Hostname: page-component-5cf477f64f-rdph2 Total loading time: 0 Render date: 2025-03-29T09:30:45.785Z Has data issue: false hasContentIssue false
  • English
  • Français

The impact of high neuroticism in parents on children's psychosocial functioning in a population at high risk for major affective disorder: A family–environmental pathway of intergenerational risk

Published online by Cambridge University Press:  13 April 2004

MARK A. ELLENBOGEN  and
SHEILAGH HODGINS
MARK A. ELLENBOGEN
Affiliation:
Université de Montréal
SHEILAGH HODGINS
Affiliation:
Université de Montréal
Get access Rights & Permissions [Opens in a new window]

Abstract

Behavioral genetic studies indicate that nongenetic factors play a role in the development of bipolar and major depressive disorders. The trait of neuroticism is common among individuals with major affective disorders. We hypothesized that high neuroticism among parents affects the family environment and parenting practices and thereby increases the risk of psychosocial problems among offspring. This hypothesis is tested in a sample of participants at high and low risk for major affective disorders, which contained parents with bipolar disorder (55), major depression (21), or no mental disorder (148) and their 146 children between 4 and 14 years of age. Parents with high neuroticism scores were characterized by low psychosocial functioning, poor parenting, more dependent stressful life events, and the use of more emotion-focused and less task-oriented coping skills. High neuroticism in parents was associated with internalizing and externalizing problems among the children, as assessed by parent and teacher ratings on the Child Behavior Checklist and clinician ratings. The results suggest that high neuroticism in parents with major affective disorders is associated with inadequate parenting practices and the creation of a stressful family environment, which are subsequently related to psychosocial problems among the offspring.This work was supported by a grant to the Research Team for the Study of the Development of Affective Disorders (Drs. S. Hodgins, A. Schwartzman, L. Serbin, O. Bernazzani, C. Laroche, W. R. Beardslee, G. A. Carlson, and R. Rende) from the Fonds de la Recherche en Santé du Québec and by grants from the combined program of the Conseil Québecois de la Recherche Sociale and Fonds de la Recherche en Santé du Québec (1994–1998) as awarded to S. Hodgins. M. A. Ellenbogen is supported by a postdoctoral fellowship from the Canadian Institutes of Health Research. The authors would like to thank members of the Research Team for the Study of the Development of Affective Disorders and anonymous reviewers for their helpful comments on these findings.

Type
Research Article
Information
Development and Psychopathology , Volume 16 , Issue 1 , March 2004 , pp. 113 - 136
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Achenbach, T. M. (1991). Manual for the Child Behavioral Checklist and 1991 Profile. Burlington, VT: University of Vermont, Department of Psychiatry.
Adrian, C., & Hammen, C. (1993). Stress exposure and stress generation in children of depressed mothers. Journal of Consulting and Clinical Psychology 61, 354–359.Google Scholar
Aldwin, C. M., Levenson, M. R., Spiro, A., & Bosse, R. (1989). Does emotionality predict stress? Findings from the Normative Aging Study. Journal of Personality and Social Psychology 56, 616–624.Google Scholar
Bagby, R. M., Bindseil, K. D., Schuller, D. R., & Rector, N. A. (1997). Relationship between the five-factor model of personality and unipolar, bipolar and schizophrenic patients. Psychiatry Research 70, 83–94.Google Scholar
Ball, D., Hill, L., Freeman, B., Eley, T. C., Strelau, J., Riemann, R., Spinath, F. M., Angleitner, A., & Plomin, R. (1997). The serotonin transporter gene and peer-rated neuroticism. NeuroReport 8, 1301–1304.Google Scholar
Barkley, R. A. (1988). Child behavior rating scales and checklists. In M. Rutter & A. H. Tuma (Eds.), Assessment and diagnosis in child psychopathology (pp. 113–155). New York: Guilford Press.
Baron, M. (1992). Molecular genetics of affective psychoses. In J. Mendlewicz & H. Hippius (Eds.), Genetic research in psychiatry (pp. 1–17). Berlin: Springer–Verlag.
Barrera, M., Sandler, I. N., & Ramsay, T. B. (1981). Preliminary development of a scale of social support: Studies on college students. American Journal of Community Psychology 9, 435–447.Google Scholar
Belsky, J., & Barends, N. (2002). Personality and parenting. In M. Bornstein (Ed.), Handbook of parenting: Vol. 3. Being and becoming a parent (2nd ed., pp. 415–438). Mahwah, NJ: Erlbaum.
Belsky, J., Crnic, K., & Woodwarth, S. (1995). Personality and parenting: Exploring the mediating role of transient mood and daily hassles. Journal of Personality 63, 905–929.Google Scholar
Berrettini, W. H., & Pekkarinen, P. H. (1996). Molecular genetics of bipolar disorder. Annals of Medicine 28, 191–194.Google Scholar
Bertelsen, A., Harvald, B., & Hauge, M. (1977). A Danish twin study of manic-depressive disorder. British Journal of Psychiatry 130, 330–351.Google Scholar
Bienvenu, O. J., Nestadt, G., Samuels, J. F., Costa, P. T., Howard, W. T., & Eaton, W. W. (2001). Phobic, panic and major depressive disorders and the five-factor model of personality. Journal of Nervous and Mental Disease 189, 154–161.Google Scholar
Blazer, D. G., Kessler, R. C., McGonagle, K. A., & Swartz, M. S. (1994). The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey. American Journal of Psychiatry 151, 979–986.Google Scholar
Blehar, M. C., Weissman, M. M., Gershon, E. S., & Hirschfeld, R. M. A. (1988). Family and genetic studies of affective disorders. Archives of General Psychiatry 45, 269–292.Google Scholar
Boggio, R. M. (1987). The predictive validity of the Parenting Dimensions Inventory: A replication and extension. Unpublished master's thesis, University of Houston.
Bolger, N. (1990). Coping as a personality process: A prospective study. Journal of Personality and Social Psychology 59, 525–537.Google Scholar
Bolger, N., & Schilling, E. A. (1991). Personality and the problems of everyday life: The role of neuroticism in exposure and reactivity to daily stressors. Journal of Personality 59, 355–386.Google Scholar
Bouchard, G., Sabourin, S., Lussier, Y., & Wright, J. (1991). The factorial structure of the French version of the Scale of Dyadic Adjustment. Canadian Journal of Counselling 25, 4–11.Google Scholar
Canli, T., Zhao, Z., Desmond, J. E., Kang, E., Gross, J., & Gabrieli, J. D. (2001). An fMRI study of personality influences on brain reactivity to emotional stimuli. Behavioral Neuroscience 115, 33–42.Google Scholar
Carpenter, D., Clarkin, J. F., Isman, L., & Patten, M. (1999). The impact of neuroticism upon married bipolar patients. Journal of Personality Disorders 13, 60–66.Google Scholar
Chase–Lansdale, P. L., & Brooks–Gunn, J. (1995). Escape from poverty: What makes a difference for children? New York: Cambridge University Press.
Chrousos, G. P. (1998). Stressors, stress and neuroendocrine integration of the adaptive response: The 1997 Hans Selye Memorial Lecture. Annals of the New York Academy of Sciences 851, 311–335.Google Scholar
Cicchetti, D., & Toth, S. L. (1998). The development of depression in children and adolescents. American Psychologist 53, 221–241.Google Scholar
Costa, P. T. J., Herbst, J. H., McCrae, R. R., & Siegler, I. C. (2000). Personality at midlife: Stability, intrinsic maturation, and response to life events. Assessment 7, 365–378.Google Scholar
Costa, P. T. J., & McCrae, R. R. (1992). The NEO Personality Inventory (NEO-PI) and NEO Five Factor Inventory (NEO-FFI) professional manual. Odessa, FL: Psychological Assessment Resources.
Deary, I. J., Battersby, S., Whiteman, M. C., Connor, J. M., Fowkes, F. G., & Harmar, A. (1999). Neuroticism and polymorphisms in the serotonin transporter gene. Psychological Medicine 29, 735–739.Google Scholar
Derryberry, D., & Rothbart, M. K. (1997). Reactive and effortful processes in the organization of temperament. Development and Psychopathology 9, 633–652.Google Scholar
Derryberry, D., & Tucker, D. M. (1994). Motivating the focus of attention. In P. M. Niedenthal & S. Kitayama (Eds.), The heart's eye: Emotional influences in perception and attention (pp. 167–196). San Diego, CA: Academic Press.
Dishion, T. J., & Bullock, B. M. (2002). Parenting and adolescent problem behavior: An ecological analysis of the nurturance hypothesis. In J. G. Borkowski & S. L. Ramey (Eds.), Parenting and the child's world: Influences on academic, intellectual, and social–emotional development. Monographs in parenting (pp. 231–249). Mahwah, NJ: Erlbaum.
Dishion, T. J., French, D. C., & Patterson, G. R. (1995). The development and ecology of antisocial behavior. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology: Vol. 2. Risk, disorder, and adaptation (pp. 421–471). New York: Wiley.
Dix, T. (1991). The affective organization of parenting: Adaptive and maladaptive processes. Psychological Bulletin 110, 3–25.Google Scholar
Dohrenwend, B. S., Krasnoff, L., Askenasy, A. R., & Dohrenwend, B. P. (1978). Exemplification of a method for scaling life events: The Peri Life Events Scale. Journal of Health and Social Behavior 19, 205–229.Google Scholar
Duncan, G. J., & Brooks–Gunn, J. (2000). Family poverty, welfare reform, and child development. Child Development 71, 188–196.Google Scholar
Edelbrock, C. S., & Achenbach, T. M. (1984). The teacher version of the Child Behavior Profile: I. Boys aged 6–11. Journal of Consulting and Clinical Psychology 52, 207–217.Google Scholar
Eley, T. C., & Plomin, R. (1997). Genetic analyses of emotionality. Current Current Opinions in Neurobiology 7, 279–284.Google Scholar
Ellenbogen, M. A., Hodgins, S., & Walker, C.-D. (2004). High levels of cortisol among adolescent offspring of parents with bipolar disorder: A pilot study. Psychoneuroendocrinology 29, 99–106.Google Scholar
Endler, N. S., & Parker, J. D. A. (1991). Coping inventory for stressful situation: Manual. Toronto, Canada: Norton.
Endler, N. S., & Parker, J. D. A. (1990). Multidimensional assessment of coping: A critical evaluation. Journal of Personality and Social Psychology 58, 844–854.Google Scholar
Eysenck, H. J. (1990). Genetic and environmental contributions to individual differences: The three major dimensions of personality. Journal of Personality 58, 245–261.Google Scholar
Fanous, A., Gardner, C. O., Prescott, C. A., Cancro, R., & Kendler, K. S. (2002). Neuroticism, major depression and gender: A population-based twin study. Psychological Medicine 32, 719–728.Google Scholar
Gelles, R. J., & Strauss, M. A. (1988). Intimate violence. New York: Simon & Schuster.
Gershon, E. S., Hamovit, J., Guroff, J. J., Dibble, E., Leckman, J. F., Sceery, W., Targum, S. D., Nurnberger, J. I., Goldin, L. R., & Bunney, W. E., Jr. (1982). A family study of schizoaffective, bipolar I, bipolar II, unipolar, and normal control probands. Archives of General Psychiatry 39, 1157–1167.Google Scholar
Gomez, R., Holmberg, K., Bounds, J., Fullarton, C., & Gomez, A. (1999). Neuroticism and extraversion as predictors of coping styles during early adolescence. Personality and Individual Differences 27, 3–17.Google Scholar
Goodyer, I. M. (2001). Life events: Their nature and effects. In I. M. Goodyer (Ed.), The depressed child and adolescent. Cambridge child and adolescent psychiatry (2nd ed., pp. 204–232). New York: Cambridge University Press.
Graham, Y. P., Heim, C., Goodman, S. H., Miller, A. H., & Nemeroff, C. B. (1999). The effects of neonatal stress on brain development: Implications for psychopathology. Development and Psychopathology 11, 545–565.Google Scholar
Gray, J. A. (1987). The psychology of fear and stress. New York: Cambridge University Press.
Grégoire, D. (2000). La parenté biologique des personnes souffrant du trouble bipolaire. Unpublished doctoral dissertation, Université de Montréal, Montréal, Canada.
Gunthert, K. C., Cohen, L. H., & Armeli, S. (1999). The role of neuroticism in daily stress and coping. Journal of Personality and Social Psychology 77, 1087–1100.Google Scholar
Halamandaris, K. F., & Power, K. G. (1997). Individual differences, dysfunctional attitudes, and social support: A study of the psychosocial adjustment to university life of home students. Personality and Individual Differences 22, 93–104.Google Scholar
Hammen, C. (1991). Generation of stress in the course of unipolar depression. Journal of Abnormal Psychology 100, 555–561.Google Scholar
Hammen, C., Gitlin, M., & Altshuler, L. (2000). Predictors of work ajustment in bipolar I patients: A naturalistic longitudinal follow-up. Journal of Consulting and Clinical Psychology 68, 220–225.Google Scholar
Hecht, H., van Calker, D., Berger, M., & von Zerssen, D. (1998). Personality in patients with affective disorders and their relatives. Journal of Affective Disorders 51, 33–43.Google Scholar
Heim, C., & Nemeroff, C. B. (1999). The impact of early adverse experiences on brain systems involved in the pathophysiology of anxiety and affective disorders. Biological Psychiatry 46, 1509–1522.Google Scholar
Hirschfeld, R. M. A., Klerman, G. L., Lavori, P., Keller, M. B., Griffith, P., & Coryell, W. (1989). Premorbid personality assessments of first onset of major depression. Archives of General Psychiatry 46, 345–350.Google Scholar
Hodges, K., Cools, J., & McKnew, D. (1988). Test–retest reliability of a clinical research interview for children: The Child Assessment Schedule. Journal of Consulting and Clinical Psychology 1, 317–322.Google Scholar
Hodges, K., Gordon, Y., & Lennon, M. P. (1990). Parent–child agreement on symptoms assessed via a clinical research interview for children: The Child Assessment Schedule (CAS). Journal of Child Psychology and Psychiatry and Allied Disciplines 31, 427–436.Google Scholar
Hodgins, S., Faucher, B., Zarac, A., & Ellenbogen, M. A. (2002). Children of parents with bipolar disorder: A population at high risk for major affective disorders. Child and Adolescent Psychiatric Clinics of North America 11, 533–553.Google Scholar
Jackson, A. P., Brooks–Gunn, J., Huang, C.-C., & Glassman, M. (2000). Single mothers in low-wage jobs: Financial strain, parenting, and preschoolers' outcomes. Child Development 71, 1409–1423.Google Scholar
Jardine, R., Martin, N. G., & Henderson, A. S. (1984). Genetic covariation between neuroticism and the symptoms of anxiety and depression. Genetic Epidemiology 1, 89–107.Google Scholar
Johnson, L., Andersson–Lundman, G., Aberg–Wistedt, A., & Mathe, A. A. (2000). Age of onset in affective disorder: Its correlation with hereditary and psychosocial factors. Journal of Affective Disorders 59, 139–148.Google Scholar
Kaufman, J., & Charney, D. (2001). Effects of early stress on brain structure and function: Implications for understanding the relationship between child maltreatment and depression. Development and Psychopathology 13, 451–471.Google Scholar
Kendler, K. S., & Gardner, C. O. (2001). Monozygotic twins discordant for major depression: A preliminary exploration of the role of environmental experiences in the aetiology and course of the illness. Psychological Medicine 31, 411–423.Google Scholar
Kendler, K. S., & Karkowski–Shuman, L. (1997). Stressful life events and genetic liability to major depression: Genetic control of exposure to the environment? Psychological Medicine 27, 539–547.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., Heath, A. C., & Eaves, L. J. (1992). A population-based twin study of major depression in women. Archives of General Psychiatry 49, 257–266.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., Heath, A. C., & Eaves, L. J. (1993). A longitudinal twin study of personality and major depression in women. Archives of General Psychiatry 50, 853–862.Google Scholar
Kochanska, G., Clark, L. A., & Goldman, M. S. (1997). Implications of mothers' personality for their parenting and their young children's developmental outcomes. Journal of Personality 65, 387–420.Google Scholar
Lepage, L. Adaptation et validation d'une mesure de réseau de support social applicable en soins infirmiers. Unpublished master's thesis, Université de Montréal, Montréal, Canada.
Lesch, K.-P., Bengel, D., Heils, A., Sabol, S. Z., Greenberg, B. D., Petri, S., Benjamin, J., Müller, C. R., Hamer, D. H., & Murphy, D. L. (1996). Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region. Science 274, 1527–1530.Google Scholar
Maier, W., Minges, J., Lichtermann, D., Franke, P., & Gänsicke, M. (1995). Personality patterns in subjects at risk for affective disorders. Psychopathology 28, 59–72.Google Scholar
Maxwell, M. E. (1992). Manual for the FIGS. Bethesda, MD: National Institute of Mental Health, Clinical Neurogenetics Branch.
McEwen, B. S. (1999). Stress and hippocampal plasticity. Annual Review of Neuroscience 22, 105–122.Google Scholar
McGuffin, P., Katz, R., & Rutherford, J. (1991). Nature, nurture and depression: A twin study. Psychological Medicine 21, 329–335.Google Scholar
McMahon, F. J., Stine, O. C., Chase, G. A., Meyers, D. A., Simpson, S. G., & DePaulo, J. R. (1994). Influence of clinical subtype, sex, and lineality on age at onset of major affective disorder in a family sample. American Journal of Psychiatry 151, 210–215.Google Scholar
Mendlewicz, J., Fieve, R. R., Rainer, J. D., & Fleiss, J. L. (1972). Manic-depressive illness: A comparative study of patients with and without a family history. British Journal of Psychiatry 120, 523–530.Google Scholar
Mendlewicz, J., & Rainer, J. D. (1977). Adoption study supporting genetic transmission in manic-depressive illness. Nature 268, 327–329.Google Scholar
Meyer, S. E., Ronsaville, D. S., Gold, P. W., Radke–Yarrow, M., & Martinez, P. E. (2001). A prospective study of children at risk for mood disorder. In G. Carlson (Chair), Juvenile bipolar disorder. Symposium conducted at the International Society for Research on Child and Adolescent Psychopathology, Vancouver, Canada.
Murray, C. J., & Lopez, A. D. (1996). Evidence-based health policy—Lessons from the Global Burden of Disease Study. Science 274, 740–743.Google Scholar
Ogilvie, A. D., Battersby, S., Bubb, V. J., Fink, G., Harmar, A. J., Goodwin, G. M., & Smith, C. A. (1996). Polymorphism in serotonin transporter gene associated with susceptibility to major depression. Lancet 347, 731–733.Google Scholar
Pekkarinen, P., Terwilliger, J., Bredbacka, P. E., Lonnqvist, J., & Peltonen, L. (1995). Evidence of a predisposing locus to bipolar disorder on Xq24-q27.1 in an extended Finnish pedigree. Genome Research 5, 105–115.Google Scholar
Plomin, R., Lichtenstein, P., Pedersen, N. L., McClearn, G. E., & Nesselroade, J. R. (1990). Genetic influence on life events during the last half of the life span. Psychology and Aging 5, 25–30.Google Scholar
Post, R. M., Leverich, G. S., Xing, G., & Weiss, S. R. B. (2001). Developmental vulnerabilities to the onset and course of bipolar disorder. Development and Psychopathology 13, 581–598.Google Scholar
Rijsdijk, F. V., Sham, P. C., Sterne, A., Purcell, S., McGuffin, P., Farmer, A., Goldberg, D., Mann, A., Cherny, S. S., Webster, M., Ball, D., Eley, T. C., & Plomin, R. (2001). Life events and depression in a community sample of siblings. Psychological Medicine 31, 401–410.Google Scholar
Rolland, J. P., Parker, W. D., & Stumpf, H. (1998). A psychometric examination of the French translations of the NEO-PI-R and NEO-FFI. Journal of Personality Assessment 71, 269–291.Google Scholar
Rubin, K. H., Hastings, P., Chen, X., Stewart, S., & McNichol, K. (1998). Interpersonal and maternal correlates of aggression, conflict, and externalizing problems in toddlers. Child Development 69, 1614–1625.Google Scholar
Rudolph, K. D., Hammen, C., Burge, D., Lindberg, N., Herzberg, D., & Daley, S. E. (2000). Toward an interpersonal life-stress model of depression: The developmental context of stress generation. Development and Psychopathology 12, 215–234.Google Scholar
Rutter, M., Pickles, A., Murray, R., & Eaves, L. (2001). Testing hypotheses on specific environmental causal effects on behavior. Psychological Bulletin 127, 291–324.Google Scholar
Saudino, K. J., Pedersen, N. L., Lichtenstein, P., McClearn, G. E., & Plomin, R. (1997). Can personality explain genetic influences on life events? Journal of Personality and Social Psychology 72, 196–206.Google Scholar
Sauer, H., Richter, P., Czernik, A., & Ludwig–Mayerhofer, W. (1997). Personality differences between patients with major depression and bipolar disorder: The impact of minor symptoms on self-ratings of personality. Journal of Affective Disorders 42, 169–177.Google Scholar
Schurhoff, F., Bellivier, F., Jouvent, R., Mouren–Simeoni, M. C., Bouvard, M., Allilaire, J. F., & Leboyer, M. (2000). Early and late onset bipolar disorders: Two different forms of manic-depressive illness? Journal of Affective Disorders 58, 215–221.Google Scholar
Serbin, L. A., Cooperman, J. M., Peters, P. L., Lehoux, P. M., Stack, D. M., & Schwartzman, A. E. (1998). Intergenerational transfer of psychological risk in women with childhood histories of aggression, withdrawal, or aggression and withdrawal. Developmental Psychology 34, 1246–1262.Google Scholar
Sharp, M. E. (1988). A multiple rater validation of the parenting dimensions inventory. Unpublished master's thesis, University of Houston.
Slater, M. A., & Power, T. G. (1987). Multidimensional assessment of parenting in single-parent families. In J. P. Vincent (Ed.), Advances in family intervention, assessment and theory (pp. 197–228). Greenwich, CT: JAI.
Solomon, D. A., Shea, M. T., Leon, A. C., Mueller, T. I., Coryell, W., Maser, J. D., Endicott, J., & Keller, M. B. (1996). Personality traits in subjects with bipolar I disorder in remission. Journal of Affective Disorders 40, 41–48.Google Scholar
Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and Family 38, 15–28.Google Scholar
Spanier, G. B., & Thompson, L. (1982). A confirmatory analysis of the Dyadic Ajustment Scale. Journal of Marriage and Family 44, 731–738.Google Scholar
Spitzer, R. L., Williams, J. B., Gibbon, M., & First, M. B. (1992). The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Archives of General Psychiatry 49, 624–629.Google Scholar
Stein, M. B., Fuetsch, M., Müller, N., Höfler, M., Lieb, R., & Wittchen, H. U. (2001). Social anxiety disorder and the risk of depression: A prospective community study of adolescents and young adults. Archives of General Psychiatry 58, 251–256.Google Scholar
Stevens, J. (1996). Applied multivariate statistics for the social sciences (3rd ed.). Mahwah, NJ: Erlbaum.
Torgersen, S. (1986). Genetic factors in moderately severe and mild affective disorders. Archives of General Psychiatry 43, 222–226.Google Scholar
Touliatos, J., Perlmutter, B. F., & Strauss, M. A. (1990). Handbook of family measurement techniques. Newbury Park, CA: Sage.
Van Os, J., Park, S. B. G., & Jones, P. B. (2001). Neuroticism, life events and mental health: Evidence for person–environment correlation. British Journal of Psychiatry, 178 (Suppl. 40), s72–s77.Google Scholar
Van Os, J., & Jones, P. B. (1999). Early risk factors and adult person–environment relationships in affective disorder. Psychological Medicine 29, 1055–1067.Google Scholar
Wallace, J. F., & Newman, J. P. (1998). Neuroticism and the facilitation of the automatic orienting of attention. Personality and Individual Differences 24, 253–266.Google Scholar
Wechsler, D. (1981). Wechsler Adult Intelligence Scale—Revised, WAIS-R Manual. Washington, DC: Psychological Corporation/Harcourt Brace Jovanovich.
Weissman, M. M., Fendrich, M., Warner, V., & Wickramaratne, P. (1992). Incidence of psychiatric disorder in offspring at high and low risk for depression. Journal of American Academy of Child and Adolescent Psychiatry 31, 640–648.Google Scholar
Weissman, M. M., Livingston–Bruce, M. L., Leaf, P. J., Florio, L. P., & Holzer, C. (1991). Affective disorders. In L. N. Robins & D. Regier (Eds.), Psychiatric disorder in America (pp. 53–80). New York: MacMillan/Free Press.