ACQ_Vol_11_no_3_2009

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ACQ Volume 11, Number 3 2009 181
Childhood predictive factors in adult depression
McCarty, C. A., Alex Mason, W. A., Kosterman, R., Hawkins,
J, D., Lenguna, L. J., McCauley, E. (2008). Adolescent
school failure predicts later depression among girls. Journal
of Adolescent Health, 43, 180–187.
Angela Clarke and Camille Vickerson
This article outlines a study that traced the origins and
permutations of depression in 808 participants from age 10
to 21. Participants were mainly from low socioeconomic and
high crime areas, and almost half the group came from
single-parent homes. The retention rate to age 21 was 95%.
The authors selected a “cascade” model to map factors
that may contribute to adult depression. This model
proposes that a dysfunction in one domain of adaptive
behaviour spills over to influence another domain and so on.
The potential depressive factors that were initially considered
were depression, low school achievement, and social and
conduct problems at the age of 10. The authors assessed
maladaptive factors evident in adolescence, including school
failure, delinquency, and social problems, and determined
their contribution to a major depressive episode (MDE) in
early adulthood. Questionnaires were used as assessment
tools.
The cascade effect for depression was found in girls
but not in boys. For girls, depression and low academic
achievement at age 10 predicted poor schooling in
adolescence, with high school failure leading to MDE at age
21. However, the cascade model did not explain the findings
that, for girls, conduct problems at age 10 directly correlated
with MDE at age 21. For boys, early childhood factors were
predictive of maladaptive adolescent behaviours such as
school failure, delinquency and social problems – but these
did not contribute to MDE at age 21.
The authors proposed two possible explanations for the
identified gender differences in the risk for depression. As
conduct problems and school failure are relatively atypical
and less accepted for girls than for boys, when present they
may signal more impaired functioning and hence have more
severe consequences. It is possible that both boys and girls
with conduct problems and school failures have vulnerability.
However girls become more prone to internalising problems
while boys’ vulnerability manifests more broadly in
externalising behaviours, substance use, etc.
In contrast to findings from other studies, the authors did
not identify a link between early social problems and MDE
in adulthood. The study also found no link in boys between
early conduct disorders and MDE in adulthood, even though
many studies have found early conduct problems in boys to
be predictive of later depression.
From a speech pathologist’s perspective, a major limitation
of this study is that there was no investigation of the role of
language impairment on the development of depression,
low academic achievement, conduct problems or social
problems. The authors only broadly acknowledged this by
suggesting that alternative constructs or measures could
account for the relationship between poor adaptation in
childhood and adolescence, and depressive symptoms in
young adulthood.
that refugee children and young people’s responses to
extremely adverse situations may be normal are also raised.
It is suggested that the child and adolescent refugee
population has high rates of poor psychological outcomes,
including depression, anxiety, and post-traumatic stress
disorder, but the reported rates vary across different studies.
Some studies reviewed in this article argued that, despite
these poor psychological outcomes, many of the refugee
children functioned well at school in their new country and
demonstrated resilience during all stages of the migration
process. A positive relationship with at least one parent
and environmental support from teachers are identified as
protective factors for positive mental health outcomes. Risk
factors for poor mental health outcomes included separation
from caregivers, combat experience or inability of parents
to cope with stress. The author discusses the importance
of supporting families in the early stages of resettlement
and discusses four types of interventions to address mental
health needs.
Investigation of risk factors for mental health
problems in preschool children
Robinson, M., Oddy, W. H., Li, J., Kendall, G. E., DeKlerk, N.
H., Silburn, S. R., et al. (2008). Pre and postnatal influences
on preschool mental health: A large-scale cohort study.
Journal of Child Psychology and Psychiatry, 49(10),
1118–1128.
Kate Desborough
This article investigates risk factors for mental health
problems among pre-school children. The authors utilised
behavioural data from the Western Australian Pregnancy
Cohort Study to examine a range of antenatal, perinatal and
postnatal risk factors and their influence on problem
behaviours in early childhood. The multiple risk factors for
childhood behavioural problems were analysed together
within a prospective pregnancy cohort to eliminate issues of
bias, reliability and validity.
Almost 2,870 children were available for longitudinal
follow-up, with 69% of children participating at 2 years and
76% participating at 5 years of age. Research data were
collected at 18 and 34 weeks gestation, at birth, and at 1,
2, 3 and 5 years of age. Child mental health was assessed
using the Child Behaviour Checklist (CBCL), which provided
measures of overall behaviour in addition to internalising and
externalising behaviours.
Results indicated that multiple stress events, such as
smoking, ethnicity, and economic hardship during pregnancy
were significant antenatal risk factors for child mental health.
Lower gestational age and male gender, as well as the
presence of “baby blues” in mothers postnatally were found
to indicate greater risk of mental health morbidity. Some
protective effect on children’s mental health status included
having more siblings and access to breastfeeding for longer
periods. These results provide a greater understanding
of the determinants of child mental health problems and
highlight the need to intervene in the antenatal, perinatal and
postnatal periods to support positive mental health in early
childhood.
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