Page 149 - Encyclopedia of Nursing Research

116 n DEPRESSion in FAMiLiES

studies using genetic probes to determine all areas than matched control families and
which relatives and which phenotypes are families whose members are diagnosed with
D associated with the genetic contributants alcohol dependence, adjustment disorders,
to mood disorders (Suppes & Rush, 1996). schizophrenia, or bipolar disorders (Keitner
The results of the familial loading studies et al., 2003). it is not surprising that depres-
are clear, whether the approach used is the sion has its most negative impact on fami-
“top-down” (i.e., studies of children with lies during acute depressive episodes (Miller
depressed parents; Currier, Mann, oquendo, et al., 1992), yet families with depressed mem-
Galfalvy, & Mann, 2006) or the “bottom- bers consistently experience more difficulties
up” approach (i.e., studies of relatives of than matched control families even after ini-
depressed children; Mondimore et al., 2007; tial treatment. Family members living with
Silk et al., 2009). Children with depressed members with depression report greater
parents have a significantly greater risk of health problems, with family members often
developing depressive disorders and other being sufficiently distressed themselves to
psychiatric disorders than do children with require therapeutic intervention (Abela et al.,
parents without depression (Abela, Zinck, 2009; Ahlström et al., 2009).
Kryger, Zilber, & hankin, 2009; Gibb, Benas, A related and important body of psy-
Grassia, & McGeary, 2009). Biological marker chosocial research focuses on depression
studies have focused on growth hormone, as a coexisting condition for those suffer-
serotonergic and other neurotransmitter ing with a chronic or life-threatening illness
receptors, sleep, and hypothalamic–pituitary (e.g., cancer, diabetes, and dementia). As an
axis (Gibb et al., 2009; Raison et al., 2006; example, researchers have focused on the
Sunderajan et al., 2010; Uher & McGuffin, negative health outcomes of family caregiv-
2008). There is increasing evidence from ers in cancer and how caregiver outcomes
genetic studies about the genetic inheritance also influence the cancer survivor’s health
of depression (holmans et al., 2007; Kendler, outcomes (e.g., Kurtz, Kurtz, Given, & Given,
Gatz, Gardner, & Pederson, 2005) and the fact 2005; Manne, ostroff, Winkel, Grana, & Fox,
that abnormalities in biological markers per- 2005; northouse et al., 2007; Segrin et al.,
sist throughout the life span. The majority of 2006). These studies provide additional evi-
studies on genetic and biomarker studies in dence of the negative impact of depression
recent years have focused on maternal trans- on the entire family when family members
mission (e.g., Gibb et al., 2009; hammen et al., are living with members with depression
2004) rather than paternal transmission of plus chronic or life-threatening illness and
depression. Currier et al. (2006) is an excep- for the importance of including family mem-
tion in that they examined sex differences bers in treatment interventions (Segrin &
in parental transmission to both male and Badger, 2010).
female offspring. Familial transmission rate Few studies have used qualitative
of mood disorders from female probands approaches to understand family members’
was almost double that of males. perspectives and treatment needs of living
Psychosocial research of depression with a depressed person (Ahlström et al.,
in families has focused on communica- 2009, 2010; Badger, 1996a, 1996b). Ahlström
tion, marital problems and dissatisfaction, et al. (2009) found, in their qualitative descrip-
expressed emotion, problem solving, coping, tive study of seven families with an adult
and family functioning (Feeny et al., 2009; member who had MDD, five themes describ-
Lazary, Gonda, Benko, Gacser, & Bagdy, ing living with major depression. Family
2009; Silk et al., 2009). The evidence strongly members (n = 18) described being forced to
supports that families who contain members relinquish control in everyday life because
with depression have greater impairment in the family members lost their energy and