Clinical significance of type of mood disturbance (depressed mood, irritable mood, or anhedonia) in children and adolescents with major depressive disorder

This study examined the various types of mood disturbances (depressed mood, irritable mood, or anhedonia) exhibited by 60 children and adolescents receiving diagnoses for Major Depressive Disorder (MDD) in the DSM-IV field trials. There were two main goals of this study: (1) to determine the extent of the heterogeneity in the types of mood disturbances expressed in children and adolescents receiving diagnoses of MDD, and (2) to determine the clinical significance of the presence or absence of the various types of mood disturbances. This second goal was accomplished by examining the relationship between the various types of mood disturbances and numerous other variables, such as age, suicidal ideation, suicidal behavior, and degree of psychiatric disturbance as measured by the Children\u27s Global Assessment Scale (CGAS). Further analyses were conducted examining gender and comorbidity. In addition, all analyses were conducted using the whole field trials sample (N = 440) as well in order to determine if the findings could be replicated in a general psychiatric sample.Contrary to what was expected, subjects receiving diagnoses of MDD were found to be fairly homogeneous with respect to mood disturbance in that the most typical presentation involved all three types of disturbances of mood. Other major findings were as follows: (1) subjects who presented with anhedonia received interviewer-generated CGAS scores indicating greater levels of functional impairment than others within the MDD category, and (2) subjects who presented with irritability were found to be significantly older than others with MDD. Both of these findings were replicated in the whole field trials sample as well

Depressed mothers' perceptions of infant behavior

Sixty lower SES, black mothers with high and low Beck Depression Inventory scores were videotaped interacting with their infants. To determine whether the mothers with depressive symptoms perceived their infants' behavior more negatively, both the mothers and trained observers (naive to group assignment) coded the videotapes. The mothers' behavior was coded in the same way. The mothers' and observers' data streams were then analyzed for proportion of time the mothers and infants were in positive, neutral, and negative behavior states and the degree to which the mother and observer agreed (proportion of time they coded the same state and the coherence value based on cross-spectral data analyses). Both the mothers and observers coded the infants of symptomatic mothers more negatively. However, the symptomatic mothers coded their infants' behavior even more negatively than the observers did. In contrast, they coded their own behavior more positively than the observers did. Both groups of mothers underestimated their own negative behavior. Finally, coherence values were lower for the symptomatic mother-observer data streams than for the nonsymptomatic mother-observer data streams, suggesting less agreement between observers and symptomatic mothers on their infants' and their own behaviors

Mothers with zero Beck depression scores act more “depressed” with their infants

Mothers who scored zero on the Beck Depression Inventory (N = 25) were compared to “depressed” mothers (high scores on the Beck) (N = 39) and nondepressed mothers (N = 98) during face-to-face interactions with their 5-month-old infants. The interaction videotapes were rated on the Interaction Rating Scales and were coded second-by-second for attentive/affective behavior states. The zero Beck mothers and their infants received lower ratings and were in less positive behavior states (alone or together) than the high scoring Beck “depressed” mother/infant dyads and even more frequently than the nondepressed mother/infant dyads. The lower activity levels, lesser expressivity, and less frequent vocalizing were suggestive of “depressed” behavior in both the mothers and their infants. In addition, the infants of the zero Beck mothers had lower vagal tone and lower growth percentiles (weight, length, and head circumference) than the infants of nondepressed mothers, although they did not differ from the infants of depressed mothers on these measures. These data suggest that mothers who report no depressive symptoms may present as much, if not greater risk, for their infants than mothers who do report depressive symptoms on the Beck Depression Inventory