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Seasonal Changes in Mood and Behavior Among Diverse SEASONAL CHANGES IN MOOD AND BEHAVIOR AMONG CHILDREN AND ADOLESCENTS DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Katharine Davies Smith, M.A. ***** The Ohio State University 2005 Dissertation Committee: Dr. Mary Fristad, Advisor Approved by Dr. Steven Beck ______________________ Dr. Michael Vasey Advisor Dr. Nancy Ryan-Wenger Department of Psychology Copyright by Katharine Davies Smith 2005 ABSTRACT Seasonal mood disorder (SMD) is likely prevalent among children and adolescents; however, there are few empirical investigations of pediatric SMD in the literature. To contribute to the field, the current study investigates the seasonality of mood and behavior among children and adolescents using longitudinal data collected from 1987 to 1998. One hundred eleven youths diagnosed with depression, 369 bereaved youths, 129 community controls, and their parents completed individual assessments at baseline, five, thirteen, and twenty-five months later. Assessment materials include several measures of depressive symptoms and diagnostic instruments. Multilevel analyses were conducted using MlwiN software. According to both parent- and child-report, youths from all three groups earn significantly higher total scores on measures of depression during the winter than the summer. On the other hand, significant seasonal effects do not arise for a measure of overall psychopathology. This implies that seasonality is limited to mood disorders. While this seasonal effect is significant, actual changes of mean scores on measures of depression from the summer to the winter are minimal, suggesting that season may have little affect on the mood and behavior for the majority of participants from each group. It is uncertain whether a few highly seasonal participants influence the mean changes between summer and winter or whether each group as a whole experiences very mild ii seasonal changes. In either case, the finding that depressed, bereaved, and community controls show similar average levels of seasonality supports the dual vulnerability model of SMD, which posits that seasonality and propensity toward depression are independent. Data collected from the youths, themselves, suggest that seasonality shown on measures of depression arise from seasonal changes in atypical vegetative symptoms as opposed to cognitive or affective symptoms. This is consistent with the hypotheses. However, data collected from their parents do not show an association between season and any particular depressive symptom cluster. Therefore, it is unclear whether seasonality of depression is attributable to the characteristics uniquely associated with SMD; namely, atypical vegetative symptoms. Overall, the current study provides useful information for understanding seasonality in mood and behavior among children and adolescents. iii Dedicated to Gregory Richard Smith iv ACKNOWLEDGMENTS This dissertation would not have been possible without the assistance of several individuals. First and foremost, I would like to thank my advisor, Mary A. Fristad, for encouraging me in its conception and supporting me through its completion. I feel indebted to Dr. Fristad for helping me develop both my research and practical skills in the field of child clinical psychology. Further, she has fostered in me an interest in and knowledge about childhood mood disorders that will aid me in my future endeavors. I also wish to thank Julie Cerel for sending me the data I required for completion of this project, as well as explaining to me logistics about how the data were collected and the meanings of numerous variables. I am also grateful to Nancy Briggs and Meade Eggleston for introducing me to multilevel analysis and providing me with several resources that assisted me in learning the new statistical technique. Also, I would like to thank Nancy for allowing me to use the student office of the Quantitative Psychology Department where the software I needed to conduct the analyses was licensed. Finally, I am thankful for the love and support that my friends and family have shown. My parents, Alice and Tony Davies, have always inspired me to learn and fostered a belief that I may achieve whatever I aspire. My husband, Greg Smith, has provided me with the emotional support I require as well as taught me how to utilize computer programs to manipulate data and format documents as the project requires. v VITA August 31, 1977 ...........................................................Born - Fairbanks, AK 2000 ..............................................................................B.A., Harvard University 2002...............................................................................M.A., The Ohio State University 2000 – 2003...................................................................Graduate Research Associate, The Ohio State University 2003 – 2004...................................................................Distinguished University Fellow, The Ohio State University PUBLICATIONS 1. Wang, Q., Leichtman, M.D., & Davies, K.I. (2000). Sharing memories and telling stories: American and Chinese mothers and their 3-year-olds. Memory, 8(3), 159- 177. 2. Smith, K. D. & Fristad, M.A. (2003). Bipolar disorder. In T. Ollendick & C. Schroeder (eds.), Encyclopedia of Pediatric and Child Psychology. New York: Kluwer Academic/Plenum Press. FIELDS OF STUDY Major Field: Psychology vi TABLE OF CONTENTS Page Abstract ............................................................................................................................... ii Dedication.......................................................................................................................... iv Acknowledgments................................................................................................................v Vita..................................................................................................................................... vi List of Tables ...................................................................................................................... x List of Figures.................................................................................................................... xi Introduction......................................................................................................................... 1 Diagnostic and clinical features ...................................................................................... 2 Adults.......................................................................................................................... 2 Children and adolescents ............................................................................................ 4 Assessment.................................................................................................................. 6 Distinction from nonseasonal mood ........................................................................... 7 Epidemiology................................................................................................................ 11 Adults........................................................................................................................ 11 Children and adolescents .......................................................................................... 12 Distinction from nonseasonal mood ......................................................................... 14 vii Onset ............................................................................................................................. 14 Adults........................................................................................................................ 14 Children and adolescents .......................................................................................... 15 Distinction from nonseasonal mood ......................................................................... 15 Long-term course.......................................................................................................... 15 Adults........................................................................................................................ 15 Children and adolescents .......................................................................................... 17 Distinction from nonseasonal mood ......................................................................... 17 Etiological mechanisms ................................................................................................ 18 Adults........................................................................................................................ 18 Children and adolescents .......................................................................................... 22 Distinction from nonseasonal mood ......................................................................... 24 Treatment ...................................................................................................................... 25 Adults........................................................................................................................ 25 Children and adolescents .......................................................................................... 29 Distinction from nonseasonal mood ......................................................................... 31 Summary......................................................................................................................
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