RESUMEN
OBJECTIVES: To examine the association between parental affective disorders and psychoactive substance use disorders and the onset of major depressive disorder (MDD) among adolescents and young adults and to determine whether this association is affected by stressful life events, family cohesion, self-esteem, or gender. METHOD: Prospective cohort study of 804 adolescents, aged 11-17 years, and their parents who were followed for seven consecutive years. The sample was drawn from the Minneapolis-St. Paul metropolitan area. Parental diagnoses were based on Structured Clinical Interview for administered during study screening stage. Diagnoses of MDD and age of onset were based on Composite International Diagnostic Interview 2.1 administered during final year of data collection. RESULTS: Of the correlates examined, only parental affective disorders, low self-esteem, and gender were significantly related to the onset of MDD. Females were twice as likely as males to experience MDD. CONCLUSIONS: The direct association between parental affective disorders and MDD onset was not affected by family cohesion, self-esteem, or stressful life events; thus more research is needed on other factors that may affect this association, such as genetic factors or other family- and intrapersonal-based variables.
Asunto(s)
Trastorno Depresivo Mayor/epidemiología , Adolescente , Edad de Inicio , Niño , Estudios de Cohortes , Trastorno Depresivo Mayor/diagnóstico , Femenino , Humanos , Masculino , Padres/psicología , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Autoimagen , Índice de Severidad de la Enfermedad , Distribución por SexoRESUMEN
A common observation in the research literature is that children of drug-dependent parents are at significantly heightened risk of adolescent drug use, abuse, and dependence. Recent research indicates that several psychological and interpersonal factors may affect the association between parents' psychoactive substance use disorder (PSUD) and drug use risks among adolescents, yet studies have failed to examine explicitly whether these factors moderate the association between PSUD and adolescent substance abuse. This paper explores these potential relationships using longitudinal data from a study that has followed three cohorts of adolescents and their families over a 7-year period. The cohorts are defined by parental diagnoses of PSUD, affective disorders, or no diagnosable disorder. The results indicate that PSUD is positively associated with adolescent drug abuse, yet this association is attenuated by strong family cohesion. Affective disorders among parents are associated with a higher risk of alcohol, but not drug, abuse. The associations are stronger in the presence of lower stress and higher self-esteem. PSUD is also associated more strongly with offspring drug and alcohol abuse when levels of use are lower. Hence, some unobserved mechanism that may involve physiological sensitivities to drugs and alcohol appears to put children of parents with drug problems at particular risk of drug and alcohol abuse. Limitations of the data and analysis are discussed.