Mental Health & Prevention 20 (2020) 200193

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Mental Health & Prevention

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The influence of parenting styles and parental depression on adolescent

depressive symptoms: A cross-sectional and longitudinal approach
Rebecka Keijser a, b, *, Susanne Olofsdotter a, Kent W. Nilsson a, b, Cecilia Åslund a, c
a
Centre for Clinical Research, Uppsala University, Västmanland County Hospital Västerås, S-72189 Västerås, Sweden
b
Mälardalen University, School of Health, Care and Social Welfare, Västerås, Sweden
c
Uppsala University, Department of Public Health and Caring Sciences, Uppsala, Sweden

A R T I C L E I N F O A B S T R A C T

Keywords: Background: Depression often emerges during early adolescence and is one of the most common mental health
Adolescence problems. The present study investigated the influence of parenting styles and parental depression on depressive
Depression symptoms during adolescence and young adulthood, using both a cross-sectional and a longitudinal approach.
Parenting behaviour
Methods: Data were obtained from the Survey of Adolescent Life in Västmanland Cohort study and comprised
Parental depression
1603 adolescents who completed questionnaires at two time points (ages 16–18 and ages 19–21).
Results: In the cross-sectional approach, a positive parenting style (Warmth, Structure, Autonomy support) was
associated with less depressive symptoms, and a negative parenting style (Rejection, Chaos, Coercion) and
parental depression were associated with more depressive symptoms in 16–18-year-old adolescents. The effect of
parental depression was stronger among adolescent females. In the longitudinal approach, a protective effect was
found, where a positive parenting style at adolescent ages 16–18 was associated with less depressive symptoms at
ages 19–21, even when controlling for initial depressive symptomatology.
Conclusions: These findings may make an important contribution to treatment programmes and family-based
prevention strategies related to adolescent depressive symptomatology, particularly regarding the potential
long-term protective effects of positive parenting style in middle and late adolescence.

1. Introduction1 Naninck et al., 2011, Wang et al., 2016). Furthermore, depression

Mental health problems often emerge during early adolescence, with
depression being one of the most common (Thapar et al., 2012, Kessler
and Bromet, 2013, Birmaher et al., 1996). Due to its high prevalence,
risk of recurrence and impairment, depression has a pronounced impact
on public health and is a potential long-term burden (Andersen and
Teicher, 2008, Hankin et al., 2007). In the present study, the influence of
parenting style and parental lifetime depression diagnosis were inves­
tigated in relation to depressive symptoms in adolescence and young
adulthood.
Depression has a preponderance among females (Lewis et al., 2015,
Wartberg et al., 2018), a difference that might depend on the influence
of psychosocial factors, biological changes during puberty and/or dif­
ferences in oestrogen and testosterone levels (Lewis et al., 2015, Spin­
hoven et al., 2011, Stikkelbroek et al., 2016, Kendler et al., 1999,
commonly co-occurs with other psychiatric diagnoses (Thapar et al.,
2012, Weller et al., 2018, Milevsky et al., 2007). An interplay between
factors such as genetics, environment, social aspects and hormonal
functions of the brain is suggested to be a possible reason for the
development of clinical levels of depression (Newman et al., 2016).
Mental health problems are not only linked to parental psychopa­
thology, but also closely linked to parenting practices and the paren­
t–adolescent relationship (Frazer and Fite, 2016, Smokowski et al.,
2015). Children who grow up in an environment with a mentally ill
parent are more likely to exhibit problems with attachment, functioning,
and interpersonal problems (Beardslee et al., 1998). Psychoeducation
such as guidance and support for parents is an affective prevention
strategy in families with depressed parents and mildly depressed ado­
lescents (Beardslee et al., 1998). Beardslee et al. (Beardslee et al., 1998)
stated that clinicians treating parents with mental illness should

* Corresponding author.
E-mail addresses: rebecka.keijser@regionvastmanland.se (R. Keijser), Susanne.olofsdotter@regionvastmanland.se (S. Olofsdotter), Kent.nilsson@
regionvastmanland.se (K.W. Nilsson), Cecilia.aslund@regionvastmanland.se (C. Åslund).
1
DSRS – Depression Self-Rating Scale. PASCQ – Parents as Social Context Questionnaire.

https://doi.org/10.1016/j.mhp.2020.200193
Received 23 April 2020; Received in revised form 2 October 2020;
Available online 11 November 2020
2212-6570/© 2021 The Authors. Published by Elsevier GmbH. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
R. Keijser et al.
evaluate potential risk factors associated with the transmission of a
disorder from a parent to an adolescent and, with such insight, direct
treatment accordingly.
The research field of parenting styles was largely introduced in a
conceptual framework by Baumrind in the early 1970s. Baumrind sug­
gested three main parenting styles that could be identified through
observation or interviews: authoritative, authoritarian, and permissive
(Baumrind, 1971, Baumrind and Black, 1967). Parenting styles reflect
how the parent communicates, thereby forming an emotional climate in
which the parent’s behaviour is expressed (Darling and Steinberg,
1993).
In the late 1980s and beginning of the 1990s, the qualitative methods
for identifying parenting styles were translated into quantitative mea­
sures through the construction of several different questionnaires
(Darling and Steinberg, 1993, Kochanska et al., 1989, Buri, 1991).
Parenting styles further consist of different subdimensions, such as
warmth, verbal hostility and ignoring misbehaviour (Olivari et al., 2013,
Robinson et al., 1995). The number and specifications of the different
parenting styles are handled differently between researchers, although
most of which supports warmth, hostility, involvement, ignoring, di­
rectives and autonomy (Skinner et al., 2005, Phillips et al., 2017,
Lamborn et al., 1991). Skinner, Johnson and Snyder (Skinner et al.,
2005) proposed that parenting styles should be assessed as unipolar
since parenting is dynamic and fluctuates and a parent often does not fit
into only one parenting style – a suggestion further supported by Egeli
et al. (Egeli et al., 2015).
Research regarding parenting styles as well as parental mental health
in association with depressive symptoms among adolescents has been
evaluated, both individually and in interaction with each other (Rasing
et al., 2019). Adolescent mental health may be influenced by an
authoritative or authoritarian parenting style (Shahimi et al., 2019).
Greater parental authoritarianism has previously been associated with
higher levels of depressive symptoms whereas greater parental author­
itativeness has been associated with fewer depressive symptoms (Chen,
Haines, Charlton, & VanderWeele, 2019)These parenting styles are
moreover affected by parental mental health, i.e. maternal depression
(Shahimi et al., 2019), which has been suggested to reduce parenting
quality independent of high marital quality and high social support
(Taraban et al., 2017). Furthermore, an authoritarian parenting style is
more dominant when maternal depressive symptomatology is more se­
vere, leading to increased pathological symptoms in adolescents (Sha­
himi et al., 2019). Since difficulties in the early parent–child relationship
may contribute to the future development of depressive symptoms
during adolescence, as well as their course and maintenance (Frazer and
Fite, 2016, Smokowski et al., 2015, Restifo and Bögels, 2009), the in­
fluence of parental depression and parenting style may be of particular
importance in this regard. Negative parenting and parental mental
illness have indeed been associated with depression among adolescents
(Garber, 2006, Schwartz et al., 2012), and a lack of warmth and avail­
ability in the parent–adolescent relationship is suggested to be an
important risk factor for adolescent depression (Sanders et al., 2014). In
a meta-analysis including children and adolescents aged 7–18 years,
parenting explained 8% of the variance in childhood depression, sug­
gesting a moderate effect (McLeod et al., 2007). Nevertheless, in­
dividuals who grow up in a warm and supportive environment are less
likely to develop mental illnesses overall (Sanders et al., 2014, Pinquart,
2017), an association that has been suggested to be more pronounced
among females (Pinquart, 2017, Milne and Lancaster, 2001).
The parent–child relationship establishes emotional tools that are
important for healthy development (Chew and Wang, 2013). However,
the relationship between the parent and the child is suggested to
transform during early adolescence when the adolescent enters puberty
and becomes more self-sufficient in their development towards adult­
hood (Smokowski et al., 2015). According to self-reports, the main
source of support for children at age 9 years is their parents, but this
changes as the child grows, and at 12–15 years, peers appear to replace
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Mental Health & Prevention 20 (2020) 200193
the parents as the main source of support (Furman and Buhrmester,
1992). During late adolescence (around age 19 years), the main source
of support changes again to a romantic partner. However, females do not
change their social support to the same extent as males, but tend to add
sources over time, and support from mothers remains important even as
they grow older (Furman and Buhrmester, 1992). Furthermore, the
family is an important source of support in terms of dealing with mental
health issues, particularly among females, but also in males (Swords
et al., 2011).
Because the influence of the parent–child relationship is known to
decrease with the increasing age of the child, the question is raised as to
whether adolescence is a breaking point after which parents no longer
play a vital role in relation to the development of psychiatric illness.
Thereby, the present study contributes to the research field by investi­
gating the influence of parenting styles and parental lifetime depression
on depressive symptoms in adolescence and young adulthood. The
findings might be of interest for future prevention programmes, where
the influence of parenting is considered.
In their review, Muñoz et al. (Muñoz et al., 2010) stated that methods
for identifying individuals at high risk for depression should be evalu­
ated continuously, and that identifying psychosocial risk markers would
advance preventive research of future depression. Preventive actions
strengthen protective factors, including social skills, problem solving,
prosocial behaviour, and social support (Muñoz et al., 2010), all of
which might be further increased through a positive parenting style. A
warm and supportive environment might prevent the development of
psychiatric illness even if other factors in the environment are harsh
(Odgers et al., 2012). From this perspective, parenting may moderate or
lower such risks (Flamm and Grolnick, 2013, Williamson et al., 2017).
The longitudinal perspective of the present study, with a focus on the
influence of parenting styles and parental depression on the develop­
ment of depressive symptoms in young adulthood, is particularly
interesting in this regard. Furthermore, possible sex differences
regarding the influence of parenting contexts in adolescence are
important to investigate from a preventive perspective.
1.1. Hypotheses
There were three hypotheses for the present study. (1) A positive
parenting style will be associated with fewer depressive symptoms
among adolescents, while a negative parenting style and parental life­
time depression will be associated with more depressive symptoms
among adolescents. (2) There will be an interaction between adolescent
sex and both parenting style and parental lifetime depression in relation
to adolescent depressive symptoms, with a stronger effect among fe­
males. (3) These associations will be present in a cross-sectional and
longitudinal study design.
2. Methods
2.1. Ethics
The SALVe-Cohort was approved by the Ethical Review Board of
Uppsala (Dnr 2012/187). All participants included in the study provided
written informed consent.
2.2. Study sample
Data for this study were obtained from the Survey of Adolescent Life
in Västmanland Cohort study (SALVeCohort) initiated in 2012 (wave 1)
in the county of Västmanland, Sweden. The SALVe-Cohort includes two
birth cohorts (born in 1997 or 1999). The present study includes data
collected in 2015 (wave 2) when the participants were 16–18 years old,
and 2018 (wave 3) when the participants were 19–21 years old. All
measures used in the present study were provided in Swedish.
Information regarding adolescent sex, age, Scandinavian ethnicity,
R. Keijser et al.
and information regarding parenting styles were collected at wave 2.
Adolescent depressive symptoms were assessed at two time points: wave
2 (participant ages 16–18) and wave 3 (participant ages 19–21). Infor­
mation about parental lifetime diagnosis of depression was provided by
the guardians at wave 2.
Of the 1868 eligible adolescent participants (Vadlin et al., 2018), 265
were excluded due to incomplete answers on the measures of the study,
or a non-responding guardian at wave 2, resulting in 1603 included
adolescent participants in the present study. There were 58.1% adoles­
cent females in the sample, 50.7% of whom were born in 1997 and
79.5% of Scandinavian ethnicity.
Based on adolescents’ ratings on the Depression Self-Rating Scale
(DSRS)[48] and indicative of elevated levels of depressed mood, the A-
criterion of the Diagnostic and Statistical Manual of Mental Disorders –
IV (DSM-IV) (Association, 2000) major depressive disorder was met by
13.3 % of the males and 33.1 % of the females at wave 2, and 17.8 % of
the males and 34.4 % of the females at wave 3. A lifetime diagnosis of
depression was reported by 8.5% of the mothers and 3.5% of the fathers
at wave 2.
The SALVe Cohort population is a representative sample of the larger
community in Sweden regarding proportions of employed parents
(92%), separated parents (30%), single-parent households (19%) and
foreign-born adolescents (9%) (SCB, Statistisk årsbok för Sverige 2012).
The disposable income of the households was representative of the
median range for single-/two-parent households in Sweden in 2012
(€1.550–2.580/€4.640–5.670) (SCB, Statistisk årsbok för Sverige 2012).
For further details of the study sample, see Vadlin et al. (Vadlin et al.,
2018).
2.3. Measures
The Depression Self-Rating Scale Adolescent version (DSRS) was
used to assess depressive symptoms among the adolescents during waves
2 and 3. The DSRS is a self-report scale with yes/no statements based on
the Diagnostic and Statistical Manual of Mental Disorders IV A-criteria
for major depressive disorders (Svanborg and Ekselius, 2003, Associa­
tion, 2000). The DSRS includes questions on the following symptom
categories occurring during the previous 2 weeks: 1) Dysphoric moo­
d/irritability; 2) Loss of interest or pleasure in most activities; 3) Sleep
disturbances; 4) Weight loss or gain/appetite disturbances; 5) Psycho­
motor agitation or retardation; 6) Fatigue or loss of energy; 7) Feelings
of worthlessness or guilt; 8) Concentration disturbances; and 9)
Thoughts of suicide. A continuous depressive symptom summation
index was created from all symptom categories. The occurrence of
symptoms was clustered, and each symptom was given a value of 1
point; a lack of symptoms generated a value of 0 (range: 0–9 points).
Internal consistency for the DSRS at waves 2 and 3 was Cronbach’s α =
.827 and α = .865, respectively.
Information regarding lifetime parental depression was assessed
with a questionnaire on which the guardian indicated diagnosed ill­
nesses or mental health problems within the family by marking a check
box in a list of specified disorders, including an item regarding previous
or present paternal or maternal depression. The answers regarding
paternal and maternal lifetime depression were then clustered and
dichotomized into presence (1) or absence (0) of lifetime depression
diagnosis in either parent (1).
Parenting styles were assessed through the Parents as Social Context
Questionnaire (PASCQ) (Skinner et al., 2005, Taylor and Francis, Taylor
and Francis Group Ltd 2017) translated into Swedish (Keijser et al.,
2020). The PASCQ is a 24-item self-rating scale providing scores on six
parenting styles: Warmth (e.g. “My parents let me know they love me”),
Rejection (e.g. “Sometimes I wonder if my parents like me”), Structure
(e.g. “When I want to understand how something works, my parents
explain it to me”), Chaos (e.g. “My parents keep changing the rules on
me”), Autonomy support (e.g. “My parents let me do the things I think
are important”), and Coercion (e.g. “My parents think there is only one
3
Mental Health & Prevention 20 (2020) 200193
right way to do things – their way”) (Skinner et al., 2005). Each
parenting style is composed of four questions with the response scale for
each item ranging from not at all true (0) to very true (3). The adoles­
cents were asked to consider both caregivers when answering the
PASCQ.
A positive summation index (PASCQpos) was created for the
parenting styles Warmth, Structure, and Autonomy support, and a
negative summation index (PASCQneg) was created for the parenting
styles Rejection, Chaos, and Coercion. Each separate parenting style (i.e.
Warmth) included four items with a total max score of 12 points. The
positive and negative parenting indices thus each ranged from 0 to 36
points. The internal consistency of the PASCQpos and the PASCQneg
summation indices was Cronbach’s α = .853, and Cronbach’s α = .846,
respectively.
2.4. Statistics
The internal consistency regarding depressive symptoms in waves 2
and 3 and the negative and positive parenting styles were measured
using Cronbach’s α with a cut-off of .7 for adequate consistency
(Tabachnick and Fidell, 2007). The Mann–Whitney U test was used to
analyse the potential sex differences in dependent and independent
factors. The effect size was calculated using r = |Z| / √N, where Z is the
standardized U (i.e. Z = (U × ɳ1 ɳ2 ⁄ Z) ⁄ √ ɳ1 ɳ2 (ɳ1+ɳ2+1) ⁄ 12). The
cut-off for the effect size was set to .1 for small effects and .3 for medium
effects. The correlations between the parenting styles were assessed
through Spearman’s rank correlation (ρ) with highly correlated vari­
ables indicating multicollinearity and controlled for by using variance
inflation factors (VIFs). Cut-offs for the VIFs were set to < 1 not corre­
lated, 1–5 moderately correlated and > 5 highly correlated. The toler­
ance cut-off was set to .4, with .84 considered high tolerance (low
multicollinearity) and .19 considered low tolerance (serious multi­
collinearity) (Allison, 1999).
The composition of the parenting styles was assessed through hier­
archical cluster analysis. The main and interaction effects on depressive
symptoms in wave 2 (cross-sectional analyses) and wave 3 (longitudinal
analyses) were analysed by multiple linear regression. The multiple
linear regression models were constructed using PASCQpos and/or neg,
parental depression, adolescent sex and age as independent variables.
Adolescent sex differences were analysed in all models and the variable
for sex was coded as male = 0 and female = 1. The analyses were
adjusted for age, i.e. born in 1999 (0) or 1997 (1) and Scandinavian
ethnicity i.e. both parents born in Scandinavia (0) or at least one parent
born outside of Scandinavia (1). The longitudinal models were further
adjusted for adolescent depressive symptoms in wave 2. Stepwise
backward elimination was used to assess the final linear regression
model. The adjustment variable for Scandinavian ethnicity was non-
significant throughout all analyses and therefore excluded in all models.
All significant interaction effects were visualized through graphs to
determine the direction of the findings. A two-sided p-value of .05 was
considered significant for all analyses (Fleiss, 1986). All analyses were
performed using the Statistical Package for the Social Sciences (IBM
SPSS Statistics for Windows, Version 26.0; IBM Corp., Armonk, NY).
3. Results
3.1. Operationalization of the PASCQ measurement
The correlations between the six parenting styles (Warmth, Rejec­
tion, Structure, Chaos, Autonomy support and Coercion), reported by
the adolescents, were strong overall, and the correlations between the
positive and negative parenting styles were in opposite directions
(Table 1). Due to the initial highly correlated parenting styles, the VIFs
and tolerance were inspected for multicollinearity. The VIFs for the
parenting styles and depressive symptoms in wave 2 ranged from 1.3 to
2.4, with tolerance ranging from .4 to .8. The VIFs for the parenting
R. Keijser et al. Mental Health & Prevention 20 (2020) 200193

Table 1 (Table 3; Model 1). Observed power for the significant main effects
Spearman’s ρ correlation coefficients of the six parenting styles of the PASCQ*. ranged from .991 to 1.000.
Parental dimensions 1 2 3 4 5 6 The multiple linear regression analyses for the interaction effects
initially consisted of the interaction terms: PASCQpos × sex, PASCQneg ×
1. Warmth -
2. Rejection –.559** - sex, PASCQpos × parental depression, PASCQneg × parental depression,
3. Structure .382** –.254** - and parental depression × sex. A stepwise backward elimination pro­
4. Chaos –.420** .526** –.178** - cedure was then used excluding one non-significant interaction term at a
5. Autonomy .597** –.525** .262** –.505** - time to assess the final linear regression model (Table 3; Model 2).
support
6. Coercion –.320** .468** –.031 .512** –.463** -
Parental depression × sex was the only significant interaction term
associated with depressive symptoms among adolescents in the cross-
*PASCQ – The Parents as Social Context Questionnaire. Correlation significant at sectional analyses (Table 3; Model 2). The observed power for the sig­
the *.05 level (2-tailed), **.01 level (2-tailed) and *** .001 level (2-tailed).
nificant interaction effect was .611. The interaction effect was visually
inspected in a graph to determine its direction. The graphs were inter­
styles and depressive symptoms in wave 3 ranged from 1.4 to 3.1, with preted in terms of ordinal, “fan-shaped” interactions with non-crossed
tolerance ranging from .4 to 7. Therefore, cluster analyses were lines. The graph indicated that parental depression was associated
completed to ensure that the linear regression analyses were not with higher reported levels of depressive symptoms among adolescents,
violated. The hierarchical cluster analyses, visualized through a an effect that was significantly more pronounced among adolescent fe­
dendrogram (Fig. 1), showed two clusters in an early stage where the males (Fig. 2).
positive parenting styles were combined in one group and the negative
parenting styles in another, supporting the use of a negative and a 3.4. Longitudinal analyses
positive index.
Regarding longitudinal effects, the multiple linear regression ana­
3.2. Sex differences between adolescents in dependent and independent lyses for the main effects of PASCQpos, depressive symptoms among
variables adolescents at wave 2, and sex, showed significant associations with
depressive symptoms at wave 3 while PASCQneg, parental depression
There was a significant difference between adolescent males and and age did not (Table 4; Model 1). Higher scores on positive parenting
females in depressive symptoms during waves 2 and 3 (Table 2), where style at wave 2 were associated with fewer depressive symptoms among
females reported higher levels of depressive symptoms. No significant adolescents at wave 3. Presence of depressive symptoms at wave 2 was a
sex differences were found between adolescent males and females strong predictor of depressive symptoms even three years later.
regarding the positive or negative parenting styles. Adolescent females consistently reported more depressive symptoms
compared with adolescent males over time (Table 4; Model 1). Observed
3.3. Cross-sectional analyses power for the significant main effects ranged from .383 to 1.0.
The multiple linear regression analyses for the interaction effects
The multiple linear regression analyses for the main effects of initially consisted of the interaction terms: PASCQpos × sex, PASCQneg ×
PASCQpos, PASCQneg, parental depression, sex, and age showed signifi­ sex, PASCQpos × parental depression, PASCQneg × parental depression,
cant associations with adolescent depressive symptoms at wave 2 and parental depression × sex. A stepwise backward elimination pro­
(Table 3; Model 1). The PASCQpos was associated with fewer reported cedure was then used excluding one non-significant interaction term at a
depressive symptoms among adolescents, while PASCQneg was associ­ time to assess a final linear regression model. The cross-sectional finding
ated with more reported depressive symptoms, as was parental depres­ of a significant interaction between parental depression × sex was not
sion. Adolescent females reported more depressive symptoms compared significant in the final longitudinal model (Table 4; Model 2).
with adolescent males. Regarding age, 18-year-old adolescents reported
more depressive symptoms compared with 16-year-old adolescents 4. Discussion

The study’s main cross-sectional findings were that a positive

parenting style was associated with fewer reported depressive symptoms
among adolescents, whereas a negative parenting style and parental
depression were associated with more reported depressive symptoms. In
the cross-sectional analyses, there was an interaction between adoles­
cent sex and parental depression, with a stronger association between
parental depression and adolescent depressive symptoms among female
adolescents. A longitudinal protective effect was found where a positive
parenting style at adolescent ages 16–18 was associated with fewer
depressive symptoms three years later at ages 19–21, even when con­
trolling for initial adolescent depressive symptomatology and parental
lifetime depression. No interaction effects were found between adoles­
cent sex and parenting style, or between parental lifetime depression
and parenting style, in relation to adolescent depressive symptoms in
either the cross-sectional or longitudinal approach.
The choice to use the parenting styles clustered into a positive and a
negative parental index, and not as separate parenting styles as recom­
mended by Skinner et al. (Skinner et al., 2005), was carefully examined
in three steps. As a first step in a correlation matrix, the high correlations
between the three positive and three negative parenting styles, and the
negative correlation between the positive and negative parenting styles,
Fig. 1. Dendrogram of the parenting styles of PASCQ showing two can be interpreted in two ways. First, the individual parenting styles are
distinct clusters. not suitable for a multiple linear regression because of multicollinearity,

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R. Keijser et al. Mental Health & Prevention 20 (2020) 200193

Table 2
Reliability, means, and sex differences between study variables.
Cronbach’s alpha, mean and standard deviation Sex differences
Study variables Cronbach’s alpha Mean (SD) Total Mean (SD) Males Mean (SD) Females Z r p

DSRS w2 .826 2.90 (2.60) 1.98 (2.22) 3.59 (2.84) –13.048 –.325 < .001
DSRS w3 .865 3.08 (2.82) 2.17 (2.25) 3.62 (2.64) –8.581 –.214 < .001
PASCQpos .853 28.29 (5.27) 28.14 (5.17) 28.38 (5.34) –1.269 –.032 .204
PASCQneg .846 7.90 (5.75) 7.67 (5.47) 8.07 (5.94) –.858 –.021 .391

Note: N = 1603; Grouping variable sex was coded male = 0 and female =1.
PASCQ – Parents as Social Context Questionnaire.
DSRS w2, w3 – The Depression Self-Rating Scale Adolescent version, wave 2, wave 3.

Table 3
Cross-sectional main effects (Model 1) and interaction effects (Model 2) of the PASCQpos, PASCQneg, parental depression, sex, and age, in relation to adolescent
depressive symptoms at wave 2 (w2).
Model 1 Independent variables Multiple regression
B1 95% CI2 SE3 t ηp4 p

Depressive symptoms w2 PASCQneg .130 .106 to .154 .012 10.532 .065 < .001
PASCQpos –.058 –.084 to –.031 .014 –4.197 .011 < .001
Parental depression .929 .569 to 1.289 .184 5.062 .016 < .001
Sex5 1.620 1.402 to 1.839 .112 14.528 .117 < .001
Age6 .225 .118 to .332 .055 4.115 .010 < .001
R2 .255
Model 2 Independent variables B1 95% CI2 SE3 t ηp4 p
Depressive symptoms w2 Parental depression .458 –.042 to .958 .255 1.798 .002 .072
PASCQneg .130 .106 to .154 .012 10.520 .065 < .001
PASCQpos –.058 –.085 to –.031 .014 –4.258 .011 < .001
Sex5 1.530 1.299 to 1.762 .118 12.967 .095 < .001
Age6 .223 .115 to .330 .055 4.073 .010 < .001
Parental depression × sex .810 .105 to 1.516 .360 2.252 .003 .024
R2 .258

PASCQ – The Parent as Social Context Questionnaire

Initial interaction terms: PASCQpos × sex, PASCQ neg × sex, PASCQpos × parental depression, PASCQneg × parental depression, and parental depression × sex
1
B unstandardized regression coefficient
2
CI: confidence interval
3
HC3 method
4 2
ηp Partial eta squared
5
Adolescent males = 0, Adolescent females = 1
6
1999 = 0, 1997 = 1

hierarchical cluster analysis was performed to ensure that the parenting

Fig. 2. Depressive symptoms in wave2 and parental depression divided by sex
of the adolescents.
and it would be difficult to interpret the potential effects in the different
models (Tabachnick and Fidell, 2007). Second, there seem to be two
clusters of these parenting styles. In a second step, a two-step cluster
analysis was performed to examine whether the participants in our
sample answered the parenting styles in a similar way (Fig. 1). The fit for
the negative as well as the positive parenting styles was good. Third,
styles clustered satisfactorily. The dendrogram (Fig. 1) shows that two
clear clusters emerged early in our sample. Taking the above into
consideration, the choice was made to use the positive and negative
parenting indices.
The number of self-reported depressive symptoms was more pro­
nounced among adolescent females than among males, in line with
previous research (Andersen and Teicher, 2008, Lewis et al., 2015,
DeFilippis and Wagner, 2014, McGuinness et al., 2012, Hankin et al.,
1998, Pace and Shafer, 2015). In the present study, such differences
were consistent from middle to late adolescence/early adulthood.
However, the sex differences between the adolescents were less distinct
during wave 3 when the participants were 19–21 years old, indicating
that the gap between adolescent males and females had narrowed, even
if females still reported more depressive symptoms. Furthermore, the
association between parental depression and adolescent depressive
symptoms was stronger among female adolescents. The mechanisms
behind the sex differences regarding depression (i.e. symptomatology)
and female preponderance are not fully understood (Lewis et al., 2015,
Wartberg et al., 2018, Hodes et al., 2017). Sex differences in depressive
symptomatology have been discussed in the light of influence of bio­
logical changes during puberty, differences in oestrogen and testos­
terone levels, and heritability (Lewis et al., 2015, Spinhoven et al., 2011,
Stikkelbroek et al., 2016, Kendler et al., 1999, Naninck et al., 2011,
Wang et al., 2016, Newman et al., 2016). Recently, the influence of
epigenetic mechanisms, where environmental factors may induce a
change in gene expression, has been suggested as a possible contributing

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R. Keijser et al. Mental Health & Prevention 20 (2020) 200193

Table 4
Longitudinal main effects (Model 1) and interaction effects (Model 2) of the PASCQpos, PASCQneg, parental depression, and depressive symptoms at wave 2 (w2), and
sex in relation to adolescent depressive symptoms at wave 3 (w3).
Model 1 Independent variables Multiple regression
B1 95% CI2 SE3 t η p4 p

Depressive symptoms w3 PASCQpos –.043 –.080 to –.006 .018 –2.286 .005 .022
PASCQneg .016 –.020 to .052 .017 .875 .001 .382
Parental depression .376 –.167 to .919 .254 1.357 .002 .175
Depressive symptoms w2 .344 .276 to .411 .034 9.284 .073 < .001
Sex5 .929 .595 to 1.262 .170 5.459 .027 < .001
Age6 -.023 –.169 to .122 .075 –.316 .000 .752
R2 .190
Model 2 Independent variables B1 95% CI2 SE3 t η p4 p
Depressive symptoms w3 Parental depression -.157 –.932 to .609 .403 –.389 .000 .688
PASCQpos -.044 –.080 to –.007 .014 –2.472 .005 .019
PASCQneg .016 –.020 to .052 .017 .952 .001 .380
Depressive symptoms w2 .342 .269 to .414 .034 9.937 .072 < .001
Sex5 .839 .494 to 1.185 .177 4.734 .020 < .001
Age6 –.023 –.168 to .122 .075 –.306 .000 .758
Parental depression × sex .882 –.186 to 1.951 .518 1.703 .002 .106
R2 .192

PASCQ – The Parent as Social Context Questionnaire

Initial interaction terms: PASCQpos × sex, PASCQ neg × sex, PASCQpos × parental depression, PASCQneg × parental depression, and parental depression × sex
1
B unstandardized regression coefficient
2
CI: confidence interval
3 2
ηp Partial eta squared
4
HC3 method
5
Adolescent males = 0, Adolescent females = 1
6
1999 = 0, 1997 = 1

factor to sex differences in depression (Hodes et al., 2017). A more
profound understanding of how factors within the family context, i.e.
social, biological, and genetic factors, contribute and interact, is
important for further understanding of mechanisms behind mood dis­
orders, as well as their prevention and treatment. Hodes et al. (Hodes
et al., 2017) suggested that further research regarding sex differences in
depression could contribute to future treatment approaches; such dif­
ferences are thus of great interest to the field of depression research.
In the cross-sectional design of the present study, positive parenting
style was associated with fewer reported depressive symptoms among
adolescents aged 16–18, whereas a negative parenting style was asso­
ciated with more reported depressive symptoms. Both parenting style
per se and the parent–child relationship have been suggested to have a
bearing on future development, course, and maintenance of depression
(Frazer and Fite, 2016, Smokowski et al., 2015, Restifo and Bögels,
2009). One possible explanation for the effects of a negative parenting
style could be that a harsh, and hence intimidating, approach towards
the adolescent causes submissive behaviour; this has been suggested to
be a key function in depression (Price et al., 1994). However, the
parental behaviour towards the adolescent could also be due to the
adolescent’s depression, as anger is more frequent among families with a
depressed adolescent (Bodner et al., 2018). It has been suggested that
maternal aggression as a response to adolescent aggression also predicts
the onset of depression among adolescents (Schwartz et al., 2014).
In the present study, a positive parenting style in adolescents aged
16–18 showed a protective effect on adolescent depressive symptoms
three years later, even when controlling for initial levels of depressive
symptomatology. A positive family context has previously been associ­
ated with less risk of developing mental illness in general and among
females in particular (Sanders et al., 2014, Pinquart, 2017, Milne and
Lancaster, 2001), findings that are consistent even in the presence of
other risk factors (Odgers et al., 2012). In that sense, positive parenting
may moderate risk and prevent development of mental illness (Flamm
and Grolnick, 2013, Williamson et al., 2017). Muñoz et al. (Muñoz et al.,
2010) highlighted the importance of methods to identify individuals at
high risk for developing depression and suggested that these methods
need to be evaluated continuously, and that identifying psychosocial
risk markers would advance preventive research. Thus, both
cross-sectional and longitudinal associations between perceived
parenting style at ages 16–18 and depressive symptoms in adolescence
and young adulthood are of particular interest to evaluate. It has been
suggested that the parent-child relationship transforms during early
adolescence when the adolescent becomes more self-sufficient and de­
velops towards adulthood (Smokowski et al., 2015). The influence of the
parent-child relationship is often suggested to decrease with increasing
age of the child (Smokowski et al., 2015, Furman and Buhrmester,
1992). Thereby, the findings of the present study are of particular in­
terest, since they indicate that the parent-child relationship may be
important for adolescent mental health even during the later period of
adolescence. Our findings may therefore contribute important infor­
mation in the field of prevention for adolescent depression, suggesting
that the importance of the parent-child relationship and family envi­
ronment should not be underestimated, even in later adolescence Yap,
Pilkington, Ryan, & Jorm, 2014. Previous research has suggested that
females do not change their social support to the same extent as males do
(Furman and Buhrmester, 1992). Instead of changing their social sup­
port females tend to add sources over time, and support from mothers
remains important even as they grow older (Furman and Buhrmester,
1992). These findings are furthermore in line with previous research
that suggests the family to be an important source of support in terms of
dealing with mental health issues, in males and females with a pre­
ponderance among females (Swords et al., 2011). Furthermore, a posi­
tive family relationship during adolescence has been shown to have a
positive impact on mental health from early adolescence to midlife
where interventions during early family life to nurture a healthy mental
development in the future were suggested to be of importance(Chen &
Harris, 2019)
The present study did not find any significant interaction effects
between parenting styles and parental lifetime diagnosis of depression in
relation to depressive symptoms among adolescents, in either the cross-
sectional or the longitudinal approach. In contrast to these findings,
Shahimi et al. (Shahimi et al., 2019) found a potential mediating role of
parenting styles between maternal depression and adolescent mental
health: as the severity of depression among mothers increased, a more
authoritarian parenting style was adopted, which led to increased
pathological symptoms in the adolescents. Moreover, mothers without

6
R. Keijser et al.
depression preferred an authoritative parenting style, and adolescents
who reported their parents as more authoritative were more likely to
have better mental health (Shahimi et al., 2019). In the present study, no
interaction between parental depression and parenting style was found
in relation to adolescent depressive symptoms. One possible reason
might be the aggregation of maternal and paternal depression, which
might have silenced possible sex-specific relationships. These findings
are, however, consistent with Rasing et al. (Rasing et al., 2019) who did
not find any interaction between maternal psychopathology and
parenting behaviour in relation to adolescent depression. A possible
explanation to these inconsistent findings could be the cultural context.
Rasing et al. (Rasing et al., 2019) included a Dutch population, Shahimi
et al. (Shahimi et al., 2019) included a population from Iran, while the
population of the present study was Swedish. Hence, in a cultural
context, Swedish and Dutch adolescents might be more similar in terms
of cultural background, possibly influencing the findings. Notably,
however, parental depression is known to reduce parenting quality
(Taraban et al., 2017) and predict perceived parenting style among
adolescents (Shahimi et al., 2019). Therefore, although no interaction
effects between these factors were found in relation to depressive
symptoms among adolescents in the present study, parenting style per se
may still be affected by parental depression. Taraban et al. (Taraban
et al., 2017) further highlighted the importance of accounting for
different factors in the broader family context when evaluating the
linkage between depressive symptoms and parenting styles. The link
between parental mental health problems and future development of
depression among adolescents has been shown, with a stronger effect
among females (Plass-Christl et al., 2017), which is similar to the present
findings.
However, the mechanisms behind the association between parental
depression and mental health problems among adolescents and its im­
pacts are not entirely understood (Olff et al., 2013). Furthermore, the
gap between known implementations and prevention strategies needs
further evaluation, with a strengthening of research and dissemination
efforts (Cuijpers et al., 2012) in which a unified approach is used to
evaluate environmental factors such as parenting styles, parental
depression, age, and sex, in relation to the aetiology of adolescent
depressive symptoms. Psychogiou et al. (Psychogiou et al., 2017)
emphasized that a family-based approach is preferable for both pre­
vention and intervention strategies for child mental health and parental
depression. The family context may be an important source of support
for coping with adolescent mental health problems (Swords et al., 2011).
As such, self-awareness of parenting style may also be helpful for both
prevention and family-based treatment of adolescent depressive
symptomatology.
4.1. Strengths and limitations
Depressive symptoms were measured using a self-report question­
naire, which includes a risk of information bias from false-positive or
false-negative participant reports. For example, individuals under the
influence of a depressive state tend to interpret their relations as more
negative. On the other hand, with regard to the estimation of subjective
experiences such as personal relationships, it has been suggested that the
most significant view of the relationship for the child is that of the child
(Smokowski et al., 2015).
We did not control for psychiatric comorbidity in the participants,
which is common in the presence of depressive symptoms (Thapar et al.,
2012, Weller et al., 2018). Moreover, no information on psychopha­
rmacological or therapeutic treatment was available, which is prob­
lematic because of the potential impact on depressive symptoms
independent of the study factors. Although this study aimed to investi­
gate late adolescence, a comparison of the findings in younger adoles­
cent groups would have contributed to a further understanding of the
importance of parenting styles in adolescence. We did not account for
other confounding factors, such as parental divorce, family size or other
7
Mental Health & Prevention 20 (2020) 200193
dysfunctionalities within the family. Another limitation was that the
participants estimated the quality of the parenting styles for both par­
ents in the same questionnaire. Thereby, the data did not allow analyses
on differences between maternal and paternal parenting styles, even
though previous research has shown differences in the impact of
parenting style depending on the sex of the parent (Milevsky et al.,
2007). An important strength of the present study is the use of both
cross-sectional and longitudinal data, shedding further light on the
importance of parenting styles and parental depression for the devel­
opment of depressive symptoms in adolescence and young adulthood.
4.2. Conclusions
The present study contributes to a further understanding of the
parental influence on depressive symptom development in middle/late
adolescence to early adulthood. The finding of a long-term protective
effect of positive parenting style in middle/late adolescence for
depressive symptomatology three years later might be of particular in­
terest for treatment programmes and family-based prevention strategies
related to adolescent depressive symptomatology. Thereby, the possible
influence of the parent-child relationship and family environment, even
in later adolescence, should not be underestimated in the prevention and
treatment of depressive symptomatology in adolescence and young
adulthood.
Funding
This study was conducted with financial support from the
Söderström König Foundation (SLS-559921, SLS-655791), Åke Wiberg’s
Foundation (M15-0239), the Swedish Research Council for Health,
Working Life and Welfare (FORTE) (2015-00897), the Swedish Brain
Foundation, the Swedish Alcohol Monopoly Research Council (SRA), the
Swedish Council for Working Life and Social Research (FAS), the
Uppsala and Örebro Regional Research Council, the Fredrik and Ingrid
Thurings Foundation, the County Council of Västmanland, the Swedish
Psychiatric Foundation and the Svenska Spel Research Foundation. The
funding sponsors had no role in the design of the study, the collection,
analysis or interpretation of data, the writing of the manuscript or the
decision to publish.
Declaration of Competing Interest
The authors report no conflicts of interest.
Supplementary materials
Supplementary material associated with this article can be found, in
the online version, at doi:10.1016/j.mhp.2020.200193.
References
Thapar, A., et al. (2012). Depression in adolescence. The Lancet, 379(9820), 1056–1067.
Kessler, R. C., & Bromet, E. J. (2013). The epidemiology of depression across cultures.
Annual review of public health, 34(1), 119–138.
Birmaher, B., et al. (1996). Childhood and Adolescent Depression: A Review of the Past
10 Years. Part I. Journal of the American Academy of Child & Adolescent Psychiatry, 35
(11), 1427–1439.
Andersen, S. L., & Teicher, M. H. (2008). Stress, sensitive periods and maturational
events in adolescent depression. Trends in Neurosciences, 31(4), 183–191.
Hankin, L. B., Mermelstein, R., & Roesch, L. (2007). Sex Differences in Adolescent
Depression: Stress Exposure and Reactivity Models. Child development, 78(1),
279–295.
Lewis, A. J., et al. (2015). Gender differences in adolescent depression: Differential
female susceptibility to stressors affecting family functioning. Australian Journal of
Psychology, 67(3), 131–139.
Wartberg, L., Kriston, L., & Thomasius, R. (2018). Depressive Symptoms in Adolescents.
Dtsch Arztebl International, 115(33-34), 549–555.
Spinhoven, P., et al. (2011). Positive and negative life events and personality traits in
predicting course of depression and anxiety. Acta Psychiatrica Scandinavica, 124(6),
462–473.
R. Keijser et al.
Stikkelbroek, Y., et al. (2016). Adolescent depression and negative life events, the
mediating role of cognitive emotion regulation. PLoS One, 11(8), Article e0161062.
Kendler, S. K., Karkowski, M. L., & Prescott, A. C. (1999). Causal Relationship Between
Stressful Life Events and the Onset of Major Depression. American Journal of
Psychiatry, 156(6), 837–841.
Naninck, E. F., Lucassen, P. J., & Bakker, J. (2011). Sex differences in adolescent
depression: do sex hormones determine vulnerability? Journal of Neuroendocrinology,
23(5), 383–392.
Wang, H., et al. (2016). Age at Onset of Puberty and Adolescent Depression: "Children of
1997. Birth Cohort. Pediatrics, 137(6).
Weller, B. E., Blanford, K. L., & Butler, A. M. (2018). Estimated Prevalence of Psychiatric
Comorbidities in U.S. Adolescents With Depression by Race/Ethnicity, 2011-2012.
J Adolesc Health, 62(6), 716–721.
Milevsky, A., et al. (2007). Maternal and Paternal Parenting Styles in Adolescents:
Associations with Self-Esteem, Depression and Life-Satisfaction. Journal of Child and
Family Studies, 16(1), 39–47.
Newman, L., et al. (2016). Early origins of mental disorder - risk factors in the perinatal
and infant period. BMC Psychiatry, 16(1), 270.
Frazer, A. L., & Fite, P. J. (2016). Maternal Psychological Control, Use of Supportive
Parenting, and Childhood Depressive Symptoms. Child Psychiatry & Human
Development, 47(3), 384–396.
Smokowski, P. R., et al. (2015). The Effects of Positive and Negative Parenting Practices
on Adolescent Mental Health Outcomes in a Multicultural Sample of Rural Youth.
Child Psychiatry & Human Development, 46(3), 333–345.
Beardslee, W. R., Versage, E. M., & Gladstone, T. R. (1998). Children of affectively ill
parents: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry, 37(11),
1134–1141.
Baumrind, D. (1971). Current patterns of parental authority. Developmental psychology, 4
(1, pt.2), 1–103.
Baumrind, D., & Black, A. E. (1967). Socialization Practices Associated with Dimensions
of Competence in Preschool Boys and Girls. Child development, 38(2), 291–327.
Darling, N., & Steinberg, L. (1993). Parenting Style as Context: An Integrative Model.
Psychological Bulletin, 113(3), 487–496.
Kochanska, G., Kuczynski, L., & Radke-Yarrow, M. (1989). Correspondence between
mothers’ self-reported and observed child-rearing practices. Child development,
56–63.
Buri, J. R. (1991). Parental authority questionnaire. Journal of personality assessment, 57
(1), 110–119.
Olivari, M. G., Tagliabue, S., & Confalonieri, E. (2013). Parenting Style and Dimensions
Questionnaire: A Review of Reliability and Validity. Marriage & Family Review, 49(6),
465–490.
Robinson, C. C., et al. (1995). Authoritative, authoritarian, and permissive parenting
practices: Development of a new measure. Psychological reports, 77(3), 819–830.
Skinner, E., Johnson, S., & Snyder, T. (2005). Six Dimensions of Parenting: A
Motivational Model. Parenting: Science and practice, 5(2), 175–235.
Phillips, B. A., Conners, F., & Curtner-Smith, M. E. (2017). Parenting children with down
syndrome: An analysis of parenting styles, parenting dimensions, and parental stress.
Research in Developmental Disabilities, 68, 9–19.
Lamborn, S. D., et al. (1991). Patterns of competence and adjustment among adolescents
from authoritative, authoritarian, indulgent, and neglectful families. Child
development, 62(5), 1049–1065.
Egeli, N. A., et al. (2015). Exploring the Factor Structure of the Revised-Parent as a Social
Context Questionnaire. Parenting, 15(4), 269–287.
Rasing, S.P.A., et al., Depression and Anxiety Symptoms in Female Adolescents: Relations
with Parental Psychopathology and Parenting Behavior. Journal of research on
adolescence: the official journal of the Society for Research on Adolescence, 2019.
Shahimi, F., Rahimi, C., & Mohamadi, N. (2019). The Mental Health of Adolescent Girls
with Depressed Mothers: The Mediating Role of the Perception of Parental Styles.
Journal of Social Service Research, 45(4), 488–497.
Taraban, L., et al. (2017). Maternal depression and parenting in early childhood:
Contextual influence of marital quality and social support in two samples.
Developmental Psychology, 53(3), 436–449.
Restifo, K., & Bögels, S. (2009). Family processes in the development of youth depression:
Translating the evidence to treatment. Clinical Psychology Review, 29(4), 294–316.
Garber, J. (2006). Depression in children and adolescents: linking risk research and
prevention. American journal of preventive medicine, 31(6 Suppl 1), S104.
Schwartz, O. S., et al. (2012). Parental Behaviors During Family Interactions Predict
Changes in Depression and Anxiety Symptoms During Adolescence. Journal of
Abnormal Child Psychology, 40(1), 59–71.
Sanders, M. R., et al. (2014). The Triple P-Positive Parenting Program: a systematic
review and meta-analysis of a multi-level system of parenting support. Clinical
Psychology Review, 34(4), 337–357.
McLeod, B. D., Weisz, J. R., & Wood, J. J. (2007). Examining the association between
parenting and childhood depression: a meta-analysis. Clin Psychol Rev, 27(8),
986–1003.
Pinquart, M. (2017). Associations of Parenting Dimensions and Styles with Internalizing
Symptoms in Children and Adolescents: A Meta-Analysis. Marriage & Family Review,
53(7), 613–640.
Mental Health & Prevention 20 (2020) 200193
Milne, L. C., & Lancaster, S. (2001). Predictors of depression in female adolescents.
Adolescence, 36(142), 207.
Chen, Ping, Harris, Kathleen Mullan, et al. (2019). Association of Positive Family
Relationships With Mental Health Trajectories From Adolescence To Midlife. JAMA
Pediatrics. https://doi.org/10.1001/jamapediatrics.2019.3336.
Chen, Ying, Haines, Jess, Charlton, Brittany, VanderWeele, Tyler, et al. (2019). Positive
parenting improves multiple aspects of health and well-being in young adulthood.
Nature Human Behaviour. https://doi.org/10.1038/s41562-019-0602-x.
Chew, E. W. C., & Wang, J. C. K. (2013). Parents as social context in youth sport: A
validation of the PASCQ with adolescent Singapore athletes. International Sports
Studies, 35(2), 34–46.
Furman, W., & Buhrmester, D. (1992). Age and sex differences in perceptions of networks
of personal relationships. Child Dev, 63(1), 103–115.
Swords, L., Hennessy, E., & Heary, C. (2011). Adolescents’ beliefs about sources of help
for ADHD and depression. Journal of adolescence, 34(3), 485–492.
Muñoz, R. F., et al. (2010). Prevention of Major Depression. Annual Review of Clinical
Psychology, 6(1), 181–212.
Odgers, C. L., et al. (2012). Supportive parenting mediates neighborhood socioeconomic
disparities in children’s antisocial behavior from ages 5 to 12. Development and
psychopathology, 24(3), 705–721.
Flamm, E. S., & Grolnick, W. S. (2013). Adolescent adjustment in the context of life
change: the supportive role of parental structure provision. Journal of Adolescence, 36
(5), 899–912.
Williamson, V., et al. (2017). The role of parenting behaviors in childhood post-traumatic
stress disorder: A meta-analytic review. Clinical Psychology Review, 53, 1–13.
Vadlin, S., Åslund, C., & Nilsson, K. W. (2018). A longitudinal study of the individual-
and group-level problematic gaming and associations with problem gambling among
Swedish adolescents. Brain Behav, 8(4), e00949.
Svanborg, P., & Ekselius, L. (2003). Self-assessment of DSM-IV criteria for major
depression in psychiatric out- and inpatients. Nordic Journal of Psychiatry, 57(4), 6.
Association, A.P., Diagnostic and statistical manual of mental disorders. IV-TR ed. 2000,
Washington, DC.
Yap, Marie Bee Hui, M, Pilkington, Pamela Doreen, P D, Ryan, Mary Siobhan, S M,
Jorm, Anthony Francis, A F, et al. (2014). Parental factors associated with depression
and anxiety in young people: a systematic review and meta-analysis. Journal of
Affective Disorders, 156, 8–23. https://doi.org/10.1016/j.jad.2013.11.007. In press.
SCB, Statistisk årsbok för Sverige. (2012). Statistiska centralbyrån, 2012 (A01 - Statistisk
årsbok för Sverige).
Taylor and Francis, Taylor & Francis Group Ltd 2017.
Keijser, R., Nilsson, K. W., & Åslund, C. (2020). Measuring parental dimensions: A
psychometric evaluation of the parents as social context questionnaire. Swedish
version. Cogent Psychology, 7(1).
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics, 5th ed. Using
multivariate statistics, 5th ed. (p. 980) Boston, MA: Allyn & Bacon/Pearson Education.
xxvii, 980-xxvii.
Allison, P. D. (1999). Multiple Regression: A Primer (Research Methods and Statistics), ed. 1.
Thousand Oaks: Pine Forge Press.
Fleiss, J. L. (1986). The design and analysis of clinical experiments. New York: Wiley.
DeFilippis, M., & Wagner, K. D. (2014). Management of Treatment-Resistant Depression
in Children and Adolescents. Pediatric Drugs, 16(5), 353–361.
McGuinness, T. M., Dyer, J. G., & Wade, E. H. (2012). Gender Differences in Adolescent
Depression. Journal of Psychosocial Nursing and Mental Health Services, 50(12), 17–20.
Hankin, B. L., et al. (1998). Development of depression from preadolescence to young
adulthood: Emerging gender differences in a 10-year longitudinal study. Journal of
Abnormal Psychology, 107(1), 128–140.
Pace, G. T., & Shafer, K. (2015). Parenting and Depression: Differences Across Parental
Roles. Journal of Family Issues, 36(8), 1001–1021.
Hodes, G. E., et al. (2017). Understanding the epigenetic basis of sex differences in
depression. Journal of Neuroscience Research, 95(1-2), 692–702.
Price, J., et al. (1994). The social competition hypothesis of depression. Br J Psychiatry,
164(3), 309–315.
Bodner, N., et al. (2018). Affective family interactions and their associations with
adolescent depression: A dynamic network approach. Development and
Psychopathology, 30(4), 1459–1473.
Schwartz, O. S., et al. (2014). Parenting During Early Adolescence and Adolescent-Onset
Major Depression: A 6-Year Prospective Longitudinal Study. Clinical Psychological
Science, 2(3), 272–286.
Plass-Christl, A., et al. (2017). Parents with mental health problems and their children in
a German population based sample: Results of the BELLA study. PloS one, 12(7),
Article e0180410.
Olff, M., et al. (2013). The role of oxytocin in social bonding, stress regulation and
mental health: An update on the moderating effects of context and interindividual
differences. Psychoneuroendocrinology, 38(9), 1883–1894.
Cuijpers, P., Beekman, A. T. F., & Reynolds, C. F. (2012). Preventing Depression. JAMA,
307(10), 1033.
Psychogiou, L., et al. (2017). Parental depressive symptoms, children’s emotional and
behavioural problems, and parents’ expressed emotion—Critical and positive
comments. PLOS ONE, 12(10), Article e0183546.