Understanding the link between parental and adolescent depressive symptoms in families at-risk for type 2 diabetes
Date
2015
Authors
Lehman, Devon Patricia, author
Shomaker, Lauren, advisor
Lucas-Thompson, Rachel, committee member
Wdowik, Melissa, committee member
Journal Title
Journal ISSN
Volume Title
Abstract
Depression and type 2 diabetes (T2D) are serious chronic diseases that show familial aggregation. However, the connection between parent and child depression and T2D risk within families at risk for T2D is poorly understood. The primary objective of the current study was to examine associations among maternal depressive symptoms, adolescent depressive symptoms, and adolescent metabolic characteristics in at-risk families. The second objective was to examine to what extent adolescent coping techniques served as a mediator of the relationship between parental and adolescent depressive symptoms. To address these objectives, I conducted a secondary, cross-sectional data analysis of the baseline phase of a T2D prevention trial with adolescents. Participants were 119 girls (age 14±2y; 62% non-Hispanic Black) and a biological parent. All girls were at risk for T2D by being overweight or obese (BMI > 85th percentile) and having a first- or second-degree relative with diabetes. By study design, girls also had at least mild-to-moderate depressive symptoms as determined with the Center for Epidemiologic Studies-Depression Scale (CES-D, total score > 16). Adolescents reported a continuous measure of depressive symptoms on the Children's Depression Inventory, and parents described their own depressive/anxiety symptoms on the Adult Self-Report. Adolescent coping skills were measured by adolescents’ report on the Responses to Stress Questionnaire-Social Stress Version. Metabolic risk factor measures included fasting glucose, fasting insulin, insulin sensitivity determined with oral glucose tolerance tests, and body composition by dual-energy x-ray absorptiometry. Parental depressive/anxiety and adolescent depressive symptoms were positively correlated (p < .05), and this relationship remained even when accounting for race, age, puberty, body fat, lean mass, height, and presence of maternal diabetes (p = .01). Parental depression/anxiety symptoms were significantly related to adolescent BMI metrics, adjusting for similar covariates (all p < .05), but parental depression/anxiety did not relate to other insulin or glucose indices after accounting for body composition. Adolescent coping strategies of disengagement coping, involuntary engagement coping, and involuntary disengagement coping were all predictive of greater adolescent depressive symptoms in adjusted analyses (all p < .05). However, parental depression/anxiety and coping had independent main effects on adolescent depressive symptoms, and there was no evidence that coping mediated the relationship between parental depressive/anxiety symptoms and adolescent depressive symptoms (all p ≥ .34). In conclusion, among adolescent girls at-risk for T2D with some depressive symptoms, higher levels of parental depressive/anxiety symptoms were related to relatively higher levels of adolescent depressive symptoms and higher adolescent BMI. Frequency of negative coping skills also predicted relatively greater depressive symptoms among adolescent girls at-risk for T2D. The positive relationship of parental depression/anxiety and adolescent adverse coping skills to depressive symptoms in teens at-risk for T2D may have applied implications for preventative efforts targeting depression and T2D in these youth. However, longitudinal data are required to help elucidate the directional nature of these associations.