Re-Examination of Parent-Child Adjustment in Juvenile Rheumatic Diseases Using Depression-Specific Indices of Parent Distress

Abstract

Objective: To re-analyze archival data in an attempt to replicate previous findings using exclusively DSM-IV Major Depression criteria items as a measure of parent distress. Furthermore, to replicate the moderating role of cognitive appraisal variables (perceived illness intrusiveness) in both the relation between parental distress and child depressive symptoms. Method: Forty-five youth and their parents in the original study (age 9-17) were recruited from a pediatric rheumatology clinic in a large children's hospital in the Midwest. Parents completed the Brief Symptom Inventory (BSI); youth completed the Child Depression Inventory (CDI) and the Illness Intrusiveness Scale. The primary rheumatologist provided diagnostic and disease severity information (i.e., (physician-rated functional disability) following a routine medical visit. Results: Thirteen depression-specific BSI items that mapped onto DSM-IV criteria for major depression were summed to comprise the primary parent measure of depressive symptoms. Results revealed a significant association between increased parent depressive symptoms and children's depressive symptoms. The interaction of parent depressive symptoms and child illness intrusiveness contributed additional variance to child depressive symptoms beyond the influence of demographic and disease variables and the main effects of parent depressive symptoms and child illness intrusiveness. Conclusion: Extrapolating depression specific indices as defined by the DSM-IV from a measure of global distress was found to be as reliable in the prediction of childhood depressive symptoms compared to other variations of the general distress measure.