Depression in Parents, Parenting, and Children Opportunities to Improve Identification, Treatment, and Prevention (2009) / Chapter Skim
Currently Skimming:
1 Introduction and Magnitude of the Problem
1 Introduction and Magnitude of the Problem
Pages 15-42
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 15... ...
have similar rates of depression compared to the entire U.S. adult population, including similar disparities in depression rates for selected population characteristics.
|
From page 16... ...
• Depression in parents can have serious biological, psychological, behavioral, and social consequences especially for children who rely on a parent for caregiving, material support, and nurturance. • Despite this impact, depression is perhaps one of the most effec tively treated psychiatric disorders, if recognized and treated early in its onset.
|
From page 17... ...
. The Composite International Diagnostic Interview is a comprehensive interview designed for the assessment of mental disorders according to the definitions and criteria of the International Statistical Classification of Diseases and Related Health Problems, 10th revision, and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition.
|
From page 18... ...
Specifically, there exists a need to identify approaches that can highlight ways to translate research knowledge into effective interventions in a broad range of parental support and child health and development strategies. Study Charge Concerned about these complex issues, the National Academies' Board on Children, Youth, and Families formed the Committee on Depression, Parenting Practices, and the Healthy Development of Children, with funding from the Robert Wood Johnson Foundation, the Annie E
|
From page 19... ...
, various health and support services for depression care, the features of interventions and implementation strategies for depression care in diverse populations, and public policies related to implementing promising interventions. Additionally, the committee visited programs focused on providing mental health services in substance abuse settings to underserviced populations.
|
From page 20... ...
In general, there is continual debate on how to define mental disorders, and specifically for depression there are many tools used in the literature to assess adults for depression. A review by Frank and Glied (2006)
|
From page 21... ...
And methods used for clinical diagnosis may vary by type of provider. Generalist physicians provide most of the depression screening and care to the general population, whereas the limited number of available specialty mental health providers (i.e., those with advanced mental health training)
|
From page 22... ...
While many studies do not specifically investigate parental depression or even note parental status among their samples, a few national surveys help give insight into the prevalence of depression among adults who are also parents in the United States. For example, a subsample of the National Comorbidity Survey Replication in 2002 reported that 17 percent of parents (with at least one child)
|
From page 23... ...
(n = 2,243) Overall Lifetime 21.7 12.6 17.3 Past 12 months 10.0 4.3 7.2 With Child ≤ 5 Years of Age Lifetime 17.2 11.5 14.8 Past 12 months 10.0 4.4 7.6 With Child 6–12 Years of Age Lifetime 22.3 12.9 17.7 Past 12 months 10.0 4.2 7.2 With Child ≥ 13 Years of Age Lifetime 24.5 14.2 19.4 Past 12 months 10.5 5.2 7.8 a"Withhierarchy" refers to a diagnostic criterion in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition that specifies that if a disorder is better explained by another mental disorder, that "other" disorder is given hierarchy over the disorder of interest, i.e., a more narrow definition of major depression disorder that does not include those with mania and hypomania.
|
From page 24... ...
Among the general population of parents, poverty status, and educational attainment did not significantly affect the prevalence of lifetime major depression. Although differences in rates by gender and marital status were similar as for prevalence of lifetime major depression, reports of major depression in the past year also found additional differences by current work status.
|
From page 25... ...
However, there seem to be some inconsistencies about whether the prevalence rates for depression in the general adult as well as in the parent population in racial/ethnic minority groups is higher or lower than their white counterparts. Existing national surveys report lower rates in lifetime prevalence for adults in these racial/ethnic minority groups (e.g., Asian Americans, African Americans)
|
From page 26... ...
P-value Rate (%) P-value Race/Ethnicity Non-Hispanic white 25.4 0.007 14.2 0.08 19.6 < 0.0001 African American 14.2 9.3 12.0 Black immigrants from the Caribbeanb 28.0 35.9 29.7 Mexican 11.9 7.8 10.3 Other Hispanic 18.5 8.2 14.6 Asian 19.7 1.8 8.8 Other 27.5 17.6 23.3 Born in United States Yes 22.4 0.009 13.2 0.03 17.9 0.0008 No 15.5 5.9 11.2 Primary Language While Growing Up Not English 14.4 0.0004 8.3 0.04 11.8 < 0.0001 English 23.6 13.5 18.6 Number of Parents Born Outside United States 0 17.3 0.30 6.8 0.09 13.0 0.15 1 20.1 17.6 19.0 2 22.6 12.9 17.8 Current Work Status Employed 23.5 0.14 11.6 0.008 17.0 0.53 Unemployed, in workforce 17.9 11.1 17.3 Not in workforce 18.5 20.8 19.2
|
From page 27... ...
22.1 0.12 15.1 0.25 17.5 0.55 Middle income (ratio of 2 to < 4.43) 17.5 11.6 16.3 Gender Male NA NA NA NA 12.6 < 0.0001 Female NA NA NA NA 21.7 Marital Status Married/cohabiting 19.8 0.0008 11.0 0.05 15.3 0.0004 Divorced/widowed/separated 31.5 19.1 25.8 Never married 18.1 15.0 17.2 Education 0–11 years 14.7 0.10 16.0 0.44 15.3 0.48 12 years 23.7 13.5 18.7 13–15 years 23.1 11.7 17.9 16 years or more 21.9 10.4 16.1 NOTES: NA = not applicable; NICHD = National Institute of Child Health and Human Development.
|
From page 28... ...
P-value Rate (5) P-value Race/Ethnicity Non-Hispanic white 11.5 NA 4.7 NA 8.0 0.09 African American 7.0 3.3 5.4 Black immigrants from the Caribbeanb 0 35.9 7.7 Mexican 5.3 3.8 4.7 Other Hispanic 9.3 2.5 6.8 Asian 9.9 0 3.9 Other 14.7 7.0 11.4 Born in United States Yes 10.3 0.04 4.5 0.36 7.5 0.08 No 6.7 2.2 4.7 Primary Language While Growing Up Not English 7.3 0.09 3.9 0.76 5.9 0.17 English 10.7 4.4 7.6 Number of Parents Born Outside United States 0 7.4 0.41 3.3 0.61 5.7 0.47 1 9.7 6.2 8.1 2 10.3 4.3 7.4 Current Work Status Employed 9.3 0.28 3.1 <0.0001 5.9 < 0.0001 Unemployed, in workforce 10.4 6.3 10.1 Not in workforce 12.2 15.0 13.0
|
From page 29... ...
a"With hierarchy" refers to a diagnostic criterion in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition that specifices that if a disorder is better explained by another mental disorder, that "other" disorder is given hierarchy over the disorder of interest, i.e., a more narrow definition of major depression disorder that does not include mania and hypomania.
|
From page 30... ...
For example, such factors as limited access to knowledge and resources as well as increased exposure to such social stressors as marginal neighborhoods, community violence, and discrimination directly affect the genesis, progression, and treatment of depression. In addition, the stigma associated with belonging to a disadvantaged group may increase individuals' isolation, thus causing or exacerbating depressive symptoms, and it may affect their treatment-seeking behaviors.
|
From page 31... ...
Comorbidities and Correlates of Depression According to the National Comorbidity Survey, approximately 75 percent of individuals who had lifetime or recent depression also had at least one additional mental health or substance abuse diagnosis (Kessler et al., 2005) , as did 60–65 percent of those with current major depression, as reported in both U.S.
|
From page 32... ...
. This recurrent pattern of illness leads to sustained individual, family, and societal costs.
|
From page 33... ...
Once depressed, parents have an effect on their own potential human capital (i.e., decreased employment, earnings, productivity) , social capital (i.e., skills, abilities, knowledge, relationships)
|
From page 34... ...
ENVIRONMENT 34 PARENT FAMILY RESOURCES FAMILY CONTEXT DEPRESSION Economic Risks to Parent from Depression HOUSEHOLD EMPLOYMENT HUMAN CAPITAL PRODUCTION PARENTING SOCIAL CAPITAL Risks to Children from Depressed Parent FAMILY HUMAN CAPITAL SOCIAL CAPITAL RESOURCES DEVELOPMENT HEALTH DEVELOPMENT FIGURE 1-1 Conceptual model of the economic impact of depressed parents on children. NOTES: Employment = unemployment, reduced productivity; Environment = physical -- housing quality, rural versus urban; social -- crime rates, racial/ethnic representation, immigrant status; economic -- unemployment rates; Family Context = number of adults in household, number of children in household, parent marital status, immigrant status; Family Resources = income, time available for home production; Family Resources = lower income, less health insurance; Health = increased risk of abuse/neglect, poor nutrition, depression, increased injury due to poor monitoring; Household Production = poorer nutrition, home safety hazards; Human Capital = less likely to continue education or participate in job training; Human Capital Development = less time reading with parent, parent less involved in school; Parenting = harsher discipline, less energy for educational activity; Social Capital = strained relationships, isolation; Social Capital Development = impairment of attachment, fewer healthy adult role models.
|
From page 35... ...
. A number of institutional and sociocultural barriers are responsible for causing and maintaining existing disparities in access to and quality of mental health services received by minority groups.
|
From page 36... ...
The focus is rarely on how depression affects parenting and child outcomes; how often it occurs in combination with other parental risks, like substance abuse and trauma; or what kinds of strategies can help to identify, treat, and prevent these negative consequences for parents and their children (Knitzer, Theberge, and Johnson, 2008)
|
From page 37... ...
have similar rates of depression compared to the entire U.S. adult population, including similar disparities in depression rates for selected population characteristics such as sex, age, and marital status.
|
From page 38... ...
Finally, the role of culture, language, and social determinants of health were identified across the chapters when literature was available when describing vulnerable populations who experience mental health disparities. A list of acronyms is provided in Appendix A
|
From page 39... ...
. Prevalence of mental disorders in Europe: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD)
|
From page 40... ...
. A prospec tive 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders.
|
From page 41... ...
. The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R)
|
From page 42... ...
. Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites: Results from the National Sur vey of American Life.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.