University Center 5 Parent Support Creating Deborah 4 for Excellence— and Education 9 Opportunities 1 0 Lovett— When Down for Young for Artists with Making Syndrome and Children with Disabilities Dinner Autism Co-Occur Autism Plans Treating Parent’s Biological Clocks and Depression: Constant Light Effects on Children By Melanie Moran onstant light has long been understood to disrupt our internal clocks, By Jan Rosemergy C resulting in problems like jet lag and health problems in extended-shift workers. A study led by Douglas McMahon, Ph.D., reveals that although the clocks of individuals exposed to constant light may get out of synch, they keep ticking. The research was published online Feb. 23 in the journal Nature Neuroscience. McMahon is professor of biological sciences and a Vanderbilt Kennedy Center investigator. Biological clocks are responsible for maintaining circadian rhythms, which affect sleep, performance, mood and more. McMahon’s findings offer insight into how to modify constant-light situations to lessen their impact on humans. Findings also may have implications for understanding and treating mood disorders affected by exposure to light. Biological Clocks In mammals, the brain’s circadian pacemaker, or biological clock, forms a 24-hour internal clock for the brain and body that regulates behavior, physiology and mood. Most of us experience the Continued on page 3 DREAMSTIME Director’s Message he greatest risk factor for depression in youth is a parent’s history of Tdepression. This likely is due to a combination of genetic and environmental factors. What happens if a depressed parent receives treatment and improves—or does not improve—and what is the effect Methodological Evolution on the parent’s children? often tell my students that there’s Answers to this question are being provided by the Parent-Child I little chance of them coming up with a ques- Project, a multi-site national project led by Judy Garber, Ph.D., and by the tion about brain development and behavior that STAR*D-Child Study, a multi-site national project, which included someone hasn’t already asked. While admittedly Nashville as a site that Garber directed. Garber, who also consulted on the a bit melodramatic, my own bias is that there is STAR*D Study design, is professor of psychology at Peabody College and a some truth to this in most scientific disciplines. Vanderbilt Kennedy Center investigator. If so, then how does research make advances of the kind for which the Vanderbilt Kennedy Parental and Child Depression Center has become so well-known? “We know that children of depressed parents tend not to fare as The great leap forward, which we call a scien- well as children of nondepressed parents,” Garber said. “That’s not to tific “breakthrough,” usually occurs in parallel say that every child experiences problems, but they are at greater risk.” Pat Levitt, Ph.D. with the development of new technologies. For Children of depressed parents are at increased risk for multiple example, while we recognized for over a century that the brain utilizes problems including social and academic difficulties, psychopathology, chemicals as messengers to convey information, it was the development substance abuse, and suicide. Continued on page 2 of new methods in the 1960s to measure these Continued on page 3 Number 13 Summer 2006 Vanderbilt University KENNEDY CENTER Summer 2006 FOR DiscoveryRESEARCH ON HUMAN DEVELOPMENT Treating Parent’s parent’s depression and children’s problems. At this point, we can say that there’s a significant Depression from page 1 relation. Possible reasons for this relation are the continued focus of the Parent-Child Offspring of depressed parents are at about 3 to Project.” 4 times greater risk of developing depressive A clear implication of the findings is that disorders themselves. if a parent is depressed, it would be prudent for “We also know that that the extent of the the parent to get treatment to help reduce the parent’s depression makes a difference,” Garber depression, Garber emphasized, because continued. “Chronic or recurrent depression in remission of parental depression is related to parents is particularly predictive of problems in changes in their children. Garber added, children, contrasted, for example, to a parent who “Depression is a very treatable condition, and it may have had a brief 6-month depressive episode is a shame that some parents are not taking the related to a stressful life event like divorce.” opportunity to get treated, if not for themselves, then for the sake of their children.” The Studies Authors of the STAR*D Study pointed out The Parent-Child Study is being conducted at that the low proportion of mothers among three sites: Nashville/Vanderbilt University, DREAMSTIME women seeking treatment suggests that there Seattle/University of Washington, and ment in their own psychopathology,” Garber likely are substantial barriers to depressed Philadelphia/University of Pennsylvania. It involves said. “If parents continued to be depressed, their mothers getting the help they need. Other 129 high-risk offspring of mothers or fathers children’s psychopathology tended not to change research has indicated that depressed low-income being treated for depression and 98 offspring of or to get a little worse.” women, in particular, tend not to use community non-depressed parents. Children range in age from In the STAR*D Study, remission of maternal care available to them, even if it is free, making 7 through 17-years-old (average age is 12). depression after 3 months of treatment was outreach, child care, transportation, and flexible “We included this comparison group,” Garber associated with reductions in children’s diagnoses treatment schedules all the more important in explained, “because changes in children of depressed and symptoms. There was an overall 11% encouraging mothers to obtain treatment. parents could simply be normative development. decrease in rates of diagnoses in children of The question is whether symptoms in children of mothers whose depression remitted compared Next Steps depressed parents are changing at a differential with an approximate 8% increase in rates of Children in the Parent-Child Project are being rate compared with age-matched children of diagnoses in children of mothers whose followed every 6 months for 2 years, and children non-depressed parents.” depression did not remit. Findings were reported in the STAR*D Study are being followed every 3 The STAR*D Study included 151 mother-child in the March 21, 2006, issue of the Journal of the months from 1 to 2 years. Researchers in both pairs in 8 primary care and 11 psychiatric American Medical Association (JAMA); Garber studies are looking at factors such as changes in outpatient clinics across 7 regional centers in the was a co-author of the study. This is the first stress, the parent-child relationship, and/or in United States. Children were ages 7 to 17 years. published study to document prospectively the children’s cognitions (i.e., how they perceive Both studies assessed children whose parents were relation between remission of a mother’s themselves, others, and the world) that may receiving treatment including medication and/or depression and her child’s clinical state. account for the relation between depression in cognitive therapy. The studies focused on remission Garber cautions that these findings do not parents and children. Follow-up research focuses of the parents’ depression in relation to changes in demonstrate a causal relation. “You can say that on temporal precedents and mediation, that is, children’s symptoms and functioning. Both studies there’s co-variation,” she continued. “It could be whether changes in parents are related to changes were funded by grants from the National Institute of that parents are improving and that causes their in the family environment, which then are Mental Health. children to improve. It could be that children’s related to changes in the children’s functioning. improvement causes parents to change. Or it “The next step is prevention,” Garber said, Findings could be that circumstances have changed for “both at the level of getting depressed parents “The bottom line in both studies is that children both of them, that some third variable such as treatment as well as intervening with children whose parents got better showed some improve- decreased stress resulted in changes in both the who are at risk for depression.” Depression in children and adolescents should be • Depression is costly due to skyrocketing Primer prevented and treated because: antidepressant prescription costs, and the costs of health care. • Depression is a significant public health concern. Internet Resources Depression in children and adolescents is charac- According to the World Health Organization, terized by at least five of the following symptoms • Depression & Bipolar Support Alliance depression is the number one cause of disability (at least one of the first two) for more of the time www.dbsalliance.org and will be the second most important disorder by than not, for at least 2 weeks: • NAMI (National Alliance for Mental Illness) 2020 in terms of disability and mortality. www.nami.org • Sadness or irritability • Depression is impairing. In teens it is associated • NAMI Tennessee • Loss of interest or pleasure with decreases in school and work performance, www.namitn.org • Change in appetite difficulties in family and peer relationships, and an • Tennessee Voices for Children • Sleep problems increased risk of alcohol and drug abuse and suicide. www.tnvoices.org • Fatigue, low energy • Depression is common. Between 20% to 40% of • Mental Health Association of Middle Tennessee • Concentration problems teens report depressed mood. www.ichope.com • Low self-esteem or guilt • Depression is chronic and recurring. Depression in • Vanderbilt Kennedy Center StudyFinder • Agitation or physical slowness childhood or adolescence places youth at risk for Select “Depression” to view studies 2 • Suicidal thoughts or behaviors disorders later in life.