Abstract
In the context of interpersonal risk models of psychopathology, little is known about the role of self-expressiveness within the family (SEF) in individual psychological distress. Therefore, the aim of this exploratory study was to examine main and interaction effects of positive and negative SEF on maternal depression and anxiety symptoms. The “Self-Expressiveness in the Family Questionnaire—Short Form” (SEFQ-SF) and the “Hospital Anxiety and Depression Scale” (HADS) were administered to a sample of 403 mothers of toddlers, preschoolers and elementary school-aged children. Regression analyses and PROCESS computational tool in particular were used to examine main and interaction/moderating effects. Positive and negative SEF revealed altogether a medium-sized main effect on depressive symptoms, and negative SEF displayed a medium-sized main effect on anxiety symptoms. Positive SEF was found to buffer the association between negative SEF and maternal depressive symptoms. These preliminary findings suggest that positive and negative SEF may be differentially targeted in interventions to prevent or decrease maternal depression and anxiety symptoms. Specifically, the cultivation of positive SEF is likely to attenuate the detrimental effects of negative SEF on specific dimensions of maternal mental health.
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References
Aiken, L., & West, S. (1991). Multiple regression: Testing and interpreting interactions. Sage Publications, Inc.
Alberti, R. E., & Emmons, M. L. (1970). Your perfect right: A guide to assertive behavior. Impact.
Ballash, N. G., Pemble, M. K., Usui, W. M., Buckley, A. F., & Woodruff-Borden, J. (2006). Family functioning, perceived control, and anxiety: A mediational model. Journal of Anxiety Disorders, 20(4), 486–497. https://doi.org/10.1016/j.janxdis.2005.05.002
Bonanno, G. A., Papa, A., Lalande, K., Westphal, M., & Coifman, K. (2004). The importance of being flexible: The ability to both enhance and suppress emotional expression predicts long-term adjustment. Psychological Science, 15(7), 482–487. https://doi.org/10.1111/j.0956-7976.2004.00705.x
Boyce, W. T., Frank, E., Jensen, P. S., Kessler, R. C., Nelson, C. A., Steinberg, L., & MacArthur Foundation Research Network on Psychopathology & Development. (1998). Social context in developmental psychopathology: Recommendations for future research from the MacArthur Network on Psychopathology and Development. Development and Psychopathology, 10(2), 143-164. https://doi.org/10.1017/S0954579498001552.
Brown, T. A., & Barlow, D. H. (2005). Dimensional versus categorical classification of mental disorders in the fifth edition of the Diagnostic and statistical manual of mental disorders and beyond: Comment on the special section. Journal of Abnormal Psychology, 114(4), 551–556. https://doi.org/10.1037/0021-843X.114.4.551
Burrowes, B. D., & Halberstadt, A. G. (1987). Self- and family-expressiveness styles in the experience and expression of anger. Journal of Nonverbal Behavior, 11(4), 254–268. https://doi.org/10.1007/BF00987256
Carona, C., Pereira, M., Moreira, H., Silva, N., & Canavarro, M. C. (2013). The disability paradox revisited: Quality of life and family caregiving in pediatric cerebral palsy. Journal of Child and Family Studies, 22(7), 971–986. https://doi.org/10.1007/s10826-012-9659-0
Carona, C., Moreira, H., Halberstadt, A., & Fonseca, A. (in press). A positive-negative bifactor model for the “Self-Expressiveness in the Family Questionnaire-Short Form”. Journal of Family Psychology.
Cicchetti, D. (2006). Development and Psychopathology. Theory and methodIn D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology (Vol. 1, pp. 1–23). Wiley.
Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100(3), 316–336. https://doi.org/10.1037/0021-843X.100.3.316
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Erlbaum.
Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155–159. https://doi.org/10.1037/0033-2909.112.1.155
Cole, P. M., Michel, M. K., & Teti, L. O. (1994). The development of emotion regulation and dysregulation: A clinical perspective. Monographs of the Society for Research in Child Development, 59(2–3), 73–100. https://doi.org/10.2307/1166139
Connolly, N. P., Eberhart, N. K., Hammen, C. L., & Brennan, P. A. (2010). Specificity of stress generation: A comparison of adolescents with depressive, anxiety, and comorbid diagnoses. International Journal of Cognitive Therapy, 3(4), 368–379. https://doi.org/10.1521/ijct.2010.3.4.368
Conway, C. C., Hammen, C., & Brennan, P. A. (2012). Expanding stress generation theory: Test of a transdiagnostic model. Journal of Abnormal Psychology, 121(3), 754–766. https://doi.org/10.1037/a0027457
Coyne, J. C. (1976). Toward an interactional description of depression. Psychiatry: Journal for the Study of Interpersonal Processes, 39(1), 28–40. https://doi.org/10.1080/00332747.1976.11023874
Cuming, S., & Rapee, R. M. (2010). Social anxiety and self-protective communication style in close relationships. Behaviour Research and Therapy, 48(2), 87–96. https://doi.org/10.1016/j.brat.2009.09.010
Cummings, E. M., Cheung, R. Y. M., & Davies, P. T. (2013). Prospective relations between parental depression, negative expressiveness, emotional insecurity, and children’s internalizing symptoms. Child Psychiatry and Human Development, 44(6), 698–708. https://doi.org/10.1007/s10578-013-0362-1
Dallaire, D. H., & Weinraub, M. (2005). The stability of parenting behaviors over the first 6 years of life. Early Childhood Research Quarterly, 20(2), 201–219. https://doi.org/10.1016/j.ecresq.2005.04.008
Dietz, L. J., Jennings, K. D., Kelley, S. A., & Marshal, M. (2009). Maternal depression, paternal psychopathology, and toddlers’ behavior problems. Journal of Clinical Child and Adolescent Psychology, 38(1), 48–61. https://doi.org/10.1080/15374410802575362
Dobson, K. S., Quigley, L., & Dozois, D. J. A. (2014). Toward an integration of interpersonal risk models of depression and cognitive-behaviour therapy. Australian Psychologist, 49(6), 328–336. https://doi.org/10.1111/ap.12079
Dodge, K. A. (1990). Developmental psychopathology in children of depressed mothers. Developmental Psychology, 26(1), 3–6. https://doi.org/10.1037/0012-1649.26.1.3
Dolz-del-Castellar, B., & Oliver, J. (2021). Relationship between family functioning, differentiation of self and anxiety in Spanish young adults. PLoS ONE, 16(3), e0246875. https://doi.org/10.1371/journal.pone.0246875
Eberhart, N. K., & Hammen, C. L. (2010). Interpersonal style, stress, and depression: An examination of transactional and diathesis-stress models. Journal of Social and Clinical Psychology, 29(1), 23–38. https://doi.org/10.1521/jscp.2010.29.1.23
Eysenck, M. W., & Fajkowska, M. (2017). Anxiety and depression: Toward overlapping and distinctive features. Cognition and Emotion, 32(7), 1391–1400. https://doi.org/10.1080/02699931.2017.1330255
Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28(10), 857–870. https://doi.org/10.1037/h0035605
Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science & Medicine, 45(8), 1207–1221. https://doi.org/10.1016/S0277-9536(97)00040-3
Folkman, S. (2008). The case for positive emotions in the stress process. Anxiety, Stress & Coping, 21(1), 3–14. https://doi.org/10.1080/10615800701740457
Fredrickson, B. L. (1998). What good are positive emotions? Review of General Psychology, 2(3), 300–319. https://doi.org/10.1037/1089-2680.2.3.300
Gross, J. J., & Thompson, R. A. (2007). Emotion Regulation: Conceptual Foundations. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 3–24). The Guilford Press.
Halberstadt, A. G. (1986). Family socialization of emotional expression and nonverbal communication styles and skills. Journal of Personality and Social Psychology, 51(4), 827–836. https://doi.org/10.1037/0022-3514.51.4.827
Halberstadt, A. G., Fox, N. A., & Jones, N. A. (1993). Do expressive mothers have expressive children? The role of socialization in children’s affect expression. Social Development, 2(1), 48–65. https://doi.org/10.1111/j.1467-9507.1993.tb00004.x
Halberstadt, A. G., Cassidy, J., Stifter, C. A., Parke, R. D., & Fox, N. A. (1995). Self-expressiveness within the family context: Psychometric support for a new measure. Psychological Assessment, 7(1), 93–103. https://doi.org/10.1037/1040-3590.7.1.93
Hames, J. L., Hagan, C. R., & Joiner, T. E. (2013). Interpersonal processes in depression. Annual Review of Clinical Psychology, 9, 355–377. https://doi.org/10.1146/annurev-clinpsy-050212-185553
Hammen, C. (1991). Generation of stress in the course of unipolar depression. Journal of Abnormal Psychology, 100(4), 555–561. https://doi.org/10.1037/0021-843X.100.4.555
Hammen, C. (2001). Vulnerability to depression in adulthood. In R. E. Ingram & J. M. Price (Eds.), Vulnerability to psychopathology: Risk across the lifespan (pp. 226–257). The Guilford Press.
Hammen, C. (2003). Interpersonal stress and depression in women. Journal of Affective Disorders, 74(1), 49–57. https://doi.org/10.1016/S0165-0327(02)00430-5
Hammen, C. (2005). Stress and depression. Annual Review of Clinical Psychology, 1, 293–319. https://doi.org/10.1146/annurev.clinpsy.1.102803.143938
Haskett, M. E., Stelter, R., Proffit, K., & Nice, R. (2012). Parent emotional expressiveness and children’s self-regulation: Associations with abused children’s school functioning. Child Abuse & Neglect, 36(4), 296–307. https://doi.org/10.1016/j.chiabu.2011.11.008
Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. http://www.processmacro.org/.
Headey, B. W., Kelley, J., & Wearing, A. J. (1993). Dimensions of mental health: Life satisfaction, positive affect, anxiety and depression. Social Indicators Research, 29(1), 63–82. https://doi.org/10.1007/BF01136197
Hobfoll, S. E., & Lerman, M. (1988). Personal relationships, personal attributes, and stress resistance: Mothers’ reactions to their child’s illness. American Journal of Community Psychology, 16(4), 565–589. https://doi.org/10.1007/BF00922772
Hofmann, S. G. (2014). Interpersonal emotion regulation model of mood and anxiety disorders. Cognitive Therapy and Research, 38(5), 483–492. https://doi.org/10.1007/s10608-014-9620-1
Keitner, G. I., & Miller, I. W. (1990). Family functioning and major depression: An overview. The American Journal of Psychiatry, 147(9), 1128–1137. https://doi.org/10.1176/ajp.147.9.1128
Khazanov, G. K., & Ruscio, A. M. (2016). Is low positive emotionality a specific risk factor for depression? A meta-analysis of longitudinal studies. Psychological Bulletin, 142(9), 991–1015. https://doi.org/10.1037/bul0000059
Kim, E. K., You, S., & Knox, J. (2020). The mediating effect of empathy on the relation between child self-expressiveness in family and prosocial behaviors. Journal of Child and Family Studies, 29, 1572–1581. https://doi.org/10.1007/s10826-019-01676-2
Kreitler, S. (2017). The meaning profiles of anxiety and depression: Similarities and differences in two age groups. Cognition and Emotion, 32(2), 1–15. https://doi.org/10.1080/02699931.2017.1311248
Lin, N., & Ensel, W. M. (1984). Depression-mobility and its social etiology: The role of life events and social support. Journal of Health and Social Behavior, 25(2), 176–188. https://doi.org/10.2307/2136667
MacKinnon, D. P., & Luecken, L. J. (2008). How and for whom? Mediation and moderation in health psychology. Health Psychology, 27(2), S99. https://doi.org/10.1037/0278-6133.27.2(Suppl.).S99
McLaughlin, K. A., Hatzenbuehler, M. L., Mennin, D. S., & Nolen-Hoeksema, S. (2011). Emotion dysregulation and adolescent psychopathology: A prospective study. Behaviour Research and Therapy, 49(9), 544–554. https://doi.org/10.1016/j.brat.2011.06.003
McLennan, J. D., Kotelchuck, M., & Cho, H. (2001). Prevalence, persistence, and correlates of depressive symptoms in a national sample of mothers of toddlers. Journal of the American Academy of Child & Adolescent Psychiatry, 40(11), 1316–1323. https://doi.org/10.1097/00004583-200111000-00012
Mendes, A. V., Loureiro, S. R., Crippa, J. A., de Meneses Gaya, C., García-Esteve, L., & Martín-Santos, R. (2012). Mothers with depression, school-age children with depression? A systematic review. Perspectives in Psychiatric Care, 48(3), 138–148. https://doi.org/10.1111/j.1744-6163.2011.00318.x
Mizokawa, A. (2013). Relationships between maternal emotional expressiveness and children's sensitivity to teacher criticism. Frontiers in Psychology, 4, Article 807. https://doi.org/10.3389/fpsyg.2013.00807.
Moses, E. B., & Barlow, D. H. (2006). A new unified treatment approach for emotional disorders based on emotion science. Current Directions in Psychological Science, 15(3), 146–150. https://doi.org/10.1111/j.0963-7214.2006.00425.x
Nunnally, J., & Bernstein, I. J. (1994). Psychometric theory (3rd edition). McGraw-Hill.
Östberg, M., Hagekull, B., & Hagelin, E. (2007). Stability and prediction of parenting stress. Infant and Child Development, 16(2), 207–223. https://doi.org/10.1002/icd.516
Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007). Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychology, Health, & Medicine, 12(2), 225–235. https://doi.org/10.1080/13548500500524088
Piche, G., Bergeron, L., Cyr, M., & Berthiaume, C. (2011). Maternal lifetime depressive/anxiety disorders and children’s internalizing symptoms: The importance of family context. Journal of the Canadian Academy of Child and Adolescent Psychiatry / Journal De L’académie Canadienne De Psychiatrie De L’enfant Et De L’adolescent, 20(3), 176–185.
Robertson, S., Zarit, S., Duncan, L., Rovine, M., & Femia, E. (2007). Family caregivers’ patterns of positive and negative affect. Family Relations, 56(1), 12–23. https://doi.org/10.1111/j.1741-3729.2007.00436.x
Rose, B. M., Holmbeck, G. N., Coakley, R. M., & Franks, E. A. (2004). Mediator and moderator effects in developmental and behavioral pediatric research. Developmental and Behavioral Pediatrics, 25(1), 58–67. https://doi.org/10.1097/00004703-200402000-00013
Schwebel, A. I., & Fine, M. A. (1992). Cognitive-behavioral family therapy. Journal of Family Psychotherapy, 3(1), 73–91. https://doi.org/10.1300/j085V03N01_04
Segrin, C. (1998). Interpersonal communication problems associated with depression and loneliness. In P. A. Andersen & L. K. Guerrero (Eds.), Handbook of communication and emotion: Research, theory, applications, and contexts (pp. 215–242). Academic Press.
Segrin, C. (2000). Social skills deficits associated with depression. Clinical Psychology Review, 20(3), 379–403. https://doi.org/10.1016/S0272-7358(98)00104-4
Segrin, C., & Dillard, J. P. (1992). The interactional theory of depression: A meta-analysis of the research literature. Journal of Social and Clinical Psychology, 11(1), 43–70. https://doi.org/10.1521/jscp.1992.11.1.43
Segrin, C., & Flora, J. (1998). Depression and verbal behavior in conversations with friends and strangers. Journal of Language and Social Psychology, 17(4), 492–593. https://doi.org/10.1177/0261927X980174005
Segrin, C., & Flora, J. (2000). Poor social skills are a vulnerability factor in the development of psychosocial problems. Human Communication Research, 26(3), 489–514. https://doi.org/10.1111/j.1468-2958.2000.tb00766.x
Segrin, C., & Rynes, K. N. (2009). The mediating role of positive relations with others in associations between depressive symptoms, social skills, and perceived stress. Journal of Research in Personality, 43(6), 962–971. https://doi.org/10.1016/j.jrp.2009.05.012
Shipman, K. L., & Zeman, J. (2001). Socialization of children’s emotion regulation in mother–child dyads: A developmental psychopathology perspective. Development and Psychopathology, 13(2), 317–336. https://doi.org/10.1017/S0954579401002073
Simões, M. (1994). Investigacões no âmbito da aferição nacional do teste das Matrizes Progressivas de Raven [Raven’s Progressive Matrices: Aferition studies]. Unpublished doctoral dissertation. The University of Coimbra. https://estudogeral.uc.pt/handle/10316/946.
Speed, B. C., Goldstein, B. L., & Goldfried, M. R. (2018). Assertiveness training: A forgotten evidence-based treatment. Clinical Psychology: Science and Practice, 25(1), 1–20. https://doi.org/10.1111/cpsp.12216
Spence, S. H., Najman, J. M., Bor, W., O’Callaghan, M., & Williams, G. M. (2002). Maternal anxiety and depression, poverty and marital relationship factors during early childhood as predictors of anxiety and depressive symptoms in adolescence. Journal of Child Psychology and Psychiatry, 43(4), 457–470. https://doi.org/10.1111/1469-7610.00037
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th edition). Allyn & Bacon/Pearson Education.
Uliaszek, A. A., Zinbarg, R. E., Mineka, S., Craske, M. G., Griffith, J. W., Sutton, J. M., Epstein, A., & Hammen, C. (2012). A longitudinal examination of stress generation in depressive and anxiety disorders. Journal of Abnormal Psychology, 121(1), 4–15. https://doi.org/10.1037/a0025835
van der Waerden, J., Galéra, C., Saurel-Cubizolles, M.-J., Sutter-Dallay, A.-L., Melchior, M., & EDEN Mother–Child Cohort Study Group. (2015). Predictors of persistent maternal depression trajectories in early childhood: Results from the EDEN mother–child cohort study in France. Psychological Medicine, 45(9), 1999-2012. https://doi.org/10.1017/S003329171500015X.
Veit, C. T., & Ware, J. E. (1983). The structure of psychological distress and well-being in general populations. Journal of Consulting and Clinical Psychology, 51(5), 730–742. https://doi.org/10.1037/0022-006X.51.5.730
Watson, D., Clark, L. A., & Carey, G. (1988). Positive and negative affectivity and their relation to anxiety and depressive disorders. Journal of Abnormal Psychology, 97(3), 346–353. https://doi.org/10.1037//0021-843x.97.3.346
Whisman, M. A., & Beach, S. R. H. (2010). Models for understanding interpersonal processes and relationships in anxiety disorders. In J. G. Beck (Ed.), Interpersonal processes in the anxiety disorders: Implications for understanding psychopathology and treatment (p. 9–35). American Psychological Association. https://doi.org/10.1037/12084-001.
Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Stanford University Press.
Wolpe, J. (1986). The positive diagnosis of neurotic depression as an etiological category. Comprehensive Psychiatry, 27(5), 449–460. https://doi.org/10.1016/0010-440X(86)90033-7
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
Zimmer-Gembeck, M. J., & Skinner, E. A. (2011). The development of coping across childhood and adolescence: An integrative review and critique of research. International Journal of Behavioral Development, 35(1), 1–17. https://doi.org/10.1177/0165025410384923
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This study was supported by the Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC) – University of Coimbra (UIDB/PSI/00730/2020).
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Carona, C., Moreira, H. & Fonseca, A. Maternal depression and anxiety in an interpersonal context: The effects of positive–negative self-expressiveness within the family. Curr Psychol 42, 10324–10333 (2023). https://doi.org/10.1007/s12144-021-02302-5
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DOI: https://doi.org/10.1007/s12144-021-02302-5