Emotion socialization within the family environment and adolescent depression

Abstract

This review evaluates research addressing the association between parent–child emotional interactions and the development and maintenance of depression in adolescence, with a focus on studies using observational research methods that assess parental responses to children and adolescents' emotional displays. We argue that parental socialization behaviors in response to different emotions expressed by youths may have distinct associations with depressive outcomes. In particular, parental behaviors that reinforce depressive behavior, reciprocate aggression, and fail to positively reinforce positive behavior have each been associated with youth depression. This review identifies a need for more observational research, including prospective, longitudinal studies, to better understand these behaviors, elucidate the directionality of influence between parental socialization behaviors and youth depression, and more clearly identify protective parental socialization behaviors. However, the use of existing findings to inform family-based interventions may improve prevention and treatment efforts directed at youth depression.

Introduction

Epidemiological research has shown that the onset of major depressive disorder (MDD) commonly occurs in adolescence, with an estimated 20–28% of young people experiencing an episode of MDD by age 19 (Hankin et al., 1998, Kessler et al., 2005, Lewinsohn et al., 1998). Episodes of adolescent depression have been associated with concurrent and future psychosocial dysfunction (Fergusson and Woodward, 2002, Lewinsohn et al., 2003, Lewinsohn et al., 1998) and with high rates of recurrence (Hankin et al., 1998, Lewinsohn et al., 1999). Despite advances in intervention development, a significant proportion of depressed adolescents fail to respond to available evidence-based treatments (Gladstone & Beardslee, 2009), and preventive interventions evidence relatively modest efficacy (Horowitz and Garber, 2006, Merry et al., 2004). Given the substantial humanitarian and economic costs of depression (World Health Organization, 2008), a better understanding of the risk and protective factors that contribute to the onset and maintenance of depression is required in order to develop better interventions to prevent and treat this disorder.

This review critically examines research into the influence of parenting behaviors on risk for depression, which is an important and potentially modifiable component of risk that could be targeted in preventive and treatment interventions for adolescent depression. We begin with an evaluation and integration of research into one aspect of parental socialization of emotion, namely parents' response to expressions of sadness, anger, and positive emotions by their children. This discussion leads to the proposal of a preliminary model linking patterns of parental responses to different emotions with youth depression. Directions for future research and clinical implications arising from this model conclude the review.