode). Participants completed a computerized flanker task, assessing cognitive control processes. Forty-one participants providing useable data were included in analyses. RESULTS: Past-year binge drinking was associated with slower and more accurate behavioral responding. The interaction of binge-drinking and depressive symptoms was related to the magnitude of early attentional components (N1 and N2), with individuals reporting high depressive symptoms and a history of binge-drinking exhibiting attenuated early attentional engagement (e.g., less negative N1) coupled with enhanced attention control processing (e.g., more negative N2). Depressive symptoms also predicted a lack of discriminated P3 amplitudes on congruent versus incongruent trials. CONCLUSION: The data suggest that depression and binge drinking in the past-year jointly interact to predict early attentional processing, with the pattern of responding consistent with a compensatory response process. Results highlight the importance of future work on binge-drinking accounting for co-occurring depression.

Associations between alcohol-use and depression symptoms in adolescence: Examining gender differences and pathways over time.

Several studies examining alcohol use and depression in youth have focused on documenting prevalence of overlap, or temporal ordering in longitudinal samples. Fewer studies have examined pathways connecting alcohol use and depression over time. This study examined gender differences between depression and alcohol use across adolescence while examining peer and family pathways as possible mediators of effects. Data was collected longitudinally from 593 families from three urban public middle schools in the United States. Participants were recruited in 6th grade and followed through 9th grade. We examined gender differences using a nested model comparison approach. Results indicated the association between depression and alcohol use differs by gender. For males, depression and alcohol use were independent across adolescence, and no significant indirect pathways were observed. For females, bidirectional effects were found between alcohol use and depression, as well as an indirect effect from depression to alcohol use via peer deviance.

Long-Term Effects of the Family Check-Up in Public Secondary School on Diagnosed Major Depressive Disorder in Adulthood.

Given the public health importance of depression, the identification of prevention programs with long-term effects on reducing the rate of depression is of critical importance, as is the examination of factors that may moderate the magnitude of such prevention effects. This study examines the impact of the Family Check-Up, delivered in public secondary schools beginning in sixth grade, on the development of major depression in adulthood (aged 28-30). The multilevel intervention program included (a) a universal classroom-based intervention focused on problem solving and peer relationship skills, (b) the Family Check-Up (selected), a brief assessment-based intervention designed to motivate parents to improve aspects of family functioning when warranted, and (c) family management treatment (indicated), focused on improving parenting skills. Demographic (gender and ethnicity) and baseline risk factors (family conflict, academic problems, antisocial behavior, and peer deviance) were examined as possible moderators in logistic regression analyses. Intervention effects on depression were moderated by baseline family conflict and academic performance, with stronger intervention effects for youth with low grade point averages and from low-conflict families at baseline. Such findings extend the emerging literature on prevention programs with long-term effects on depression, and highlight directions for future research to enhance such effects.

Attention bias in youth: associations with youth and mother's depressive symptoms moderated by emotion regulation and affective dynamics during family interactions.

Recent research has highlighted the potential role of attention bias for emotional stimuli as a possible cognitive risk factor for depression in youth. However, differences in youth emotion regulation or maternal affect may moderate the association between maternal and youth depression and youth attention biases. The current study investigated the relationship between maternal and youth depressive symptoms and youth (aged 11-17 years) attention bias for sad and happy faces in 59 mother-youth dyads, examining whether positive and negative maternal affect observed during structured interaction tasks or youth emotion regulation tendencies moderated associations between maternal and youth depression and attention biases. Youth suppression interacted with maternal and youth depression to predict sad attentional biases in youth, while maternal positive affect interacted with maternal depression to predict happy attention biases in youth.

Evaluating the Efficacy of the Family Check-Up Online to Improve Parent Mental Health and Family Functioning in Response to the COVID-19 Pandemic: A Randomized Clinical Trial.

This study evaluated the effects of an enhanced version of the Family Check-Up Online (FCU-O), adapted to address parent and family functioning in response to the COVID-19 pandemic. In order to increase accessibility, the FCU-O was delivered as a web-based application coupled with online coaching support, a service delivery model that is consistent with pandemic-related limitations for in-person intervention, as well as the limited staffing and resources available in many schools and health care settings despite the increased need for mental health services driven by the pandemic. This registered clinical trial (blinded) tested the effects of the intervention on parental mental health, parenting behaviors, and family functioning from pre-treatment to 2-month follow-up. Families were randomly assigned to receive the FCU-O (N = 74) or to a wait-list control condition (N = 87). Random assignment to the FCU-O was associated with significant improvements in parental well-being, including reduced anxiety, depression, and perceived stress. Further, the FCU-O predicted significant improvements in adaptive parenting skills (e.g. less negative/coercive parenting, greater proactive parenting), and enhancements in family-relational functioning (e.g. improved coparenting). Effect sizes were small to moderate in magnitude (partial eta squared values between 0.03 and 0.11). The results indicate that online delivery of a family-centered intervention may represent a promising approach for addressing pandemic-related impacts on parent and family functioning.

Coping strategies as mediating mechanisms between adolescent polysubstance use classes and adult alcohol and substance use disorders.

Adolescent polysubstance use is a robust predictor of substance use in adulthood and can be exacerbated by poor coping with stress over time. We examined whether latent classes of adolescents' polysubstance use predicted alcohol use disorder and substance use disorder diagnoses in adulthood via multiple stress coping strategies. Self-reported frequency of past 3-month alcohol, tobacco, and marijuana use in 792 adolescents (aged 16/17) were used to form latent classes of polysubstance use. Self-reported aggressive, reactive, substance use and cognitive coping strategies (ages 18/19, 22/23, 23/24) were examined as multiple mediators of polysubstance use classes and alcohol use disorder and substance use disorder in adulthood (age 26/27) controlling for demographic covariates. Latent class analysis resulted in High, Experimental, and Low polysubstance use classes. Those in high and experimental polysubstance use classes, compared to those in the low polysubstance use class, had greater use of aggressive and reactive coping strategies, which respectively predicted greater substance use disorder and alcohol use disorder in adulthood. Across all comparisons (high vs low, experimental vs low, and high vs experimental), higher polysubstance use was associated with greater substance use coping, which predicted both alcohol and substance use disorder. Greater polysubstance use, even experimental use, in adolescence is a significant risk factor for developing alcohol use disorder and substance use disorder in adulthood and this occurs, in part, via maladaptive stress coping strategies.

Effects of binge drinking and depression on cognitive-control processes during an emotional Go/No-Go task in emerging adults.

INTRODUCTION: The goal of the current study was to examine differences in neurocognitive processes across groups marked by binge drinking and depression to identify patterns of cognitive and affective processing impairments. METHODS: Undergraduate students (N = 104; 64% female) were recruited based on self-reported symptoms of depression and alcohol use. They completed an emotional Go/No-Go task while undergoing EEG. Mean amplitudes for N2 and P3 components were examined with 2 (Depressed/Non-depressed) X 2 (Binge/Non-binge drinkers) X 4 (Happy/Sad/Angry/Calm) X 3 (Left/Middle/Right) X 2 (Go/No-Go) repeated measures ANOVAs. RESULTS: There were significant Trial Type X Valence X Depression X Binge Drinking interactions for N2 (F(3, 80) = 6.62, p < .01) and P3 (F(3, 80) = 4.65, p < .01) components. There was a significant Valence X Depression X Binge Drinking interaction for response bias (F(3, 65) = 3.11, p < .05). LIMITATIONS: The source of our sample may be a limitation, as all participants were university students, potentially making the results less generalizable. Further, we cannot be certain that social desirability did not interfere with honest reporting of alcohol use in this population. CONCLUSIONS: Differences in early inhibitory control were observed across emotions based on trial type among depressed non-binge drinkers, and these differences were attenuated in the presence of binge drinking. Further, the effects of depression on later inhibitory control were specific to non-binge drinkers. Results help to clarify the nature of underlying patterns of neurocognitive and affective risk processes that could be targeted by prevention and intervention programs.

Family psychology in challenging times.

In this brief article, the new editor of the Journal of Family Psychology outlines the scope and policies of the journal, and introduces the editorial team of associate editors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An ecological approach to promoting early adolescent mental health and social adaptation: family-centered intervention in public middle schools.

This study examined the impact of the Family Check-Up (FCU) and linked intervention services on reducing health-risk behaviors and promoting social adaptation among middle school youth. A total of 593 students and their families were randomly assigned to receive either the intervention or middle school services as usual. Forty-two percent of intervention families engaged in the service and received the FCU. Using complier average causal effect analyses, engagement in the intervention moderated intervention outcomes. Families who engaged in the intervention had youth who reported lower rates of antisocial behavior and substance use over time than did a matched control sample. Results extend previous research indicating that a family-centered approach to supporting youth in the public school setting reduced the growth of antisocial behavior, alcohol use, tobacco use, and marijuana use throughout the middle school years.

The role of substance use coping in linking depression and alcohol use from late adolescence through early adulthood.

Although theoretical models highlight the role of coping motivations in promoting co-development of depression and alcohol use, few longitudinal studies have examined such processes across early adulthood. The current study examined the role of coping in the association between depression and alcohol use across late adolescence and early adulthood. A control sample of adolescents (N = 498) from a longitudinal prevention trial completed the Brief Symptom Inventory, Life Events Coping Inventory, and a self-report survey on alcohol use at ages 17, 22, and 23, as well as the Composite International Diagnostic Interview at age 28-30. Path analyses integrated self-report and diagnostic measures. Although gender differences were observed in mean levels of depression, alcohol use, and the use of substances to cope, we did not find gender differences in structural relations across these domains over time. Substance use coping served as an intervening pathway in the association between alcohol use and depression both at the symptom level from age 17 to 23, and in predicting longer term diagnostic outcomes at ages 28-30. Depressive symptoms in early adulthood were indirectly related to major depressive disorder (MDD) through two independent paths, including the stability of depressive symptoms over time, and through the influence of depression on increasing the tendency to use substances to cope with stress. Our results underscore that coping effects provide unique predictive power across developmental transitions, over and above the stability of depressive symptoms and alcohol use, underscoring coping motives as a promising intervention target that may prevent co-occurring depression and substance use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Long-term cross-over effects of the family check-up prevention program on child and adolescent depression: Integrative data analysis of three randomized trials.

OBJECTIVE: The present study examined prevention effects of the family check-up (FCU) prevention program on longitudinal changes in youth depression, using harmonized data collected across three prevention trials, including one trial initiated in early childhood and two initiated in early adolescence (total N = 2,322). METHOD: Data from parent and youth reports of youth depression were harmonized using Moderated Nonlinear Factor Analysis (MNLFA), which provides a robust means to examine differential item functioning (DIF) across subgroups of participants (e.g., age groups, ethnic groups), and creates scale scores based on all available items while accounting for individual differences. Long-term intervention effects were tested using a multi-informant growth model examining changes in depression from baseline to up to 14-year postbaseline. RESULTS: Across trials, significant long-term effects of the FCU on reductions in depression were observed, although effects were found to wane after approximately 10 years. CONCLUSION: FCU effects on depression across trials were attained with a relatively brief parenting program designed to reduce behavior problems and improve relational functioning that emphasized parental motivation to change while supporting positive parenting strategies. Implications of these results are discussed, along with directions for future work in this area. (PsycInfo Database Record (c) 2021 APA, all rights reserved).