Resilience in Children of Parents with a History of Depression: Coping and the Regulation of Positive and Negative Affect

Bruce E. Compas, Jennifer Potts, Michelle M. Reising, Kristen L. Reeslund, J. Austin Williamson Vanderbilt University Emily Garai, Rex Forehand University of Vermont

This research was supported by grants R01MH069940 and R01 MH069928 from the National Institute of Mental Health. Address correspondence to Bruce E. Compas, Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville, TN 37203; bruce.compas@vanderbilt.edu. The authors are grateful to Diana Apostle, Jennifer Champion, Mary Jo Coiro, Madeleine Dunn, Christina Grice, Kelly A. Haker, Emily Hardcastle, Gary Keller, Sheryl Margolis, Mary Jane Merchant, Aaron Rakow, Lauren Simmons, Darlene Whetsel, Mi Wu, and Katelyn Watkins for their many contributions to this project.

2 Abstract Objective and Method: The role of coping and the regulation of positive and negative affect were examined in a sample of children (n = 143; age 9-15-years-old) of parents with a history of depression using multiple methods of assessment (parent and child reports on questionnaires, interviews, direct observations of child behavior). Results: Childrens use of secondary control coping strategies (acceptance, cognitive reappraisal, distraction) was related to higher levels of observed positive affect, lower levels of observed sad affect, and lower depressive symptoms. Coping and sad affect were independent predictors of depressive symptoms when entered together in multiple regression analyses. Childrens use of secondary control coping also predicted increases in their levels of observed positive affect and decreases in sadness across two interactions with their parents, controlling for initial levels of both emotions. Conclusions: The importance of these findings for the role of coping and emotion regulation in preventive interventions to enhance resilience in children of depressed parents is highlighted. Key words: Parental depression, children, resilience, coping, emotion-regulation

3 Resilience in Children Parents with a History of Depression: Coping and the Regulation of Positive and Negative Affect Children of depressed parents offer an important opportunity for understanding processes of both risk and resilience. These children are at significantly increased risk for both internalizing and externalizing psychopathology. They experience depression or other mental health disorders at rates from 2 to 6 times higher than children in the general population and the majority of children of depressed parents will develop at least one psychological disorder by the end of adolescence (England & Sim, 2009; Goodman, 2007). However, in spite of the substantial risk associated with parental depression, many children of depressed parents do not develop significant psychopathology. Therefore, it is important to understand processes that contribute to resilience to inform the development of preventive interventions for this high-risk population. Resilience is broadly defined as the process of achieving positive outcomes in spite of exposure to significant stress or adversity (e.g., Compas & Reeslund, 2009; Luthar, 2006; Masten, 2001). One perspective on resilience emphasizes the importance of the ability regulate emotions under stress, including the capacity to both dampen down negative affect and increase positive affect when faced with stress and adversity. Specifically, Davidson (2000) has defined resilience as the maintenance of high levels of positive affect and well-being in the face of significant adversity (p. 1198). Further, Davidson argued that it is not that resilient individuals do not experience negative affect, but rather they are able recover from negative emotions more quickly---negative affect does not persist. The ability to mobilize and experience positive emotions is important in enhancing and repairing negative mood, increasing appetitive motivation, and increasing approach and active behavior (e.g., Joorman & Gotlib, 2007; Keenan et al., 2009; Shaw et al., 2006). It is plausible, therefore, that children of depressed parents who

4 do not develop psychopathology may have the ability to generate higher levels of positive affect and reduce negative affect in response to stress (Forbes et al., 2006; Silk et al., 2006). However, the processes that lead to the up-regulation of positive affect and down-regulation of negative affect in response to stress in children of depressed parents are not clear. In order to understand processes related to resilience, it is first important to consider processes that place children of depressed parents at risk. Extensive research has focused on the mechanisms that account for increased risk in children whose parents suffer from depression, including biological, psychological and interpersonal processes (e.g., England & Sim, 2009; Goodman, 2007). Although the mechanisms of risk are complex, one salient risk process is exposure to significant interpersonal stress within families of parents who suffer from depression (Hammen, Brennan, & Shih, 2004), including two types of stressful interactions between parents and children that are the result of parents symptoms of depression (Jaser et al., 2005). First, parents who are depressed may be emotionally and physically withdrawn and unavailable to their children. Examples include a parent who suffers from hypersomnia and cannot leave her bed in the morning to help her child prepare for school, or a parent who is overwhelmed with sadness and is emotionally non-responsive to a child. Second, depressed parents can also be irritable and intrusive. For example, a parent may ruminate about worries about his childs safety and overly monitor the childs activity, or respond to a childs misbehavior with anger and hostility. Further, many depressed parents vacillate between these two patterns creating an environment for children characterized by unpredictability and a lack of control, and these patterns persist even when parents are not in a major depressive episode (Jaser et al., 2005, 2008; Langrock et al., 2002). As a consequence, sources of resilience in children of depressed parents may involve skills that children can use to cope with uncontrollable, unpredictable stress.

5 Models of coping and emotion regulation suggest that responses that are aimed at accommodating or adapting to sources of stress, as opposed to directly acting on changing sources of stress, are most adaptive for stressors that are unpredictable and uncontrollable (e.g., Connor-Smith et al., 2000; McCarty et al., 1999). This is reflected in the concept of secondary control coping and includes acceptance, cognitive reappraisal, generating positive cognitions, and distraction (Compas et al., 2001; Connor-Smith et al., 2000). The use of secondary control coping by children of depressed parents in response to parental withdrawal and intrusiveness is related to lower levels of both internalizing and externalizing symptoms (e.g., Jaser et al., 2005, 2007, 2008; Langrock et al., 2002), suggesting that this type of coping can serve a protective function for children of depressed parents. However, the relations between childrens use of secondary control coping strategies and their ability to regulate positive and negative affect during stressful interactions with their parents has not been studied. Further, previous research on child and adolescent coping in general has focused primarily on coping and its associations with negative emotions related to depression and anxiety; the relation between coping and positive affect in children and adolescents has been relatively overlooked (Compas et al., 2001). Among the subtypes of secondary control coping, cognitive reappraisal has received the most attention in research on the association between coping and positive and negative affect. For example, Gross and John (2003) found that use of cognitive reappraisal to regulate emotions was associated with the expression of greater positive emotion and less negative emotion, better interpersonal functioning, and positive well-being. Similarly, Urry (2009) found that reappraisals that involved viewing a negative stimulus in more positive terms were related to decreased negative emotion. In one of the few studies with children and adolescents, Jaser et al. (2010) found that adolescents use of secondary control coping (including cognitive reappraisal) was

6 correlated with higher levels of positive affect and this association was moderated by mothers current depressive symptoms such that coping was associated with positive affect only for adolescents whose mothers had currently elevated depressive symptoms. In addition to the broad associations between coping and positive and negative affect, models of resilience also emphasize the temporal aspects of coping and the regulation of emotions. As suggested by Davidson (2000), the coping and emotion-regulation strategies used by resilient individuals should be associated with the ability to sustain positive affect when faced with stressful circumstances and the capacity to shorten the duration or dampen the intensity of negative affect. For example, the use of distraction (a form of secondary control coping) is associated with decreases in sad mood in response to negative stimuli (Joormann, Siemer, & Gotlib, 2007) and positive reappraisals are associated with increases in positive affect (Giuliani, McCrae, & Gross, 2008). These temporal processes have not been studied in at-risk children of depressed parents. The present study examined the role of secondary control coping (cognitive reappraisal, distraction, acceptance) as a source of resilience in children of depressed parents. Specifically, in a sample of children and adolescents whose parents had a history of major depressive disorder, we tested the relations between the use of secondary control coping, levels of observed positive and negative (sad) affect during interactions with their parents, and child/adolescent symptoms of depression. First, we examined the global relations between coping, observed positive and negative affect, and depressive symptoms. Second, we examined the role of coping in the persistence versus dampening of negative affect and the ability to sustain positive affect in the context of stressful parent-child interactions. We hypothesized that childrens use of secondary control coping would be associated with lower symptoms of depression, and higher positive

7 affect and lower negative affect during interactions with parents. Further, we hypothesized that levels of positive and negative affect during interactions with their parents would be associated with symptoms of depression, and we examined the relative contributions of positive and negative affect and secondary control coping as predictors of depressive symptoms in linear multiple regression analyses. Finally, we hypothesized that the use of secondary control coping would be related to sustained levels of positive affect and dampening of negative affect during a positive, followed by a stressful, parent-child interaction task. To address limitations in much of the previous research on child/adolescent coping (Compas et al., 2001), we used multiple methods (parents reports, adolescents self-reports, interviews, direct observations) to control for problems with shared method variance among different constructs. Methods Participants The sample consisted of 143 children (ages 9-15-years-old) and their parents drawn from the baseline assessment of preventive intervention study. All parents had experienced at least one episode of major depressive disorder (MDD) during the lifetime of their child (median of 4 episodes); 28% were in a current episode of depression. One hundred twenty-seven of the parents were mothers and 16 were fathers with a mean age 41.9 years. Eighty-one percent of the parents were Euro-American, 11.9% were African American, 0.7% were Asian American, 2.8% Hispanic American, and 2.8 % mixed ethnicity. Annual household income for the families ranged from below $5,000 to over $180,000, with mean annual income between $40,000 and $60,000. Education levels for the parents ranged from less than high school to completion of a graduate program: 6.3 % of the parents had not completed high school, 7.7% had a high school education, 32.2% had received a degree from a technical school or had completed at least one

8 year of college, 30.8% had received a degree from a 4 year college, and 23.1% had completed graduate education. Sixty percent of parents were married, 21.7% were divorced, 5.6% were separated, 11.2% had never married, and 1.4% were widowed. Children in the sample included 74 boys (mean age =11.2) and 69 girls (mean age = 11.8 years). Seventy-three percent of children were Euro-American, 14.7% were African American, 2.1% were Asian American, 1.4% Hispanic American, 0.7% were American Indian or Alaska Native and 8.4 % mixed ethnicity. In order to identify a sample of children at-risk for depression, children were screened and excluded from the study if they met criteria for current major depressive disorder (i.e., the sample represents children of parents with a history of of depression who were at risk for psychopathology; see below). In families with more than one child in the targeted age range, one child was randomly selected for inclusion in the analyses to avoid possible problems of non-independence of children within the same family. Measures Parental depression diagnoses. Parents past and current history of MDD was assessed and other Axis I disorders were screened with the Structured Clinical Interview for DSM (SCID; First et al., 2001), a semi-structured diagnostic interview used to assess current and previous episodes of psychopathology according to DSM-IV criteria (American Psychiatric Association, 1994). Inter-rater reliability, calculated on a randomly selected subset of these interviews, indicated 93% agreement (kappa = 0.71) for diagnoses of MDD. Adolescents depressive symptoms. The Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR) were used to assess childrens symptoms of depression. Reliability and validity of the CBCL and YSR are well established (Achenbach & Rescorla, 2001). The Affective Problems scale was used in the current analyses as an index of childrens depressive

9 symptoms (items include lack of enjoyment, sleep disruption, appetite disturbance, sadness, suicidal ideation, underactivity, feelings of worthlessness). The discriminant validity of the Affective Problems scale in predicting diagnoses of depression has been established (Ferdinand, 2008; van Lang et al., 2005). Internal consistency for this scale in this study was = .84 for the CBCL and =.90 for the YSR. All children in the sample completed the YSR to allow for complete data on all measures. The internal consistency for the YSR Affective Problems scale was adequate with the younger age group (9-10- year-olds) in the current sample ( = .80). Raw scores on the CBCL and YSR scores were used in all analyses to maximize variance (i.e., some variability is lost when the raw scores are converted to T scores). A composite measure of adolescents affective symptoms was created by converting scores from adolescent (YSR) and parent (CBCL) reports to z-scores and calculating the mean z-score for each participant ( = .80). Childrens depressive symptoms were also quantified using the Schedule for Affective Disorders and Schizophrenia for School-Age Children- Present and Lifetime Version (K-SADSPL; Kaufman et al., 1997). The K-SADS-PL is a reliable and valid semi-structured interview that generates DSM-IV Axis I child psychiatric diagnoses. Separate interviews were conducted with parents and children and were combined to yield both current and lifetime psychiatric diagnoses. Inter-rater reliability for diagnoses of MDD, calculated on a randomly selected subset of these interviews, indicated 96% agreement (kappa = 0.76). The entire depression section of the KSADS (i.e., both screener and supplement) was administered to all children in the study and their participating parents in order to obtain full information on any and all current depression symptoms the children were experiencing. Each threshold symptom was scored as a 2, each subthreshold symptom was scored as a 1, and any symptom not present was scored as 0. These

10 symptoms scores were then summed to represent the childrens total current depression symptoms on the K-SADS ranging from 0 to 18, giving more weight to a threshold symptom (coded a 2) than to a subthreshold symptom (coded a 1). Parent-child reports of childrens coping. The parental depression version of the Responses to Stress Questionnaire (Connor-Smith et al., 2000; Jaser et al., 2005, 2008) was used to assess how adolescents responded to stressors related to their parents depression (e.g., My mom/dad seems to be sad or cries a lot of the time; My mom/dad does not want to do things with the family; My mom/dad is too upset, tense, grouchy, angry, and easily frustrated). Items cover five factors of coping and stress responses: primary control engagement coping, secondary control engagement coping, disengagement coping, involuntary engagement/stress reactivity, and involuntary disengagement (Connor-Smith et al., 2000). Adolescents and their parents were asked separately to rate each item with regard to the degree/frequency with which the adolescent responded to the identified stressors. To control for response bias and individual differences in base rates of item endorsement, proportion scores were calculated by dividing the score for each factor by the total score for the RSQ (Vitaliano, Maiuro, Russo, & Becker, 1987). We focused our analyses on secondary control coping (acceptance, positive thinking, cognitive restructuring, distraction) in the current study because these are the coping skills that are best suited for coping with uncontrollable stressors related to parental depression (e.g., Jaser et al., 2005). Internal consistency for secondary control coping was =.75 for parents and =.82 for adolescents. A composite measure of adolescents coping was created by converting scores from adolescent and parent reports to z-scores and calculating the mean z-score for each participant ( = .79). Adolescents positive and negative affect during interactions with parents. Childrens positive and sad affect was assessed using the Iowa Family Interaction Ratings scales (IFIRS) to

11 code videotaped interactions between each child and his or her parent (Melby & Conger, 2001). Parents and children participated in two 15-minute interactions, first about a pleasant activity that the parent and child enjoyed doing together in the past several months (i.e., Task 1 as a positive task), and second about a recent stressful time when the parent was really depressed, down, or grouchy, which made it difficult for the family (i.e., Task 2 was a stressful task). The sequence of the discussion of the positive topic followed by the discussion of the stressful topic allowed for analyses of changes in childrens emotions in response to a stressor. For some of the analyses, codes from these two interactions were combined to provide a broad index of childrens sadness and positive affect for the first set of regression analyses, whereas in other analyses separate codes for these emotions on the two tasks were used in analyses of the changes in childrens emotions across the two interaction tasks. The IFIRS is a global coding system comprised of codes that reflect content of conversation, emotional affect, and non-verbal behavior to determine scoring (Melby & Conger, 2001). There are multiple codes in the system, but the two of interest for this study are labeled in the IFIRS as sadness and positive mood (referred to here as positive affect). Sadness includes any negative statements about the self or pessimistic statements, in addition to non-verbal behavior such as frowning or crying. The positive affect (mood) code includes any verbal content that is positive in nature regarding the self, the other interactor (i.e., the childs parent), friends, other family members, events or situations. It also includes non-verbal behaviors such as smiling or laughing. All codes have a 9-point scale, 1 representing not at all characteristic and 9 representing mainly characteristic. Coders focus on frequency and intensity of the behaviors and verbal statements to assign each participant a score on all codes. Each 15-minute parent-child interaction was coded by two independent raters (doctoral

12 students in clinical psychology and advanced undergraduate research assistants). Coders completed extensive training to learn the codes in the IFIRS system and to become reliable with other coders. Training for coding the interactions consisted of approximately 35 hours of instruction and practice including reading and studying the manual and taking a written test on the content, coding specific interactions to test for reliability, and meeting weekly with a team of experienced coders. Once a newly trained coder achieved agreement with 80% of codes on an interaction with scores previously established by trained coders, he or she was considered prepared to code independently and able to complete consensus on interactions with other coders. All coders attended weekly meetings throughout the study during which coders could discuss recently coded interactions and clarify questions in order to prevent drift between coders. After completing coding on each parent-child interaction, the two coders then met to assign consensus codes for any codes that differed by two or more points on the 1 to 9 scale. They attained a consensus score for each discrepant code by discussing the examples they noted for each code and referring to the coding manual to verify their examples. Inter-rater reliabilities (intraclass correlations) were .83 (Task 1, positive affect), .70 (sadness, Task 1), .78 (positive affect, Task 2), and .77 (sadness, Task 2). Following procedures used previously with the IFIRS codes (e.g., Champion et al., 2009; Lim et al., 2008; Melby et al., 1998), scores from the positive and stressful parent-child interaction tasks were converted to z-scores and a mean between the two z-scores was calculated to create composite codes for positive affect and sadness. These composite codes were used in the analyses to represent a global measure of the childs positive affect and sadness during the two interactions with his/her parent. The codes for each task (positive and negative) were used separately to analyze temporal changes in the childs level of positive affect and sadness as they

13 changed from the positive task to the negative task. Procedures Upon expressing interest in the study, each parent completed an initial phone interview to begin to determine initial eligibility for the baseline assessment of the prevention study. If determined eligible from the phone interview, the family then participated in a baseline assessment in the laboratory to assess psychological history and ultimately determine eligibility for randomization into the intervention trial. These assessments included structured clinical interviews with the parent and the child, questionnaires completed by parents and children, and two 15-minute-long video taped parent-child interactions between the parent and the child. Prior to beginning the diagnostic interviews, the parent and child completed a form to identify something pleasant they had recently done together and something stressful and difficult for the family that had occurred the last time the parent was sad, down, and/or irritable. Parents and children were informed that these topics would be used for the videotaped discussions later. Upon completion of the diagnostic interviews, the parent and child participated in the two video taped discussions. The positive task (i.e., discussion of their selected pleasant activity) was administered first. A cue card was provided with questions to guide the discussion. The interviewer filled in the cue cards using the form the parent and child completed before the interviews. Questions for the first task included: What happened when we ___? How did we feel when we ___? What are some other fun activities would we like to do together? What prevents us from doing fun activities together? After 15 minutes, the interviewer entered the room to switch the cue cards and tell the parent and child to sift to the stressful topic for the second 15-minute interaction (i.e., discussion about the parents depression). The cue card for the second task had the following questions: What happened the last time___? What kinds of

14 feelings or emotions do we usually have when mom/dad is sad, down, irritable, or grouchy? What do we do to reduce the stress when mom/dad is sad, down, irritable or grouchy? After 15 minutes, the interviewer would turn off the camera and do a short debriefing with the parent and child to ask how the interactions went for them and answer any questions. Families were screened to determine eligibility, primarily to discern that at least one parent in the family had experienced at least one major depressive episode or dysthymia during the childs lifetime. If two parents met criteria for depression or dysthymia, the parent who initially contacted the study was designated as the target parent. The following parental diagnoses or characteristics were excluded from the sample: bipolar I, schizophrenia, or schizoaffective disorder. Child diagnoses that led to exclusion from the study included mental retardation, pervasive developmental disorders, alcohol or substance use disorders, current conduct disorder, bipolar I disorder, and schizophrenia or schizoaffective disorder. Additionally, if a child in the family met criteria for current depression or was acutely suicidal, the family was placed on hold, and the same re-assessment procedure was applied as described above. The Institutional Review Boards at the two participating university research sites approved all procedures in the study. Doctoral students in clinical psychology completed extensive training for the structured clinical interviews and conducted all interviews in psychology laboratories at the two universities. All participants provided informed consent prior to participation in the study, and each participant received $40 compensation for their participation in the baseline assessment. Results Descriptive Statistics Means and standard deviations for measures of parent and child reports of childrens

15 coping, childrens observed positive affect and sadness, and childrens affective and depressive symptoms are presented in Table 1. The mean T scores for affective problems on the CBCL (M = 60.14) and YSR (M = 56.21) were moderately elevated, consistent with this sample representing a group of children at risk for depression. A subgroup of children had scores on the affective symptoms scale above the clinical cut off of 70 (98th percentile) on the YSR (5.7%) and the CBCL (14.9%). These rates are 2 to 7 times higher than the rates (2%) found in the normative samples for this scale and suggest that this sample was at elevated risk for depression. The mean K-SADS symptom score of 3.67 reflects some combination of one to two current threshold depression symptoms or one to three current subthreshold depression symptoms; in other words, these children were on average below full criteria for MDD, but they were experiencing some threshold and subthreshold depressive symptoms. Mean levels of observed emotions were 5.97 for positive affect on Task 1(between somewhat and moderately characteristic of the childs behavior), 4.08 for positive affect on Task 2 (between minimally and somewhat characteristic of the childs behavior), 3.95 (minimally to somewhat characteristic) for sadness on Task 1, and 5.22 for sadness on Task 2 (somewhat to moderately characteristic). Positive affect (r = .31, p < .001) and sadness (r = .33, p < .001) were both significantly correlated across the two tasks. Positive affect decreased significantly (t = -13.50, p < .001), and sadness increased significantly (t = 8.41 p < .001) from Task 1 to Task 2, providing support that the second task was more stressful than the first. Global Associations of Coping, Observed Affect and Depressive Symptoms Correlational analyses. Correlations among the composite parent and child reports of childrens coping, positive and negative affect (summed across the two observation tasks), and depressive symptoms on the composite of the CBCL/YSR and on the K-SADS are presented in

16 Table 2. As hypothesized, the composite parent-child measure of childrens use of secondary control coping was associated with fewer affective symptoms on the CBCL/YSR composite (r = -.55, p < .001), fewer symptoms of depression on the K-SADS (r = -.39, p < .001), and lower levels of observed sadness (r = -.21, p < .05) and higher levels of observed positive affect (r = .35, p < .001) as measured by the composite scores across the two observation tasks. Levels of observed positive affect were correlated with lower affective symptoms on the CBCL/YSR composite (r = -.26, p < .01) and lower symptoms of MDD on the K-SADS (r = -.22, p < .01). Observed sadness was associated with higher affective symptoms on the CBCL/YSR composite (r = .27, p < .01) and higher MDD symptoms on the K-SADS (r = .18, p < .05). Child age was not significantly related to any of the measures of coping, symptoms, or affect. Linear multiple regression analyses. The associations of coping, observed affect, and depressive symptoms were examined further in two linear multiple regression models, first with the CBCL/YSR composite measure of affective symptoms as the dependent variable and then with symptoms of MDD on the K-SADS as the dependent variable (see Tables 3 and 4). The final step of the regression analyses predicting the composite CBCL/YSR affective symptoms score revealed that childrens use of secondary control coping strategies was a significant predictor ( = -.51, p < .001), and observed sadness was also a significant predictor when included in the analyses along with coping ( = .15, p < .05). Positive affect was not a significant predictor of CBCL/YSR affective symptoms when included in the regression equation with secondary control coping. Secondary control coping was also a significant predictor of MDD symptoms on the K-SADS ( = -.35, p < .01) even when included with observed sadness and positive affect. Although observed sadness and positive affect were significantly correlated with K-SADS symptoms in the bivariate analyses, they were no longer significant when examined in

17 the regression equations with secondary control coping. Temporal Associations of Coping and Observed Affect Linear multiple regression analyses were conducted to examine the associations between childrens use of secondary control coping and changes in positive and sad affect from the first (positive) interaction task to the second (stressful) task (see Table 5). As reported above, mean levels of sad affect increased from the first to the second task and sad affect on the first task was significantly related to sadness on the second task ( = .33, p < .001). When secondary control coping was added to the regression equation, it was related to sadness in Task 2 controlling for sadness in the first task ( = -.18, p < .05); greater use of secondary control coping was related to decreases in observed sadness from the first to the second task. Positive affect decreased from the first to the second task and positive affect on the first task was a significant predictor of positive affect on the second task ( = .31, p < .001). When secondary control coping was added to the regression equation, it was related to positive affect in Task 2 controlling for positive affect in the first task ( = .31, p < .001); greater use of secondary control coping was predictive of increases in positive affect from the first to the second task. Coping remained a significant predictor of changes in sadness ( = -.21, p < .05) and positive affect ( = .30, p < .001) when initial levels of both types of emotions were controlled for in the third block of the analyses. Discussion In this study we examined coping and the regulation of positive and negative affect in children of depressed parents. We used multiple methods to capture these processes, including parent and child reports on standardized questionnaires, interviews, and direct observations of children during interactions with their parents. Support was found for the all of the primary hypotheses. Coping was related to depressive symptoms and to observed levels of positive and

18 negative affect, and levels of observed affect were correlated with depressive symptoms. Further, coping was related to changes in childrens observed positive and negative affect across two parent-child interaction tasks. The current findings build on and extend previous research on coping in children of depressed parents. We replicated previous studies that found that the use of secondary control coping in response to stressors resulting from a parents depression is related to lower depressive symptoms for children (e.g., Jaser et al., 2005, 2008). However, by using composite measures of childrens coping and of childrens depressive symptoms we were able to control for possible shared method variance that limited previous studies that relied on only parent or child reports of childrens coping and symptoms. By including a count of depressive symptoms on the composite of the CBCL and YSR as well as on the K-SADS, we provided additional evidence that secondary control coping can serve a potential protective function in these at-risk children. Further, we found evidence that childrens use of secondary control coping, including cognitive reappraisal, acceptance, and distraction, is related to observed levels of positive and negative affect. Secondary control coping was related not only to lower levels of sadness but also to higher levels of positive affect, suggesting that coping may serve the dual function of both dampening negative emotions and enhancing positive emotions. Both observed sadness and positive affect were significantly related to childrens depressive symptoms in the correlation analyses. However, when secondary control coping, sadness, and positive affect were included together in regression analyses, coping and sad affect remained significant predictors whereas the effect for positive affect was no longer significant. This suggests that the association of positive affect and depressive symptoms is shared with (partially accounted for by) coping but that sad affect has an independent relation with depressive symptoms.

19 To our knowledge, the analyses of coping as a predictor of changes in sadness and positive affect across the two observation tasks provide the first findings that coping may be related to the temporal dynamics of the regulation of emotions during interactions between children and their parents with a history of depression. Specifically, greater use of secondary control coping was predictive of increases in positive affect from a discussion about a pleasant topic to a discussion about a recent source of stress in the parent-child relationship. Similarly, the use of secondary control coping was predictive of decreases in sadness across these two tasks. These findings shed some light on the processes that may underlie the ability to up-regulate positive affect and down-regulate negative affect as markers of resilience (Davidson, 2000). Specifically they suggest that the use of secondary control coping skills (acceptance, cognitive reappraisal, distraction) may help children of parents with a history of depression to sustain positive emotions and dampen negative emotions during stressful interactions with their parents. It is noteworthy that these effects held up even though mean levels of sadness increased and mean levels of positive affect decreased across the tasks---that is, the second discussion of the stressful topic was clearly a more negatively emotionally charged discussion for these children. However, coping may have served as a resource to mitigate increases in sadness and to sustain positive emotions. This pattern suggests that coping may be an important feature of resilience in children of depressed parents. These findings provide further support for the linkages between the constructs of coping and emotion regulation (Compas, 2009; Compas, Jaser, & Benson, 2009). Although research on these constructs has developed rather independently, there have been recent calls to identify points of overlap in the development and functions of coping and emotion-regulation (e.g., Skinner & Zimmer-Gembeck, 2009). Coping is a relatively broader construct that captures a

20 range of actions that individuals initiate to manage stress and adversity. The current findings support the view that one of the functions of coping includes the regulation of affect under stress. The results of this study complement recent intervention research that has highlighted the importance of enhancing emotion-regulation and secondary control coping skills in children of depressed parents (e.g., Kovacs et al., 2006; Weisz et al., 2009). For example, in a randomized controlled trial, Compas et al. (2009) found that, relative to a self study control condition, a family cognitive-behavioral preventive intervention was associated with lower symptom of depression, mixed anxiety depression, total internalizing and externalizing symptoms, and fewer psychiatric diagnoses in children of depressed parents at post-intervention and at 6 and 12-month follow-ups. Further, Compas et al. (2010) found that changes in secondary control coping from baseline to the 6-month follow-up predicted changes in all of the symptom measures at the12month follow-up. The current study provides further insights into how secondary control coping may work in the context of interventions---by helping children to simultaneously increase positive affect and dampen negative affect. This study has several limitations that need to be addressed in future research. First, the sample was somewhat limited in ethnic and racial diversity; future studies will benefit from including more diverse samples of depressed parents and their children. Second, data on childrens coping, depressive symptoms, and emotions were obtained concurrently; future studies should include assessment of these constructs at multiple points in time to examine their associations prospectively. Third, the model of resilience that guided the current study emphasizes the role of neurocognitive processes, especially relative activation in the left and right hemispheres of the prefrontal cortex, in the regulation of positive and negative affect in response to stress (Davidson, 2000, 2003). Future studies that examine the relations between

21 coping, the regulation of positive and negative affect, and brain function in children of depressed parents will be important in addressing the underlying neurobiology of resilience. These limitations notwithstanding, the current findings provide new evidence for the processes that underlie resilience in children at-risk. The use of secondary control coping to manage unpredictable and uncontrollable stress associated with parental depression appears to exert its effects in part through the up-regulation of positive affect and the dampening of negative affect. Enhancing coping skills in order to improve emotion-regulation may be an important pathway to increasing resilience in this at-risk population of children.

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28 Table 1. Means and Standard Deviations of Measures of Childrens Depressive Symptoms, Coping, and Positive and Sad Affect.
Mean SD

CBCL Affective Problems T-score YSR Affective Problems T-score K-SADS Symptoms of MDD Child Secondary Control Coping (Child report) Child Secondary Control Coping (Parent report) Observed Sadness (Task 1) Observed Sadness (Task 2) Observed Positive Affect (Task 1) Observed Positive Affect (Task 2)

60.14 56.21 3.67 .24 .22 3.95 5.22 5.97 4.08

7.95 7.42 3.10 .05 .05 1.49 1.61 1.46 1.40

29 Table 2. Correlations Among Measures of Childrens Depressive Symptoms, Coping and Affect.
1 2 3 4 5

1. CBCL/YSR Affective Problems 2. K-SADS Symptoms of MDD 3. Child Secondary Control Coping 4. Observed Sadness (Composite) 5. Observed Positive Affect (Composite) 6. Child Age

-.51*** -.55*** .27** -.26** --.39*** .18* -.22** --.21* .35*** --.35***

.14

.11

-.07

.13

-.15

Note.* p < .05. ** p < .01. ***p < .001

30 Table 3. Regression Analyses Testing Coping and Affect as Predictors of Affective Symptoms DV: CBCL/YSR Affective Symptoms Block 1 R2 = .30*** Secondary Control Coping Block 2a R2 = .30*** Secondary Control Coping Observed Positive Affect Block 2b R2 = .32*** Secondary Control Coping Observed Sadness Block 3 R2 = .31*** Secondary Control Coping Observed Positive Affect Observed Sadness Final Model R2 = .33*** -.51** -.03 .15* .22 .00 .14 -.52** .16* .26 .02 -.53** -.08 .24 .00 -.55** sr2 .30

Note. Model values are Adjusted R2. = standardized beta; sr2 = semi-partial correlation squared. * p < .05. ** p < .01.*** p < .001.

31 Table 4. Regression Analyses Testing Coping and Affect as Predictors of K-SADS Depressive Symptoms DV: K-SADS MDD Symptoms Block 1 R2 = .14*** Secondary Control Coping Block 2a R2 = .15*** Secondary Control Coping Observed Positive Affect Block 2b R2 = .15*** Secondary Control Coping Observed Sadness Block 3 R2 = .15*** Secondary Control Coping Observed Positive Affect Observed Sadness Model R2 = .16*** Note. Model values are Adjusted R2. = standardized beta; sr2 = semi-partial correlation squared. * p < .05. ** p < .01.*** p < .001. -.35** -.07 .08 .10 .00 .01 -.37** .10 .13 .01 -.35** -.10 .11 .01 -.39** sr2 .15

32 Table 5. Regression Analyses Predicting Task 2 Affect from Task 1 Affect and Coping Task 2 Sadness Block 1 R2 = .102** Task 1 Sadness Block 2 R2 = .l29** Task 1 Sadness Secondary Control Coping Block 3 R2 = .l40** Task 1 Sadness Task 1 Positive Affect Secondary Control Coping Model R2 = .158**
_______________________________________________________________________________________________

.33***

sr2 .11

.31*** -.18*

.09 .03

.35*** .14 -.21*

.11 .02 .04

Task 2 Positive Affect Block 1 R2 = .091** Task 1 Positive Affect Block 2 R2 = .l78** Task 1 Positive Affect Secondary Control Coping Block 3 R2 = .214** Task 1 Positive Affect Task 1 Sadness Secondary Control Coping .18* -.22*** .30*** .03 .04 .08 .25** .31*** .06 .09 .31*** sr2 .10

33 Model R2 = .231** Note. Model values are Adjusted R2. = standardized beta; sr2 = semi-partial correlation squared. * p < .05. ** p < .01.*** p < .001.