title: Mediated moderation of the relation between maternal and adolescent depressive symptoms: role of adolescent physical health.
abstract: BACKGROUND
  To examine the mediating effect of family functioning on the relation between maternal and adolescent depressive symptoms and determine whether the magnitude of the mediating effect is different for adolescents with and without chronic physical health conditions.
  
  
  METHODS
  Data come from the National Longitudinal Survey of Children and Youth. A representative survey of 11,813 adolescents and their mothers was included. Maternal and adolescent depressive symptoms were measured using the 12-item Center for Epidemiological Studies Depression Scale. Family functioning was measured using the McMaster Family Assessment Device. Multilevel multiple-group path analysis was used to examine potential mediating and moderating effects.
  
  
  RESULTS
  Family functioning measured when adolescents were 14-15 years mediated the relation between maternal depressive symptoms (measured at 10-13 years) and adolescent depressive symptoms (measured at 16-19 years) for both adolescents with [αβ = 0.02 (0.02, 0.03)] and without chronic health conditions [αβ = 0.01 (0.00, 0.01)]. These findings provided evidence to suggest mediated moderation, Δαβ = 0.02 (0.01, 0.03), that is, the mediating effect of family functioning was significantly larger for adolescents with chronic health conditions.
  
  
  CONCLUSIONS
  The mediating effect of family functioning in the relation between maternal and adolescent depressive symptoms is larger for adolescents with chronic health conditions. Within the framework of family-centered care, maternal depressive symptoms and family functioning are suitable targets for preventive intervention for adolescents with chronic health conditions.
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, McMaster Innovation Park 201A, Hamilton, ON, L8S 4K1, Canada. ferroma@mcmaster.ca.|Department of Pediatrics, McMaster University, Hamilton, Canada. ferroma@mcmaster.ca.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. ferroma@mcmaster.ca.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ferro
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health / Q000706:statistics & numerical data*; D000328:Adult; D002908:Chronic Disease; D003863:Depression / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Adolescent; Chronic condition; Chronic illness; Depression; Family functioning; Mothers; Path analysis; Stress