1. Chapter 6 Mood Disorders H. Melis Yavuz Psyc 330
Developmental Psychohathology

2. Depressive Disorders in Childhood
Depressed children: seem to be unhappy, hopeless, lower self esteem, more internal (as opposed to external) attributions, external locus of control, irritable Historically : depressive disorders in children received very little attention because it was not believed to occur in childhood BUT depression is an important and prevalent problem in childhood
When negative moods are :
extreme or
persistent or
interfere with daily life

3. Internalizing Disorders
Problems related to internal states of the individual.
Anxious-Depressed affect
Withdrawal
Somatic complaints
Empirical Approach

4. Internalizing Disorders
Are prevalent in childhood and adolescence
7 to 12 % of American children and adolescents
Even higher rates for Turkish sample (Erol et al., 2005)
Stable from preschool to adolescence
Continuity from 4 months to 7,5 years
(Kagan & Snidman, 1999)
The prevalence rate is for internalizing disorders. It might be lower for depression. But reported prevalence rates probably underestimate the scope of the problem

5. Depressive Disorders
Major depression is the most prevalent form of mood disorders in childhood and adolescence
By age of 18, ¼ of all children will have experienced clinically significant depressive symptoms.
Approximately 40-60% of young people with depression experience a relapse. (Coghill & Usala, 2006)
So it is a serious pervasive problem. (McLeod et al., 2007)

6. Depressive Disorders Interfere with child’s daily functioning
Is a persistent problem
Undermines school and social functioning
(Mc Leod et al., 2007)

7. Gender Differences in Depression
In childhoold, no gender differences
In adolescence, more prevalent in girls than boys

8. Possible Reasons for Gender Differences
Hormones
Girls are suggested to be more open to the effects of stressors because of their hormones
Socialization
Worries or sad mood are more accepted in girls than boys
Cultural reinforcement of feminine stereotypic behaviors (e.g., emotional, helpless, passive, self- sacrificing)
In childhood these expectations are more fluid but in adolescence they become more important
Temperament in preschool
Boys display greater surgency /extraversion: high intensity pleasure , high activity
Girls show more fearfulness and anxiety

9. Depressed Child/ Adolescent: Cognitive Vulnerability (Jacobs et al
The cognitive vulnerability is an enduring characteristic of the child, not family, relationships environment etc.
Important for development and maintenance of depression
Presence of maladaptive self-schema
Helplessness and unlovability
Cognitive factors interact with environmental stressors to increase risk for emotional disorders
Stressors cognitive vulnerability
Exposure to mild uncontrollable stress might impair cognitive functioning in adolescents
Having an impaired cognitive functioning might negatively affect environment
More related to adolescents instead of children

10. Cognitive Vulnerability to Depression
Attributional style
Negative events are attributed to
Internal, global, and stable causes
Vs External, specific, and unstable
Attributing low self efficacy to ones-self after a negative event
Increase the feeling of hopelessness / helplessness

11. Cognitive Vulnerability to Depression
Attributional style is a more potent predictor of depression as children age
Attributional style is continuous
Mediator
Negative eventAttributional style  Depression
Moderator
Negative event Depression
Attributional Style
Vicious Cycle

12. Cognitive Vulnerability to Depression
Self Perception:
Negative self-perceptions regarding one’s competence  is a cognitive vulnerability for depression
Negative self-perceptions might arise from negative competency evaluations of significant others
Reciprocal
Inaccurate self-perception depression

13. Cognitive Vulnerability to Depression
Information processing theory
Integrative approach
Biases in information processing are core aspects of depression
Higher depression in youth
Recall negative information (as compared to positive information)
Rehearse negative memories more
Recall positive information less well
Recall fewer positive autobiographical memories
Rate negative words as self-descriptive more
Recall memories for negative self-descriptions

14. Factors Related to Depression
Genetic /Biological factors
Hormones
Neurotransmitters
Heritability of depression
Temperament
Environmental factors
Depressed Parents
Stressful environments
Having a relative with depression makes one more likely to have depression

15. Child Temperament Emotionality: Positive and negative emotionality
Positive Emotionality: expression of energy, being active and enthusiastic; high approach, low shyness.
Negative Emotionality: tendency to give fearful, sad, angry, or irritated reactions to stressors; high frustration and distractibility.
High negative emotionality is related to anxiety and depression while
Low levels of positive emotionality is associated with depression (Watson & Clark, 1991)

16. Child Temperament PE and NE might bias child’s information processing
Depression prone cognitive styles are shaped
PE and NE might affect child’s reactivity to environment
Children with low PE may be less responsive to potentially rewarding stimuli
Low PE and high NE children may elicit fewer protective factors from the environment
Less likely to have positive peer relations
More likely to elicit harsh parenting
(Durbin et al., 2005)

17. Child Temperament A study form our Lab! Exuberance – Bubbles Episode
Bubble shooting toy
Asked to blow up bubbles any way they
wished
Coding
Latency to smile
Peak intensity of smiling
Presence/absence of smiling, laughter, positive vocalizations, high and low energy movements
Exuberance 1 – 2

18. Child Temperament Fearfulness 1 – 2
Fearfulness – Adjusted Spider Episode
A remote controlled car outfitted with a scary mask
Prompts to approach, touch and play with the toy
Coding
Latency to approach the toy /touch the toy
Verbal, facial and bodily distress
Proximity seeking with the mother
Fearfulness 1 – 2

19. Child Temperament High levels of Fearfulness Low levels of Exuberance
Were related to internalizing behaviors of Turkish preschoolers.
(Yavuz et al., 2009) 

20. Environmental Factors : Parental Depression
Shared heredity (genetic similarity)
Attachment
 Modeling maladaptive cognitions / ways of thinking
Parenting

21. Parental Depression Mother is emotionally less available for the child
Less effective parenting
Higher levels of negative parenting
Control (excessive regulation of child’s activities)
Punishment,
Negative affect,
Rejection (disopproval, criticism)
Overprotection
Perceive child behaviors as more problematic
Lower levels of positive parenting
Warmth,
Responsiveness / sensivitity
Higher withdrawal from interaction with the child

22. Parenting
Retrospective findings depressed people report mothers as more rejecting and controlling
High maternal control increase child depression by reducing child’s perceived mastery and personal control and inducing perceived helplessness (McLeod et al., 2007)
Maternal rejection is a more important variable to differentiate between depressed and non- depressed individuals

23. Parenting Not many studies about the role of positive parenting
Our study revealed observed maternal responsiveness as an important predictor for preschool children’s internalizing behaviors.
(Yavuz et al., 2009) 

24. Parenting and Depression
Meta-analysis (McLeod et al., 2007)
Different dimensions of parenting explained 4 to 11 % of variance
Parental warmth 4%
Parental control 5%
Parental rejection 8%
Overall parenting explained 8% of variance in childhood and adolescence depression
Moderate effect size

25. Temperament and Parenting
Not all children with high negative temperamental affect and/or low positive temperamental affect develop depression
Not all children who receive negative parenting develop depression

26. Temperament and Parenting
Temperament and parenting behaviors interact to predict child outcomes.

27. Interaction Between Temperament and Parenting
Early et al. (2002)
Temperamental Wariness/ Fear High Internalizing Behaviors
Karreman et al. (2010)
Fearfulness High Internalizing Behaviors
Letcher et al. (2004)
Negative Reactivity & Low Approach High Depression
Oldehinkel et al. (2006)
High frustration High Depression
Fearfulness High Depression (in girls only)
Low Maternal Sensitivity
High Negative Control / Over-involvement
Negative Control
Low Warmth
Overprotection and low warmth
Rejection

28. Other Risk Factors Stress Low SES Maternal stress
Stressful life experiences
Chronic stressors
Risk for negative parenting practices and maternal depression
Low SES