As a parent, you influence your child’s depression (and why that is also good news)
‘Shouldn’t you get out of bed for once?’ Critical or controlling behaviour from parents, however well intentioned, can worsen the symptoms of young people with depression. That is the conclusion of PhD research by psychologist Wilma Wentholt. But warmth and emotional support can, in fact, have a protective effect.
A few months before defending her PhD, Wentholt came across a quote at a scientific conference by the American anthropologist Mary Catherine Bateson (1939–2021): ‘The pathology is not in the child, the mother or the father, but it is in the system.’ For Wentholt, who trained as an educational scientist and now works as a researcher in clinical psychology, this perspective felt like coming home. ‘It is not a one-way process. Problems do not lie within one person, but within the dynamics. If something is going on with the child, it affects the parents, and vice versa.’ The decision was quickly made: the sentence became one of the ten propositions accompanying her dissertation Blue Kaleidoscope – Disentangling Family Perspectives in the Context of Adolescent Depression, which she will defend on 13 May.
Involving parents
During her PhD research, Wentholt examined how parental behaviour influences a child’s depression and the different perspectives involved in this process — a topic that has received relatively little attention so far. Unlike parents of young children with mental health problems, parents of adolescents with clinical depression are not always closely involved in treatment within mental healthcare services. ‘Their children often stop going to school, struggle with low self-esteem, experience persistent sadness and suicidality. That is stressful and worrying for parents too, and it affects their own functioning,’ Wentholt explains. ‘At the same time, these young people are still living at home and are constantly interacting with their parents.’ According to Wentholt, it therefore makes more sense to involve parents more actively. ‘To support both parents and adolescents as effectively as possible, we first need to understand what is happening within the family.’
In the RE-PAIR study, psychologists led by professor Bernet Elzinga investigate how everyday conflicts between adolescents and their parents may trigger or maintain depressive symptoms.
Lab day
Wentholt and her colleagues conducted a literature review and additionally studied two groups within the RE-PAIR study: 35 adolescents with clinical depression and both of their parents, and 80 adolescents without depression together with both parents. All participants attended a full-day programme during a ‘lab day’ at treatment centre LUBEC. In both groups, the researchers conducted interviews and asked adolescents and parents to discuss topics they frequently argued about at home, such as screen use. The adolescents also planned an outing together with their parents and shared an experience they had found difficult.
Warmth and criticism
The researchers recorded these conversations and subsequently analysed the parents’ observed behaviour. ‘We looked at how much emotional support and autonomy support parents showed, and to what extent parents were critical or psychologically controlling,’ Wentholt explains. After the conversations, both adolescents and parents were asked how they had experienced the interaction. ‘We asked adolescents: how well did your mother listen? How critical was your father? And we also asked parents: how critical were you towards your child during this conversation?’
'Adolescents with depression experienced their parents as less supportive and more critical'
Affection has a positive effect
The literature review showed clearly that observed parental behaviour influences a child’s depression, but that this is not a simple one-to-one relationship and varies greatly between families.
‘In our own RE-PAIR study, we found that parents of adolescents with depression did not behave differently from parents in the control group, but adolescents with depression did perceive their parents as less supportive and more critical,’ Wentholt says. In addition, the mood of adolescents with depression deteriorated further when parents displayed psychologically controlling behaviour. ‘But we did not see this effect among adolescents without depression,’ Wentholt adds. They appeared to be less affected by their parents’ negative behaviour.
A protective role as a parent
Adolescents with depression therefore seem to be especially sensitive to their parents’ behaviour. This may be confronting, but it can also offer hope. ‘It means that as a parent, you can also play a protective role in the development of depression,’ she explains. ‘Previous research has shown that being bullied at school is a major risk factor for depression. But if your parents see you and support you at home, that can reduce the risk of depression later in life.’
Setting boundaries with empathy
The advice, then, is to be generous with warmth and affection, while being cautious about criticism and controlling behaviour. However, Wentholt stresses: ‘That does not mean you cannot correct your child or that you stop parenting altogether. You can still set boundaries in a supportive and empathetic way.’ It is also important for parents to reflect on their own behaviour, as this benefits their child’s mood.‘Check whether your child experiences your interactions in the same way as you do, and try to relate to your child’s perspective,’ Wentholt advises.
'Being less critical does not mean you can no longer correct your child'
Take the perspective seriously
This is also something she would like to pass on to fellow researchers conducting similar studies: ‘Make sure your conclusions closely match what you have actually measured. If you assessed parenting from the adolescent’s perspective, then you can draw conclusions about that perspective — but not about the parent’s actual behaviour.’