Child Psychiatry and Human Development

, Volume 40, Issue 4, pp 575–588 | Cite as

Parental Depression as a Moderator of Secondary Deficits of Depression in Adult Offspring

  • Christine Timko
  • Ruth C. Cronkite
  • Ralph Swindle
  • Rebecca L. Robinson
  • Anne Sutkowi
  • Rudolf H. Moos
Original Article


This study examined whether having a depressed parent intensifies the secondary deficits that often co-occur with offspring’s depression symptoms. The sample was adult offspring of parents who had been diagnosed with depression 23 years earlier (N = 143) and demographically matched nondepressed parents (N = 197). Respondents completed mailed questionnaires. After controlling for demographic factors, offspring who were more depressed experienced more impairment: physical dysfunction, pain, and disability; anxiety, smoking, and drinking-related problems; poorer social resources; negative events and severe stressors; and reliance on emotional discharge coping. Parental status (depressed or not depressed) was not directly related to offspring impairment once offspring depression symptoms were controlled. However, parental status moderated associations between offspring’s depression severity and their impairment: relationships between depression and impairments were generally stronger for offspring of depressed parents than for offspring of nondepressed parents. Depressed individuals who are offspring of depressed parents may be at particular risk for the secondary deficits of depression.


Depression Parents Adult offspring Moderator 



This work was supported by Eli Lilly and Company and the Department of Veterans Affairs Office of Research and Development (Health Services Research and Development Service). We thank Akash Desai for help with manuscript preparation. The views expressed here are the authors’ and do not necessarily represent the views of the Department of Veterans Affairs.


  1. 1.
    Gotlib IH, Hammen CL (2002) Handbook of depression. Guilford Press, New YorkGoogle Scholar
  2. 2.
    Goodman SH, Gotlib IH (2002) Children of depressed parents: Mechanisms of risk and implications for treatment. American Psychological Association, Washington, DC doi: 10.1037/10449-000
  3. 3.
    Golinkoff M (2007) Managed care best practices: the road from diagnosis to recovery: access to appropriate care. J Manag Care Pharm 13:S23–S27PubMedGoogle Scholar
  4. 4.
    Aikens JE, Kroenke K, Nease DE Jr, Klinkman MS, Sen A (2008) Trajectories of improvement for six depression-related outcomes. Gen Hosp Psychiatry 30:26–31. doi: 10.1016/j.genhosppsych.2007.10.003 PubMedCrossRefGoogle Scholar
  5. 5.
    Alschuler KN, Theisen-Goodvich ME, Haig AJ, Geisser ME (2008) A comparison of the relationship between depression, perceived disability, and physical performance in persons with chronic pain. Eur J Pain 12:757–764. doi: 10.1016/j.ejpain.2007.11.003 PubMedCrossRefGoogle Scholar
  6. 6.
    Arnow BA, Hunkeler EM, Blasey CM, Lee J, Constantino MJ, Fireman B, Kraemer HC, Dea R, Robinson R, Hayward C (2006) Comorbid depression, chronic pain, and disability in primary care. Psychosom Med 68:262–268. doi: 10.1097/01.psy.0000204851.15499.fc PubMedCrossRefGoogle Scholar
  7. 7.
    Simms LJ, Gros DF, Watson D, O’Hara MW (2008) Parsing the general and specific components of depression and anxiety with bifactor modeling. Depress Anxiety 25:E34–E46. doi: 10.1002/da.20432 PubMedCrossRefGoogle Scholar
  8. 8.
    Friedman-Wheeler DG, Ahrens AH, Haaga DA, McIntosh E, Thorndike FP (2007) Depressive symptoms, depression proneness, and outcome expectancies for cigarette smoking. Cognit Ther Res 31:547–557. doi: 10.1007/s10608-006-9064-3 PubMedCrossRefGoogle Scholar
  9. 9.
    Grant BF, Harford TC (1995) Comorbidity between DSM-IV alcohol use disorders and major depression: results of a national survey. Drug Alcohol Depend 39:197–206. doi: 10.1016/0376-8716(95)01160-4 PubMedCrossRefGoogle Scholar
  10. 10.
    Graham K, Massak A, Demers A, Rehm J (2007) Does the association between alcohol consumption and depression depend on how they are measured? Alcohol Clin Exp Res 31:78–88. doi: 10.1111/j.1530-0277.2006.00274.x PubMedCrossRefGoogle Scholar
  11. 11.
    Jacobson NS, Martell CR, Dimidjian S (2001) Behavioral activation treatment for depression: returning to contextual roots. Clin Psychol Sci Pract 8:255. doi: 10.1093/clipsy/8.3.255 CrossRefGoogle Scholar
  12. 12.
    Kendler KS, Karkowski LM, Prescott CA (1999) Causal relationship between stressful life events and the onset of major depression. Am J Psychiatry 837–841Google Scholar
  13. 13.
    Patton GC, Coffey C, Posterino M, Carlin JB, Bowes G (2003) Life events and early onset depression: cause or consequence? Psychol Med 33:1203–1210. doi: 10.1017/S0033291703008626 PubMedCrossRefGoogle Scholar
  14. 14.
    Matheson K, Anisman H (2003) Systems of coping associated with dysphoria, anxiety and depressive illness: a multivariate profile perspective. Stress 6:223–234. doi: 10.1080/10253890310001594487 PubMedCrossRefGoogle Scholar
  15. 15.
    Ravindran AV, Matheson K, Griffiths J, Merali Z, Anisman H (2002) Stress, coping, uplifts, and quality of life in subtypes of depression: a conceptual frame and emerging data. J Affect Disord 71:121–130. doi: 10.1016/S0165-0327(01)00389-5 PubMedCrossRefGoogle Scholar
  16. 16.
    Cronkite RC, Moos RH, Twohey J, Cohen C, Swindle R Jr (1998) Life circumstances and personal resources as predictors of the ten-year course of depression. Am J Community Psychol 26:255–280. doi: 10.1023/A:1022180603266 PubMedCrossRefGoogle Scholar
  17. 17.
    Moos RH, Cronkite RC, Moos BS (1998) Family and extrafamily resources and the 10-year course of treated depression. J Abnorm Psychol 107:450–460. doi: 10.1037/0021-843X.107.3.450 PubMedCrossRefGoogle Scholar
  18. 18.
    Weissman MM, Wickramaratne P, Nomura Y, Warner V, Pilowsky D, Verdeli H (2006) Offspring of depressed parents: 20 years later. Am J Psychiatry 163:1001–1008. doi: 10.1176/appi.ajp.163.6.1001 PubMedCrossRefGoogle Scholar
  19. 19.
    Ensminger ME, Hanson SG, Riley AW, Juon HS (2003) Maternal psychological distress: adult sons’ and daughters’ mental health and educational attainment. J Am Acad Child Adolesc Psychiatry 42:1108–1115. doi: 10.1097/01.chi.0000070261.24125.f8 PubMedCrossRefGoogle Scholar
  20. 20.
    Lieb R, Isensee B, Hofler M, Pfister H, Wittchen HU (2002) Parental major depression and the risk of depression and other mental disorders in offspring: a prospective-longitudinal community study. Arch Gen Psychiatry 59:365–374. doi: 10.1001/archpsyc.59.4.365 PubMedCrossRefGoogle Scholar
  21. 21.
    Peisah C, Brodaty H, Luscombe G, Anstey KJ (2004) Children of a cohort of depressed patients 25 years later: psychopathology and relationships. J Affect Disord 82:385–394. doi: 10.1016/j.jad.2004.03.002 PubMedGoogle Scholar
  22. 22.
    Weissman MM, Warner V, Wickramaratne P, Moreau D, Olfson M (1997) Offspring of depressed parents. 10 years later. Arch Gen Psychiatry 54:932–940. doi: 10.1176/appi.ajp.163.6.1001 PubMedGoogle Scholar
  23. 23.
    Timko C, Cronkite RC, Berg EA, Moos RH (2002) Children of parents with unipolar depression: a comparison of stably remitted, partially remitted, and nonremitted parents and nondepressed controls. Child Psychiatry Hum Dev 32:165–185. doi: 10.1023/A:1017924421229 PubMedCrossRefGoogle Scholar
  24. 24.
    Timko C, Cronkite RC, Swindle R, Robinson RL, Turrubiartes P, Moos RH (2008) Functioning status of adult children of depressed parents: a 23-year follow-up. Psychol Med 38:343–352. doi: 10.1017/s0033291707002073 PubMedCrossRefGoogle Scholar
  25. 25.
    Spitzer RL, Endicott J, Robins E (1978) Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 35:773–782PubMedGoogle Scholar
  26. 26.
    Billings AG, Moos RH (1984) Treatment experiences of adults with unipolar depression: the influence of patient and life context factors. J Consult Clin Psychol 52:119–131. doi: 10.1037/0022-006X.52.1.119 PubMedCrossRefGoogle Scholar
  27. 27.
    Moos RH, Cronkite RC, Finney JW (1992) Health and daily living form manual. Mind Garden, Palo Alto, CAGoogle Scholar
  28. 28.
    Moos RH (1993) Coping responses inventory: adult form manual. Psychological Assessment Resources, Inc., Odessa, FLGoogle Scholar
  29. 29.
    Moos RH (2004) Coping responses inventory: an update on research applications and validity. Psychological Assessment Resources, Inc., Odessa, FL (manual supplement)Google Scholar
  30. 30.
    Beck A, Steer R (1987) Manual for the Beck Depression Inventory. Psychological Corporation, San Antonio, TXGoogle Scholar
  31. 31.
    Holmes TH, Rahe RH (1967) The social readjustment rating scale. J Psychosom Res 11:213–218. doi: 10.1016/0022-3999(67)90010-4 PubMedCrossRefGoogle Scholar
  32. 32.
    Adrian C, Hammen C (1993) Stress exposure and stress generation in children of depressed mothers. J Consult Clin Psychol 61:354–359. doi: 10.1037/0022-006X.61.2.354 PubMedCrossRefGoogle Scholar
  33. 33.
    Garber J, Martin NC (2002) Negative cognitions in offspring of depressed parents: Mechanisms of risk and implications for treatment. In: Goodman SH, Gotlib IH (eds) Children of depressed parents: mechanisms of risk and implications for treatment. American Psychological Association, Washington, DC, pp. 121–153. doi: 10.1037/10449-005
  34. 34.
    Latendresse SJ, Rose RJ, Viken RJ, Pulkkinen L, Kaprio J, Dick DM (2008) Parenting mechanisms in links between parents’ and adolescents’ alcohol use behaviors. Alcohol Clin Exp Res 32:322–330. doi: 10.1111/j.1530-0277.2007.00583.x PubMedCrossRefGoogle Scholar
  35. 35.
    Connor-Smith JK, Compas BE, Wadsworth ME, Thomsen AH, Saltzman H (2000) Responses to stress in adolescence: measurement of coping and involuntary stress responses. J Consult Clin Psychol 68:976–992. doi: 10.1037/0022-006X.68.6.976 PubMedCrossRefGoogle Scholar
  36. 36.
    Swindle RW Jr, Cronkite RC, Moos RH (1989) Life stressors, social resources, coping, and the 4-year course of unipolar depression. J Abnorm Psychol 98:468–477. doi: 10.1037/0022-006X.52.1.119 PubMedCrossRefGoogle Scholar
  37. 37.
    Radke-Yarrow M, Klimes-Dougan B (2002) Parental depression and offspring disorders: A developmental perspective. In: Goodman SH, Gotlib IH (eds) Children of depressed parents: mechanisms of risk and implications for treatment. American Psychological Association, Washington, DC, pp. 155–173. doi: 10.1037/10449-006

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Christine Timko
    • 1
    • 2
  • Ruth C. Cronkite
    • 1
    • 2
  • Ralph Swindle
    • 3
  • Rebecca L. Robinson
    • 3
  • Anne Sutkowi
    • 1
    • 2
  • Rudolf H. Moos
    • 1
    • 2
  1. 1.Center for Health Care EvaluationDepartment of Veterans Affairs Health Care System (152-MPD)Menlo ParkUSA
  2. 2.Stanford University Medical CenterPalo AltoUSA
  3. 3.Eli Lilly and CompanyIndianapolisUSA

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