1. Study suggests predicting depression and PTSD before deployment could help soldiers cope

    October 17, 2017 by Ashley

    From the BioMed Central press release:

    A set of validated, self-reported questions administered early in a soldier’s career could predict mental health problems such as depression and post-traumatic stress disorder (PTSD) after return from deployment, according to a study published in the open access journal BMC Psychology.

    The questions assess 14 psychological attributes such as adaptability, coping ability and optimism. They could be used to identify high-risk individuals and provide them with psychological and social resources to help them cope with stressors of deployment including combat trauma and extended separation from friends and family, researchers at Naval Postgraduate School and Research Facilitation Laboratory, USA suggest.

    In addition to scoring psychological health attributes before deployment, the researchers also generated an individual, composite risk score for each soldier using baseline psychological attributes and demographic information such as gender, age, race/ethnicity, marital status, education, and military occupation group. They found that out of those whose score classified them as being at highest risk for psychological health disorders (i.e. at the top 5% of the score), 31% screened positive for depression, while 27% screened positive for PTSD after return from deployment.

    Professor Yu-Chu Shen, lead author of the study said: “We found that soldiers who had the worst pre-military psychological health attribute scores — those in the bottom 5% of scores — carried much higher odds of screening positive for depression and PTSD after returning home than the top 95%. Soldiers who score worst before deployment might be more susceptible to developing debilitating mental health disorders when they are later exposed to combat environments.”

    The findings suggest that psychological screening before deployment, in combination with other personnel information, can be helpful in identifying individuals who carry significant risk for psychological health disorders, according to the authors. Being aware of this risk could enable tailored interventions to increase soldiers’ psychological health prior to exposing them to combat. Identifying individuals at risk of adverse psychological outcomes could also translate into savings on costs resulting from treatment and lost productivity.

    To investigate the association of psychological attributes in soldiers before deployment and their risk for depression and PTSD after their return, the authors used data from three sources on 63,138 soldiers who enlisted after 2008: the Army’s personnel database, pre- and post-deployment health assessments, and the Global Assessment Tool (GAT).

    GAT is an annual resilience and psychological health assessment completed by all members of the US Army. It consists of a 105-item questionnaire that captures 14 attributes of health and resilience that are considered important for life in the military. These attributes include optimism and catastrophizing, which may reflect how a person responds to the stress of combat; positive affect and organisational trust, which capture how a person may respond to leadership; and resilience and coping ability.

    The authors caution that GAT in its current form is not designed to be used as a screening tool on which employment decisions should be based.

    Professor Shen said: “In this study, we illustrate the potential value for psychological health screening such as GAT in public safety and national defense occupations. However, for any strategy based on screenings like this to be successful and effective, we also highlight the importance for future screening tools to be designed to detect and minimize strategic responding — that is personnel adapting their answers if they know that their career progression and chance of deployment may depend on their screening scores. Strategic responding may undermine the effectiveness of a screening tool in identifying the risk for mental health disorders.”


  2. Study examines sleep problems in young people

    October 16, 2017 by Ashley

    From the James Cook University press release:

    A collaborative research project involving James Cook University and the University of Queensland indicates high rates of sleep problems continuing through teenage years and into early adulthood — but also suggests a natural remedy.

    Dr. Yaqoot Fatima from JCU’s Mount Isa Centre for Rural and Remote Health was associated with a study that tracked more than 3600 people from the age of 14 until they were 21.

    “Just over a quarter of the 14-year-olds reported sleep problems, with more than 40 percent of those still having sleep problems at 21,” said Dr. Fatima.

    She said the causes of sleep problems were different at different ages.

    Maternal factors, such as drug abuse, smoking, depression and anxiety among mothers are the most significant predictors of adolescent sleep problems in their children, at 14-years-old. For all people studied, being female, having experienced early puberty, and being a smoker were the most significant predictors of sleep problems at 21 years.”

    She said adolescent depression or anxiety were linking factors for sleep problems between the two ages.

    “It’s a vicious circle. Depression and anxiety are well-established risk factors for sleep problems and people with sleep problems are often anxious or depressed,” she said.

    Dr. Fatima said that as well as the traditional factors, excessive use of electronic media is emerging as another significant risk.

    “In children and adolescents, it’s found to be strongly associated with later bedtime and shorter sleep duration, increasing the risk of developing sleep disturbances,” she said.

    Dr. Fatima said the study was worrying as it revealed a high incidence of persistent sleep problems and possible concurrent health problems among young people — but it also strongly suggested an answer to the problem.

    “Even allowing for Body Mass Index and other lifestyle factors, we found that an active lifestyle can decrease future incidence and progression of sleep problems in young subjects. So, early exercise intervention with adolescents might provide a good opportunity to prevent their sleep problems persisting into later life.”

    She said the next study being considered would look at what factors lead to young adults’ sleep problems continuing as they grow older and how that might be prevented.


  3. Study suggests anxiety and depression caused by childhood bullying decline over time

    by Ashley

    From the University College London press release:

    A new UCL-led study has provided the strongest evidence to date that exposure to bullying causes mental health issues such as anxiety years later.

    The study, published today in JAMA Psychiatry and funded by MQ: Transforming Mental Health and the Economic and Social Research Council, found that the detrimental effects of bullying decreased over time, which the authors say shows the potential for resilience in children exposed to bullying.

    “Previous studies have shown that bullied children are more likely to suffer mental health issues, but give little evidence of a causal link, as pre-existing vulnerabilities can make children both more likely to be bullied and experience worse mental health outcomes. We used a robust study design to identify causation,” said the study’s lead author, Dr Jean-Baptiste Pingault (UCL Psychology & Language Sciences).

    The study involved 11,108 participants from the Twins Early Development Study (TEDS), which is based at King’s College London. By surveying twins, researchers were able to look at the associations between bullying and mental health outcomes, and then account for the confounding effects of their genes and shared environmental influences because they studied both monozygotic (“identical”) twins who have matching genes and home environments and dizygotic (“non-identical”) twins, who don’t share all of their genes, but have matching home environments. Both children and their parents filled out questionnaire: at age 11 and 14 they were asked about peer victimization, and at 11 and 16 they were asked about mental health difficulties.

    The effect sizes were stronger before controlling for shared environmental factors and genetics, confirming that bullying itself is only partly to blame for the poor mental health outcomes experienced by bullied children.

    The researchers found that, once confounding factors were removed, there remained a causal contribution of exposure to bullying to concurrent anxiety, depression, hyperactivity and impulsivity, inattention, and conduct problems. Two years later, the impact on anxiety persisted. Five years later, there was no longer an effect on any of those outcomes, but 16-year-olds who had been bullied at age 11 remained more likely to have paranoid thoughts or cognitive disorganisation (a tendency for thoughts to become derailed).

    “While our findings show that being bullied leads to detrimental mental health outcomes, they also offer a message of hope by highlighting the potential for resilience. Bullying certainly causes suffering, but the impact on mental health decreases over time, so children are able to recover in the medium term,” Dr Pingault said.

    “The detrimental effects of bullying show that more needs to be done to help children who are bullied. In addition to interventions aimed at stopping bullying from happening, we should also support children who have been bullied by supporting resilience processes on their path to recovery. Our findings highlight the importance of continuous support to mental health care for children and adolescents” he said.

    Dr Sophie Dix, Director of Research at MQ: Transforming Mental Health said: “This important research is further strong evidence of the need to take the mental health impacts of bullying seriously. We hope this study provides fresh impetus to make sure young people at risk — and those currently being bullied — get effective help as soon as possible.”

    “More than one in five UK young people say they’ve recently been bullied. And now this unprecedented study gives the strongest evidence to date that bullying can directly cause many common mental health conditions — and have a serious effect on mental health in the long-term. But the good news is that it shows that people can and do get better — demonstrating the importance of resilience. Now we need to understand why this is and develop new ways, through research, to intervene and change lives,” she said.


  4. Study suggests bright light therapy at midday may help with symptoms of bipolar and depression

    October 15, 2017 by Ashley

    From the Northwestern University press release:

    Daily exposure to bright white light at midday significantly decreased symptoms of depression and increased functioning in people with bipolar disorder, a recent Northwestern Medicine study found.

    Previous studies found morning bright light therapy reduced symptoms of depression in patients with Seasonal Affective Disorder (SAD.). But patients with bipolar disorder can experience side effects such as mania or mixed symptoms from this type of depression treatment. This study implemented a novel midday light therapy intervention in an effort to provide relief for bipolar depression and avoid those side effects.

    Compared to dim placebo light, study particpants assigned to bright white light between noon and 2:30 p.m. for six weeks experienced a significantly higher remission rate (minimal depression and return to normal functioning). More than 68 percent of patients who received midday bright light achieved a normal level of mood, compared to 22.2 percent of patients who received the placebo light.

    The group receiving bright light therapy also had a much lower average depression score of 9.2 compared to 14.9 for the placebo group and significantly higher functioning, meaning they could go back to work or complete tasks around the house they hadn’t been able to finish prior to treatment.

    The study was published Oct. 3 in the American Journal of Psychiatry.

    “Effective treatments for bipolar depression are very limited,” said lead author Dr. Dorothy Sit, associate professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. “This gives us a new treatment option for bipolar patients that we know gets us a robust response within four to six weeks.”

    Patients also experienced minimal side effects from the therapy. No one experienced mania or hypomania, a condition that includes a period of elation, euphoria, irritability, agitation, rapid speech, racing thoughts, a lack of focus and risk-taking behaviors.

    “As clinicians, we need to find treatments that avoid these side effects and allow for a nice, stable response. Treatment with bright light at midday can provide this,” said Sit, also a Northwestern Medicine psychiatrist.

    The study included 46 participants who had at least moderate depression, bipolar disorder and who were on a mood stabilizer. Patients were randomly assigned to either a 7,000 lux bright white light or a 50 lux placebo light. The light therapy patients were instructed to place the light box about one foot from their face for 15-minute sessions to start. Every week, they increased their exposure to the light therapy by 15-minute increments until they reached a dose of 60 minutes per day or experienced a significant change in their mood.

    “By starting at a lower dose and slowly marching that dose up over time, we were able to adjust for tolerability and make the treatment suitable for most patients,” Sit said.

    Sit and her colleagues also observed a noticeable effect of bright light therapy by four weeks, which is similar to other studies that test light therapy for non-seasonal depression and depression during pregnancy.

    Light therapy has conventionally been tested using morning light at awakening because previous research has suggested that morning light helps reset circadian rhythms and can be helpful in the treatment of SAD, Sit said. However, the mechanism of response is unclear in bipolar disorder. To understand the possible effects of midday bright light on circadian rhythms in patients with depression and bipolar disorder, Sit and colleagues are planning new studies to investigate.


  5. Study suggests earlier school start times may increase risk of adolescent depression and anxiety

    October 13, 2017 by Ashley

    From the University of Rochester Medical Center press release:

    Teenagers who start high school before 8:30 a.m. are at higher risk of depression and anxiety, even if they’re doing everything else right to get a good night’s sleep, a recent study out of Rochester, N.Y., suggests.

    Led by University of Rochester Medical Center clinical assistant professor in Psychiatry Jack Peltz, Ph.D., the study, recently published in Sleep Health, not only reinforces the theorized link between sleep and adolescent mental health, but is among the first to demonstrate that school start times may have a critical impact on adolescent sleep and daily functioning. The findings provide additional evidence in the national debate over how school start times impact adolescent health.

    “Our study is consistent with a growing body of research demonstrating the close connection between sleep hygiene and adolescent mental health,” says Peltz, who is also on the faculty of Daemon College in Amherst, N.Y. “But ours is the first to really look at how school start times affect sleep quality, even when a teen is doing everything else right to get a good night’s sleep. While there are other variables that need to be explored, our findings show that earlier school start times seem to put more pressure on the sleep process and increase mental health symptoms, while later school start times appear to be a strong protective factor for teens.”

    Peltz is one of many investigators now exploring ways to address what has become a nationwide sleep epidemic among adolescents. About 90% of high-school-aged adolescents get insufficient sleep on school nights, or barely meet the required amount of sleep (8-10 hours) needed for healthy functioning. School start times, among other interventions (ie. limiting electronic use before bedtime), have become a critical point of interest. The research to date, however, has primarily focused on the academic benefits of delaying school start times for adolescents, rather than examining how earlier start times may disrupt sleep-related processes and affect mental health outcomes, says Peltz.

    “Looking at school start times as a larger contextual variable that may moderate sleep hygiene, sleep quality and adolescent functioning, fills an important gap in the literature,” he says.

    With the help of a grant from the National Sleep Foundation, Peltz’ and his co-authors used an online tool to collect data from 197 students across the country between the ages of 14 and 17. All children and parents completed a baseline survey that included questions about the child’s level of sleep hygiene, family socioeconomic status, their circadian chronotype (roughly, whether you are a “morning person” or “night person”), and their school start times. They were separated into two groups: those who started school before 8:30 a.m. and those who started after 8:30 a.m. (which is currently the recommended start time for high schoolers by the American Academy of Pediatricians).

    Over a period of seven days, the students were instructed to keep a sleep diary, in which they reported specifically on their daily sleep hygiene, levels of sleep quality and duration, and their depressive/anxiety symptoms.

    The results showed that good baseline sleep hygiene was directly associated with lower average daily depressive/anxiety symptoms across all students, and the levels were even lower in students with school start times after 8:30. However, students with good baseline sleep hygiene and earlier school start times had higher average daily depressive/anxiety symptoms.

    “Our results suggest that good sleep hygiene practices are advantageous to students no matter when they go to school,” says Peltz. “Maintaining a consistent bedtime, getting between 8 and 10 hours of sleep, limiting caffeine, turning off the TV, cell phone and video games before bed… these efforts will all benefit their quality of sleep and mental health. However, the fact that school start times showed a moderating effect on mental health symptoms, suggests that better sleep hygiene combined with later school start times would yield better outcomes.”

    Peltz says one possible explanation for the difference may be that “earlier starting students” have more pressure on them to get high quality sleep, or there may be other aspects of the school environment that vary by start time that may trigger their depression/anxiety symptoms. Peltz says there may be other lifestyle changes that coincide with earlier start times as well (for example, morning nutrition or exercise) that require closer scrutiny.

    “More studies are definitely needed, but our results help clarify the somewhat mixed findings with other sleep hygiene-focused interventions, by suggesting that school start times may be a very important contextual factor,” he says.

    Peltz hopes the evolving evidence in this area will help propel more concrete national sleep hygiene recommendations for children and teens, similar to what the American Dental Association recommends for oral health.

    “If we don’t sleep, eventually we will die…our brains will cease to function,” he says. “At the end of the day, sleep is fundamental to our survival. But if you have to cram for a test or have an important paper due, it’s one of the first things to go by the wayside, although that shouldn’t be.”


  6. Study suggests exercise can help with depression prevention

    by Ashley

    From the University of New South Wales press release:

    A landmark study led by the Black Dog Institute has revealed that regular exercise of any intensity can prevent future depression — and just one hour can help.

    Published in the American Journal of Psychiatry, the results show even small amounts of exercise can protect against depression, with mental health benefits seen regardless of age or gender.

    In the largest and most extensive study of its kind, the analysis involved 33,908 Norwegian adults who had their levels of exercise and symptoms of depression and anxiety monitored over 11 years.

    The international research team found that 12 percent of cases of depression could have been prevented if participants undertook just one hour of physical activity each week.

    “We’ve known for some time that exercise has a role to play in treating symptoms of depression, but this is the first time we have been able to quantify the preventative potential of physical activity in terms of reducing future levels of depression,” said lead author Associate Professor Samuel Harvey from Black Dog Institute and UNSW.

    “These findings are exciting because they show that even relatively small amounts of exercise — from one hour per week — can deliver significant protection against depression.

    “We are still trying to determine exactly why exercise can have this protective effect, but we believe it is from the combined impact of the various physical and social benefits of physical activity.

    “These results highlight the great potential to integrate exercise into individual mental health plans and broader public health campaigns. If we can find ways to increase the population’s level of physical activity even by a small amount, then this is likely to bring substantial physical and mental health benefits.”

    The findings follow the Black Dog Institute’s recent Exercise Your Mood campaign, which ran throughout September and encouraged Australians to improve their physical and mental wellbeing through exercise.

    Researchers used data from the Health Study of Nord-Trøndelag County (HUNT study) — one of the largest and most comprehensive population-based health surveys ever undertaken — which was conducted between January 1984 and June 1997.

    A healthy cohort of participants was asked at baseline to report the frequency of exercise they participated in and at what intensity: without becoming breathless or sweating, becoming breathless and sweating, or exhausting themselves. At follow-up stage, they completed a self-report questionnaire (the Hospital Anxiety and Depression Scale) to indicate any emerging anxiety or depression.

    The research team also accounted for variables which might impact the association between exercise and common mental illness. These include socio-economic and demographic factors, substance use, body mass index, new onset physical illness and perceived social support.

    Results showed that people who reported doing no exercise at all at baseline had a 44% increased chance of developing depression compared to those who were exercising one to two hours a week.

    However, these benefits did not carry through to protecting against anxiety, with no association identified between level and intensity of exercise and the chances of developing the disorder.

    According to the Australian Health Survey, 20 percent of Australian adults do not undertake any regular physical activity, and more than a third spend less than 1.5 hours per week being physically active. At the same time, around 1 million Australians have depression, with one in five Australians aged 16-85 experiencing a mental illness in any year.

    “Most of the mental health benefits of exercise are realised within the first hour undertaken each week,” said Associate Professor Harvey.

    “With sedentary lifestyles becoming the norm worldwide, and rates of depression growing, these results are particularly pertinent as they highlight that even small lifestyle changes can reap significant mental health benefits.”


  7. Study looks at postpartum depression risk, duration and recurrence

    October 9, 2017 by Ashley

    From the PLOS press release:

    Postpartum affective disorder (AD), including postpartum depression (PPD), affects more than one in two hundred women with no history of prior psychiatric episodes, and raises the risk of later affective disorder for those women, according to a new study published in PLOS Medicine by Marie-Louise Rasmussen from Statens Serum Institut, Denmark, and colleagues.

    PPD is estimated to affect more than 5 percent of all women following childbirth, making it the most common postnatal complication of childbearing. In the new study, researchers analyzed data from the Danish national registries on 457,317 women who had a first child (and subsequent births) between 1996 and 2013 and had no prior psychiatric hospital contacts or use of antidepressants. Postpartum AD was defined as an antidepressant prescription fill or hospital contact for depression within six months after birth.

    In the Danish cohort, 0.6% of all childbirths among women with no history of psychiatric disease led to postpartum AD. A year after their first treatment, 27.9% of these women were still in treatment; after four years, that number was 5.4%. For women with a hospital contact for depression after a first birth, the risk of postpartum AD recurrence was 21%; the recurrence was 15% for women who took antidepressants after a first birth. These rates mean that, compared to women without history of AD, postpartum AD is 46 and 27 times higher in subsequent births for women with postpartum AD after their first birth.

    “These population-based figures provide valuable guidance to physicians treating women with PPD,” the authors say. “It underlines the seriousness of single initial episodes and highlights the necessity of both primary and secondary preventive measures of which several exist.”


  8. Study suggests that child abuse may affect brain wiring

    October 6, 2017 by Ashley

    From the McGill University press release:

    For the first time, researchers have been able to see changes in the neural structures in specific areas of the brains of people who suffered severe abuse as children. Difficulties associated with severe childhood abuse include increased risks of psychiatric disorders such as depression, as well as high levels of impulsivity, aggressivity, anxiety, more frequent substance abuse, and suicide.

    Crucial insulation for nerve fibres builds up during first two decades of life

    For the optimal function and organization of the brain, electrical signals used by neurons may need to travel over long distances to communicate with cells in other regions. The longer axons of this kind are generally covered by a fatty coating called myelin. Myelin sheaths protect the axons and help them to conduct electrical signals more efficiently. Myelin builds up progressively (in a process known as myelination) mainly during childhood, and then continue to mature until early adulthood.

    Earlier studies had shown significant abnormalities in the white matter in the brains of people who had experienced child abuse. (White matter is mostly made up of billions of myelinated nerve fibres stacked together.) But, because these observations were made by looking at the brains of living people using MRI, it was impossible to gain a clear picture of the white matter cells and molecules that were affected.

    To gain a clearer picture of the microscopic changes which occur in the brains of adults who have experienced child abuse, and thanks to the availability of brain samples from the Douglas-Bell Canada Brain Bank (where, as well as the brain matter itself there is a lot of information about the lives of their donors) the researchers were able to compare post-mortem brain samples from three different groups of adults: people who had committed suicide who suffered from depression and had a history of severe childhood abuse (27 individuals); people with depression who had committed suicide but who had no history of being abused as children (25 individuals); and brain tissue from a third group of people who had neither psychiatric illnesses nor a history of child abuse (26 people).

    Impaired neural connectivity may affect the regulation of emotions

    The researchers discovered that the thickness of the myelin coating of a significant proportion of the nerve fibres was reduced ONLY in the brains of those who had suffered from child abuse. They also found underlying molecular alterations that selectively affect the cells that are responsible for myelin generation and maintenance. Finally, they found increases in the diameters of some of the largest axons among only this group and they speculate that together, these changes may alter functional coupling between the cingulate cortex and subcortical structures such as the amygdala and nucleus accumbens (areas of the brain linked respectively to emotional regulation and to reward and satisfaction) and contribute to altered emotional processing in people who have been abused during childhood.

    The researchers conclude that adversity in early life may lastingly disrupt a range of neural functions in the anterior cingulate cortex. And while they don’t yet know where in the brain and when during development, and how, at a molecular level these effects are sufficient to have an impact on the regulation of emotions and attachment, they are now planning to explore this in further research.


  9. Study suggests sleep deprivation may help reduce depression symptoms in some patients

    October 2, 2017 by Ashley

    From the University of Pennsylvania School of Medicine press release:

    Sleep deprivation — typically administered in controlled, inpatient settings — rapidly reduces symptoms of depression in roughly half of depression patients, according the first meta-analysis on the subject in nearly 30 years, from researchers at the Perelman School of Medicine at the University of Pennsylvania. Partial sleep deprivation (sleep for three to four hours followed by forced wakefulness for 20-21 hours) was equally as effective as total sleep deprivation (being deprived of sleep for 36 hours), and medication did not appear to significantly influence these results. The results are published today in the Journal of Clinical Psychiatry.

    Although total sleep deprivation or partial sleep deprivation can produce clinical improvement in depression symptoms within 24 hours, antidepressants are the most common treatment for depression. Such drugs typically take weeks or longer to experience results, yet 16.7 percent of 242 million U.S. adults filled one or more prescriptions for psychiatric drugs in 2013. The findings of this meta-analysis hope to provide relief for the estimated 16.1 million adults who experienced a major depressive episode in 2014.

    Previous studies have shown rapid antidepressant effects from sleep deprivation for roughly 40-60 percent of individuals, yet this response rate has not been analyzed to obtain a more precise percentage since 1990 despite more than 75 studies since then on the subject.

    “More than 30 years since the discovery of the antidepressant effects of sleep deprivation, we still do not have an effective grasp on precisely how effective the treatment is and how to achieve the best clinical results,” said study senior author Philip Gehrman, PhD, an associate professor of Psychiatry and member of the Penn Sleep Center, who also treats patients at the Cpl. Michael J. Crescenz VA Medical Center. “Our analysis precisely reports how effective sleep deprivation is and in which populations it should be administered.”

    Reviewing more than 2,000 studies, the team pulled data from a final group of 66 studies executed over a 36 year period to determine how response may be affected by the type and timing of sleep deprivation performed (total vs early or late partial sleep deprivation), the clinical sample (having depressive or manic episodes, or a combination of both), medication status, and age and gender of the sample. They also explored how response to sleep deprivation may differ across studies according to how “response” is defined in each study.

    “These studies in our analysis show that sleep deprivation is effective for many populations,” said lead author Elaine Boland, PhD, a clinical associate and research psychologist at the Cpl. Michael J. Crescenz VA Medical Center. “Regardless of how the response was quantified, how the sleep deprivation was delivered, or the type of depression the subject was experiencing, we found a nearly equivalent response rate.”

    The authors note that further research is needed to identify precisely how sleep deprivation causes rapid and significant reductions in depression severity. Also, future studies are needed to include a more comprehensive assessment of potential predictors of treatment outcome to identify those patients most likely to benefit from sleep deprivation.


  10. Study suggests midlife depression may stem from tension with mothers and siblings

    September 30, 2017 by Ashley

    From the Iowa State University press release:

    Relationships with our mothers and siblings change as we become adults and start our own families, but the quality of those relationships still has an effect on our well-being, particularly at midlife.

    A new study led by Iowa State University researcher Megan Gilligan found that tension with our mothers and siblings, similar to our spouses, is associated with symptoms of depression. The research, published in the journal Social Sciences, found all three relationships have a similar effect and one is not stronger than another.

    “Family scholars have focused a lot on the relationship we have with our spouse,” said Gilligan, an assistant professor of human development and family studies. “There is this assumption that as you go through your life course, you leave these other relationships with your parents and siblings behind, but you don’t. You carry those with you.”

    The relationship between mothers and daughters is even more significant. The research shows tension between mothers and adult children was a stronger predictor of depression for daughters than it was for sons. However, gender did not make a difference in relationships with spouses and siblings. Gilligan says this makes sense based on her previous research.

    “We know that mothers and daughters in adulthood have the closest relationships and also the most conflictual. These are really intense relationships,” she said. “Later in life, adult children start providing more care to their parents, and daughters in particular are often caregivers for their mothers.”

    Midlife is key to findings

    Midlife is often characterized as stable and uneventful, but in reality, it is a time of change and transition for many people, Gilligan said. For example, adult children may be leaving the house and aging parents start requiring more care. Additionally, researchers know that midlife adults often react more strongly to family conflict than older adults do.

    While there is a great deal of research on young families and family dynamics later in life, there is a gap at midlife, Gilligan said. Given the potential for greater conflict with mothers or siblings related to these midlife changes, it is important to understand the consequences of negative relationships on our psychological well-being.

    “Midlife is a time when siblings are often coming back together as they prepare and navigate care for parents,” she said. “For that reason, it’s a pivotal time when these family relationships might be experiencing more tension, more strain, more discord.”

    Professionals should consider whole family

    The research team used data collected through the Within-Family Differences Study. Their analysis included 495 adult children within 254 families. For a majority of families, multiple siblings participated in the study. Researchers measured depressive symptoms and tension among family members through survey questions. They controlled for race, gender and education.

    In the paper, Gilligan and her colleagues explained that they expected all three relationships would predict depressive symptoms, but the effect would vary depending on the salience of the relationship. The fact that they found no significant difference between spouses, mothers and siblings is important to note, especially for practitioners. Gilligan says instead of focusing solely on a romantic partner or spouse, marriage and family therapists should ask about other sources of family stress.

    “These findings show that we are navigating other family relationships at the same time and we’re not experiencing them in isolation; we’re experiencing them simultaneously,” Gilligan said. “The stress people are experiencing may be the result of a romantic partner or spouse. However, it could also be that they’re fighting with their siblings or they’re experiencing a lot of tension with their mother even though they are 50 years old.”