Beyond childhood depression

Sylvain-Jacques Desjardins | Prevention of depression in childhood is the best way to thwart the condition in adulthood, according to John Abela. The McGill psychology professor has just completed research in which he examined whether psychological and environmental factors can make children vulnerable to developing depression.

Psychology professor John Abela holding a Jornada 690 Photo: Owen Egan

"Children are currently experiencing pessimism, sadness and depression at an unprecedented rate," he warns, noting past studies focused on adults rather than children. "Depression is not age defined. By the time they're 14 years old, up to nine percent of children have already experienced at least one episode of severe depression."

Results of Abela's study, which are being presented at a conference sponsored by the Society for Research on Child Development next week, were culled with the help of some 35 undergraduate and graduate McGill psychology students. The research team gathered its evidence through an unprecedented set of diagnostic interviews, multiple symptom assessments and stress measurements.

Abela's study broke new ground by examining how children who are at risk for depression see themselves, the world, the future; and how these beliefs can affect their emotional well-being. The research team confirmed that kids who are vulnerable to depression have a tendency to make pessimistic remarks; have low self-esteem; poor coping strategies such as chewing over their problems without solving them; rigid and extreme personality traits that include self-criticism and over-dependency on their parents.

"Younger kids experienced depression as sadness, irritability, being bored, tired or had trouble sleeping," he says. "Some even wished they were dead."

The researcher determined that children whose parents have a history of depression have higher levels of pessimistic thinking than children whose parents don't have a history of depression. Simply put, pessimistic thinking among these high-risk kids could cause higher levels of depression.

To prove his theory, Abela recruited two groups of children aged between six and 14. About 140 high-risk children were enlisted and monitored for 14 months. A second set of 40 low-risk children, whose parents had no history of depression, were recruited as a control group. The low-risk group was interviewed once and didn't participate in the full study.

The main goal of having two groups of kids was to determine whether psychological (pessimistic thinking) and environmental factors (school or home) could trigger vulnerability to depression and if these factors are increased in high-risk children.

"By using a high-risk sample of children," Abela explains, "we also maximized the number of participants who experienced periods of depression during the course of the study."

After an initial interview, high-risk kids were telephoned every six weeks to assess their symptoms of depression and inquire if they had experienced any negative events in their lives. This process lasted 12 months. Over the next two months, each child was given a handheld computer (Jornada 690s) to monitor symptoms of depression.

The computers were pre-programmed to let the children know when they should record how they were feeling. An alarm would sound, the child would open the computer and a set of questions, one at a time, would appear on the screen. All questions were read aloud by the computer and responses appeared on the screen. The kids simply had to touch responses that best described their mood at the time.

Other compelling findings emerged from the computerized mood monitoring. "The most riveting was how children who had a parent with a history of depression exhibited much higher levels of vulnerability than low-risk children and consequently were four times more likely to be depressed themselves," Abela says. "Although epidemiological studies have shown that children of parents with a history of major depressive episodes are more likely to develop major depressive disorders than children of parents without such a history, relatively little research has examined why."

The researcher confirmed that cognitive factors (like pessimistic thinking) play a role in the kids' vulnerability to depression, even in those as young as six years old, who are also capable of developing clinically severe depression. As well as showing higher levels of cognitive vulnerability, high-risk kids also are more likely to show interpersonal vulnerability, like insecure attachment to their parents, then are their low-risk peers.

Abela believes his study results are very promising. "Our findings will have a significant impact on our understanding of the treatment and prevention of depression in children," he says. "Discovering the psychological and environmental factors that confer vulnerability to depression in children will provide clinicians with a tool for identifying children at risk for depression.

"Identification of such children is essential so that their pessimistic tendencies can be modified and subsequent bouts of depression avoided."

All 140 participants in the study and their parents were educated on how to prevent depression. "We helped train the children to challenge pessimistic styles of thinking," Abela says. "Styles of thinking can be identified and styles of thinking can be changed."

Parents seeking resources to help their children overcome depression, says Abela, should consider reading Martin Seligman's The Optimistic Child (HarperTrade) as a start. A psychology professor at the University of Pennsylvania, Seligman was Abela's thesis supervisor.

John Abela's research or equipment was funded by the following organizations: Canada Foundation for Innovation, Les Fonds québécois de la recherche sur la nature et les technologies and the National Alliance for Research on Schizophrenia and Depression's Young Investigator Award.

The Child and Adolescent Depression Clinic of the Allan Memorial Institute site of the McGill University Health Centre: 843-1619.