This pilot study examined the feasibility of treating depressed mothers who brought their depressed children for treatment. Nine mothers completed a 12-week treatment of interpersonal psychotherapy. Both mothers and children showed improvements in depressive symptoms and social functioning over the course of treatment based on evaluations at weeks 0, 6, and 12. Improvement in maternal depression was associated with improved social functioning in children, though not reductions in child depressive symptoms. However, it was difficult to engage depressed mothers in treatment when they came primarily for their child's treatment.
This study examined the relationship between education levels, nicotine and alcohol use, mental health issues, and child abuse potential during pregnancy. 100 women participated in interviews during their third trimester that assessed demographics, depression, anxiety, substance use, and child abuse potential. Results found that higher education levels, less depression/anxiety, and less drug use correlated with lower child abuse potential. Mental health issues were also related to increased alcohol/nicotine use during pregnancy. The findings suggest targeting early intervention efforts at at-risk mothers and infants, as experiences during pregnancy impact fetal development and later maternal/infant well-being.
Peritraumatic Dissociation in Labour: Is it a sentinel signal of mothers at r...BASPCAN
Peritraumatic dissociation during labour may be a sentinel signal for impaired parenting among mothers with histories of trauma and PTSD. A study assessed women's experiences of dissociation during labour using the Peritraumatic Dissociation Experiences Questionnaire and found that higher dissociation scores predicted poorer postpartum bonding. The study suggests labour may act as a stress test revealing parenting difficulties for trauma-affected mothers. Identifying and addressing peritraumatic dissociation during labour could help prevent impaired parenting among at-risk mothers.
This study examined the role of family empowerment and resilience in predicting recovery from psychosis. Ninety-nine family members of patients with psychotic disorders completed assessments of family empowerment, resilience, and the patients' recovery. Regression analysis found that higher levels of family empowerment and resilience significantly predicted greater recovery in patients, accounting for 8.7% of the variance in recovery outcomes. The findings suggest that strengthening family empowerment and resilience may benefit the treatment of psychotic disorders.
Genetic factors contribute significantly to depression based on family, twin, and adoption studies:
1) Family studies show relatives of depression sufferers have twice to three times higher depression rates than the general population.
2) Twin studies find higher concordance rates for depression in identical twins compared to fraternal twins, supporting a genetic influence.
3) Adoption studies found biological relatives of adopted out depression sufferers were much more likely to have depression than adoptive relatives, eliminating effects of shared family environment.
When ADHD presents in traumatized children: A differential diagnoses.sophiaerez
This document discusses the importance of considering trauma and post-traumatic stress disorder (PTSD) as potential differential diagnoses when a child presents with symptoms of attention deficit hyperactivity disorder (ADHD). It notes that trauma, especially prolonged or interpersonal trauma at a young age, can produce effects that overlap with ADHD symptoms. Assessing for a history of trauma is crucial to properly diagnose and treat the child's symptoms. Misdiagnosing trauma as ADHD could result in ongoing trauma if the root cause is not addressed, as well as unnecessary medication without treating the underlying trauma.
An 8-week meditation and emotion regulation training program was developed to integrate contemplative practices with psychological models of emotion regulation. It was tested on 82 female schoolteachers randomly assigned to training or wait-list control groups. Assessments before, after, and 5 months post-training found that compared to controls, the training group reported reduced negative affect and increased positive affect, mindfulness, and prosocial responses. They also showed enhanced ability to recognize emotions in others, reduced physiological stress responses, and less hostile behavior, with most effects maintained at follow-up. The findings suggest contemplative practices can influence emotional behavior and integrating them with psychological models benefits emotion regulation.
This systematic review evaluated the effectiveness of various treatments for infantile colic based on 27 controlled trials. Eliminating cow's milk protein by substituting with hypoallergenic formula was effective, with an effect size of 0.22. Treatment with dicyclomine was also effective, with an effect size of 0.46, but it has serious potential side effects. Advising parents to reduce stimulation of infants was beneficial, with an effect size of 0.48, whereas advising increased carrying and holding did not reduce crying. The effectiveness of other interventions like soy formula, low lactose formula, simethicone, and herbal tea were unclear based on the evidence.
This study examined whether prenatal maternal psychosocial resources (conceptualized as "felt security") moderate the association between neonatal medical problems and infant fussing and crying at 12 months postpartum. The study assessed maternal felt security during pregnancy using measures of attachment, relationship quality, self-esteem, and social support. At birth, infants were classified as healthy or having a medical problem. Experience sampling was used to assess infant fussing and crying in mothers of healthy infants and those with medical problems at 12 months. Results showed that prenatal maternal felt security interacts with infant health at birth to predict later infant fussing and crying, with higher prenatal felt security associated with less fussing and crying among infants with
This study examined the relationship between education levels, nicotine and alcohol use, mental health issues, and child abuse potential during pregnancy. 100 women participated in interviews during their third trimester that assessed demographics, depression, anxiety, substance use, and child abuse potential. Results found that higher education levels, less depression/anxiety, and less drug use correlated with lower child abuse potential. Mental health issues were also related to increased alcohol/nicotine use during pregnancy. The findings suggest targeting early intervention efforts at at-risk mothers and infants, as experiences during pregnancy impact fetal development and later maternal/infant well-being.
Peritraumatic Dissociation in Labour: Is it a sentinel signal of mothers at r...BASPCAN
Peritraumatic dissociation during labour may be a sentinel signal for impaired parenting among mothers with histories of trauma and PTSD. A study assessed women's experiences of dissociation during labour using the Peritraumatic Dissociation Experiences Questionnaire and found that higher dissociation scores predicted poorer postpartum bonding. The study suggests labour may act as a stress test revealing parenting difficulties for trauma-affected mothers. Identifying and addressing peritraumatic dissociation during labour could help prevent impaired parenting among at-risk mothers.
This study examined the role of family empowerment and resilience in predicting recovery from psychosis. Ninety-nine family members of patients with psychotic disorders completed assessments of family empowerment, resilience, and the patients' recovery. Regression analysis found that higher levels of family empowerment and resilience significantly predicted greater recovery in patients, accounting for 8.7% of the variance in recovery outcomes. The findings suggest that strengthening family empowerment and resilience may benefit the treatment of psychotic disorders.
Genetic factors contribute significantly to depression based on family, twin, and adoption studies:
1) Family studies show relatives of depression sufferers have twice to three times higher depression rates than the general population.
2) Twin studies find higher concordance rates for depression in identical twins compared to fraternal twins, supporting a genetic influence.
3) Adoption studies found biological relatives of adopted out depression sufferers were much more likely to have depression than adoptive relatives, eliminating effects of shared family environment.
When ADHD presents in traumatized children: A differential diagnoses.sophiaerez
This document discusses the importance of considering trauma and post-traumatic stress disorder (PTSD) as potential differential diagnoses when a child presents with symptoms of attention deficit hyperactivity disorder (ADHD). It notes that trauma, especially prolonged or interpersonal trauma at a young age, can produce effects that overlap with ADHD symptoms. Assessing for a history of trauma is crucial to properly diagnose and treat the child's symptoms. Misdiagnosing trauma as ADHD could result in ongoing trauma if the root cause is not addressed, as well as unnecessary medication without treating the underlying trauma.
An 8-week meditation and emotion regulation training program was developed to integrate contemplative practices with psychological models of emotion regulation. It was tested on 82 female schoolteachers randomly assigned to training or wait-list control groups. Assessments before, after, and 5 months post-training found that compared to controls, the training group reported reduced negative affect and increased positive affect, mindfulness, and prosocial responses. They also showed enhanced ability to recognize emotions in others, reduced physiological stress responses, and less hostile behavior, with most effects maintained at follow-up. The findings suggest contemplative practices can influence emotional behavior and integrating them with psychological models benefits emotion regulation.
This systematic review evaluated the effectiveness of various treatments for infantile colic based on 27 controlled trials. Eliminating cow's milk protein by substituting with hypoallergenic formula was effective, with an effect size of 0.22. Treatment with dicyclomine was also effective, with an effect size of 0.46, but it has serious potential side effects. Advising parents to reduce stimulation of infants was beneficial, with an effect size of 0.48, whereas advising increased carrying and holding did not reduce crying. The effectiveness of other interventions like soy formula, low lactose formula, simethicone, and herbal tea were unclear based on the evidence.
This study examined whether prenatal maternal psychosocial resources (conceptualized as "felt security") moderate the association between neonatal medical problems and infant fussing and crying at 12 months postpartum. The study assessed maternal felt security during pregnancy using measures of attachment, relationship quality, self-esteem, and social support. At birth, infants were classified as healthy or having a medical problem. Experience sampling was used to assess infant fussing and crying in mothers of healthy infants and those with medical problems at 12 months. Results showed that prenatal maternal felt security interacts with infant health at birth to predict later infant fussing and crying, with higher prenatal felt security associated with less fussing and crying among infants with
Psychological assessment of burns by Suhasini Oliveira, National Burns Centre...NationalBurnsCentre2000
This document provides information about psychological assessment of burn patients from the National Burns Centre in India. It describes the purpose of psychological assessment as helping to identify psychological problems in burn patients who often experience anxiety, depression, and other issues. It outlines several assessment methods and standardized tests that are used, including the Zung Self-Rating Depression and Anxiety Scales. Treatment options discussed include counseling, relaxation techniques, cognitive behavioral therapy, and other approaches.
This document provides an introduction to a thesis submitted for a Master's degree in Metaphysical Science. It discusses resilience from both traditional psychology and metaphysical perspectives. Traditional psychology views resilience as a learned skill developed through life experiences and external supports. Metaphysics sees resilience as an innate capacity connected to the Pure Mind that can be strengthened through mystical meditation and living according to metaphysical principles. The document provides an overview of key concepts that will be explored further in the following chapters.
The document summarizes research on depression in secondary school adolescents. It finds that adolescent depression is increasing and often goes undetected, resulting in students "suffering in silence." Early detection and treatment are critical as depression can negatively impact academics and mental health, increasing risks like suicide. However, teachers and parents often lack expertise to accurately identify depression. The document calls for increased education to help recognize symptoms and support students struggling with internalizing disorders like depression and anxiety.
The document is a community calendar from The Children's Hospital at Saint Peter's University Hospital that provides information on various autism and health-related programs and events taking place in April 2013. It discusses Saint Peter's comprehensive approach to autism treatment, including establishing autism programs in Ghana, Africa and at a school in Edison, New Jersey. It also lists support groups, health screenings, education classes, and special events related to autism, cancer, diabetes and other health topics happening that month.
The document summarizes several studies that examined correlations between teen pregnancy/motherhood and depression. One study found 53.6% of teen mothers exhibited depression symptoms, and depression was associated with decreased maternal confidence and social support. Another study found factors like social isolation, maternal competence, and weight/shape concerns predicted depression levels in teen mothers. However, one Columbia University study found that for some teen mothers, pregnancy increased a sense of purpose and safety-conscious behaviors as support from mothers/grandmothers increased. The proposed study would use the Beck Depression Inventory to examine correlations between depression levels before and after pregnancy in 200 teen mothers.
Chronic Emotional Detachment, Disorders, and Treatment-Team BSarah M
This document discusses chronic emotional detachment and how it may lead to increased rates of mental health disorders like anxiety, depression, and PTSD. It hypothesizes that suppressing natural emotions to conform to societal pressures causes stress and depersonalization over time. When a distressing trigger occurs, this imbalance can lead to mental disorders. The document reviews literature linking emotional suppression to increased disorders in populations like veterans and refugees. It proposes studying the relationship between evolutionary survival mechanisms and societal norms. The methodology section describes a mixed-methods study using surveys, interviews, and archival data from a random sample to understand subjective emotional experiences and medication effectiveness.
Therapeutic relationships with children and adolescents with cystic fibrosis and their families requires understanding development tasks, providing choices to promote independence, and establishing trust. Barriers like lack of experience and resistance to care can be addressed through play therapy, bibliotherapy, and reminding the family of treatment importance. Community supports for this family include exercise funding, counseling, and social programs to help manage the challenges of cystic fibrosis.
This document discusses the rationale for developing trauma-informed service systems. It begins by defining psychological trauma and reviewing research showing high rates of trauma in vulnerable populations. Trauma affects brain development and can cause lasting negative impacts. The document advocates for a universal precautions approach and trauma-informed care across organizations, rather than just trauma-specific treatment. It outlines 12 criteria for building trauma-informed mental health systems, such as having trauma-focused policies, training staff, and involving trauma survivors. The goal is to minimize re-traumatization and promote healing.
This study examined the effects of age on the detection of emotional information. Young and older adults completed a visual search task to detect target images of different valence (positive, negative) and arousal (high, low) levels among arrays of distracting images. Response times were recorded and compared between age groups. The study aimed to test three competing hypotheses about how aging may impact the detection of emotional versus neutral information.
Polyvagal theory case vingette (health-ptsd-microagressions)Michael Changaris
This slide deck explores a hypothetical clinical case through the lens of poly-vagal theory, micro-aggressions, somatic experiencing and neurodevelopment sequencing.
This document provides a sample one-experiment paper following APA style guidelines. It includes sections like the title, author byline, abstract, introduction, method, results and discussion. The method section describes the visual search task used, participant characteristics including ages and sample sizes, and materials/procedure. Young and older adults had to detect target images of different valence and arousal levels within 3x3 arrays. Their reaction times were recorded and compared to examine age differences in emotional processing.
Dissociative Identity Disorder (DID) is a complex disorder resulting from severe childhood trauma. Recent neurobiological research has provided insights into the brain mechanisms underlying DID and has informed the development of new treatment approaches. Phase-oriented treatment aims to help patients overcome fears of dissociated personality parts and traumatic memories through gradual exposure, with the goal of full personality integration. Promising treatments incorporate elements shown to affect relevant brain regions, such as hypnotherapy, and have been shown to potentially reverse brain changes caused by early trauma. Further research integrating biological and clinical understanding holds hope for more successful treatment outcomes.
More than baby blues_Senefeld, Reider, Schooley_10.13.11CORE Group
Maternal depression has significant negative effects on mothers, infants, and children. It can compromise parenting, impair the mother-infant relationship, and negatively impact child growth and development. Screening and treatment programs are effective but underutilized, especially in developing countries. The HEAL program implements a group intervention model with Latina women that uses screening tools and educates participants on depression, stress management, and empowerment to help mitigate the impacts of maternal mental health issues.
Study finds massage lowers depression, anxiety and pain in children with sickle cell disease. This is a Research Brief on the first study on topic that solely focused on children and used a conrol group.
This document provides an overview of obsessive compulsive disorder (OCD) in children and adolescents. It defines OCD as characterized by recurrent obsessions and compulsive behaviors done to neutralize obsessions. OCD commonly first appears in childhood, presenting challenges for diagnosis and treatment of young patients. The document discusses diagnostic criteria, common manifestations, prevalence and onset, neurobiology, influences, and current treatment methods of pediatric OCD. It aims to educate readers on how OCD affects children and adolescents and what successful treatment involves.
This document discusses childhood trauma treatment services provided by The Children's Home in Cincinnati, Ohio. It notes that childhood trauma is highly prevalent in the US, with many children experiencing physical abuse, neglect, sexual victimization or witnessing violence. Left untreated, childhood trauma can lead to serious long-term health problems. The Children's Home provides evidence-based trauma therapy using models like TF-CBT and works with a network of experts to train its therapists. It aims to help vulnerable children overcome trauma and avoid poor health outcomes through its experienced staff and proven therapy methods.
Examining Neural Correlates of Mindfulness and Emotion Regulation4.7Monika Wanis
This document summarizes a study examining age-related differences in emotion regulation and the role of mindfulness. It finds that older adults show a positivity bias when rating images and increased prefrontal cortex activation during cognitive reappraisal compared to young adults. Older adults report higher levels of dispositional mindfulness. Higher mindfulness is associated with greater prefrontal cortex recruitment and reduced amygdala reactivity during reappraisal for both age groups. The study aims to further examine relationships between mindfulness, cognitive reappraisal success, and neural correlates with an additional older adult participant. Future work developing interventions using mindfulness to enhance emotion regulation abilities in aging is discussed.
The document discusses the benefits of pet therapy for children in hospitals. It describes how pet therapy can distract children from psychological stresses like anxiety, fear and loneliness caused by being hospitalized. Research studies discussed found that pet therapy significantly improved children's moods and physiological indicators of stress. The majority of children in one study said their top wishes were to own or be with pets, rather than being sick or going home. Overall, the document argues that pet therapy provides emotional and psychological benefits to hospitalized children by distracting them from their condition.
Children Coping With A Parents Terminal IllnessJ L
This document summarizes research on helping children cope with a parent's terminal illness. It finds:
1) Children experience grief and distress during the terminal phase, yet this period is seldom investigated. Interventions aim to improve family communication and prepare children.
2) Risk and protective factors like the quality of parenting influence children's adaptation. Open communication with surviving parents helps children cope.
3) A study grouped children by age (3-5, 6-8, 9-11 years) to clarify their experiences during illness, death, and bereavement and inform interventions.
A customer was experiencing delays and brownouts in their application due to bottlenecks in their I/O bound configurations for client configurations. Using a central view provided by CACHEfx, they were able to identify the root cause of delays being either client side, NFS server side, shifting hotspots or network bottlenecks. CACHEfx also provided breakdowns of NFS commands to understand application profiles. This allowed them to resolve the problems by caching frequently accessed data, offloading overworked NFS servers, and speeding data to I/O intensive clients using the Gear6 Scalable Caching Appliance.
El documento describe cuatro regímenes demográficos: antiguo, de transición, moderno y regresivo. El régimen antiguo se caracteriza por altas tasas de natalidad y mortalidad, con un bajo crecimiento natural. El régimen de transición tiene una disminución de la natalidad y mortalidad, con un alto crecimiento natural. El régimen moderno tiene bajas tasas de natalidad y mortalidad, con un lento crecimiento de la población. Finalmente, el régimen regresivo tiene tasas de natalidad decrecientes y mortal
Psychological assessment of burns by Suhasini Oliveira, National Burns Centre...NationalBurnsCentre2000
This document provides information about psychological assessment of burn patients from the National Burns Centre in India. It describes the purpose of psychological assessment as helping to identify psychological problems in burn patients who often experience anxiety, depression, and other issues. It outlines several assessment methods and standardized tests that are used, including the Zung Self-Rating Depression and Anxiety Scales. Treatment options discussed include counseling, relaxation techniques, cognitive behavioral therapy, and other approaches.
This document provides an introduction to a thesis submitted for a Master's degree in Metaphysical Science. It discusses resilience from both traditional psychology and metaphysical perspectives. Traditional psychology views resilience as a learned skill developed through life experiences and external supports. Metaphysics sees resilience as an innate capacity connected to the Pure Mind that can be strengthened through mystical meditation and living according to metaphysical principles. The document provides an overview of key concepts that will be explored further in the following chapters.
The document summarizes research on depression in secondary school adolescents. It finds that adolescent depression is increasing and often goes undetected, resulting in students "suffering in silence." Early detection and treatment are critical as depression can negatively impact academics and mental health, increasing risks like suicide. However, teachers and parents often lack expertise to accurately identify depression. The document calls for increased education to help recognize symptoms and support students struggling with internalizing disorders like depression and anxiety.
The document is a community calendar from The Children's Hospital at Saint Peter's University Hospital that provides information on various autism and health-related programs and events taking place in April 2013. It discusses Saint Peter's comprehensive approach to autism treatment, including establishing autism programs in Ghana, Africa and at a school in Edison, New Jersey. It also lists support groups, health screenings, education classes, and special events related to autism, cancer, diabetes and other health topics happening that month.
The document summarizes several studies that examined correlations between teen pregnancy/motherhood and depression. One study found 53.6% of teen mothers exhibited depression symptoms, and depression was associated with decreased maternal confidence and social support. Another study found factors like social isolation, maternal competence, and weight/shape concerns predicted depression levels in teen mothers. However, one Columbia University study found that for some teen mothers, pregnancy increased a sense of purpose and safety-conscious behaviors as support from mothers/grandmothers increased. The proposed study would use the Beck Depression Inventory to examine correlations between depression levels before and after pregnancy in 200 teen mothers.
Chronic Emotional Detachment, Disorders, and Treatment-Team BSarah M
This document discusses chronic emotional detachment and how it may lead to increased rates of mental health disorders like anxiety, depression, and PTSD. It hypothesizes that suppressing natural emotions to conform to societal pressures causes stress and depersonalization over time. When a distressing trigger occurs, this imbalance can lead to mental disorders. The document reviews literature linking emotional suppression to increased disorders in populations like veterans and refugees. It proposes studying the relationship between evolutionary survival mechanisms and societal norms. The methodology section describes a mixed-methods study using surveys, interviews, and archival data from a random sample to understand subjective emotional experiences and medication effectiveness.
Therapeutic relationships with children and adolescents with cystic fibrosis and their families requires understanding development tasks, providing choices to promote independence, and establishing trust. Barriers like lack of experience and resistance to care can be addressed through play therapy, bibliotherapy, and reminding the family of treatment importance. Community supports for this family include exercise funding, counseling, and social programs to help manage the challenges of cystic fibrosis.
This document discusses the rationale for developing trauma-informed service systems. It begins by defining psychological trauma and reviewing research showing high rates of trauma in vulnerable populations. Trauma affects brain development and can cause lasting negative impacts. The document advocates for a universal precautions approach and trauma-informed care across organizations, rather than just trauma-specific treatment. It outlines 12 criteria for building trauma-informed mental health systems, such as having trauma-focused policies, training staff, and involving trauma survivors. The goal is to minimize re-traumatization and promote healing.
This study examined the effects of age on the detection of emotional information. Young and older adults completed a visual search task to detect target images of different valence (positive, negative) and arousal (high, low) levels among arrays of distracting images. Response times were recorded and compared between age groups. The study aimed to test three competing hypotheses about how aging may impact the detection of emotional versus neutral information.
Polyvagal theory case vingette (health-ptsd-microagressions)Michael Changaris
This slide deck explores a hypothetical clinical case through the lens of poly-vagal theory, micro-aggressions, somatic experiencing and neurodevelopment sequencing.
This document provides a sample one-experiment paper following APA style guidelines. It includes sections like the title, author byline, abstract, introduction, method, results and discussion. The method section describes the visual search task used, participant characteristics including ages and sample sizes, and materials/procedure. Young and older adults had to detect target images of different valence and arousal levels within 3x3 arrays. Their reaction times were recorded and compared to examine age differences in emotional processing.
Dissociative Identity Disorder (DID) is a complex disorder resulting from severe childhood trauma. Recent neurobiological research has provided insights into the brain mechanisms underlying DID and has informed the development of new treatment approaches. Phase-oriented treatment aims to help patients overcome fears of dissociated personality parts and traumatic memories through gradual exposure, with the goal of full personality integration. Promising treatments incorporate elements shown to affect relevant brain regions, such as hypnotherapy, and have been shown to potentially reverse brain changes caused by early trauma. Further research integrating biological and clinical understanding holds hope for more successful treatment outcomes.
More than baby blues_Senefeld, Reider, Schooley_10.13.11CORE Group
Maternal depression has significant negative effects on mothers, infants, and children. It can compromise parenting, impair the mother-infant relationship, and negatively impact child growth and development. Screening and treatment programs are effective but underutilized, especially in developing countries. The HEAL program implements a group intervention model with Latina women that uses screening tools and educates participants on depression, stress management, and empowerment to help mitigate the impacts of maternal mental health issues.
Study finds massage lowers depression, anxiety and pain in children with sickle cell disease. This is a Research Brief on the first study on topic that solely focused on children and used a conrol group.
This document provides an overview of obsessive compulsive disorder (OCD) in children and adolescents. It defines OCD as characterized by recurrent obsessions and compulsive behaviors done to neutralize obsessions. OCD commonly first appears in childhood, presenting challenges for diagnosis and treatment of young patients. The document discusses diagnostic criteria, common manifestations, prevalence and onset, neurobiology, influences, and current treatment methods of pediatric OCD. It aims to educate readers on how OCD affects children and adolescents and what successful treatment involves.
This document discusses childhood trauma treatment services provided by The Children's Home in Cincinnati, Ohio. It notes that childhood trauma is highly prevalent in the US, with many children experiencing physical abuse, neglect, sexual victimization or witnessing violence. Left untreated, childhood trauma can lead to serious long-term health problems. The Children's Home provides evidence-based trauma therapy using models like TF-CBT and works with a network of experts to train its therapists. It aims to help vulnerable children overcome trauma and avoid poor health outcomes through its experienced staff and proven therapy methods.
Examining Neural Correlates of Mindfulness and Emotion Regulation4.7Monika Wanis
This document summarizes a study examining age-related differences in emotion regulation and the role of mindfulness. It finds that older adults show a positivity bias when rating images and increased prefrontal cortex activation during cognitive reappraisal compared to young adults. Older adults report higher levels of dispositional mindfulness. Higher mindfulness is associated with greater prefrontal cortex recruitment and reduced amygdala reactivity during reappraisal for both age groups. The study aims to further examine relationships between mindfulness, cognitive reappraisal success, and neural correlates with an additional older adult participant. Future work developing interventions using mindfulness to enhance emotion regulation abilities in aging is discussed.
The document discusses the benefits of pet therapy for children in hospitals. It describes how pet therapy can distract children from psychological stresses like anxiety, fear and loneliness caused by being hospitalized. Research studies discussed found that pet therapy significantly improved children's moods and physiological indicators of stress. The majority of children in one study said their top wishes were to own or be with pets, rather than being sick or going home. Overall, the document argues that pet therapy provides emotional and psychological benefits to hospitalized children by distracting them from their condition.
Children Coping With A Parents Terminal IllnessJ L
This document summarizes research on helping children cope with a parent's terminal illness. It finds:
1) Children experience grief and distress during the terminal phase, yet this period is seldom investigated. Interventions aim to improve family communication and prepare children.
2) Risk and protective factors like the quality of parenting influence children's adaptation. Open communication with surviving parents helps children cope.
3) A study grouped children by age (3-5, 6-8, 9-11 years) to clarify their experiences during illness, death, and bereavement and inform interventions.
A customer was experiencing delays and brownouts in their application due to bottlenecks in their I/O bound configurations for client configurations. Using a central view provided by CACHEfx, they were able to identify the root cause of delays being either client side, NFS server side, shifting hotspots or network bottlenecks. CACHEfx also provided breakdowns of NFS commands to understand application profiles. This allowed them to resolve the problems by caching frequently accessed data, offloading overworked NFS servers, and speeding data to I/O intensive clients using the Gear6 Scalable Caching Appliance.
El documento describe cuatro regímenes demográficos: antiguo, de transición, moderno y regresivo. El régimen antiguo se caracteriza por altas tasas de natalidad y mortalidad, con un bajo crecimiento natural. El régimen de transición tiene una disminución de la natalidad y mortalidad, con un alto crecimiento natural. El régimen moderno tiene bajas tasas de natalidad y mortalidad, con un lento crecimiento de la población. Finalmente, el régimen regresivo tiene tasas de natalidad decrecientes y mortal
El documento habla sobre los menores inmigrantes no acompañados (MINA) en España. Explica que un MINA es un menor de edad de otro país que se encuentra en España sin sus padres o tutores legales. El número de MINA en España ha aumentado mucho en los últimos años, llegando a más de 11,000 en 2005. La mayoría de los MINA en España son marroquíes y tienen entre 14-16 años.
Treatment Of Depressed Mothers To Depressed Childrenguestcb5107
This pilot study examined the feasibility of treating depressed mothers who brought their depressed children for treatment. Nine mothers completed a 12-week treatment of interpersonal psychotherapy. Both mothers and children showed improvements in depressive symptoms and social functioning over the course of treatment based on evaluations at weeks 0, 6, and 12. Improvement in maternal depression was associated with improved social functioning in children, though not reductions in child depressive symptoms. However, engaging depressed mothers in their own treatment when they come to the clinic for their child's treatment was difficult.
The document discusses gear and body adaptations for surviving in the Gobi Desert. It recommends bringing light clothing for day, heavy clothing for night, canteens, a knife, and a survival kit. The body adapts to the desert by sweating to cool off and replenish fluids through the integumentary system, shivering to stay warm via the muscular system, and avoiding dehydration which stresses the immune system by drinking water.
Mapa De Bits, Almacenamiento, Tarjetas, Formatos Y Rawedudacosta.foto
El documento describe los diferentes tipos de imágenes digitales como mapas de bits y vectores, profundidad de color, formatos de archivo y sistemas de almacenamiento como tarjetas de memoria, discos duros y ópticos. También explica los ajustes y correcciones que se pueden realizar a imágenes RAW para mejorar parámetros como la temperatura, exposición, sombras, brillo y contraste.
Efficacy of Interpersonal Psychotherapy for Postpartum Depression. (O'hara et...Sharon
This study evaluated the efficacy of interpersonal psychotherapy (IPT) for treating postpartum depression. 120 women meeting criteria for major depression were randomly assigned to receive either 12 weeks of IPT or be in a waiting list control group. Women receiving IPT showed significantly greater reductions in depressive symptoms and higher recovery rates compared to the control group based on standardized depression scales. IPT was found to be an effective treatment for postpartum depression that could serve as an alternative to antidepressant medication.
- The document proposes a longitudinal study to examine the effects of parental behavior on child anxiety over time from ages 6 to 18.
- It reviews previous literature that found parental control to be consistently correlated with childhood anxiety, and parental acceptance to have a moderate effect in reducing anxiety.
- The proposed study would use measures from a previous study examining the relationship between parental and child anxious self-talk, and apply them longitudinally to assess effects of parental behaviors like acceptance, psychological control, and behavioral control on child anxiety over 12 years.
This document summarizes a study that investigated factors like mind-mindedness, stress, and empathy in parents of children with Down syndrome, 22q11 deletion syndrome, and typically developing children. The study used new measures of mind-mindedness and measured levels of mind-mindedness, empathy, and parental stress in 160 parents total. Results found significant effects between parental stress levels and diagnosis, and between mind-mindedness and parental stress. However, no significance was found for other relationships tested. The study suggests mind-mindedness can predict variance in parenting stress levels.
Early occuring maternal deppression and maternal negativity in predicting you...hamsulbasri
Early maternal depression and maternal negativity can negatively impact children's emotion regulation and socioemotional development. This longitudinal study examined how initial maternal depression and negative parenting behaviors predicted children's emotion regulation at age 4 and socioemotional functioning at age 5. The study also analyzed whether children's emotion regulation mediated the relationship between maternal depression and socioemotional outcomes. Finally, the study investigated if the effects of maternal depression on children's social acceptance were stronger for children exposed to high versus low maternal negativity.
1) Pediatric mania may represent a developmental subtype of bipolar disorder that is characterized by predominantly irritable mood, a chronic rather than episodic course, and high rates of comorbidity with conditions like attention-deficit/hyperactivity disorder and conduct disorder.
2) Research has found high rates of ADHD (60-90%) in children and adolescents with mania, suggesting shared familial etiological factors.
3) The atypical presentation of pediatric mania, including irritability rather than euphoria and a chronic mixed state, has led to misdiagnoses; however, adolescent and adult longitudinal studies provide support for childhood-onset mania representing a valid disorder.
This study examines the relationship between experiences of repeated bullying victimization before age 12 and levels of depression in late adolescence and adulthood, while controlling for prior mental health and stressful life events. Using data from the National Longitudinal Survey of Youth 1997, the study finds that repeated bullying victimization before age 12 is associated with higher levels of depression from late adolescence into adulthood. Subgroup analyses show these relationships are specific to females, with whites primarily affected in late adolescence and non-whites in adulthood. The study concludes that experiences of bullying during childhood can serve as a marker for subsequent mental health problems later in life.
This study examines the validity of using a 2-question screening tool called the Patient Health Questionnaire (PHQ-2) to detect depression in adolescents in primary care settings. The PHQ-2 is currently recommended for screening depression in adults but has not been tested for use with adolescents. The study administered the PHQ-2 along with two established depression measures, the Children's Depression Inventory and Beck Depression Inventory, to 85 adolescents ages 13-17. Results found a significant relationship between responses on the PHQ-2 and the other depression measures. Using the PHQ-2 to classify adolescents as depressed or not depressed correctly classified 73% of cases. This supports using the brief PHQ-2 screen to identify depression in adolescents
This literature review examined 10 research studies on the connection between attachment disorders and psychopathy. The studies generally found correlations between insecure attachment styles or lack of bonding with parents and later mental health issues. However, many studies relied on small, homogenous samples and self-reported data. Larger, more diverse samples and observational methods could strengthen findings in future research.
Evidence-Based Practice Summary Brief exploring the effects of palliative care on pain management in children with terminal illnesses. This project was written to be presented at the Kaiser Permanente Research Symposium in conjunction with Sonoma State Nursing.
Parenting Practices among DepressedMothers in the Child Welf.docxkarlhennesey
Parenting Practices among Depressed
Mothers in the Child Welfare System
Patricia L. Kohl, Jacqueline Njeri Kagotho, and David Dixon
The purpose of this study was to analyze a nationally representative sample of families referred
to Child Protective Services (CPS) agencies, the National Survey of Child and Adolescent
Weil-Being, to examine the association between maternal depression and parenting practices
over a 36-month follow-up period.Three hypotheses were tested: (1) Depressed mothers are'
more likely to demonstrate harsh parenting than are nondepressed mothers; (2) depressed
mothers are more likely to demonstrate neglectful parenting than are nondepressed mothers;
and (3) depressed mothers are more likely to demonstrate emotional maltreatment than are
nondepressed mothers. The interaction between depression and time was also analyzed for
each parenting practice to determine how changes in maternal depression affected changes in
parenting. The sample for this study was 1,536 mother-child dyads in which the child was age
three to 10 years and remained in the home after a CPS investigation. Depression remained
high across time points and was associated with increased risk of emotional maltreatment and
neglect over a 36-inonth period. In addition, self-reported emotional maltreatment remained
high across time points. Implications of this work are the needs for better identification of
mental health needs for mothers entering the child welfare system and parent training to
specifically address positive parenting.
KEY WORDS: child welfare; maternal depression; National Survey
of Child and Adolescent Well-Being; parenting
M
aternal depression, a critical public
health concern, is prevalent among
mothers referred to Child Protective
Services (CPS) agencies. In fact, nearly a quarter of
adults entering the child welfare system meet the
diagnostic criteria for a major depressive episode
in the preceding 12 months (U.S. Department of
Health and Human Services, Administration on
Children.Youth and Families [HHS, ACYF], 2005),
compared with only 7% of adults in the general
population (Kessler, Chiu, Demier, & Walters, 2005).
Furthermore, w ômen have an increased likelihood
of experiencing depression compared with men
(Kessler et al., 2003), and women exposed to a
high number of chronic Stressors—as many women
referred to CPS agencies are—are three times more
likely than women with less exposure to Stressors to
experience maternal depression (Orr,James, Burns,
& Thompson, 1989). Given that women comprise
the vast majority of primary caregivers among the
child welfare population (HHS, ACYF, 2005), it is
important to understand how maternal depression
affects outcomes after a CPS referral.
The high rate of maternal depression in the child
welfare system is a concern given its influence on
parenting practices. Symptoms of depression may
impede a woman's capacity to provide care for her
children, placing her at risk to engage in neglectful
parentin ...
Parenting Practices among DepressedMothers in the Child Welf.docxhoney690131
The study analyzed parenting practices among depressed mothers involved with the child welfare system using data from the National Survey of Child and Adolescent Well-Being. It found that maternal depression was associated with increased risk of emotional maltreatment and neglect over 36 months. Depression levels remained high over time and emotional maltreatment risk also remained elevated. This implies the need for better identification of mental health needs for mothers in the system and parent training to address positive parenting practices.
Attention deficit/hyperactivity disorder (ADHD) is characterized by a persistent lack of attention and/or heightened activity level compared to peers. It is diagnosed when these behaviors are present in multiple settings and interfere with functioning. However, the diagnostic criteria and assessment procedures for ADHD have been criticized for being subjective and not scientifically validated. There is ongoing debate around ADHD's classification as a disorder and appropriate treatment approaches.
Here are a few issues with the methodology described:
- The sample size of 24 mother-infant dyads is very small, making it difficult to generalize findings to the broader population. Larger samples are needed to increase statistical power and generalizability.
- The demographic characteristics provided - race, marital status, income, education - do not reflect the diversity of the population. A more diverse sample would improve external validity.
- No information is given about how participants were recruited or selected. Details on the sampling method and inclusion/exclusion criteria are needed to evaluate potential selection biases.
- No measures or variables are described. It's unclear what data was collected from participants or how constructs were operationalized and assessed.
The literature review summarizes two studies that evaluated the effectiveness of using screening tools to identify risk of postpartum depression in postpartum women. The Edinburgh Postpartum Depression Scale and Postpartum Depression Screening Scale were found to be reliable screening methods. One study found that 27% of women screened positive for depression symptoms using telephone screening 8 weeks postpartum. The other study identified that 25.6% of Turkish women screened positive for depression using the Edinburgh scale within the first postpartum year. Both studies support the conclusion that screening tools can effectively identify women at risk for developing postpartum depression when used by nurses.
O R I G I N A L P A P E RSelf-Reported Depressive Symptoms.docxhopeaustin33688
O R I G I N A L P A P E R
Self-Reported Depressive Symptoms Have Minimal Effect
on Executive Functioning Performance in Children
and Adolescents
Benjamin D. Hill • Danielle M. Ploetz •
Judith R. O’Jile • Mary Bodzy • Karen A. Holler •
Martin L. Rohling
Published online: 9 May 2012
� Springer Science+Business Media, LLC 2012
Abstract The relation between mood and executive
functioning in children and adolescents has not been previ-
ously reported. This study examined the association between
self-reported depressive symptoms in both clinical outpa-
tient and psychiatric inpatient samples to the following
measures of executive functioning: the Controlled Oral
Word Association Test, Animal Naming, Trail Making Test,
and Wisconsin Card Sorting Test. Records from children and
adolescents aged 7–17 years old with an IQ [ 70 were
examined. Data were gathered at either an outpatient neu-
ropsychology clinic (n = 89) or an inpatient psychiatric
hospital setting (n = 81). Mood was measured with the
Children’s Depression Inventory. Generally, statistical
associations between self-reported depressive symptoms and
executive functioning were small and non-significant. The
variance predicted by mood on measures of executive
functioning was minimal (generally less than 2 %) for the
total sample, the outpatient group, inpatient group, and a
subgroup who endorsed elevated mood symptoms. These
results suggest that impaired performance on measures of
executive functioning in children and adolescents is mini-
mally related to self-reported depressive symptoms.
Keywords Executive functioning � Mood � Depression �
Cognitive ability � Neuropsychological assessment
Introduction
There is a long standing debate that has generated a con-
siderable amount of research in adults concerning the
relationship between levels of emotional disturbance and
their effects on performance on standard neuropsycholog-
ical tests. It appears that when the literature is taken as a
whole, adults diagnosed with psychiatric disorders tend to
perform worse than individuals without diagnoses (Basso
and Bornstein 1999; Cassens et al. 1990; Kindermann and
Brown 1997; Sackeim et al. 1992; Sherman et al. 2000;
Sweet et al. 1992; Tancer et al. 1990; Veiel 1997).
Depression, the most common mood disorder, is generally
associated with dysfunctional memory performance in the
adult literature (Burt et al. 1995; Christensen et al. 1997).
However, adult studies have shown conflicting patterns of
results across other neuropsychological domains. Some
researchers have reported depression to also be associated
with executive dysfunction (McDermott and Ebmeier
2009; Reppermund et al. 2007; Merriam et al. 1999; Martin
et al. 1991). However, others studies have reported no
effect of depression on executive functioning (Castaneda
et al. 2008; Miller et al. 1991; Rohling et al. 2002, Markela-
Lerenc et al. 2006).
While many different adult populations have been
.
1) The document discusses the use of psychosocial interventions (PSI) for patients with severe mental illness, including techniques from cognitive behavioral therapy.
2) It presents a case study of a patient named Andrea who was admitted to an acute psychiatric ward and describes how staff overcame obstacles to engage Andrea and her family using PSI approaches.
3) Key aspects of the PSI used included flexible time for the nurse to build rapport with Andrea, assessing her symptoms and medication side effects, involving her family by addressing needs and devising a crisis plan, and explaining the stress vulnerability model to provide support and communication.
This document discusses ADHD in youth. It describes ADHD as a disorder characterized by inattention, hyperactivity, and impulsiveness. While the causes are debated, research suggests it has both genetic and environmental factors. One study found maternal hostility was associated with higher ADHD symptoms in children, even after controlling for genetics. Other research has found certain genetic variants can increase risk and severity of ADHD. Diet may also impact ADHD symptoms, as one study found rats on a "Western-style" diet displayed more hyperactive and impulsive behaviors. Treatment approaches for ADHD, like stimulant medications, are controversial but some research has found medications can significantly reduce ADHD symptoms for many patients.
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Treatment Of Depressed Mothers To Depressed Children
1. DEPRESSION AND ANXIETY 19:51–58 (2004)
Brief Report
TREATMENT OF DEPRESSED MOTHERS OF
DEPRESSED CHILDREN:
PILOT STUDY OF FEASIBILITY
Helen Verdeli, Ph.D.,n Tova Ferro, Ph.D., Priya Wickramaratne, Ph.D., Steven Greenwald, M.P.H.,
Carlos Blanco, M.D., Ph.D., and Myrna M. Weissman, Ph.D.
Numerous studies have shown that depression is highly familial and impairing
and that a history of depression in a parent is the strongest risk factor for
depression in a child. Many of the parents in these studies have never received
sustained treatment despite histories of recurrent depression. None of the studies
have examined the effects of maternal symptom remission on offspring
symptom or functioning. We sought to determine the feasibility of treating
depressed mothers who brought an offspring for the treatment of depression and
to examine the relationship between improved maternal depression and
symptomatic improvement and social functioning in their offspring. Nine
mothers bringing their offspring for treatment of depression, and who were
evaluated and found to be currently depressed, completed a 12-week open trial of
interpersonal psychotherapy. Mothers and their depressed offspring were
assessed by independent evaluators at weeks 0, 6, and 12 for depressive
symptomatology and social functioning. Although the rates of depression were
high among the mothers, few eligible mothers agreed to participate. Of the 12
who entered treatment, 9 (75%) completed it. Mothers and offspring improved
with regard to depressive symptomatology and global functioning over the course
of the trial. Improvement in maternal depression was significantly associated
with improvement in offspring functioning but not symptom reduction.
Improvement of maternal depression may be associated with improved outcomes
in depressed offspring. However, it is difficult to engage depressed mothers in
treatment for themselves if they come to the clinic to bring their child for
treatment of depression. It may be more feasible to study the effect of improved
maternal depression on offspring by sampling depressed mothers
coming for their own treatment and then assessing their children over
the course of maternal treatment. Depression and Anxiety 19:51–58, 2004.
& 2004 Wiley-Liss, Inc.
Key words: depressed mothers; IPT; depressed children
n
Divisions of Child Psychiatry and Clinical and Genetic Correspondence to: Dr. Helen Verdeli, Division of Clinical and
Epidemiology, New York State Psychiatric Institute, Depart- Genetic Epidemiology, New York State Psychiatric Institute-
ment of Psychiatry, Columbia University College of Physi- Columbia University, 1051 Riverside Drive, Unit 24, New York,
cians and Surgeons and Mailman School of Public Health, NY 10032. E-mail: verdelih@child.cpmc.columbia.edu
Columbia University, New York, New York
Received for publication 5 November 2002; Accepted 25 August 2003
Presented as an Invited Address at the New York State Office
of Mental Health Annual Meeting, December 5, 2000, Albany, DOI 10.1002/da.10139
New York Published online in Wiley InterScience (www.interscience.wiley.com).
& 2004 WILEY-LISS, INC.
2. 52 Verdeli et al.
INTRODUCTION for suicide, (3) were currently in treatment for
E pidemiologic studies across diverse cultures have
depression, or (4) had a medical condition that could
cause depression. Inclusion criteria for offspring were:
shown that the highest rate of depression occurs in
(1) age 6–18 years, (2) initially identified through case
women and the highest risk for first onset of major
records as having a diagnosis of a DSM-IV unipolar,
depression is in women of childbearing years [Kessler
nonpsychotic depression made by clinic staff (child
et al., 1993; Regier et al., 1987; Robins et al.,
psychiatrists, doctoral-level child psychologists, and
1984;Weissman et al., 1988, 1996]. Depression is also
clinical child social workers), (3) in current treatment,
associated with impairment in social and occupational
(4) an IQ above the 75 percentile as assessed with the
functioning, including parenting [Broadhead et al.,
1990; Johnson et al., 1992; Murray and Lopez, 1996, Test of Nonverbal Intelligence, and (5) not participat-
ing in another research protocol. Comorbid diagnoses
Wells et al., 1989]. History of depression in a parent is
in offspring were not a basis for exclusion. All subjects
one of the strongest risk factors for depression in a
provided written informed consent, and their offspring
child, with a two- to threefold increased risk for
written informed assent, after they were given a
occurrence in offspring of depressed parents [Hammen
complete description of the study.
et al., 1990; Weissman et al., 1997].
Our recent studies found that in addition to the high
lifetime rates of depression in women and their PROCEDURE
offspring, high rates of concurrent depression exist in
Screen. Before entering the study, mothers were
mothers and their offspring brought for treatment of
depression. However, only a minority of mothers who screened for depression, anxiety disorders, and sub-
stance use disorders with the Patient Problem Ques-
have an episode of depression concurrent with their
tionnaire [PPQ; Spitzer et al., 1994; Spitzer, 1997]
offspring (22%) are receiving psychiatric treatment
[Ferro et al., 2000]. This finding is consistent with when they brought their offspring for treatment of
depression. The PPQ screening procedure and results
reports from community samples in which only about
of its use in a screening study have been previously
one third of depressed people receive treatment
described in detail [Ferro et al., 2000].
[Kessler, 1994; Leaf et al., 1985; Young et al., 2001].
Eligibility evaluation. If mothers screened positive
An important and unexamined issue is how treatment
for depression and negative for substance abuse/
of maternal depression af fects the symptomatology and
dependence on the PPQ, they were asked to participate
functioning of their depressed offspring who are also in
in an eligibility evaluation for the study which involved
treatment.
a structured diagnostic assessment with the 24-item
In this report, we examine the feasibility of identify-
Hamilton Rating Scale for Depression [HRSD; Ha-
ing the depressed mothers for treatment from among
those who were bringing their offspring for treatment milton, 1960] on which the mother had to score above
12, and the Structured Clinical Interview for Diag-
of depression. We also examined the relationship
nostic and statistical manual of mental disorders, 4th
between improved maternal depression, and sympto-
matic improvement and social functioning in their Edition [DSM-IV; SCID; Spitzer et al., 1992]. The
other exclusion criteria were also assessed at this time.
offspring. We chose to treat maternal depression with
If after HRSD and SCID evaluation mothers were
interpersonal psychotherapy (IPT) because it is an
eligible to participate in the study, they were entered
empirically tested treatment for depression that also
into the open clinical trial.
addresses interpersonal functioning [Weissman et al.,
Independent evaluations. Upon entry to the study,
2000]. This was a pilot study designed to find a feasible
mothers and their offspring were assessed by an
research strategy for studying the impact of treating
maternal depression on offspring depression. independent clinical evaluator at weeks 0 (baseline), 6
(interim), and 12 (termination) for depressive sympto-
matology/clinical status and social functioning. Mater-
SUBJECTS AND METHODS nal independent evaluations were carried out in a
blinded manner to those of their offspring and vice
SUBJECTS versa. Independent evaluations were conducted by
Subjects were mothers over 18 years of age who were clinically experienced interviewers who took part in a
ascertained when they sought evaluation or treatment training session with two of the authors (T.F. and H.V.).
for depression in their offspring at the Department of Training involved didactic information, mock evalua-
Child Psychiatry at Columbia Presbyterian Medical tions, and two supervised evaluations.
Center (CPMC) and themselves met DSM-IV criteria Treatment. During the open trial, mothers received
for a unipolar, nonpsychotic depression. Additional weekly IPT for 12 weeks in 45-min sessions from an
maternal inclusion criteria were: (1) biological mother experienced clinician (e.g., MSW, PhD, or MD)
of depressed offspring, (2) residing with the offspring trained in the delivery of IPT by an experienced IPT
for Z1 year, and (3) fluent in English or Spanish. therapist. IPT is a time-limited, empirically based
Mothers were excluded if they: (1) had a current (past 6 psychotherapy for the treatment of depression [Weiss-
months) substance use disorder, (2) were at acute risk man et al., 2000]. If, according to their clinicians,
3. Brief Report: Depressed Mothers and Children 53
mothers did not show improvement by week 6, one of DATA ANALYSIS
us (C.B.) undertook a medication evaluation of the
subjects. At the end of treatment, mothers were offered We conducted outcome data analyses using two
a referral for continued treatment in the community if approaches.
it was deemed necessary by the clinician. Children Random regression analysis. The change in out-
received treatment as usual (psychotherapy and/or come variable that each individual (mother or child)
medication) at a CPMC pediatric psychiatry outpatient experiences over time is first modeled using a
clinic. polynomial regression model with the individual’s
outcome variable at each specific time as the dependent
variable and the number of weeks after baseline
MATERNAL-DEPENDENT MEASURES assessment as the independent variable. Because the
Depression. We used the 24-item HRSD [Hamil- number of observations per individual is r3, we
ton, 1960] as a clinician-rated measure of depressive employed a linear regression model. The model [Byrk
symptomatology and its change over time. An HRSD and Raudenbush, 1992] posits that the individual
score of 8–17 reflects mild depression, 18–24 moderate response of each subject is a function of the number
depression, and 425 severe depression [Katz et al., of weeks since baseline assessment [a line with inter-
1995]. The Beck Depression Inventory [BDI; Beck cept (baseline response) and slope (improvement rate)].
et al., 1961] was used as a self-report measure of Models were also fitted using a quadratic term, to
depressive symptomatology. A BDI score of Z16 test for deviations from linearity. The model was
suggests a diagnosis of major depression [Katz et al., applied to (a) estimate a mean rate of improvement in
1995]. The Clinical Global Impressions Severity of outcome variable for each of the two groups, mothers
Illness Scale [CGI-SI; McGlashan, 1973] was also used. and children; and (b) examine the extent of variation
The CGI-SI is a brief clinician-rated scale that assesses around each of these means as follows. Initially,
overall severity of mental illness. coef ficients associated with the intercept and slope
Social Functioning. The Social Adjustment Scale- were treated as random coefficients to determine
Self-Report (SAS-SR; Weissman and Bothwell, 1976) whether the rate of improvement varies between
was employed to assess maternal social functioning. subjects. If there is no significant variation, the
The SAS-SR is a brief self-report instrument that is coef ficients are treated as fixed. Using a random
widely used to measure change in social functioning. A regression model to analyze longitudinal data permits
higher score represents greater impairment. Maternal one to use information at all assessment points in the
social functioning was also assessed with the Global study. A further advantage of this approach is that it
Assessment of Function [GAF; APA, 1994]. The GAF allows for missing observations and subjects measured
is a clinician-rated assessment of current (past month) at different times, as well as estimation of random
functional impairment. A higher score represents person-specific effects.
better functioning. Although the preceding analyses will let us deter-
mine whether the mother/child outcome scores im-
prove over the treatment period, it does not allow us to
OFFSPRING-DEPENDENT MEASURES determine whether the changes in children’s outcome
Depression. The HRSD, described above, was also scores (i.e., symptoms and functioning) are associated
employed to assess clinician rated depression in with changes in mother’s symptoms and functioning.
children. We employed the Children’s Depression To determine whether changes in children are related
Inventory [CDI; Kovacs, 1980] as a self-report measure over time to maternal change, we fitted a random
of depression in offspring. A score of Z19 indicates the regression model to child outcomes which included
presence of depression. The CGI-SI was also used to both time-varying and time-invariant covariates as
assess overall severity of mental illness in offspring. independent variables in the model.
Social Functioning. Social functioning of offspring Specifically, the regression model was as follows.
was assessed with the Social Adjustment Inventory for The dependent variable considered was each child’s
Children and Adolescents [SAICA; John et al., 1987]. outcome at each study time point, the time variable
The SAICA is derived from the SAS for use with (i.e., number of weeks from baseline assessment) was
children and adolescents and, like the SAS, a higher the independent variable, and maternal score (HAM-
score indicates greater impairment. Offspring social D, GAS, etc.) at the dif ferent study time points was
functioning was also assessed with the Children’s treated as a nonrandom time dependent covariate. If
Global Assessment Scale [C-GAS; Shaffer et al., the estimate of the coef ficient corresponding to this
1993]. The C-GAS is a clinician-rated assessment of nonrandom time dependent covariate is significantly
current (past month) functional impairment in all areas different from zero, we can infer an association
of a child’s life, with a higher score representing better between change in mother’s score and change in child’s
functioning. A cutoff score of 61 was determined to outcome. All random regression analyses were per-
best discriminate cases of psychopathology in an formed using the Proc Mixed software in the SAS
epidemiologic study by Bird and colleagues [1987]. system (SAS, Cary, NC).
4. 54 Verdeli et al.
Endpoint analysis. The sample consisted of all Nine (75%) of the 12 mothers completed the open
mothers and children who entered treatment. In this trial of IPT. One dropped out at week 3 when her child
analysis, the last score obtained either at interim or was placed in foster care and subsequently hospitalized;
early termination evaluation was used for mothers and another at week 2 owing to lack of time for treatment;
children, respectively, who dropped out of the study. and the third at week 4 stating that treatment had
The end point samples consisted of 12 mothers and 12 helped her and she felt no need to continue. The third
children, respectively. The results of an end point mother and her child completed a termination evalua-
analysis may be considered an estimate of the overall tion and these data are included in the random
performance of a treatment program, including the regression analyses where the sample size is therefore
ability to retain patients in treatment. equal to 10. For the nine mothers who completed the
We assessed dif ferences between baseline scores and open trial, the average number of sessions was 11.1 (sd
values at week 12 on each of the outcome measures 2.7). In addition to IPT, one mother received medica-
using paired t-tests to test whether these differences tion in conjunction with IPT from the study psychia-
were significantly dif ferent from zero. The Bonferroni trist when, following the guidelines of our protocol, she
method was used to control for Type 1 errors owing to did not improve by week 6 of treatment.
multiple comparisons. Both the actual P values and the
Bonferroni P values are reported.
OUTCOME ASSESSMENT
Maternal depression was treated with IPT [Weiss-
RESULTS man et al., 2000]. Our primary hypotheses were that:(a)
Between October 1997 and December 1998, 171 both maternal depressive symptoms and functioning
mothers were approached and asked to be screened for would improve as a result of treatment, (b) offspring
the study. Of these mothers, 168 (98%) agreed to be depressive symptoms and functioning would likewise
screened and 45 of 168 (27%) were eligible for improve, and (c) improvement of maternal depressive
diagnostic evaluation. Thirty-five (78%) of these symptomatology would be associated positively with
eligible mothers completed the study evaluations; 17 offspring improvement in depressive symptoms and
of the 35 (49%) met the study inclusion criteria and 12 functioning.
(34%) agreed to participate. Mothers who were eligible Effect of treatment on mothers. Results of the
did not enter the study for a variety of reasons random regression analysis showed significant improve-
including offspring refusal of treatment, mothers ment over the 12-week study period in mothers’
wanting treatment closer to her home, and offspring depressive symptoms as measured by both the HRSD
participation in other research that precluded maternal and the BDI (Table 1). There were no significant
participation in a treatment study. differences between mothers in rate of improvement.
Whereas few mothers agreed to participate in the Mother’s HRSD decreased an average of 0.66/week
study, the rate of depressions in the mothers was high: during the study period, whereas mothers’ BDI decreased
15% screened positive for current depression. The an average of 0.83/week over the study period. In
mean age of participating mothers was 42 years [range addition a significant improvement over the study period
32–52, standard deviation (sd) 6.1] and their diagnoses, was observed in mothers’ global functioning measured by
based on the SCID interview, were major depressive the GAF and social functioning as measured by the SAS.
disorder (75%), dysthymia (8%), and concurrent major Results of the end point analysis (not shown) were similar
depressive disorder and dysthymia (17%). Mothers’ to those obtained from the random regression analysis
mean number of children (including full and half and can be obtained upon request.
siblings of the target offspring) was 3.5 (sd 2.1). Nearly Not shown, results of the random regression model
half of the mothers were Spanish speaking (42%) and indicate that baseline severity, as measured by the HRSD,
most were of minority origin (67% Hispanic, 17% were negatively correlated with rate of improvement,
African American, and 17% White). Most mothers implying that more severely depressed mothers showed
were married (33%) or separated/divorced (50%), greater improvement (r ¼ À.4478). These results how-
although 8% were never married and 8% widowed. ever, failed to reach statistical significance (P ¼ .2397).
Most mothers (67%) were high school graduates and Change in offspring outcomes over study period.
33% had also completed some college. Mothers’ The random regression analysis showed significant
household income fell into the following categories: improvement in offspring’s depressive symptoms over
o$10,000 (60%), $10,000–25,000 (20%), and the study, as measured by the HRSD, with child HRSD
$25,000–60,000 (20%) (household income was missing scores decreasing an average of 0.44/week over the
for two mothers). Most mothers (58%) were not study period (Table 1). However, there was no
employed and 33% were on public assistance. significant difference between subject variation in
The mean age of the offspring was 14.1 years (sd 2.3) these rates of improvement. We observed a trend
and 67% were girls. Diagnoses of the offspring, based (Po.06) in the offspring’s CGI-SI, with offspring
on clinician rating, were major depressive disorder CGI-SI scores decreasing by an average of 0.06/week
(67%) and dysthymia (31%). over the study period. Results of the end point analysis
5. Brief Report: Depressed Mothers and Children 55
TABLE 1. Outcome of mothers and their children over the period of maternal treatment for depressionn
Random regression test of linear trends
(Baseline–Week 12)
Variable Baseline Week 6 Week 12 E4 P (E4)
Depression rating scalesa
HamiltonFmother 10/17.4 7 8.0 9/14.0 7 8.7 9/9.1 7 8.0 À0.66 .04
HamiltonFchild 10/12.7 7 4.6 8/7.0 7 3.5 9/7.5 7 3.6 À0.44 .007
BDIFmother 10/20.0 7 9.1 9/20.2 7 15.5 8/9.9 7 10.1 À0.83 .03
CDIFchild 10/13.1 7 5.6 8/12.2 7 5.2 7/10.4 7 7.5 À0.20 .30
Clinical global impressionsFSIa
Mother 10/3.6 7 0.8 9/3.2 7 1.1 9/2.7 7 1.2 À0.07 .11
Child 10/3.4 7 3.4 8/2.9 7 0.8 9/2.7 7 1.0 À0.06 .06
Global functioningb
GAFFmother 10/56.0 7 5.0 9/59.2 7 9.5 9/69.0 7 9.3 1.04 .009
C-GASFchild 10/58.4 7 7.5 8/60.1 7 8.8 9/63.1 7 8.0 0.40 .24
Social adjustmenta
SASFmother 10/2.5 7 0.4 NA 8/2.0 7 0.7 À0.05 .05
SAICAFchild 10/2.0 7 0.4 NA 8/1.8 7 0.3 À0.01 .34
Values are expressed as mean (sd), unless otherwise indicated.
n
N ¼ 10 owing to inclusion of data from the termination evaluation completed by the mother–child dyad who dropped out of the study at week 4.
a
A higher score indicates greater impairment.
b
A lower score indicates greater impairment.
NA ¼ variable was not assessed at this time.
were similar to those obtained from the random accepted treatment was comparable with the literature
regression analysis and can be obtained upon request. on clinical trials [Pocock, 1999]. However, recruitment
Relationship of maternal depression with of mothers of offspring attending an urban teaching
offspring outcome. We found no significant associa- hospital for participation in a clinical trial was fraught
tion between change in maternal depression over time with difficulties such as children not residing with their
and change in offspring depression over time for any biological mothers, cancelation of numerous appoint-
measure of depressive symptomatology. When the ments, and family relocation. Whereas the rate of
association between change in maternal depression (as depression was high in the mothers bringing their
measured by the HDRS and BDI) and offspring children to treatment, numerous mothers needed to be
functioning (as measured by the CGI-SI, C-GAS, and screened to find those who would accept treatment for
SAICA) was examined, the change in maternal HDRS themselves.
scores over time was significantly associated with Mothers and offspring in the present study improved
change in offspring C-GAS scores (i.e., decreasing with regard to depressive symptomatology and func-
maternal HRSD scores were associated with increasing tioning over the 12 weeks. Although both mothers and
C-GAS scores in offspring; Table 2). There was a 0.45 offspring improved over the course of the open
increase in offspring C-GAS score associated with a trial, the rate of maternal improvement was approxi-
one-unit decrease in maternal HRSD score (Po.03). mately twice that of offspring improvement and was
We conducted exploratory analyses to determine found in both independent evaluator and self-rated
whether a relationship existed between improvement in measures.
maternal global functioning and offspring outcome. Our finding of maternal improvement is consistent
No significant association was found between maternal with the literature on the treatment of depression with
GAF and offspring CDI, HRSD, CGI, C-GAS, or IPT in adults [Di Mascio et al., 1979; Elkin et al., 1995]
SAICA. However, when offspring outcomes were and whereas the offspring in the present study received
categorized into two groups by the median baseline treatment as usual and did not follow an established
values, there was a significant association (Po.002) treatment protocol, their improvement is suggestive of
between offspring who had a baseline C-GAS score of that found in empirical studies of the treatment of
60 and change in maternal global functioning. These depression in adolescents [Brent et al., 1997; Emslie
offspring had a 0.67 increase in C-GAS for every one- et al., 1997; Mufson et al., 1999]. The lesser rate of
unit increase in maternal GAF. improvement in offspring might be related to several
factors. Offspring treatment was not standardized and
many offspring were already engaged in treatment
DISCUSSION when their mothers entered the study and probably
experienced some symptomatic improvement before
The delivery of IPT was acceptable to mothers in our study began, as reflected in the offspring’s low
that the completion rate of 75% for those mothers who baseline HRSD. Finally, time must be considered
6. 56 Verdeli et al.
TABLE 2. Regression effects of mothers’ Hamilton and global functioning correlated with their children’s outcome
Child’s outcomen E P (E) df
Child’s Hamilton 0.06 .61 15
CDI 0.02 .88 13
CGI-SI 0.04 .14 15
C-GAS À0.45 .03 15
SAICA À0.009 .40 6
n
N ¼ 10.
CDI, Children’s Depression Inventory; CGI-SI, Clinical Global Impressions Severity of Illness Scale; C-GAS, Children’s Global Assessment
Scale; SAICA, Social Adjustment Inventory for Children and Adolescents.
a factor with regard to improvement of depressive form of psychotherapy were used. The present study is
symptomatology in both mothers and offspring. also limited in that many offspring were already in
Our hypothesis that reduction of maternal depres- treatment when the study began and the average age
sion would be associated with offspring outcome was was in adolescence, a period in which one’s peer group
supported for improvement in offspring functioning is usually the primary interpersonal influence. In
but not for improvement in offspring depressive addition, a longer interval may be required to observe
symptomatology. Furthermore, improvement in ma- the effects of maternal improvement on symptomatic
ternal global functioning was significantly associated outcome in offspring. It must also be acknowledged
with improvement in offspring global functioning that children in treatment for depression would be
when it was stratified on the basis of baseline severity. expected to improve over time even if their mothers
Surprisingly, we found no significant association were not receiving concurrent treatment for depres-
between improvement in maternal and offspring sion. Finally, the present study is generalizable to a self-
depressive symptomatology over the course of the selected group of moderately depressed mothers who
study. This might be explained by offspring treatment are predominantly urban, of low socioeconomic status,
status as discussed above or, alternatively, by the fact Hispanic, and bringing their offspring for evaluation or
that at age 14 the offsprings’ peer group exerted a treatment of depression. In light of these considera-
greater influence on them than did their mothers. It tions, the findings presented here should be considered
might also be that the association between maternal preliminary.
and offspring depressive symptomatology requires a
longer time (e.g., 6 or 12 months) to appear. It remains
unclear whether maternal depression has a stronger CLINICAL AND RESEARCH IMPLICATIONS
association with offspring functioning than offspring Clinically, the findings alert clinicians to the high
depression or whether changes in global functioning rates of depression in mothers bringing their offspring
precede those of depressive symptomatology. If the for treatment of depression. Whereas many mothers
latter is true, a longer interval might lead to stronger will not accept treatment for themselves, in the context
results in offspring. of bringing their children to treatment, the limited
number who do may benefit. The research implications
regarding feasibility are less positive. Sampling de-
LIMITATIONS pressed mothers from a pediatric clinic where children
The present report is a pilot study and has major are being brought for treatment of depression does not
limitations, the most significant of which are its appear feasible. The mothers were dif ficult to recruit
uncontrolled design and small sample size. As a result, and seemed already overburdened with their children’s
the findings can suggest only associations between schedule. It was difficult to coordinate the timing of
variables and not their direction. This report cannot both treatments.
determine whether the relationship between maternal As a result of this experience, we are now studying
depression and offspring functioning is driven by depressed mothers who have come for their own
change in mother or offspring. In particular, we cannot treatment, and we are evaluating their children. This
illuminate the nature of the relationship between is an ancillary study to the multisite Sequential
change in maternal depression and offspring outcome. Treatment Alternatives to Relieve Depression Study
Furthermore, as an open trial, we did not focus on (STAR*D). STAR*D will compare the effectiveness of
efficacy of treatment but on the existence of a different treatment options for MDD and will enroll
relationship between maternal symptom reduction 4,000 adults across 13 Regional Coordinating Centers
and offspring outcome. To achieve symptom reduction [Rush et al., 2003]. Focusing on the common clinical
in mothers we employed IPT; however, it is possible question of what to do next when patients fail to
that reduction would occur more rapidly or be respond to a standard trial of treatment with an
qualitatively different if medication and/or another antidepressant medication, STARnD aims to define
7. Brief Report: Depressed Mothers and Children 57
which subsequent treatment strategies are both accep- psychotherapy in acute depression. Arch Gen Psychiatry 36:
table to patients, and provide the best clinical results. 1450–1456.
There are two ongoing studies of the impact of Elkin I, Gibbons RD, Shea MT, Sotsky SM, Watkins JT, Pilkonis PA,
treating depressed mothers on their children: Garber et Hedeker D. 1995. Initial severity and differential treatment
al. (PI–Vanderbilt University) are conducting a study outcome in the National Institute of Mental Health Treatment
of Depression Collaborative Research Program. J Consult Clin
focusing on the effect of treating parental MDD on
Psychol 63:841–847.
children’s (aged 8–16) socioemotional adjustment.
Emslie GJ, Rush AJ, Weinberg WA, Kowatch RA, Hughes CW,
Their study includes three groups receiving either 16 Carmody T, Rintelmann J. 1997. A double-blind, randomized,
weekly sessions of cognitive-behavioral therapy (CBT), placebo-controlled trial of fluoxetine in children and adolescents
pharmacotherapy, or placebo, with approximately 60 with depression. Arch Gen Psychiatry 54:1031–1037.
patients/group, as well as a comparison group of 90 Ferro T, Verdeli H, Pierre F, Weissman MM. 2000. Screening for
nondepressed mothers (patients are recruited from depression in mothers bringing their offspring for evaluation or
psychiatric settings). Riley (PI–Johns Hopkins School treatment of depression. Am J Psychiatry 157:375–379.
of Public Health; 5RO1MH5834-02) targeted 150 Hamilton M. 1960. A rating scale for depression. J Neurology
depressed women and their children [75 mothers Neurosurg Psychiatry 12:56–62.
receiving 16 weekly group CBT sessions, and 75 Hammen C, Burge D, Burney E, Adrian C. 1990. Longitudinal study
receiving medication (Paroxetine)] and a comparison of diagnoses in children of women with unipolar and bipolar
group of 50 nondepressed mothers and their children, affective disorder. Arch Gen Psychiatry 47:1112–1117.
recruited from a family-planning clinic. John K, Gammon GD, Prusoff BA, Warner V. 1987. The social
All three proposals using different treatments are adjustment scale inventory for children and adolescent (SAICA):
Testing of a new semistructured inerview. J Am Acad Child Adolesc
top-down studies sampling from the depressed
Psychiatry 26:898–911.
mothers. All have the goal of determining the effect
Johnson J, Weissman MM, Klerman GL. 1992. Service utilization
of depressed mothers’ symptom reduction on their and social morbidity associated with depressive symptoms in the
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Katz R, Shaw BF, Vallis TM, Kaiser AS. 1995. The assessment of
Acknowledgments. This study was supported by severity and symptom patterns in depression. In: Beckham EE,
the National Institute of Mental Health (5T32MH- Leber WR, editors. Handbook of depression. Second edition.
16434 to T.F., 5P30MH43878 to M.M.W., 5T32MH1- New York: Guilford Press, p 61–85.
5144 to C.B.); a Samuel Priest Rose Research Award Kessler RC. 1994. The National Comorbidity Survey of the United
(to M.M.W.); the Klingenstein Third Generation States. Int Rev Psychiatry 6:365–376.
Foundation (to M.M.W.); and a NARSAD Young Kessler RC, McGonagle KA, Swartz M, Blazer DG, Nelson CB.
Investigator’s Award (to C.B.). We thank Florence 1993. Sex and depression in the National Comorbidity Survey, I:
Lifetime prevalence, chronicity and recurrence. J Affect Disord
Pierre, M.A., Talia Zaider, and Wanda Liriano,
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