Depressive symptoms and the metabolic syndrome in childhood and adulthood: A prospective cohort study.

Objective: To examine the reciprocal associations between depressive symptoms and clinical definitions of the metabolic syndrome in childhood and adulthood. Design: Population-based prospective cohort study of 921 participants (538 women and 383 men) in Finland. The components of the metabolic syndrome were measured in childhood (mean age 12 years) and again in adulthood (mean age 33 years). A revised version of the Beck Depression Inventory was used to assess depressive symptoms at the mean ages of 24 and 33. Main Outcome Measures: Metabolic syndrome defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP), the European Group for the Study of Insulin Resistance, and the International Diabetes Federation criteria. Results: In women, depressive symptoms were associated with increased risk of the metabolic syndrome in adulthood (odds ratio for NCEP metabolic syndrome per 1 SD increase in depressive symptoms 1.40, 95% confidence interval 1.05-1.85). The metabolic syndrome in childhood, in turn, predicted higher levels of depressive symptoms in adulthood (p = .03). In men, no associations were found between depressive symptoms and the clinical definitions of the metabolic syndrome. Conclusion: The process linking depressive symptoms with the metabolic syndrome may go into both directions and may begin early in life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood depressive symptoms and adolescent cigarette use: A six-year longitudinal study controlling for peer relations correlates.

Objective: To examine potential pathways between childhood depressive symptoms and adolescent cigarette use, controlling for potential “third variable” causes. Design: Participants included 250 youth (60% girls) who were in Grades 4 to 6 at study outset and in Grades 10 to 12 (M age = 16.78) at a 6-year follow-up. At Time 1, children completed measures of depressive symptoms, as well as peer nominations of peer acceptance, rejection, and aggressive behavior. Main Outcome Measures: Time 2 measures included adolescents’ own and close friends’ cigarette use, depressive symptoms, and externalizing behaviors; parents also reported on adolescent behaviors. Results: Higher levels of childhood depressive symptoms and aggressive behavior were associated longitudinally with cigarette use in adolescence. After controlling for other associations, higher levels of childhood depressive symptoms also were associated with higher levels of friends’ cigarette use in adolescence and higher levels of adolescent depressive symptoms; each of these adolescent outcomes was concurrently associated with cigarette use. Conclusion: Depressive symptoms in childhood may lead to altered developmental trajectories that either directly or indirectly contribute to adolescent outcomes, including cigarette use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression, self-esteem, and anger in emerging adulthood: Seven-year trajectories.

This study used a school-based community sample (N = 920) to examine trajectories of depressive symptoms, self-esteem, and expressed anger in the critical years of emerging adulthood (ages 18-25). Using data from 5 waves, the authors discovered that multilevel models indicated that, on average, depressive symptoms and expressed anger declined, whereas self-esteem increased. Between-persons predictors of variability in trajectories included gender (gender gaps in depressive symptoms and self-esteem narrowed), parents' education, and conflict with parents (depressive symptoms and expressed anger improved fastest in participants with highly educated parents and in those with higher conflict). Across time, increases in social support and marriage were associated with increased psychological well-being, whereas longer periods of unemployment were connected with higher depression and lower self-esteem. Emerging adulthood is a time of improving psychological well-being, but individual trajectories depend on specific individual and family characteristics as well as role changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories of maternal depressive symptoms, maternal sensitivity, and children's functioning at school entry.

Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, the authors modeled trajectories of maternal depressive symptoms from infant age 1 month to 7 years. The authors identified 6 trajectories of maternal depressive symptoms: high-chronic, moderate-increasing, high-decreasing, intermittent, moderate-stable, and low-stable. Women on these depression trajectories varied in sociodemographic risk and in changes in observed maternal sensitivity over time. Maternal sensitivity was generally higher and increased when depressive symptoms were low; sensitivity was lower and decreased when depressive symptoms were either high or increasing. Child outcomes at 1st grade were examined by trajectory group. The authors discuss the complexity of disentangling maternal symptoms from maternal sensitivity and sociodemographic risk when predicting children's functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional Support From Parents Early in Life, Aging, and Health.

The purpose of this study is to estimate the relationship between receiving emotional support from parents early in life and an individual's health in adulthood. Analysis of data from a nationally representative sample of adults ages 25-74 years suggests that a lack of parental support during childhood is associated with increased levels of depressive symptoms and chronic conditions in adulthood. These associations between early parental support and adult health persist with increasing age throughout adulthood. Personal control, self-esteem, and social relationships during adulthood account for a large portion of these long-term associations. These findings underscore the importance of adopting a life course perspective in studying the social determinants of health among adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental trajectories of anxiety symptoms among boys across early and middle childhood.

This study examined the developmental trajectory of anxiety symptoms among 290 boys and evaluated the association of trajectory groups with child and family risk factors and children's internalizing disorders. Anxiety symptoms were measured using maternal reports from the Child Behavior Checklist (T. M. Achenbach, 1991, 1992) for boys between the ages of 2 and 10. A group-based trajectory analysis revealed 4 distinct trajectories in the development of anxiety symptoms: low, low increasing, high declining, and high-increasing trajectories. Child shy temperament tended to differentiate between initial high and low groups, whereas maternal negative control and maternal depression were associated with increasing trajectories and elevated anxiety symptoms in middle childhood. Follow-up analyses to diagnoses of preadolescent depression and/or anxiety disorders revealed different patterns on the basis of trajectory group membership. The results are discussed in terms of the mechanisms of risk factors and implications for early identification and prevention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental trajectories of adolescents' depressive symptoms: Predictors of change.

in a sample of 240 adolescents assessed annually in Grades 6 through 11, the developmental trajectories of their depressive symptoms were examined using latent factor growth modeling. Growth in mother-reported adolest.ent depressive symptoms was quadratic; growth in adolescent-reported symptoms was linear. In the model with gender and maternal depression, girls reported a greater increase in depressive symptoms over time than boys, and adolescents of mothers with histories of mood disorders had higher initial levels of depressive symptoms than offspring of never-depressed mothers. After gender and maternal depression were controlled, initial levels of negative attributions and stressors significantly predicted initial levels of adolescent- and mother-reported depressive symptoms. Attributional styles that were increasingly negative across time were associated with significantly higher initial levels (mother reported) and increasing growth (adolescent reported) of depressive symptoms. Reciprocal models in which development of depressive symptoms predicted the development of attributions and stress also were examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An investigation of the object relations theory of depression.

The current study investigated a particular aspect shared by a number of theories of depression under the common heading of object relations theory (ORT), namely that depression is associated with a continuing pattern of poor attachment that is laid out in childhood and continues into adulthood. The study examined the relationship between attachment (both parental and peer) and depressive symptoms in young adults (N = 85) of Northern Ireland. Results provided support for the continuity of perceptions of attachment styles across the life span and revealed that perceptions of early attachment experiences, as well as continuing peer attachment styles, appeared to be predictive of current depressive symptoms. More specifically, the analyses revealed a statistically significant positive correlation between perceived quality of current peer attachment and symptoms of depression, as well as a statistically significant negative correlation between self-reported childhood maternal care and symptoms of depression. However, other self-reported measures of childhood attachment were not found to be significant predictors of depressive symptoms (i.e., paternal care, maternal overprotection, paternal overprotection). Taken together, the findings lend some support for this important element of a number of object relations theories, as they pertain to depression. Further empirical research is indicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories of stressful life events and depressive symptoms during adolescence.

This 4-yr longitudinal study of 191 girls and 185 boys living in intact families in the rural Midwest examines the trajectories of life events and depressive symptoms in adolescence. The trajectories of depressive symptoms differ between boys and girls. Compared with boys, girls experienced a greater number of depressive symptoms after age 13. Changes in uncontrollable events are associated with the increases in girls' but not boys' depressive symptoms. Latent growth curve analyses show that, over 4 yrs, (1) depressive symptoms for girls changed according to a curvilinear pattern that is associated with changes in stressful events; (2) the level of depressive symptoms is related to the level of life events for both boys and girls; and (3) change in depressive symptoms is significantly related to change in stressful events only for girls. Girls living with less supportive mothers are more vulnerable to negative life changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological factors in the development of mood disorders with a seasonal pattern

The psychiatric records of a 7-year period were searched for cases with seasonal mood disorders. Among 358 cases with a mood disorder there were 41 patients with 3 or more admissions, 4 of which were demonstrating a seasonal pattern. It was found that the depressive or manic episodes of these patients were anniversary reactions associated with intense traumatic experiences in childhood, adolescence or adulthood. The seasonal pattern of the depressive episodes fulfilled the DSM-IV diagnostic criteria. The time and sometimes the place of the traumatic event acted as triggers eliciting the clinical symptoms. This study showed that anniversary reactions may constitute a subgroup of seasonal mood disorders manifesting both depressive and manic episodes, which are precipitated primarily by psychological factors rather than climatic conditions.     

Spousal associations between functional limitation and depressive symptom trajectories: Longitudinal findings from the Study of Asset and Health Dynamics Among the Oldest Old (AHEAD).

Objective: To examine spousal associations between functional limitation and depressive symptom trajectories in a national sample of older long-term married couples. Design: We used 14.5-year longitudinal data on functional limitations and depressive symptoms from 1,704 couples participating in the Study of Asset and Health Dynamics Among the Oldest Old (AHEAD). Main Outcome Measures: Activities of daily living and a short version of the Center for Epidemiologic Studies Depression scale were used. Results: Between-person difference findings corroborate previous research by showing that levels and changes in functional limitations and depressive symptoms are closely interrelated among wives and husbands. Our results further demonstrate sizable associations in levels and changes in functional limitations and depressive symptoms between spouses. For example, functional limitation levels in one spouse were associated with depressive symptom levels in the other spouse. Spousal associations remained after controlling for individual (age, education, cognition) and spousal covariates (marriage duration, number of children) and did not differ between women and men. Conclusion: Our findings highlight the important role of marital relationships in shaping health trajectories in old age because they show that some of the well-documented between-person differences in functional limitations and depressive symptoms are in fact related to spouses. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Depressive symptoms and physical decline in community-dwelling older persons

CONTEXT: Significant symptoms of depression are common in the older community-dwelling population. Although depressive symptoms and disability may commonly occur in the same person, whether depressive symptoms contribute to subsequent functional decline has not been elucidated. OBJECTIVE: To determine whether depressive symptoms in older persons increase the risk of subsequent decline in physical function as measured by objective performance-based tests. DESIGN: A 4-year prospective cohort study. SETTING: The communities of Iowa and Washington counties, Iowa. PARTICIPANTS: A total of 1286 persons aged 71 years and older who completed a short battery of physical performance tests in 1988 and again 4 years later. MAIN OUTCOME MEASURES: Baseline depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. Physical performance tests included an assessment of standing balance, a timed 2.4-m (8-ft) walk, and a timed test of 5 repetitions of rising from a chair and sitting down. RESULTS: After adjustment for baseline performance score, health status, and sociodemographic factors, increasing levels of depressive symptoms were predictive of greater decline in physical performance over 4 years (odds ratio for decline in those with depressed mood vs those without, 1.55; 95% confidence interval [CI], 1.02-2.34). Even among those at the high end of the functional spectrum, who reported no disability, the severity of depressive symptoms predicted subsequent decline in physical performance (odds ratio for decline, 1.03; 95% CI, 1.00-1.08). CONCLUSIONS: This study provides evidence that older persons who report depressive symptoms are at higher risk of subsequent physical decline. These results suggest that prevention or reduction of depressed mood could play a role in reducing functional decline in older persons.     

Do Behavioral Disturbances in Persons With Alzheimer's Disease Predict Caregiver Depression Over Time?

Random effects models were used to examine the association between behavioral disturbances in persons with Alzheimer's disease (N = 90) and caregiver depressive symptoms at 2-month intervals over an 18-month period. There was substantial variability in trajectories of change in caregiver depressive symptoms over time but no systematic increase in distress despite increased severity of dementia symptoms. Total behavioral disturbances were associated with higher levels of caregiver depressive symptoms: this effect was primarily attributable to aggressive behaviors. No consistent departure from linearity was evident in the relationship between behavior and depression over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal study of family obligation and depressive symptoms among Chinese American adolescents.

The purpose of this 2-year, 3-wave longitudinal study of Chinese American adolescents was to examine how family obligation behaviors and attitudes change over time; how gender, nativity, and birth order predict these trajectories; and whether family obligation relates to depressive symptoms. Findings suggest that family obligation behaviors decreased over the 2-year period but that family obligation attitudes were stable. Moreover, foreign-born adolescents reported higher levels of family obligation behavior than U.S.-born adolescents, and firstborn adolescents reported higher family obligation attitudes than laterborn adolescents. There were no gender differences in family obligation behaviors or attitudes. The findings also suggest that initial higher levels of family obligation were associated with subsequently fewer depressive symptoms. Finally, changes in family obligation behaviors related to changes in depressive symptoms over time such that increasing family obligation behaviors related to decreasing depressive symptoms. The results highlight the importance of understanding the role of family obligation to Chinese American adolescents’ mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children’s inferential styles, 5-HTTLPR genotype, and maternal expressed emotion-criticism: An integrated model for the intergenerational transmission of depression.

The authors tested a model for the intergenerational transmission of depression integrating specific genetic (5-HTTLPR), cognitive (inferential style), and environmental (mother depressive symptoms and expressed-emotion criticism [EE-Crit]) risk factors. Supporting the hypothesis that maternal depression is associated with elevated levels of stress in children’s lives, mothers with a history of major depressive disorder (MDD) exhibited higher depressive symptoms across a 6-month multiwave follow-up than mothers with no depression history. In addition, partially supporting our hypothesis, levels of maternal criticism during the follow-up were significantly related to mothers’ current depressive symptoms but not to history of MDD. Finally, the authors found support for an integrated Gene × Cognition × Environment model of risk. Specifically, among children with negative inferential styles regarding their self-characteristics, there was a clear dose response of 5-HTTLPR genotype moderating the relation between maternal criticism and children’s depressive symptoms, with the highest depressive symptoms during the follow-up observed among children carrying 2 copies of the 5-HTTLPR lower expressing alleles (short [S] or long [LG]) who also exhibited negative inferential styles for self-characteristics and who experienced high levels of EE-Crit. In contrast, children with positive inferential styles exhibited low depressive symptoms regardless of 5-HTTLPR genotype or level of maternal criticism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent depressive symptoms as predictors of adult depression: moodiness or mood disorder?

OBJECTIVE: The authors' goal was to examine the relationship between subclinical depressive symptoms in adolescence and major depressive episodes in adulthood. METHOD: An epidemiologic sample of 776 young people received psychiatric assessments in 1983, 1985, and 1992. Among adolescents not meeting criteria for major depression, the authors estimated the magnitude of the association between subclinical adolescent depressive symptoms and adult major depression. RESULTS: Symptoms of major depression in adolescence strongly predicted an adult episode of major depression: having depressive symptoms more than two-standard-deviations above the mean in number predicted a two-fold to three-fold greater risk for an adult major depressive episode. CONCLUSIONS: Symptoms of depression in adolescence strongly predict an episode of major depression in adulthood, even among adolescents without major depression.     

Co-occurring delinquency and depressive symptoms of adolescent boys and girls: A dual trajectory modeling approach.

Co-occurring trajectories of delinquent behavior and depressive symptoms and their correlates were examined in a longitudinal sample of 985 middle-adolescent boys and girls (mean age = 15.54 years at Time 1). Dual trajectory analysis was used to identify the co-occurring trajectories. For boys (n = 472), 4 delinquency and 4 depression trajectory groups were found. For girls (n = 513), 3 delinquency and 3 depression trajectory groups were identified. The linkage between co-occurring trajectories was higher for girls than for boys. Stressful life events and childhood precursors of the outcomes predicted trajectory group membership for both genders fairly consistently. Findings suggest heterogeneity in developmental courses of delinquent behavior and depressive symptoms across adolescent boys and girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of fathers' social class on cardiovascular disease in middle-aged men

BACKGROUND: The independent effect of early life circumstances on adult cardiovascular risk is still unresolved. We assessed the associations of father's social class with cardiovascular risk factors and with risk of ischaemic heart disease and stroke in adult life. METHODS: We did a longitudinal study of cardiovascular disease in 5934 men aged 40-59 years at enrollment. A cross-sectional measurement survey was done between 1978 and 1980 and a follow-up questionnaire was completed in 1992. The main endpoints were non-fatal myocardial infarction and stroke based on general practitioners' reports obtained between screening and 1992 and on recall of physician-diagnosed ischaemic heart disease in the 1992 questionnaire. FINDINGS: Father's social class was strongly associated with social class in adulthood (fathers' occupation was manual for 41.3% of professionals [I] vs 89.1% for unskilled manual workers [V]) and was significantly related to height (non-manual vs manual 175.4 cm [SE 0.2] vs 172.9 cm [0.1], p < 0.0001) and obesity (213 [14.1%] vs 804 [20.1%], p < 0.0001) irrespective of adult social class; no association was found with blood glucose (log, 1.69 [0.005] vs 1.70 [0.003], p = 0.22) or cholesterol (6.34 [0.03] vs 6.29 mmol/L [0.02], p = 0.16. Men whose fathers' social class was manual had significantly higher rates of non-fatal myocardial infarction (342/4006 vs 92/1510) and self-reported physician-diagnosed ischaemic heart disease (686/4006 vs 192/1510) than men whose fathers' social class was non-manual, even after adjustment for adult social class and other established risk factors (relative odds 1.3 [95% Cl 1.0-1.7], p < 0.05 and 1.3 [1.1-1.6], p < 0.01, respectively). The influence of father's social class on non-fatal myocardial infarction and ischaemic heart disease was only seen in men whose adult social class was non-manual. No association was seen between father's social class and non-fatal stroke. INTERPRETATION: Father's social class is strongly associated with adult social class. The higher risk of non-fatal myocardial infarction and self-reported physician-diagnosed ischaemic heart disease seen in men whose father's social class was manual suggests that socioeconomic status early in life has some persisting influence on ischaemic heart disease risk in adult life.     

Pathways from childhood abuse and neglect to HIV-risk sexual behavior in middle adulthood.

Objective: This study examines the relationship between childhood abuse and neglect and sexual risk behavior in middle adulthood and whether psychosocial factors (risky romantic relationships, affective symptoms, drug and alcohol use, and delinquent and criminal behavior) mediate this relationship. Method: Children with documented cases of physical abuse, sexual abuse, and neglect (ages 0–11) processed during 1967–1971 were matched with nonmaltreated children and followed into middle adulthood (approximate age 41). Mediators were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995 and official arrest records through 1994 (N = 1,196). Past year HIV-risk sexual behavior was assessed via self-reports during 2003–2004 (N = 800). Logistic regression was used to examine differences in sexual risk behavior between the abuse and neglect and control groups, and latent variable structural equation modeling was used to test mediator models. Results: Child abuse and neglect was associated with increased likelihood of risky sexual behavior in middle adulthood, odds ratio = 2.84, 95% CI [1.74, 4.64], p ≤ .001, and this relationship was mediated by risky romantic relationships in young adulthood. Conclusions: Results of this study draw attention to the potential long-term consequences of child abuse and neglect for physical health, in particular sexual risk, and point to romantic relationships as an important focus of intervention and prevention efforts. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Social support and hostility as predictors of depressive symptoms in cardiac patients one month after hospitalization: a prospective study

OBJECTIVE: Hospitalization for cardiac disease is associated with an increased risk for depression, which itself confers a poorer prognosis. Few prospective studies have examined the determinants of depression after hospitalization in cardiac patients, and even fewer have examined depression within the weeks after hospital discharge. The present study assessed the prospective relations among perceptions of social support and trait hostility in predicting symptoms of depressive symptoms at 1 month after hospitalization for a diagnostic angiography in 506 coronary artery disease (CAD) patients. METHOD: A series of structural equation models 1) estimated the predictive relations of social support, hostility, and depressive symptoms while in the hospital to symptoms of depression 1 month after hospitalization, and 2) compared these relations across gender, predicted risk classification, and age. RESULTS: Social support assessed during hospitalization was independently negatively associated with depressive symptoms 1 month after hospitalization, after controlling for baseline symptoms of depression, gender, disease severity, and age. Hostility was an indirect predictor of postdischarge depressive symptomology by way of its negative relation with social support. This pattern of relations did not differ across gender, predicted risk classification, and age. CONCLUSIONS: Our findings suggest that a patient's perceived social support during hospitalization is a determinant of depressive symptoms 1 month later. The relation of social support and hostility to subsequent depressive symptoms was similar across a variety of populations.