Stress exposure and stress generation in children of depressed mothers.

Two hypotheses were tested: (1) One mechanism contributing to the high rate of disorder in children of women with affective disorders is elevated exposure to stressful events and conditions, and (2) the children of depressed women, particularly women with unipolar depression, contribute to event occurrence because of increased interpersonal conflict. Life stress interview assessments were made at 6-mo intervals for 3 yrs on 53 children of unipolar, bipolar, medically ill, and normal women. Both hypotheses were confirmed. Transactional models of risk and further studies of the interpersonal functioning of children at risk for depression are needed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal communication: Predictors of outcome at follow-up in a sample of children at high and low risk for depression.

Separate lines of investigation have shown the increased risk of dysfunction for children of depressed women and impaired interaction between depressed mothers and their children. The link between the two was examined in 57 children at high and low risk for depression. Children of unipolar depressed, bipolar depressed, chronically medically ill, and normal, mothers were evaluated at a 6-mo follow-up. Hierarchical regression analyses suggested a relation between maternal interaction behavior on 2 dimensions, task focus and affective quality, and children's subsequent depression and school behavior; academic performance was related only to affective quality of interaction. Chronic stress was predictive of more negative, critical maternal behavior, whereas depressed mood was associated with less task involvement. Maternal interactions are viewed as a marker of a complex, mutual process involving interpersonal relationships in an adverse environmental context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children of depressed mothers: Maternal strain and symptom predictors of dysfunction.

Because of both methodological and theoretical limitations, previous studies of offspring of parents with affective disorders have rarely tested psychosocial models of depressive vulnerability. The current research is part of a longitudinal investigation of psychosocial risk for disorder in 8- to 16-year-old children of unipolar, bipolar, medically ill, and normal mothers. High rates of psychopathology, including depression, were found in children in the high-risk groups. The current study evaluated the separate contributions of maternal depressive history, current self-reported depressive symptoms (Beck Depression Inventory scores), and chronic strains to observe relations between these ordinarily confounded variables and children's psychiatric diagnoses and current functioning. Hierarchical regression analyses indicated that chronic strain added significantly to the prediction of several outcomes and that current depressive symptoms were more predictive of children's scores than was maternal history of affective disorder. Both chronic strains and current Beck Depression Inventory scores are viewed as concomitants of affective disorder but are not specific to it. Therefore studies of the risk to children conferred by parental disorder cannot assume that diagnostic status as such is a single risk factor and must attend to the effects of ongoing stressors and nonspecific symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric and psychological morbidity as a function of adaptive disability in preschool children with aggressive and hyperactive-impulsive-inattentive behavior

Children with high levels of aggressive-hyperactive-impulsive-inattentive behavior (AHII; n = 154) were subdivided into those with (n = 38) and without (n = 116) adaptive disability (+AD/-AD) defined as a discrepancy between expected versus actual adaptive functioning. They were compared to each other and a control group of 47 normal children. Both AHII groups were more likely to have attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct disorder than control children; more symptoms of general psychopathology; greater social skills deficits; more parental problems; and lower levels of academic achievement skills. Compared to AHII - AD children, AHII + AD children had (1) more conduct disorder; (2) greater inattention and aggression symptoms; (3) more social problems, less academic competence, and poorer self-control at school; (4) more severe and pervasive behavior problems across multiple home and school settings; and (5) parents with poorer child management practices. Thus, adaptive disability has utility as a marker for more severe and pervasive impairments in AHII children.     

Depressed mood in Chinese children: Relations with school performance and family environment.

A sample of primary school children in Shanghai, People's Republic of China, participated in this 2-year longitudinal project. Information on the family environment, children's social functioning, academic achievement, and depression was collected from multiple sources. The mean depression scores in the Chinese children was found to be similar to those found for children in the West. Depression was positively associated with aggressive-disruptive behavior and negatively associated with social competence. School social and academic difficulties were concurrently and positively correlated with depression. Moreover, social adjustment problems at age 8 were associated with depression at age 10. Academic difficulties were predictive of later depression only for children from families in which the mother was rejecting and parents had a conflictual relationship. Finally, decline in social and academic performance was related to depressed affect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maltreatment, competency deficits, and risk for academic and behavioral maladjustment.

Maltreatment was predicted to negatively affect children's academic and behavioral adjustment through the creation of deficits in academic engagement, social competencies, ego resiliency, and ego control. Teachers' comprehensive evaluations, school records, and camp counselors' ratings were obtained for 229 socioeconomically disadvantaged children (ages 5–12 years), 146 of whom had been maltreated. Maltreated children showed less academic engagement, more social skills deficits, and lower ego resiliency than nonmaltreated comparison children. Maltreated children manifested multiple forms of academic risk and showed more externalizing and internalizing behavior problems. The effects of maltreatment on academic maladjustment were partially mediated by academic engagement, whereas maltreatment's effects on behavior problems were mediated fully by social competencies and ego resiliency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life stressors, social resources, coping, and the 4-year course of unipolar depression.

Little is known about the effects of psychosocial factors on the long-term course of unipolar depression. This article examines the 4-year stability and change in life stressors, social resources, and coping, and their effect on the course of treated unipolar depression among 352 men and women. Depressed patients were assessed at treatment intake and at 1-year and 4-year follow-ups. Over the 4 years, patients improved in symptom outcomes, the quality of social resources, and coping responses; there were some declines in life stressors. Life stressors, social resources, and coping were related to patient functioning concurrently, after controlling for demographics, initial treatment, and initial dysfunction severity. Preintake medical conditions and family conflict consistently predicted poorer long-term outcomes. The findings imply that medical conditions and family conflict are important risk factors that predict poorer long-term outcome of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cross-sectional and longitudinal comparisons of bipolar and unipolar depressed groups on the MMPI.

Compared MMPI admission and remission profiles in 34 patients (17 bipolar and 17 unipolar) hospitalized for depression. There were no significant demographic differences or difference in behaviorally rated depression between the bipolar and unipolar groups. Relatively normal profiles for the bipolar group and abnormal profiles for the unipolar group significantly differentiated the 2 groups at admission, but, with 1 exception, the differences dissipated at recovery. Thus, greater changes over time were found in the self-reported personality characteristics of unipolar Ss than in bipolar Ss. After recovery from the depressive episode, there was a significant shift within unipolar Ss from withdrawal and lack of interest in others to a greater concern for socially approved behavior. The implications of change in the unipolar group and stability in the bipolar group and the more enduring personality characteristics of the 2 groups are discussed. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Generation of stress in the course of unipolar depression.

The effect of stressful events on depression has been amply demonstrated, but the opposite relation is also important. The author examined event occurrence over 1 yr in 14 women with unipolar depression who were compared with demographically matched groups of women with bipolar disorder (n?=?11), chronic medical illness (n?=?13), or no illness or disorder (n?=?22). Interview assessments of life events, severity, and independence of occurrence confirmed the hypothesis that unipolar women were exposed to more stress than the normal women, had significantly more interpersonal event stress than all others, and tended to have more dependent events than the others. The implication is that unipolar women by their symptoms, behaviors, characteristics, and social context generate stressful conditions, primarily interpersonal, that have the potential for contributing to the cycle of symptoms and stress that create chronic or intermittent depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial adjustment and educational outcome in adolescents with a childhood diagnosis of attention deficit disorder

OBJECTIVE: To conduct a retrospective follow-up study of psychosocial adjustment and educational outcome in adolescents with a childhood diagnosis of attention deficit disorder (ADD) and a group of clinical controls. METHODS: Groups included male and female subjects aged 14 to 18 years at time of follow-up with childhood diagnosis of ADD (cases; n = 48) versus other neurodevelopmental disorders (clinical controls; n = 37). Cases were also subdivided based on the presence of conduct disorder (CD) at follow-up. All groups were compared on measures of academic performance, self-esteem, behavior, alcohol and substance use, and adaptive functioning. RESULTS: Cases had significantly lower academic performance and poorer social, emotional, and adaptive functioning than clinical controls. Cases with CD had significantly lower academic performance, greater externalizing behaviors and emotional difficulties, and lower adaptive functioning than cases without CD. Cases with CD fared worse than clinical controls on self-report measures of behavior, socialization skills, and alcohol and substance use. CONCLUSIONS: These academic and psychosocial problems in adolescents with a childhood diagnosis of ADD suggest potential long-term ramifications for vocational and psychological functioning into adulthood. In addition, the presence of CD in some of these cases during adolescence appears to further increase the risk for maladaptive outcome.     

Maternal depression and maternal treatment of siblings as predictors of child psychopathology.

Maternal treatment of sibling pairs with affectively ill and well mothers was examined longitudinally in relation to child psychiatric status. Mothers and children in 77 families (34 unipolar, 16 bipolar, and 27 control mothers) were observed in interaction across early, middle, and late childhood and early adolescence. Interaction was assessed on dimensions of maternal engagement and critical-irritable behavior. The study examined the relative contributions of maternal depression, the quality of maternal treatment, and differential treatment of siblings to each child's psychiatric status. By maternal report, older siblings' symptoms were predicted by maternal bipolar or unipolar illness; younger siblings' symptoms were predicted by lower maternal engagement and higher maternal critical-irritable behavior in early childhood, in addition to maternal affective illness. For the younger sibling, persistent patterns of maternal treatment were also related to both maternal and child reports of problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in psychological adjustment from infancy to 8 years

The objective of this study was to explore sex differences in development from infancy to 8 years of age in a community sample. Measures of biological, social, interactive, and parental functioning as well as teacher reports were obtained. There were minimal differences in infancy, but major psychosocial differences emerged with increasing age. In the biological sphere boys were disadvantaged only in ratings of language and motor skills at 3 to 4 years old. They showed greater temperamental "difficulty" and low persistence factor scores from 5 years onward. Boys were significantly more likely to have problems with adaptive behavior and social competence and to show behavior problems of the hyperactive and aggressive type, as rated by mothers. Parent and family functioning measures did not differentiate between the sexes. Teachers rated boys as having more problems in academic and behavioral domains the first 3 years of school. Path analyses combining data sets gathered when the children were 3 to 8 years old demonstrated the differential courses of development for boys and girls although temperamental flexibility was the best predictor of behavioral adjustment for both sexes. A social learning explanation of the increased incidence of problems among males is supported, although biological influences are not ruled out.     

Psychosocial dimensions of learning disabilities: external validation and relationship with age and academic functioning

This study was designed to assess the following in a group of 152 children with learning disabilities between the ages of 7 and 13 years: (a) the relationships between age and psychosocial functioning: (b) the relationships among psychosocial functioning, cognitive abilities, and academic achievement; and (c) the external validity of statistically derived psychosocial subtypes. Participants were assigned to one of seven psychosocial subtypes on the basis of a profile-matching algorithm. Overall, the findings suggested no increase in psychopathology with advancing age. In addition, clear relationships were found between academic achievement patterns and personality subtypes. Finally, the subtypes could be distinguished on the basis of a behavior problem checklist not used for the construction of the subtypes.     

Social adjustment and the course of affective illness: a one-year controlled longitudinal study involving bipolar and unipolar outpatients

The association between social adjustment and recurrent affective episodes was examined in 27 recovered bipolar patients and 24 recovered unipolar patients who had been receiving maintenance treatment for at least 1 year. Social adjustment variables and psychiatric status were assessed by bimonthly interviews over the 1-year period using the Social Adjustment Scale (SAS) and the Research Diagnostic Criteria (RDC). Variations in the social adjustment scores were analyzed in the 2 months preceding the onset of a recurrent affective episode. Furthermore, social adjustment variables at entry into the study were assessed to investigate whether there was any association between these and the potential timing of a recurrent episode. Results revealed no significant deterioration in social adjustment during the 2 months preceding a recurrent affective episode. However, it was demonstrated that there was a relationship between a patient's overall social adjustment score at entry into the study and the onset of recurrent affective episodes, independent of any residual depressive symptomatology. Specifically, impaired work adjustment in bipolar and unipolar patients was associated with recurrent episodes. Impaired social and leisure activities adjustment in bipolar patients was also associated with recurrent episodes, and impaired marital adjustment in unipolar patients was associated with recurrent episodes. These results suggest that social maladjustment could be a risk factor for both unipolar and bipolar recurrent affective episodes and that impairment in specific areas of social functioning could be used to predict outcome.     

The impact of maternal HIV infection on parenting in inner-city African American families.

Parenting behavior and its association with child psychosocial adjustment were examined in inner-city African American families. Participants included 86 HIV-infected women and their noninfected children and 148 HlV-seronegativo women and their noninfected children. Interview data were collected concerning maternal physical health, parenting behaviors, and child psychosocial adjustment. The results indicated that mother-child relationship quality and monitoring were important parenting factors for adaptive child psychosocial functioning. HIV-infected mothers reported poorer mother-child relationship quality and less monitoring of their children's activities than did noninfected mothers, suggesting that maternal HIV infection may disrupt effective parenting. Directions for future research and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of methylphenidate in the classroom: What dosage, for which children, for what problems?

In this study the authors conducted single-case analyses of the dosage and time-course effects of methylphenidate (MPH; Ritalin) on disruptive classroom behavior, math and reading performance, and social engagement. Clear individual differences were demonstrated (a) across children (aged 7 yrs) with attention deficit hyperactivity disorder (ADHD); (b) across academic, behavioral, and social domains of functioning; (c) for dose-response effects; and (d) in the onset and duration of effects. These results are in contrast to the majority of group studies that suggest a generally positive and linear dose-response effect for MPH across both children and domains of functioning. No particular dose-response relationship between disruptive behavior and academic performance was indicated. However, an increasing dosage of MPH was associated with increasing social withdrawal for 2 of the 3 participants. Implications for school-based medication evaluations and for designing optimal comprehensive interventions for children who receive MPH are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A comparative study of the long term psychosocial functioning of childhood acute lymphoblastic leukemia survivors treated by intrathecal methotrexate with or without cranial radiation

BACKGROUND: Although previous research has delineated medical, cognitive, and neuropsychologic late effects of central nervous system (CNS) prophylaxis for childhood acute lymphoblastic leukemia (ALL), it has been difficult to draw conclusions about the long term psychosocial sequelae of these treatments due to methodologic problems that led to inconclusive results in past studies. In the current study, the authors examined the long term psychosocial functioning of childhood ALL survivors who had been treated on a Phase III clinical protocol (Cancer and Leukemia Group B [CALGB] 7611) between 1976 and 1979, in which they were randomized to receive either 2400 centigray of cranial radiation (CRT) with intrathecal methotrexate (IT-MTX) or intermediate dose systemic methotrexate (IV-MTX) with IT-MTX. METHODS: One hundred ten survivors of childhood ALL (mean age, 20.8 years) treated on CALGB 7611 who were age 14 years or older and disease free for at least 1 year were studied a mean of 14.7 years after their entry on CALGB 7611. In a telephone interview, a psychosocial assessment battery was administered to the patients, consisting of measures that assessed psychologic, sexual, social, and vocational functioning as well as any delayed physical effects. RESULTS: Survivors who had received CRT + IT-MTX had significantly poorer academic achievement (P = 0.0001), poorer self-images with regard to their bodies (P = 0.001), and greater psychologic distress (P = 0.005). CONCLUSIONS: Cranial radiation used to treat children with ALL has significant long term sequelae in terms of poorer academic achievement and psychosocial functioning. These data add weight to the conclusion that CRT prophylaxis should only be used to treat children who are at high risk of CNS relapse.     

Predicting Academic Difficulties: Does a Complex, Multidimensional Model Outperform a Unidimensional Teacher Rating Scale?

The main objective of this study was to compare a multidimensional model (i.e., including social, cognitive, physical, behavioural, and language functioning) of academic readiness and a unidimensional teacher-rated screening questionnaire on the basis of accuracy in predicting future problems in children. The participants were 146 children (80 boys and 66 girls) living in disadvantaged communities in Ontario, Canada. Data were collected in junior kindergarten and at Grade 3. Constructs were assessed with multiple methods and multiple raters. Results for the multidimensional model indicated that social-behavioural functioning, and to a lesser extent, cognitive/language skills were most salient in differentiating between children with problems and those without. The multidimensional model had accuracy and sensitivity comparable to the unidimensional model, but the multidimensional model also had a high rate of false positives as indicated by poor specificity. Implications for identifying high-risk children are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors in the current adjustment of young adult daughters of alcoholic and problem drinking fathers.

The adjustment status of women whose fathers were alcoholic, psychiatrically disturbed, or normal was compared to determine the extent of daughters' vulnerability and whether family climate and social support variables moderated the development of symptomatology. The 240 respondents, who were either university staff members or students, comprised four groups: women with normal fathers (n?=?81), women with alcoholic and problem drinking fathers (n?=?114), women with psychiatrically disturbed fathers (n?=?30), and women with both parents who were alcoholic or problem drinkers (n?=?15). Daughters of alcoholic and problem drinking fathers reported more neurotic and acting-out symptoms than did daughters of normal fathers. However, a similar elevation of neurotic and acting-out symptoms was found among the daughters of psychiatrically disturbed fathers, who in addition had significantly higher depression scores than did the daughters of alcoholic and problem drinking fathers. Daughters' rates of alcohol use did not distinguish the groups. Family climate and social support variables were found to be related to daughters' current adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Epilepsy in the school aged child: Cognitive-behavioral characteristics and effects on academic performance.

Discusses the cognitive-behavioral and academic functioning of children with epilepsy, the effects of anticonvulsant medications and other peri-ictal phenomena, and their relative impact on cognitive functioning and school achievement. Learning problems often occur in children with epilepsy, with the greatest difficulties in arithmetic, spelling, reading comprehension, and word recognition. Epileptic children also tend to experience more problems in overall achievement, concentration, and mental processing than nonepileptic children. While epileptic children tend to fall within the normal range of IQ, the distribution of their scores is skewed toward the lower level of functioning. Peri-ictal phenomena can effect brain discharges, which can thereby effect concentration, attention, and learning ability. Anticonvulsant medications have potentially negative side effects on neuropsychological functioning as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)