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THE EFFECTS OF PARENTAL DEPRESSION ON
CHILDREN AND FAMILIES: A REVIEW OF PRESENT KNOWLEDGE: AREAS FOR
FURTHER STUDY
Carolyn Byrne
Depression has been traditionally viewed as
a condition of the individual where the individual received a diagnosis
and treatment for depression and little attention was given to the
worlds of the depressed individual. There is now considerable literature
indicating that depression's effects encompass the individuals'
social worlds of family, friends, and work (Coyne, Burchill &
Stiles, 1991; Cummings & Davies, 1994; Hammen, 1992; Wells &
Brennan, 1991). It has been well established that children growing
up in a family with a depressed parent are at increased risk for
emotional, social and academic problems in childhood (Hammen, 1991),
and psychopathology in adulthood (Weissman, Gammon, John, Merinkagas,
Warner, Prusoff and Sholomkas, 1987). Further, families where one
parent is depressed experience more marital discord, stress and
rates of divorce, when compared to families with no depressed parent
(Teti, Gelfand & Pompa, 1990).
Rates of depression are rising and age of onset
is earlier than in previous generations (Klerman, 1986). Depression
is now viewed as a major public health problem with significant
costs to society. In the past 2 decades, considerable efforts have
been spent attempting to explore the  effects
of parental depression and on children and the family.
Studying the effects of parental depression
in children and families are complicated by several factors. The
first is the heterogeneity of depression; depression is not one
clear-cut diagnosable entity. The Diagnostic and Statistical Manual
of Mental Disorders (1994) lists twelve different diagnostic categories
of depressive and bipolar disorders, each with some different properties
of presentation, severity and in some cases, etiology. Drawing definite
conclusions from the research literature can be difficult as many
studies group different types of depressed subjects together. Second,
individuals may manifest different illness trajectories that affect
children and families very differently. Third, many of the depressive
disorders are not "pure" disorders alone but coexist with
other disorders which cloud the research findings and result in
very different manifestations of the illness. Fourth, methods of
determining depression varies from study to study. Some use a symptom
check list, others a structured clinical interview, giving rise
to differences in the severity of depression across studies, Fifth,
there is variability across studies in determining child risk as
studies differ on who is informing about the child's difficulties
(parent, child or teachers); the measures used to determine difficulties
(symptom checklists, a parental report); and also in the unit of
analysis (the household or the individual child). Despite these
difficulties there is evidence that children growing up in a family
where a parent is depressed are at increased risk compared to children
who do not have a depressed parent. This paper will review the literature,
identify the present state of knowledge and highlight future areas
for study.
CONCLUSIONS
This review has attempted to be as comprehensive
as possible in exploring the effects of parental depression on children
and families. The literature from two major perspectives was reviewed.
Literature that focuses on research exploring
the external/objective factors that place children and families
at risk when a parent has depression was reviewed. While considerable
knowledge has been gained using this perspective what is remarkably
absent from this perspective are the evaluations of intervention
studies aimed to ameliorate the negative effects of parental depression.
A model was developed that highlighted the research findings from
this perspective. This model indicates the contribution of all family
members placing both the child and family at risk and moves the
focus solely on the depressed parent placing the child and family
at risk to identifying multiple contributions of all family members
that can increase the risk for child and family difficulties.
The literature that focuses on research explores
the subject's point of view in understanding and managing depression
was also reviewed. While this knowledge provides some answers as
to how the depressed individual and family comes to understand and
manage the depressive experience there remains questions as to how
children interpret this experience and of how parents can actively
reduce the harmful effects of parental depression. A second model
was developed that highlights the research findings from this perspective.
This model illustrates the active processes that the depressed individual
and adult family members use in understanding the depression and
activities the adult family members engage in, in dealing with the
depressed individual. Further research in this line of inquiry is
needed to complete the model by exploring the active ways the depressed
individual, the partner and children manage the depression. This
model then shows the active rather than passive ways family members
deal with the depressive experience.
Reviewing knowledge from both type of inquiry
points to the importance of considering knowledge form different
paradigms to gain a broad understanding of the effects of parental
depression on children and families.
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