Child-specific and family-wide risk factors using the retrospective Childhood Experience of Care & Abuse (CECA) instrument: a life-course study of adult chronic depression - 3.
BACKGROUND
An earlier paper [Brown, G.W., Craig, T.K.J., Harris, T.O., Handley, R.V., Harvey, A.L., 2007a-this issue. Development of a retrospective interview measure of parental maltreatment using the Childhood Experience of Care & Abuse (CECA) instrument - a life-course study of adult chronic depression - 1. J. Affect. Disord. doi:10.1016/j.jad.2007.05.022] documented an association between parental maltreatment and risk of adult chronic depression. This paper explores the contribution of other child-specific factors (e.g. conduct problems) and family-wide factors (e.g. parental discord).


METHODS
Data are derived from an enquiry of 198 women largely comprising of adult sister pairs. Data was collected by semi-structured interviews covering a wide range of parental behaviour and childhood behaviour.


RESULTS
Parental maltreatment emerged as channelling the effect of family-wide factors on risk of adult chronic depression, but with a child's conduct problems and shame-withdrawal partly mediating this link. A child's depression before 17, although correlated with parental maltreatment, did not appear to play a significant role in adult depression. This core model is supplemented by analyses exploring the mechanisms involved. A mother's rejection/physical abuse and her depression via her lax control, for example, account for the link of parental maltreatment with conduct problems. Also 'rebelliousness' of a child relates to the chances of her low affection moving to rejection. "Rebelliousness" also appears to play a role in why the paired sisters so often had a different experience of maltreatment.


CONCLUSIONS
The data is collected retrospectively - but see [Brown, G.W., Craig, T.K.J., Harris, T.O., Handley, R.V., Harvey, A.L., 2007b-this issue. Validity of retrospective measures of early maltreatment and depressive episodes using the Childhood Experience of Care and Abuse (CECA) instrument - A life-course study of adult chronic depression - 2. J. Affect. Disord. doi:10.1016/j.jad.2007.06.003].


CONCLUSIONS
Child-specific factors play a major role in the origins of adult chronic depressive episodes. This, however, is fully consistent with an equally significant contribution from family-wide factors. The crucial point is that the link of the latter with such depression appears to be indirect and mediated very largely by parental maltreatment.
Brown
George W
GW
Department of Social Psychiatry Group, King's College London, St Thomas' Hospital Campus, Lambeth Palace Road, London, SE1 7EH, UK. george.brown@kcl.ac.uk
Craig
Tom K J
TK
Harris
Tirril O
TO
Handley
Rachel V
RV
Harvey
Anna L
AL
Serido
Joyce
J
D000328:Adult; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000523:psychology; D015982:Bias; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000523:psychology; D002908:Chronic Disease; D019955:Conduct Disorder / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006801:Humans; D007206:Individuality; D007406:Interview, Psychological; D008131:London; D008425:Maternal Behavior / Q000523:psychology; D008875:Middle Aged; D016487:Parenting / Q000523:psychology*; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D012059:Rejection, Psychology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012752:Shame; D035781:Siblings / Q000523:psychology