Biased Maintenance of Attention on Sad Faces in Clinically Depressed Youth: An Eye-Tracking Study.

The role of negative attention biases (AB), central to cognitive models of adult depression, is yet unclear in youth depression. We investigated negative AB in depressed compared to healthy youth and tested whether AB are more pronounced in depressed than at-risk youth. Negative AB was assessed for sad and angry faces with an eye-tracking paradigm [Passive Viewing Task (PVT)] and a behavioural task [Visual Search Task (VST)], comparing three groups of 9-14-year-olds: youth with major depression (MD; n = 32), youth with depressed parents (high-risk; HR; n = 49) and youth with healthy parents (low-risk; LR; n = 42). The PVT revealed MD participants to maintain attention longer on sad faces compared to HR, but not LR participants. This AB correlated positively with depressive symptoms. The VST revealed no group differences. Our results provide preliminary evidence for a negative AB in maintenance of attention on disorder-specific emotional information in depressed compared to at-risk youth.

"I Am a Total Loser" - The Role of Interpretation Biases in Youth Depression.

Negative interpretation biases have been found to characterize adults with depression and to be involved in the development and maintenance of the disorder. However, less is known about their role in youth depression. The present study investigated i) whether negative interpretation biases characterize children and adolescents with depression and ii) to what extent these biases are more pronounced in currently depressed youth compared to youth at risk for depression (as some negative interpretation biases have been found already in high-risk youth before disorder onset). After a negative mood induction interpretation biases were assessed with two experimental tasks: Ambiguous Scenarios Task (AST) and Scrambled Sentences Task (SST) in three groups of 9-14-year-olds: children and adolescents with a diagnosis of major depression (n = 32), children and adolescents with a high risk for depression (children of depressed parents; n = 48), as well as low-risk children and adolescents (n = 42). Depressed youth exhibited substantially more negative interpretation biases than both high-risk and low-risk groups (as assessed with both tasks), while the high-risk group showed more negative interpretation biases than the low-risk group only as assessed via the SST. The results indicate that the negative interpretation biases that are to some extent already present in high-risk populations before disorder onset are strongly amplified in currently depressed youth. The different findings for the two tasks suggest that more implicit interpretation biases (assessed with the SST) might represent cognitive vulnerabilities for depression whereas more explicit interpretation biases (assessed with the AST) may arise as a consequence of depressive symptomatology.

Risk of Depression in the Offspring of Parents with Depression: The Role of Emotion Regulation, Cognitive Style, Parenting and Life Events.

Children of depressed parents are at heightened risk for developing depression, yet relatively little is known about the specific mechanisms responsible. Since preventive interventions for this risk group show small effects which diminish overtime, it is crucial to uncover the key risk factors for depression. This study compared various potential mechanisms in children of depressed (high-risk; n = 74) versus non-depressed (low-risk; n = 37) parents and explored mediators of parental depression and risk in offspring. A German sample of N = 111 boys and girls aged 8 to 17 years were compared regarding children's (i) symptoms of depression and general psychopathology, (ii) emotion regulation strategies, (iii) attributional style, (iv) perceived parenting style and (v) life events. Children in the high-risk group showed significantly more symptoms of depression and general psychopathology, less adaptive emotion regulation strategies, fewer positive life events and fewer positive parenting strategies in comparison with the low-risk group. Group differences in positive and negative attributional style were small and not statistically significant in a MANOVA test. Maladaptive emotion regulation strategies and negative life events were identified as partial mediators of the association between parental depression and children's risk of depression. The study highlights the elevated risk of depression in children of depressed parents and provides empirical support for existing models of the mechanisms underlying transmission. Interestingly, the high-risk group was characterised by a lack of protective rather than increased vulnerability factors. These results are crucial for developing more effective preventive interventions for this high-risk population.

Qualitative evaluation of a preventive intervention for the offspring of parents with a history of depression.

BACKGROUND: Meta-analyses of randomised controlled trials suggest that psychological interventions to reduce children's risk of depression are effective. Nevertheless, these effects are modest and diminish over time. The Medical Research Council recommends a mixed-methods approach to the evaluation of complex interventions. By gaining a more thorough understanding of participants' perspectives, qualitative evaluations of preventive interventions could improve their efficacy, longevity and transfer into clinical practice. METHODS: 18 parents and 22 children who had received a 12-session family- and group-based cognitive-behavioural intervention to prevent youth depression as part of a randomised controlled trial took part in semi-structured interviews or a focus group about aspects which had been perceived as helpful, elements they were still using after the intervention had ended, and suggestions they had for improving the intervention. RESULTS: The chance to openly share and discuss their experiences of depression within and between families was considered helpful by both children and parents. Children benefitted the most from learning coping strategies for dealing with stress and many still used them in everyday life. Parents profited mostly from increasing positive family time, but noted that maintaining new routines after the end of the intervention proved difficult. Participants were generally content with the intervention but commented on how tiring and time consuming it was. CONCLUSIONS: Managing parents' expectations of family-based interventions in terms of their own mental health needs (versus those of their children) and leaving more room for open discussions may result in interventions which are more appealing to participating families. Increasing intervals between sessions may be one means of improving the longevity of interventions. TRIAL REGISTRATION: The original RCT this evaluation is a part of was registered under NCT02115880 .

Preventing depression in the offspring of parents with depression: A systematic review and meta-analysis of randomized controlled trials.

One major predictor of depression onset is having a depressed parent. This study provides the first systematic review and meta-analysis of preventive interventions for offspring of depressed parents. We searched six literature databases and included randomized controlled trials which concerned the non-depressed offspring (aged 18 or younger) of a depressed parent, who received a preventive intervention designed to reduce the risk of depression or a comparison condition. Primary and secondary outcome measures were the severity and incidence of childhood depression. 14 publications reporting data from seven trials (n=935 children) were included and were of relatively high quality. The effect of the interventions (versus any control condition) on depressive and internalising symptoms at post-intervention follow-up (up to four months) was small but significant [g'=-0.20, 95% CI (-0.34; -0.06), p=0.005; I2=0.00%]. The interventions also had a small but significant effect on depression incidence [Risk Ratio=0.56; 95% CI(0.41;0.77); d'=-0.42]. Intervention effects were not present in the short-term (up to 12months post-intervention) or long-term (15-72months post-intervention) follow-ups. Interventions targeting the offspring of depressed parents show promise not only in reducing symptoms of depression but also in preventing the onset of depression, at least immediately after the intervention.