Family supportive communication and depression during early to middle adolescence: a technology-enhanced naturalistic observational study

PROJECT SUMMARY Depression is a common debilitating disorder in adolescents that compel high levels of support and care from parents. In addition to the benefits of symptom reduction, support from parents may promote positive emotions and reduce negative emotions in the daily lives of youth. Although examined as separate constructs, youth support seeking and parental support constitute a dynamic dyadic process (i.e., supportive communication), wherein the coordination between the youth and the parent’s behaviors is associated with depression risk. Youth who benefit most from parental support, such as those with depression risk, are more likely to receive lower quality support, which may discourage future attempts at seeking parental support. To better inform future interventions targeting this crucial protective process for the prevention of depression, we will characterize four indices of the parent-youth supportive communication – youth support seeking, parent enactment of support, support concordance (i.e., concordance between parent enactment of support and youth support seeking), and youth perception of parental support – in the daily lives of youth with and without risk for depression. A multi-method and multi-information investigation of supportive communication can better reveal how interventions can promote the coordination of parent and youth behaviors for maximum benefit in youth with risk for depression. The proposed intensive longitudinal methods will characterize supportive communication in parent-youth dyads as they arise in real time and in real world settings over a two-week period. Study will recruit 100 12-15 year old youth with high and low levels of depression symptoms, as well as primary caregivers. Over a two week period, the study will conduct continuous measurements of parent-youth proximity using Bluetooth signal strengths, automated event-contingent ecological momentary assessments of supportive communication with parents and youth, and obtain naturalistic video recordings of parent-youth conversations in daily life to address the following specific aims: Aim 1) Develop, test, and refine a coding system to describe parent-youth supportive communication in video recordings of daily conversations using existing pilot data from two families; Aim 2) Characterize daily parent-youth supportive communication in youth with high and low levels of depression risk; Aim 3) Test whether the four indices of supportive communication mediate associations between depression risk and daily negative and positive emotions at end-of-day, independent of stress; and Exploratory Aim) Explore whether the association between depression risk and supportive communication differ by youth self-reported gender, race/ethnicity and socio-economic status. Significance: Insights from this innovative study will help to pinpoint strategies for improving supportive communication in daily life, and inform the design of a family-focused ecological momentary intervention for the prevention of adolescent depression.