Rosemary Calderon

Depression in Young People: Initial Presentation and Clinical Course

OBJECTIVE This project was designed to provide prospective data on the clinical presentation and longitudinal course of depression in children and adolescents. METHOD Children and their parent(s) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School Age Children) at intake, and then yearly for 3 years. Collateral data were collected on school, social, and family functioning. RESULTS Mean length of initial depressive episode was 35.6 weeks, SD of 26 weeks. Of the 65 depressed youths who completed the 3-year follow-up, 35 (54%) disclosed another episode of depression. Demographic, family-environment, and diagnostic variables were explored as predictors of characteristics of initial episode, recurrence of depression, and psychosocial competence at follow-up. Female gender and presence of a coexisting anxiety disorder were significantly related to severity of initial depression. Family environment was the only predictor significantly related to overall psychosocial competence over 3 years. CONCLUSIONS The findings confirm depression in youth as a valid clinical phenomenon, with substantial risk of recurrence. Increased levels of stress in the family environment were associated with poorer overall outcomes.

Psychopathology in Parents of Depressed Children and Adolescents

One hundred and seventeen biological mothers and 63 biological fathers of depressed and nondepressed, psychiatrically disturbed children and adolescents were interviewed with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version. Diagnostic information was also obtained on 54 biological fathers who were unavailable for interview. Histories of depressive disorders and other forms of psychopathology were reported at high rates in the parents. Major depression was the most commonly reported disorder in interviewed parents of both sexes, but it was reported more often in mothers. Substance abuse and antisocial pathology was more prevalent in fathers. Depression in parents did not distinguish depressed from nondepressed probands, but maternal history of anxiety disorders, alcoholism and/or drug abuse, and suicidality did. Depressed probands were more likely than their nondepressed peers to have two parents with histories of depression. Mothers of younger patients had more substance abuse and suicidality in their histories than mothers of adolescents. They also reported earlier age of onset of depression and earlier age of entry into treatment.

Risks for suicidality in major depressive disorder

This investigation developed a hierarchical multiple regression model to assess the potential risk factors for suicidality in youths 7 to 17 years old. Variables were assessed in three domains: self-perceptions, demography and diagnosis, and home/environment. The model controlled for major depressive disorder (MDD), which has confounded previous investigations, by evaluating potential risks in a diagnostically heterogenous sample, and then evaluating these risks in a subsample with MDD. Conduct problems and depressive thinking emerged as the most powerful predictors in both samples. Hopelessness, life stress, and maternal psychopathology predicted suicidality only in the total sample. Separation anxiety protected MDD youths. These results suggest that suicidal MDD youths may comprise a distinct subgroup of depressed youths.

Stress and Coping in Hearing Mothers of Children With Hearing Loss: Factors Affecting Mother and Child Adjustment

The present study examines maternal and child adjustment as a result of the application of a stress and coping model (Folkman, Schaefer, & Lazarus 1979) to factors associated with having a school-aged child with a hearing loss. Thirty-six hearing mothers of children with hearing loss participated in the study. Information was gathered through parent and teacher questionnaires and home interviews and observations. Results indicated that ( a ) social support emerged as an important predictor of maternal adjustment as well as a buffer between current life stress and maternal adjustment, and ( b ) maternal problem-solving skill emerged as a significant predictor of child adjustment and as a mediating factor between childs age and teacher rating of child adjustment. The discussion focuses on possible explanations for these findings, the utility of a competency-based rather than psychopathology-based perspective in understanding parent and child outcomes, and implications for intervention strategies.

Early Social-Emotional, Language, and Academic Development in Children with Hearing Loss: Families with and without Fathers.

As a group, children with significant hearing loss are at greater risk than other children for outcomes far below their potential, despite the institution of various educational approaches at increasingly earlier ages. Research suggests some benefits of early intervention for deaf children and their families. However, there remains a paucity of research into how family variables may affect child outcomes. The present study investigated the effect of paternal presence or absence on the social-emotional, language, and academic outcomes of 22 deaf and hard of hearing children ages 43-83 months. The children had graduated anywhere from 9 to 47 months earlier from an early intervention program for deaf and hard of hearing children 3 years of age or younger. Results indicated that children whose father is present have significantly better academic and language outcomes than those without a father present. Possible explanations for the findings are discussed, as well as implications of these findings for services offered by early intervention programs.

Early Intervention: Outcomes and Issues.

This article concerns research and clinical issues in the provision of early intervention to young deaf children and their families. The existing outcome literature on the use of Oral-only and Total Communication approaches is reviewed. Then, the methodological and practical difficulties of outcome research are explored. The authors propose a developmental/transactional, clinically-based process model for evaluating the effectiveness of early intervention on the basis that we need to better understand how the interactions of both family and therapist/intervenor attributes relate to more or less beneficial outcomes of intervention.

The Nexus of Culture and Sensory Loss

The development and adaptation of deaf children and their families is an area of study that is fascinating and complex. Having a significant hearing loss may have radically different consequences for the child and his or her family, depending on such factors as the hearing status of the child’s parents, the etiology of deafness, the age at which deafness occurred, the type of communication approach(es) adopted by the family, the type of schooling that is selected, and the amount and nature of contact that both the deaf child and his or her parents have with other deaf children and adults. All of these factors (and more) will influence how the child and family perceive deafness and its social, educational, and vocational consequences.