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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Suggested Citation:"Index." National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/12565.
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Index A African Americans, 25, 26, 28, 54, 128, 129, 130, 136, 137, 139, 207, 216, Access to care, barriers to, 1, 16, 35-36, 37, 259, 305, 306, 309, 314, 318, 326, 88, 258-261 328, 334, 347 Action for Boston Community Age factors. See also Adolescents; Child; Development, 353 Children; Early childhood; Infants Acupuncture, 220-221 and toddlers; Newborns Acute life events, 74, 76, 78, 79, 80, 83, 84, children of depressed parents, 23, 49-50, 85-86, 87, 91, 94, 95-96, 97, 102, 51, 61, 119, 121, 125, 134, 139, 136, 347 149, 151, 152, 153, 155, 159-160, Addiction Severity Index, 194 199, 387, 411 Adolescents discrimination, 88 coping, 150 gestational at birth, 211 depression, 58, 86, 89-90, 149-150, 153 maternal, 128 emotional and behavioral problems, onset of depression, 73, 75-76, 78, 120, 127, 146, 148, 151-152 151, 152, 153 interventions, 232-233, 293-294 prevalence of depression, 15, 24 onset of depression, 75, 76, 96 traumatic experiences, 156, 157, 158 parenting practices of depressed parents, Agency for Health Care Policy and 51, 60, 125-127 Research, 235 as parents, 89, 124, 128, 130-131 Agency for Healthcare Research and physical health and health care Quality, 8, 358, 359, 360, 375, 420, utilization, 135, 140 423, 424 prevention of adverse effects in, 293-294 Aggression, dysregulated, 80, 120, 122, resilience to stress, 101 128, 141, 148, 151, 154, 155, 297 risky behaviors, 135-136, 140, 149 Alateen, 308 school dropout, 149 Alcohol abuse, 90, 97-98, 123, 124, 136, substance abuse, 140 140, 141, 145, 156, 224, 228, 254, Affect. See Negative affectivity 256, 308, 389 453

454 INDEX Alcoholics Anonymous 12-Step Program of Assuring Better Child Health and Recovery, 308 Development Initiative, 193, 367 Alternative medicines Asthma, 120, 122, 137, 138-139 acupuncture, 220-221 Attachment, impaired, 34, 50, 60, 82, 92, aromatherapy, 220 93, 99, 120, 122, 124, 147-148, 159, exercise, 219-220 164, 289, 295, 296, 323, 327, 331, massage therapy, 220 352 omega-3 fatty acids, 218 Attachment Q-Set, 352 phototherapy, 219 Attention deficit hyperactivity disorder, 128- reflexology, 220-221 129, 138, 154, 296-297 St. John’s wort, 218-219 Australia, 159, 190, 198, 240-241, 245- yoga, 220 246, 288, 302 American Academy of Family Practice, 186 Autism, 89 American Academy of Pediatrics, 186, 213, Avoidant personality disorder, 98, 148 350 Avon Longitudinal Study of Parents and American College of Obstetricians and Children, 23 Gynecologists, 186, 239, 240, 350 American Indians, 260, 309 American Recovery and Reinvestment Act, B 422 Beck Depression Inventory, 57, 161, 191, Annie E. Casey Foundation, 18 194, 195, 251, 253, 254, 296, 300, Antenatal depression 301, 325, 327, 329, 331, 335 education interventions, 239 Behavioral Activation Treatment for and fetal development, 50-51, 132-133, Depression, 254 136-137 Behavioral Screening Questionnaire, and newborn neurobehavioral outcomes, 323 144-145, 152 Biological perspectives in depression, 73, pharmacotherapy, 136-137 74, 76, 77-78, 79-84, 100-101 and pregnancy outcomes, 136 Bipolar disorder, 76, 79, 125, 218 psychotherapy, 217 Bootcamp for New Dads, 248 telecare, 226, 240 Borderline personality disorder, 98 Antidepressants. See Pharmacotherapy; Boston Consortium of Services for Families individual drugs in Recovery Model, 194 Antisocial disorders, 31, 94, 125, 126, 141, Boston Public Health Commission, 20, 194, 324 255, 308 Anxiety disorders Brain development, 51 in adolescents, 150, 154 Brief Patient Health Questionnaire, 253 in children of depressed parents, 126, Bupropion, 209, 212, 214, 235 150, 151, 154, 159 coping strategies, 150, 362 and infant temperament, 145, 146 parental, 9, 12, 13, 31, 51, 52, 74, 97, C 98, 102, 120, 121, 136, 138, 139, California Endowment, 18 141, 145, 376, 401 Canada, 122, 137, 188, 208, 211, 287, 316, and pregnancy outcomes, 136 320 screening for, 183, 187, 199 Caribbean immigrants, black, 25, 26, 28, 54 substance use disorder and, 193 Caring for Every Child’s Mental Health treatment, 209, 227, 240, 242-243, 245, Campaign, 361 246, 247, 296, 347 Case management, 12, 225, 255, 257, 261- Arthritis, 31 262, 351, 363, 364, 397, 398, 402 Asian Americans, 25, 26, 54, 334 Center for Addiction and Pregnancy, 194

INDEX 455 Center for Epidemiologic Studies Depression genetics and, 132 Scale, 57, 128, 208, 233, 237, 251, integrative model of risk, 133 305, 306, 324, 325, 328, 329, 335 mediators, 132, 133, 134, 139, 161 Center for Mental Health Services, 399 moderators, 52, 60-61, 132, 133, 134, Child, Adolescent, and Family Branch, 161, 162 361 parenting practices and, 122, 132, 136 Center for Reducing Health Disparities, physical health and health care 262-263 utilization, 33, 135-140, 162 Centering Healthcare Institute, 302 preventive interventions, 17, 132, Centering Parenting, 302-303 288-301 Centering Pregnancy, 302 research gaps and opportunities, Centers for Disease Control and Prevention, 131-135, 146, 157-158, 161-163, 8, 10, 13, 23, 189, 190, 360, 374, 411-413 375, 377, 427 resilience, 58-59, 61 treatment and prevention initiatives, risk factors, 51-52, 58-59, 122 358-359 sex of the child and, 132 Centers for Medicare and Medicaid targeting interventions, 132 Services, 12, 13, 401, 402 television viewing and, 139 Child abuse and neglect, 34, 52, 75, 78, Chile, 241 83, 84, 89-91, 92, 93, 127-128, 156, Chronic epilepsy, 138 157-158, 164, 257, 303, 307, 368 Chronic medical conditions Child Abuse Potential Inventory, 127, 128 in children, 120, 122, 133, 135, 137, Child and Adolescent Health Measurement 138-139 Initiative, 192 in parents, 31, 32, 51, 98-99 Child and Adolescent Mental Health and Chronic mild depression. See Dysthymic Substance Abuse State Infrastructure disorder Grants, 361 Chronic stress. See also Stress Child Behavior Checklist, 288, 319, 321, and brain development, 51 335 and children’s functioning, 50-51, 89, Childhood 133-134, 142, 150-153 exposure to adversity, 75, 78, 83, 84, demographic correlates, 87-88 89-91, 92, 93; see also Child abuse environmental sources, 88-89, 126 and neglect and etiology of depression, 79, 81-84, preventive interventions, 293-294 87-89 Children, number in households with and immune response, 83-84 depressed parents, 32 parenting circumstances, 89 Children’s functioning. See also Adolescents; resilience and protective factors, 99-101 Infants and toddlers; Newborns; Circles of Care, 361 Psychological problems of children Citalopram, 209, 214 chronic health conditions, 120, 122, Cocaine addiction, 145, 254 133, 135, 137, 138-139 Cognitive-behavioral therapy and chronic stress in parents, 89, for antepartum women, 217, 218, 286 133-134 for children of depressed parents, comorbidities with parental depression 324-325 and, 132, 136, 140 in community mental health setting, developmental screening, 184, 186, 191- 243, 244 192, 197-198 effectiveness, 49, 160-161, 215-216, developmental stage and, 49, 133-134 221, 225, 228, 231, 233, 235, 237, environment and, 33, 135, 137, 139 238, 243, 246-247, 254, 298 exposure history and, 49-50, 60, 63, 91, exemplary collaborative care studies, 132 231, 233, 235, 237, 238

456 INDEX general population, 215-217 health problems, 31, 32, 51 in home visitation program, 253 impacts, 1, 31 mindfulness-based CBT, 216-217 integration into treatment and with parenting training component, 160- prevention, 52-53 161, 298, 330 literature on, 59-60 with pharmacotherapy, 213-214, 231 prevalence, 37, 145, 194 for postpartum women, 160-161, 217, research challenges, 51-55 218, 286 risk factors, 208 prevention programs, 300-301, 330-331, and screening for depression, 21, 54-55 348 treatment considerations, 98, 206, 208 for substance use disorder, 254 vulnerable populations, 53-54 Web-based, 227, 246-247 Composite International Diagnostic Cognitive/intellectual/academic Interview, 17 performance, 141, 143, 148-149, Comprehensive care model, 194, 206, 309 158, 159-160, 221 Comprehensive Community Mental Health Cognitive reappraisal, 101, 300 Services Program for Children and Cognitive restructuring, 216, 295, 326 Their Families, 361 Cognitive triad model, 91 Conduct disorders, 31, 154, 159, 296, 330, Cognitive vulnerabilities, 91-92, 93, 120, 334 143, 149-150, 164 Coping. See also Resilience and protective Collaborative care, 5, 11, 224-225, 226- factors 227, 229, 230-238, 242, 255, 256- accommodative or secondary control, 257, 265, 345, 346, 357, 358, 368, 101, 150, 300 374, 386, 388, 410 with chronic stress, 88, 297 Collaborative Health Program on the cognitive reappraisal, 101 Psychobiology of Depression, 32 with comorbidities, 31 Commonwealth Fund, 193, 367 with early adversity, 91 Community-based interventions gender differences, 76, 96 cognitive-behavioral therapy, 243, 244 interventions, 334-335 exemplary models, 357 ruminative thinking, 86, 95, 96, 216 network-focused approach, 262-263 Coronary heart disease, 17, 47, 83, 84, 99 preventive, 309-310 Corticotrophin releasing hormone, 81, 83 screening, 184, 186, 190, 192-193, Cortisol, 59, 81-82, 83, 136, 143, 146, 152, 263-264 328 treatment, 190, 205-206, 224-225, 239, Council on Coordination and 241, 244-246, 249, 262-264 Collaboration, 361 Community environment Couple therapy, 49 and chronic stress, 88-89 C-reactive protein, 83, 84 and impacts of depression, 33 Criminal justice system, exemplary Community Health Centers, 362 strategies, 355-356 Community Initiative on Depression, 249 Culturally and linguistic considerations. See Comorbidities and co-occurring conditions. also Race/ethnicity See also Substance use disorders; in access to care, 4, 10, 16, 35, 88, 197, other psychopathologies 376 and children’s functioning, 132, 136, 140 in etiology of depression, 76, 85, 88, chronic health conditions in children as, 163 140 intervention appropriateness, 226-227, coping strategies, 31 257, 263-264, 282, 308-309, 312, and delivery of services, 53, 208 355, 397, 417 in etiology of depression, 74, 75, 97-99, in parenting, 94-95, 163, 413 102-103 protective factors, 261

INDEX 457 provider sensitivity and training, 259- Dopamine, 100 260, 261, 391 Duloxetine, 209, 212 in research 30, 216, 262, 264, 371, 376, Dysphoria, 75, 91, 96, 145-146, 254 414, 416, 417, 418, 425 Dysthymic disorder and children’s functioning, 132, 134, 148-149, 154 D comorbidities, 98 etiology, 73, 74-75, 78, 86, 90, 102 Delaware Mental Health Association, 300 and parenting quality, 160, 289 Delivery of services. See also Community- prevalence, 1, 15, 16, 22, 24-25 based interventions; Home visitation research issues, 57-58, 61, 138 programs; Internet; Interventions; screening for, 251 Primary care settings; Specialty sociodemographic disparities, 24-25 mental health settings treatment, 98, 289, 320-321 algorithm-based disease management utilization of health services, 54 approach, 243 comorbidities and, 52-53 inefficiencies in, 222 E integrated approach, 5, 52-53, 59 opportunities and challenges, 6 Early childhood provider education and training, 11-12, education interventions, 292-293 194, 206, 222-223, 224-225, 230, emotional and behavior problems, 151, 241, 242, 261, 401 154 transdisciplinary approach, 46-47 exemplary strategies for, 352-354 Developmental disabilities and disorders, exposure to adverse events, 82, 83 89, 98, 120, 138, 213 onset of depression, 75 Developmental perspective parent-child interactions, 294-296 children’s functioning, 49, 133-134 preventive interventions in, 290-293, literature search, 60 303-304 parenting, 2, 33, 50-51 Early Childhood Comprehensive Systems, psychopathology, 33, 50, 141 367-368 research, 49-51, 60 Early Head Start, 184, 192-193, 290, 292- Diabetes, 17, 31, 99, 207, 347 293, 297-298, 303-304, 352, 353, Diathesis-stress models, 74, 84, 91, 102 388, 397 Disruptive behavior disorders, 154 Eating disorders, 97, 324 Dissemination and implementation of Edinburgh Postnatal Depression Scale, 57, practices and programs. See also 187, 188, 190, 191, 195-196, 233, Learning environments 240, 241, 242, 287, 288, 316, 317, Agricultural Extension Service model, 323, 326, 366 422 Educational attainment. See also Patient attributes that facilitate adoption, education 422-423 and comorbidities, 99 guidelines for adopting innovations, impact of depression on, 32, 263 423-425 and prevalence of depression, 24, 27, 29, opportunities and challenges, 7 87 research agenda, 425-426 Eicosapentaenoic acid, 218 strategies, 422 Electroencephalogram asymmetry, 143, 152 Docosahexaenoic acid, 218 Emotional self-regulation, 50, 51, 99, 100, Domestic violence, 127, 128, 189, 197, 208, 125, 141, 146, 148, 154 252, 255, 257, 291-292, 303, 307, Employment 312, 351, 389, 417 assistance, 305, 307

458 INDEX retention in, 32, 346 resilience and protective factors, 74, 75, security, 303 76, 99-101, 102 status, 4, 24, 26, 28, 31, 33, 34, 87, 99, social stressors, 76, 87 250, 263, 291, 344, 347-348 European preventive interventions, 368-370 Entre Familia Program, 20 Evaluation of interventions. See also Quality Environmental factors, 33, 74, 76, 78, 84- improvement 91, 135, 137, 139 availability of studies, 206 Epigenetic processes, 82 design of studies, 65, 161 Ethnicity. See Race/ethnicity; individual lack of standards, 19-20 ethnic groups Every Child Succeeds, 352 Etiology of depression Exercise, 219-220 acute life events and, 74, 76, 78, 79, 80, 83, 84, 85-86, 87, 91, 94, 95-96, 97 age at onset, 73, 75-76, 78, 153 F bidirectional influences, 46, 74, 75, 84, Failure to thrive, 138 86, 87, 91, 93, 154 Familial depression, 75, 78 biological perspectives, 73, 74, 76, 77- Families First, 248 78, 79-84, 100-101 Family. See also Domestic violence; Marital childhood exposure to adversity, 75, 78, composition, 22, 87, 137, 149, 289, 300 83, 84, 89-91, 92, 93 defining, 21-22 and children’s functioning, 49-50, 60, development, 5 63, 91, 132 disruption, 75, 90 chronic stress and, 79, 81-84, 87-89 intergenerational conflict, 94-95 cognitive vulnerability, 91-92 violence, 52, 53, 90, 92, 127 co-occurring disorders, 74, 75, 97-99, Family Connections, 353, 354 102-103 Family Relationship Inventory, 299 course of, 73, 77-78 Family Talk, 299-300, 309, 332-335, 369, diathesis-stress models, 74, 84, 91, 102 370 environmental factors, 74, 76, 78, 84-91 Fetal development, 50-51, 60, 62, 124, 131, genetic vulnerability, 56, 73, 76, 77, 78, 133, 136-137, 142, 146, 212 79-81, 92, 95-96, 97 Finland, 55, 369-370 hormonal factors, 73, 76, 82 Fiscal challenges immune system processes and, 73, 83- cost-effectiveness of interventions, 231, 84, 99 238, 248-249, 257 integrative research, 56, 96-97 funding gaps, 398-399 interpersonal vulnerabilities, 92-95 health insurance coverage, 394-395 kindling model, 77-78 reimbursement of providers, 395-398 literature searches, 56 Florida, 196 moderators, 96 Fluoxetine, 209, 213-214 modifiers, 73, 79 Food and Drug Administration, 211, 212 neuroendocrine functioning, 73, 77, 81- Foster care, 21, 22, 355 83, 91, 100 perinatal, 76-77 personal vulnerabilities, 74, 91-97, 102 personality disorders and, 74, 95-96, 98 G and psychological problems in children, Gender differences. See also Maternal; 49-50, 60, 148-149, 152-153, 154, Paternal 158-159 children’s functioning, 132 research gaps and opportunities, 56, coping strategies, 76, 96 101, 411 etiology of depression, 73, 76, 79, 85- 86, 87

INDEX 459 exposure and reactivity to adversity, 85- Hispanics, 25, 26, 28, 54, 157, 207, 232, 86, 87 236, 259, 261, 306, 308-309, 314, and genetic influences, 79 318, 326, 328, 334 in parenting, 151 Hogg Foundation for Mental Health, 262 prevalence and incidence of depression, Home Observation for Measurement of the 4, 15, 24, 27, 29, 30-31, 85-86 Environment, 306 in psychological problems of children, Home visitation programs 146, 151, 154, 157, 158 effectiveness, 251-252, 291-292 Gene-environment interaction, 81, 97 European programs, 251 General Health Questionnaire, 297 exemplary strategies, 351-352 Generalized anxiety disorder, 97 mental health consultants to, 252 Genetic national models, 10, 195, 251, 291, 352, mediators, 81, 132, 141, 142-143, 147, 376 153 number of, 250-251 vulnerability, 47, 56, 73, 76, 77, 78, 79- population served, 195 81, 92, 95-96, 97 preventive interventions, 291-292 Genetic testing, 81 quality improvement, 351-352 Global Burden of Disease Study, 16 screening for depression, 184, 195-196, Glucocorticoid receptor, 82 197, 351 Group psychoeducation, 245 treatment delivery in, 195, 226-227, Guideline-based treatment, 223, 224-225, 250-253 228, 239-240, 248-249, 257 Homelessness, 25, 184, 193, 194, 199 Hormonal factors, 73, 76, 82 Households with children, 1, 22 H Hyperactivity, 159 Hypertension, 31, 211 Hamilton Rating Scale for Depression, 57, Hypothalamic-pituitary-adrenal functioning, 235, 256, 319, 325 50, 80, 81, 82, 83, 97, 133-134, 142, Hampshire Project, 222-223 152 Harm avoidance, 96 Head Start, 2, 10, 255, 304, 352, 353, 354, 372, 373, 376, 388, 397, 418, I 421 Health insurance Illinois, 55, 190, 196-197, 363-364 coverage, 35, 258, 259, 401 Immigrants and refugees. See also Race/ reimbursement strategies, 401-402 ethnicity; specific ethnic groups Health maintenance organizations, 208-209 correlates of depression, 53, 85-86, 87 Health Resources and Services intergenerational conflict, 94-95 Administration, 8-9, 10, 11, 13, 18, prevalence of depression, 15, 25, 26, 28, 359-360, 374-375, 377, 401, 427 37, 230 see also Maternal and Child Health Immune system associations, 73, 83-84, 99 Bureau Impacts of depression. See also Children’s Healthcare Effectiveness Data and functioning Information Set, 209, 229 economic, 16, 17, 34 Healthy Families America, 195, 251, 291, family and society, 5, 16, 17, 31-34, 37 352 individual, 31, 32 Healthy Families Massachusetts, 292 Improving Mood-Promoting Access to Healthy People 2010, 359 Collaborative Treatment, 346-348 Healthy People 2020, 374 Incarcerated women, 25, 135, 355 Heartstrings, 248 Income correlate, 4, 9, 23, 31, 87, 89, 99, Help Me Grow Program, 195-196, 366 137, 189

460 INDEX Incredible Years Parenting Training collaborative care, 5, 11, 224-225, Program, 297-298, 304, 309 226-227, 229, 230-238, 242, 255, Individuals with Disabilities Education Act, 256-257, 265, 345, 346, 357, 358, 399 368, 374, 386, 388, 410 Infants and toddlers. See also Early community-based settings, 190, 205- childhood; Newborns 206, 224-225, 239, 241, 244-246, affective functioning, 142-143 249, 262-264 attachment, 34, 50, 60, 82, 92, 93, 99, comprehensive care model, 194, 206, 120, 122, 124, 147-148, 159, 164, 309 289, 295, 296, 323, 327, 331, 352 cost-effectiveness, 231, 238, 248-249, breastfeeding, 136-137 257 interpersonal functioning, 151 culturally enhanced, 226-227, 239, 257, massage therapy, 295 263-264, 282, 308-309, 312, 355, neurobehavioral functioning, 143, 152 397, 417 parent-child interactions, 60, 160-161, defined, 206 294-296 exportability and sustainability, 231, 238 parenting practices, 51, 60, 119, 123- group psychoeducation, 245 125, 160, 161 guideline-based treatment, 223, 224- physical health and health care 225, 228, 239-240, 248-249, 257 utilization, 137-139 health communication, 245-246 sleep intervention, 288, 316-317 home visitation, 195, 226-227, 250-253, stress response, 152 291-292 temperament, 141-142, 145 multidisciplinary models of care, 206, Institute of Medicine, 4, 18, 35-36, 284, 227, 231, 238, 239, 240-242, 348, 285, 303, 393 373, 409, 426 Interactive Coaching for At-risk Parents, outcomes, 224-227, 232-237, 238 326-327 parenting education, 185, 298 Interleukin, 86 patient education, 184, 185, 197-198, Internet. See Web-based interventions 224-225, 226-227, 228, 230, 239, Internet and American Life Project, 246 241, 242, 245, 246, 347 Interpersonal dissatisfaction and conflict, patient preferences, 206, 241, 264, 414 32, 52, 60 pregnancy and postpartum settings, 224- Interpersonal functioning, 33, 50, 51, 92- 227, 238-242, 257-258 95, 141, 143, 151-152, 160 primary care practices, 206, 222-238, Interpersonal psychotherapy 241, 242 for antepartum women, 217, 218, 286 problem solving, 226-227, 244 culturally enhanced, 257 provider education and training, 11-12, for dysthymia, 289, 320 194, 206, 222-223, 224-225, 230, effectiveness, 160, 221, 257, 287, 289, 241, 242, 261, 401 290 screening, 183, 184, 185, 190, 240, 253- general population, 215-217 254, 261 for postpartum women, 160, 286, 290 self-help, 224-225, 228, 247 ROSE Program, 287, 314 in specialty mental health settings, 207, Interventions. See also Evaluation of 224-225, 242-244 interventions; Pharmacotherapy; state public health programs, 190 Prevention of adverse effects; Quality stepped-care approach, 221, 242, 265, improvement 346 adherence support, 229-230, 241, 247 in substance use disorder settings, 243, case management, 12, 225, 255, 257, 253-256 261-262, 351, 363, 364, 397, 398, targeting, 132, 206 402 telecare, 226-227, 228-229, 238

INDEX 461 telephone support, 240, 242, 287 Locus coeruleus-norepinephrine, 81, 83 translational research, 18, 47 Louisiana, 252, 352 vulnerable populations, 239, 256-258, 261-264 Web-based, 197, 222, 224-227, 228, M 246-248, 264, 265, 310, 364, 414 Maine, 189 workplace, 248-250 Major depressive disorder. See also Intimate partner violence, 92, 93, 189 Postpartum depression Iowa, 55, 193, 364-365, 367, 391 and children’s functioning, 123, 147, Irritability, Depression, and Anxiety Scale, 155-158, 293 296 comorbidities, 15, 31, 37, 97, 99, 193- 194, 253 defined, 22, 56 J DSM-IV criteria, 56, 60 Japan, 17, 145 etiology, 73, 75, 76, 77, 78, 79, 80, 82, Johns Hopkins Bayview Medical Center, 85, 87, 90, 91, 93, 94, 103, 127 194 parental, 16, 22, 23, 24, 26-29, 32-33 paternal vs. maternal, 155-158 prevalence, 1, 15, 16, 17, 22, 23, 24, 25, K 26-29, 32-33, 76, 193, 282 preventive interventions, 293-294, 295, Kiddie-Schedule for Affective Disorders and 306, 315, 325, 330 Schizophrenia, 319, 325 screening for, 56-57, 187, 190, 191, 195, 253 sociodemographic disparities, 24, 25, L 26-29, 76, 87, 261 Learned helplessness, 100, 143 treatment effectiveness, 209, 217, 218- Learning disabilities, 98 219, 225, 244, 253, 257, 289, 293 Learning environments. See also treatment interventions, 224, 225, 241, Dissemination and implementation of 242, 243, 253 practices and programs utilization of health services, 36, 54, mechanisms of learning, 420-421 208, 240, 258 organizational structure, leadership, and Mamás y Bebés/Mothers and Babies Course, climate, 421-422 310 LETS Act!, 254 Marital/parental discord Literature on depression. See also and children’s functioning, 122, 126, Methodological issues; Research 130, 151, 152 challenges impact of depression on, 34, 60, 61, 77, challenges in evaluating, 44, 61-68 92-93, 102, 250 correlates of depression, 43, 59-60 impact on depression, 76, 90, 93, 189, definition and measurement of 251 depression and parenting, 43, 55-56 interventions, 49, 250, 251, 298, 312, developmental approach, 43, 60 417 etiology, 43, 56 spousal psychological problems, 76, 94 issues considered in searching, 19, 43, Marital status 44, 55-61 and children’s development of knowledge base on depression, 4, 18, 33 depression, 122 risk and resilience in children, 43, 58-59 and comorbidities, 99 screening of parents, 43, 56-58 and etiology of depression, 76, 87, 93 vulnerable populations, 52-53 and prevalence of depression, 4, 15, 24, 27, 29, 31, 37, 48

462 INDEX and recurrence of depression, 90 Mirtazapine, 212 and risk of depression, 87, 93, 158, 283 Missouri, 249 and treatment of depression, 48, 49 Modifying factors, 73, 79 Marital support, 146 Montgomery Asberg Depression Rating Marital therapy, 49 Scale, 321 Massachusetts, 193, 251, 292 MotherCare, 242 Maternal and Child Health Bureau, 359- Motherisk Program, 211 360, 399 Mother’s Assessment of the Behavior of Her Maternal Attitudes Questionnaire, 253 Infant, 295, 328-329 Medicaid, 12, 45, 192, 350, 363, 365-366, Moving to Opportunity, 306-307 367, 387, 395, 396-397, 398, 399, Multidisciplinary models of care, 206, 227, 401, 402 231, 238, 239, 240-242, 348, 373, Medical Expenditure Panel Survey, 24, 63 409, 426 Medical fragility, 138 Mental Component Score, 233 Mental Health Services for Children and N Families Community Program, 399 National Center for Children in Poverty, 55, Mental retardation, 89 367-368 Methodological issues. See also Literature National Committee for Quality Assurance, on depression; Research challenges 209 comparability of studies, 44, 63-64 National Comorbidity Survey-Replication, cross-sectional designs, 8, 66, 122, 138, 22-23, 24, 25, 30-31, 32-33, 63, 64- 375 65, 97, 155, 156, 157, 158 defining and measuring depression, 20- National Epidemiologic Survey on Alcohol 21, 67, 162 and Related Conditions, 54 effect size, 52, 64, 65-66, 119, 122-123, National Institute of Child Health and 124, 144, 247, 254, 256, 306, 357 Human Development, 10, 27, 29, generalizability of samples, 62-63, 64, 377 67, 155, 157, 158, 217, 231, 238, National Institute of Mental Health, 8, 32, 288, 294, 297, 360, 390, 425 242, 253, 360, 375, 377 measurement and other errors, 67 National Institute on Alcohol Abuse and mediation of effects, 66, 161 Alcoholism, 377 moderation of effects, 66-67, 162 National Institute on Drug Abuse, 10, 254, randomized treatment and intervention 377 studies, 65, 66-67 National Institute on Nursing Research, 377 replication of findings, 67-68 National Institutes of Health, 8, 13, 36, 46, reporter bias, 135, 145, 147 360, 374, 427 sample size, 44, 65-66 National Latino and Asian American Study, Methodological pluralism, 63-64 25, 54 Mexican American Prevalence and Service National Mental Health Information Center, Survey, 54 360-361 Mexicans, 25, 26, 28, 54, 261 National Registry of Evidence-based Michigan, 196-197 Programs and Practices, 361 MidAmerica Coalition on Health Care, 249 National Research Council, 18 Middle childhood National Survey of American Life, 25, 54 depression, 153, 154 National Survey of Substance Abuse parenting practices, 51, 125-127, Treatment Services, 193 137-139 Negative affectivity, 96, 100, 120, 123, 142, Mindfulness-based cognitive therapy, 147, 151 216-217 Neonatal adaptation syndrome, 211, 212 Minnesota Family Investment Program, 305

INDEX 463 Neonatal Behavioral Assessment Scale, 144, Parenting practices 295 of abuse survivors, 127, 128 Netherlands, 55, 295, 368-369 of adolescent parents, 89, 124, 128, Neurobehavioral outcomes, 143, 144-145 130-131 Neurobiology authoritarian, 124 of depression, 47, 91 children with disabilities, 89, 120 of stress hormones, 59 and children’s functioning, 122, 132, Neuroendocrine functioning, 73, 77, 81-83, 136 91, 100 cultural considerations, 94-95, 163, 413 Neuropeptide-Y, 100 definition and measurement, 55-56 Neuroticism, 81, 86, 95-96 developmental perspective, 2, 33, 50-51 New Chance Project, 305-306 disengaged/withdrawn/lax, 119, 123, New Hope Project, 305 124, 125, 126, 129, 150, 151, 300 New Jersey, 55, 190, 365, 367 disrupted, 127 New Mexico, 189 effective/healthy, 121, 136, 352-354 New York, 125 fathers, 119, 134 New Zealand, 84 gender differences, 151 Newborns genetic factors, 81 neonatal adaptation syndrome, 211, 212 health management, 5, 120, 125, neurobehavioral outcomes, 144-145 135-140 physical health and health care hostile/negative, 119, 122-123, 125, utilization, 135, 136-137 129, 139, 153 stress response, 136 infants and toddlers, 51, 60, 119, 123- Norepinephrine reuptake inhibitors, 209 125, 160, 161 North Carolina, 365-366 intergenerational patterns of problems, Nortriptyline, 214, 215 94 Nurse-Family Partnership, 10, 195, 251, interventions, 48, 51, 132, 285-288, 291, 352, 376 294-298, 314-335, 352-354 intrusive, 51, 124, 126, 127, 150, 151, 161, 300 O mediators and moderators, 60-61, 122, 126-127, 128-131 Obesity and overweight, 136, 139 middle childhood and adolescence, 51, Office of the Surgeon General, 7-8, 362, 60, 119, 125-127, 137-139 374 prenatal health behaviors, 123-124 Office of Women’s Health, 362 protective factors, 146 Ohio, 195-196, 351, 352, 366 psychobiological effects in children, 120 Olmstead Medical Center, 242 and psychological problems of children, Omega-3 fatty acids, 218 5, 120, 122, 124, 125, 126, 127, Overcoming Depression on the Internet, 247 142, 146, 150, 151, 152, 153 Oxytocin, 59 punitive, 32, 127-128, 130; see also Child abuse remission/recovery from depression and, P 119, 123, 160-161 Panic disorder, 97, 324 research challenges, 47-48, 50-51, 55-56 Parent and Child Series Program, 296 screening for, 185, 189 Parent Behavior Checklist, 288 social supports and, 129 Parent-child relationship, 6, 59, 63, 82, 92, stress and, 129-130 123, 125, 126, 221, 281, 289, 290, substance use disorders and, 127, 128, 291, 294-298, 304, 305, 312, 313, 194 325, 326-331, 343, 345, 348, 349, transactional processes, 134, 135, 142, 386, 400, 416 146, 154-155, 163

464 INDEX treatment combined with training, 298 screening, 57, 183, 186, 189, 190, 197, two-generation approach, 48 199, 240, 359, 364 Parenting Stress Index, 128, 185, 296-297, state initiatives, 197, 363, 364-365, 391 325 and substance use disorder, 193 Parents as Teachers, 251 telephone support, 240 Parents/caregivers. See also Foster care; training of providers, 391 Marital; Maternal; Paternal treatments, 205, 214-215, 218, 219, adolescents as, 89 220, 239-240, 241, 242, 247, 264 alcohol abuse, 90, 97-98, 123, 124, 136, Perinatal Mental Health Consultation 140, 145, 156, 224, 243, 253, 254, Service, 363 308, 389 Persistent pulmonary hypertension, 211 death of, 90 Personal vulnerabilities, 74, 91-97, 102 defining, 21-22 Personality disorders, 74, 95-96, 98 grandparents/other relatives, 21, 22, 48, Pew Research Center, 246 89, 134-135, 163, 413 Pharmacotherapy. See also individual drugs mental illness in, 90 adherence, 208-209, 229-230 number in U.S., 22 antepartum, 146, 208, 210-213 prevalence of depression, 2, 8, 21-23, and breastfeeding, 136-137 32-33, 102, 134-135, 282, 290, 312, effectiveness, 161, 209, 213-215, 288 313, 353 general population, 209-210 psychopathlogy other than depression, and parenting, 161 51, 58-59, 90, 94 postpartum, 161, 208, 213-215 Paroxetine, 209, 210-211, 214, 235 psychotherapy combined with, 213-214, Partners in Care, 233, 346-348 231, 244 Partnerships for Youth Transition, 361 safety during pregnancy, 209-213 Paternal in substance use disorder settings, 256 alcohol and drug use, 156, 157 therapeutic endpoint, 210 depression, 23, 30-31, 134, 136, 148, treatment rates, 208 154-159 Phototherapy, 219 parenting, 119, 134 Policy issues, 30, 55 work status, 24 Postpartum Dads, 248 Patient education, 184, 185, 197-198, 224- Postpartum depression 225, 226-227, 228, 230, 239, 241, alternative therapies, 218, 219, 220 242, 245, 246, 347 barriers to treatment, 258, 396, 402 Patient Health Questionnaire, 57, 187, 188, and child functioning, 137-138, 145, 189, 191, 253, 365 153, 158, 159-160, 289 Patient preferences, 206, 241, 264, 414 defined, 50 Paul Wellstone and Pete Domenici Mental education interventions, 224 Health Parity and Addiction Equity effectiveness of interventions, 214-215, Act of 2008, 258 217, 218, 295, 302, 303, 304, 315, Perinatal depression 316-317, 322-323, 328-329 alternative medicine, 218, 219, 220, etiology, 57, 76, 160 264 exercise and, 219, 220 defining, 56 federal initiatives, 344, 358, 359, 360, education interventions, 239, 364 374 etiology, 76-77 health behaviors and, 124 federal initiatives, 359-360 infant temperament, 145, 146-147 and newborn elevated cortisol, 136 interventions and delivery approaches, prevalence, 358 224, 225, 226, 227, 238-242, 247, preventive interventions, 310 248, 251, 257-258, 264, 310, 316- research needs, 264, 414 317, 414, 416

INDEX 465 and parenting, 137-138, 160, 161, 294, paternal, 23 295 perinatal, 358 paternal, 77 postpartum, 23, 189-190 pharmacotherapy, 161, 208-209, 212, sociodemographic disparities, 2-3, 4, 15, 213-214 19, 23-31, 37, 54 phototherapy, 218 vulnerable populations, 24-31, 37, 53, prevalence, 23, 189-190 263, 304, 425 prevention, 285, 286-288, 291, 301-302, Prevention of adverse effects. See also 303, 310, 315, 322-325, 328 Interventions psychotherapy and psychosocial adults and adolescents of parenting age, interventions, 160, 208, 217, 286, 285-286 290, 322-323, 328-329 child-focused, 17, 132, 290-294, public awareness, 189, 302, 365 324-331 rates, 50, 76, 189 cognitive-behavioral therapy and risk factors/predictors, 76, 189 parenting skills, 300-301, 330-331 screening and diagnosis, 48, 57, 58, 183- combined components, 330-335 184, 186-187, 188, 189, 190-191, community-based, 304, 309-310 198, 225, 258 co-occurring conditions, 307-308 state initiatives, 363-364, 365, 367 culturally and linguistically appropriate, treatment, generally, 48, 208-209 308-309 yoga and, 220 employment and income assistance Postpartum Education for Parents, 248 programs, 305-307 Postpartum Support International, 248 European approaches, 368-370 Posttraumatic stress disorder, 97, 157, 158, examples, 314-335 193, 257 family-focused, 6, 281, 283, 299-301, Poverty status 307-310, 332-335 and access to care, 59 framework for, 282-283, 284-285 and children’s functioning, 153 group care model, 302-303 and prevalence of depression, 27, 29 indicated, 285 Pregnancy. See also Fetal development knowledge base on, 18 alternative medicine, 219-220 parent-child relationship, 304, 305, 312, antidepressant safety, 209-213 313, 325, 326-331 health behaviors during, 123-124 parent-focused, 287, 304, 314-317 risk factors for depression, 189-190 parenting interventions, 48, 51, 132, substance abuse, 124, 145, 194-195 285-288, 294-298, 309, 314-335, Pregnancy Risk Assessment Monitoring 352-354 System, 23, 190, 358-359 peer support, 316-317 Prenatal care, 51, 123 poverty mitigation, 303-307 Prevalence of depression pregnant and postpartum women, 285, data collection issues, 8, 37, 48, 53, 54, 286-288, 291, 301-302, 303, 310, 56-57, 134-135, 290, 375 315, 322-325, 328 comorbidities, 37, 145, 194 research gaps and opportunities, 6, 310- educating providers about, 363 312, 414-416 general adult population, 13, 15, 22, 25, selective, 285 36, 102 targeting, 132, 150 households with children, 16, 37 telephone peer support, 287 international, 17, 23 treatment of parent’s depression, 288- maternal, 23, 145, 186, 189-190, 194, 290, 318-325 263, 293, 304 two-generation, 33, 36, 299-301 parental/caregiver, 2, 8, 21-23, 32-33, 102, universal and public health approaches, 134-135, 282, 290, 312, 313, 353 281-282, 285, 301-303

466 INDEX for vulnerable families, 78, 282, 303-309 cognitive/intellectual/academic Web-based approaches, 310 performance, 141, 143, 148-149, Primary Care Evaluation of Mental 158, 159-160, 221 Disorders, 253 depression, 50, 51, 141, 143, 147, 149- Primary care settings 150, 153 adherence reminders, 229-230 emotional self-regulation, 50, 51, 99, collaborative care, 230-238 100, 125, 141, 146, 148, 154 exemplary strategies, 349-351 gender differences, 146, 151, 154, 157, guideline-based treatment, 223, 228 158 inefficiencies in, 222 genetic mechanisms, 141, 142-143, 147, physician education, 222-223, 258-259 153 quality improvement, 349-351 interpersonal functioning, 33, 50, 51, screening for depression, 21, 59, 183- 141, 143, 151-152, 160 184, 185-192 mediators, 143, 146-147, 151-152, 156 self-help interventions, 228 moderators, 143, 145-146, 149, 150, telecare, 228-229 152-153, 154, 158-159 treatment interventions, 206, 222-238, neurobehavioral outcomes, 143, 241, 242 144-145 Problem solving interventions, 226-227, parenting practices and, 5, 120, 122, 244 124, 125, 126, 127, 142, 146, 150, Program of Resources, Information, and 151, 152, 153 Support for Mothers, 302 paternal depression and, 154, 155-158 Proinflammatory cytokines, 47, 83 peer interactions, 151-152 Project THRIVE, 367-368 persistence following parental recovery Promoting Healthy Development Survey, or remission, 159-161 192 protective effects, 149 Promotoras de Salud, 239 research challenges, 50, 161-163 Protective factors. See Resilience and risk factors, 144, 145-146, 153 protective factors school dropout, 149 PROTOTYPES Women’s Center, 20, 194, stress responses and cortical activity, 50- 255, 308 51, 142, 150-153 Provider education and training, 11-12, temperament, 141-143, 145-147 194, 206, 222-223, 224-225, 230, timing and duration of exposure and, 241, 242, 261, 401 49-50, 60, 148-149, 152-153, 154, Provider-patient-family communication, 16, 158-159 223, 260 violence and, 149 Psychobiological effects in children, 120 vulnerability factors, 50, 140-144 Psychological problems of children. See Psychopathology of depression also Adolescents; Infants and young cumulative risk, 67 children; Newborns developmental perspective, 44, 50, 63, adolescent sexual behavior, 149 67 affective functioning, 96, 100, 120, 123, Psychotherapy. See also Cognitive- 141, 142-143, 147, 148, 151 behavioral therapy; Interpersonal attachment, 34, 50, 60, 82, 92, 93, 99, psychotherapy 120, 122, 124, 147-148, 159, 164, computer-assisted approaches, 243-244 289, 295, 296, 323, 327, 331, 352 effectiveness, 288-290 attention deficits, 146, 154 number and duration od sessions, 231 behavior problems or psychopathology, treatment rates, 208 122, 141, 151, 153-159 Public awareness, 189, 302, 365 bidirectionality, 142, 143, 154-155, 163 Public Health Service Act, 401

INDEX 467 Q insurance coverage and reimbursement strategies, 12-13, 401-402 Quality improvement interagency task force, 10-11, 400 community-level models, 357 promoting and supporting research, criminal justice system, 355-356 426-427 European approaches, 368-370 supporting innovative strategies, 13, federal-level initiatives, 358-362 375-376 framework, 36 training program for providers, 11-12, IMPACT model, 346-348 401 parent-child dimension, 348-349 Relaxation therapy, 295 patient education, 185 Research challenges. See also Literature on PIC model, 233, 346-348 depression; Methodological issues primary care, 349-351 approach of this study, 3, 19-20 public awareness activities, 367-368 challenges, 43, 45-55 research gaps and opportunities, 370- charge to committee, 18-19 371, 417-418 comorbidities, correlates, and context, 3, school-based services, 354-355 43, 51-55, 68 by service setting, 349-357 context for this study, 22-31 state-level initiatives, 362-368 defining depression, 22-23 in treatment of adult depression, 185, defining parents and family unit, 21-22 243, 346-348 developmental perspective, 3, 43, 49-51, Quality of care 63, 67, 68, 162-163 barriers to, 4-5, 16, 35-36, 37, 88 genetic component, 63, 67 mental health care distinguished, 4 integrative models, 3, 43, 45-47, 56, 62- Quick Inventory of Depressive 63, 68, 96-97, 133 Symptomatology-Self-report, 236, interdisciplinary approach, 45 237, 249 psychopathology perspective, 50 scope of this study, 2-3, 20-22 screening for depression, 54-55, 56-58 R service delivery models, 52-53 Race/ethnicity. See also Vulnerable theoretical balanced with real world, 62 populations transactional models, 163 and chronic stress, 88 transdisciplinary approaches, 45, 46-47 discrimination, 88, 263 translation/dissemination of results, 18, minority health providers, 260 46-47, 62 and parenting style, 94 two-generation approach, 3, 43, 47-49, and paternal depression, 157 68 prevalence of depression, 15, 24, 25, 26, vulnerable populations, 53-54 28, 30-31 Research gaps and opportunities psychiatric epidemiological studies, etiology of depression, 56, 101, 411 52-53 children’s functioning, 131-135, 146, utilization of health services, 230-231, 157-158, 161-163, 411-413 259 parenting, 47-48, 50-51, 55-56 RAND depression screener, 188 preventive interventions, 310-312, Reach Out, Stand Strong, Essentials for 414-416 New Mothers (ROSE Program), 287, quality improvement, 370-371, 417-418 304, 314-315 screening and identification of parents, Recommendations 56-58, 183, 198, 413 improving awareness and understanding, treatment of depression, 264, 413-414 7-9, 374-375 vulnerable populations, 416-417

468 INDEX Resilience and protective factors. See also targeted, 189-192 Coping tools and approaches, 1, 56-58, 183, biological processes in, 100-101 185, 187, 188, 191 for children’s functioning, 58-59, 61, 149 in substance use disorder treatment defined, 99 settings, 193-194 integrative research, 100 Second Chance Act of 2007, 356 parenting-related, 146 Selective serotonin reuptake inhibitors, 209, universal variables, 99-100 210-211, 212, 213, 219, 256 Rhode Island, 366-367 Self-help, 224-225, 228, 247 Robert Wood Johnson Foundation, 18 Separation anxiety, 154 Ruminative thinking, 86, 95, 96, 150, 216 Sequenced Treatment Alternatives to Relieve Depression, 98, 207-208, 209, 289, 318-319, 360 S Serotonin, 56, 80, 100, 220, 328 Serotonin norepinephrine reuptake Schizophrenia, 79 inhibitors, 209, 212 School-based services, exemplary strategies, Sertraline, 209, 213, 214, 289 354-355. See also Early Head Start; Sex differences. See Gender differences; Head Start Maternal; Paternal Screening and identification of parents Single parenthood, 22, 87, 137, 289, 300, child developmental screening linked to, 309 184, 186, 191-192, 197-198 Smoking. See Tobacco use community services, 184, 186, 190, Social disadvantage, 1, 15, 25, 37, 89, 102, 192-193 136, 322, 388 comorbidities and co-occurring factors Social exclusion, 88 and, 21, 54-55 Social functioning, 32, 60, 143, 155, 213, cost and effectiveness, 196 235, 245, 257 diagnostic criteria, 20-21 Social marginalization, 35, 260, 261, 263 Early Head Start programs, 192-193 Social phobia, 97, 154 education and support components, 184, Social stressors, 76, 87 185, 197-198 Social support, 6, 76, 86, 87, 89, 92, 93, functional status as a parent, 185, 189 129, 130, 131, 132, 138, 189, 221, in home visitation programs, 184, 195- 244, 245, 251, 262, 286, 287, 292, 196, 197 301-302, 309, 316-317, 351, 388 implementation challenges, 184, 196-198, Socioeconomic status. See also Educational literature searches, 56-58 attainment; Employment; Marital opportunities for, 54-55, 59 status; Poverty status; Race/ethnicity and persistence of depression, 183, 185 and chronic stress, 87, 88 policy issues, 55 prevalence of depression, 15 in primary care settings, 21, 59, 183- Speak Up When You Are Down, 367 184, 185-192 Special Supplemental Nutrition Program in prenatal and postpartum visits, 48, for Women, Infants, and Children, 2, 57, 58, 183-184, 186-187, 188, 189, 193, 257, 364, 372, 388 190-191, 198, 225, 258 Specialty mental health settings process, 186-189 interventions in, 207, 224-225, 242-244 rates, 190-191 screening, 21 recommendations and guidelines of St. John’s wort, 218-219 professional organizations, 183 State Children’s Health Insurance Program, research gaps and opportunities, 56-58, 362, 394, 395, 396 183, 198, 413 State initiatives systematic approach with treatment, postpartum depression, 363-364, 365, 183, 184, 185, 190, 240 367

INDEX 469 screening for depression, 55, 192-193 screening for depression in treatment treatment interventions, 190 settings, 193-194, 253-254 Statewide Family Network Grant Program, treatment of depression, 243, 253-256 361 Suicidal ideation, 155 Stepped Care Treatment of Postpartum Support and Train to Enhance Primary Depression, 242 Care, 364 Stigma and biases, 4, 10, 14, 30, 35, 36, Systemic challenges 190, 197, 206, 208, 241, 243, 246, complexity of interventions, 389-391, 249, 259, 260, 261, 262, 263-264, 210-211 265, 344, 363, 367, 374, 376, 391- cultural and linguistic sensitivity, 16 392, 397 family-focused two-generation issues, Strengthening Families Program, 307-308 16, 387 Stress, 4. See also Acute life events; Chronic integrated strategies for co-occurring stress; Vulnerable populations conditions, 388-389 bidirectional effects, 86 for low-income and minority families, and children’s functioning, 132, 136-137 387-388 comorbidities and, 1 dysregulation of response, 81-83, 133- 134, 136-137, 150 T and etiology of depression, 7, 74, 76, Telecare, 226-227, 228-229, 238 78, 79, 80, 81-83, 85-86 Telephone support, 240, 242 fetal exposure to, 50-51, 142 Television viewing, 139 gender differences, 85-86 Temperament, 141-143, 145-147, 296 hormones, see Cortisol Temporary Assistance for Needy Families, hypothalamic-pituitary-adrenal 2, 366, 388 functioning, 50-51, 80, 81, 82, 83, Tobacco use, 98, 120, 123, 124, 136, 139, 97, 133-134, 142, 150-153 140, 145, 190 integration of research on, 47 Toddler-parent psychotherapy, 295-296, moderators, 96 330-331 and parenting, 129-130 Trait anxiety, 31, 145, 240 resilience to, 59, 76 Training primate model of stress inoculation, 59 clinician, 189 Structured Clinical Interview for DSM-IV, transdisciplinary approach, 45-46 57, 128, 186, 194, 315 Transactional processes Subclinical depression, 32, 60, 73, 153, 191 in parenting, 134, 135, 142, 146, 154- Substance Abuse and Mental Health 155, 163 Services Administration, 8, 10, 11, in psychological problems of children, 13, 18, 36, 193, 254-255, 360-361, 142, 143, 154-155, 163 374, 377, 401, 427 Traumatic experiences, 36, 56, 156, Substance use disorders 157-158 adolescents, 140, 154 Treatment. See also Alternative medicines; behavioral treatments, 254-255 Cognitive-behavioral therapy; co-occurring disorders, 15, 31, 36, Interpersonal psychotherapy; 97-98, 156, 157, 193-194, 253-254, Pharmacotherapy 307-308 antepartum, 208, 210-213, 217 environmental challenges, 194 approaches, 205-206, see also Delivery integrated models of care, 253-256 of health services; Interventions parenting practices and, 127, 128, 194 barriers to, 16, 31, 258-261 in parents, 94, 136-137 behavioral, 254-255 paternal, 156, 157 comorbidities and, 98, 206, 208 prenatal, 124, 145 costs, 17 prevention of depression, 307-308 defined, 206

470 INDEX effectiveness, 5, 15, 17, 160-161, 205, defined, 30 206 employment and income assistance impact on children of depressed parents, programs, 305-307 160-161, 221 engaging, 197, 261-264 outcome measures, 205 identifying, 1-2 to prevent adverse outcomes in children, families with co-occurring conditions, 49, 221, 288-290, 298 307-308 research gaps and opportunities, 264, low-income and minority mothers, 413-414 256-258 Treatment-seeking behaviors, 30, 31 prevalence of depression, 23-31 Tryptophan, 80 policy implications, 30, 263 preventive interventions, 303-309 research challenges, 30, 53-54, 263 U responding to the needs of, 387-388 research opportunities, 416-417 UIC Perinatal Mental Health Project, 242 risk factors, 257, 303-307 United Kingdom, 23, 158, 159 treatment interventions, 239, 256-258, United States, prevalence of depression, 17 261-264 University of California, Berkeley, 360 treatment-seeking behaviors, 30 University of California, Davis, 262 trust issues, 206, 259, 260, 262, 263, University of Illinois at Chicago, 242, 363 265, 388, 397 University of Texas at Austin, 262 U.S. Department of Health and Human Services, 8, 9, 10, 18, 344, 373, 375, W 376, 377, 400 U.S. Preventive Services Task Force, 185 Washington state, Maternal Support “First U.S. Surgeon General, 7-8, 36, 259, 362, Steps” Program, 190 374 Web-based interventions, 197, 222, 224- Utilization of health care 227, 228, 246-248, 264, 265, 310, for children of depressed parents, 33, 364, 414 135-140, 162 Wegner’s chronic illness model, 221 mental health services, 36, 54, 208, 240, Whites, 25, 26, 28, 54, 83, 157, 191, 207, 258 236, 259, 261, 318, 324, 326, 328, network-focused approach, 262-263 332, 347 Women, Co-occurring Disorders Study, 254-255 V Wisconsin, 196-197, 305 Work Towards Wellness Program, 366-367 Venlafaxine, 209, 212, 214 Workforce issues Violence. See also Child abuse; Domestic minority providers, 260 violence; Intimate partner violence; provider education and training, 11-12, Marital/parenting discord 194, 206, 222-223, 224-225, 230, adolescent behavior, 154 241, 242, 260, 261, 391-394, 401 exposure to, 30, 52, 53, 66, 67, 78, 90, Workplace, 248-250 92, 120, 127, 149, 163, 193, 208, World Health Organization, 16, 17, 32 257, 283, 388 World Health Surveys, 17 substance use disorders and, 193, 194 treatment programs, 194, 255 Visiting Nurse Associations, 193 Y Vulnerable populations. See also Cultural and linguistic considerations Yoga, 220 barriers to care, 35-36, 257-260 Youth Self-Report Depression Subscale, 299

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Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration.

A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families.

The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public.

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