Children whose mothers have a history of depression become increasingly drawn to sad faces as their own symptoms worsen, a two-year Binghamton University study of 242 youngsters has found. The finding could offer clues about how depression develops in vulnerable children.

The team found that depressive symptoms predicted later changes in attention patterns, although attention patterns did not predict subsequent changes in depressive symptoms. Children whose mothers had no such history instead looked less at happy faces as their symptoms rose.

How the Study Worked

Researchers at the university's Mood Disorders Institute assessed the children every six months over two years. Each child was shown pairs of faces, one neutral and the other happy, sad or angry, while eye-tracking technology recorded which drew attention.

Earlier research had linked depression to greater attention toward sad faces, but those effects were small. Scientists have debated whether such attention patterns cause depression or result from it.

Lead author Kelly Gair, a doctoral student at Binghamton, said the team examined how attention and symptoms predicted one another across time points. Such work lets researchers 'catch things as they're developing', added institute director Brandon Gibb.

Read more

Family History Matters

Among children whose mothers had major depressive disorder, rising symptoms were tied to greater attention toward sad faces. These at-risk children lose some of their ability to pull their attention away from sad things, he said.

In lower-risk children, depression appeared to erode a protective factor: how much attention they pay to happy faces, he added. Gair suggested that children of depressed mothers see more sad faces at home, so those faces stand out more when they feel low.

Psychotherapist Ciara Bogdanovic said such shifts in attention may deepen depressive symptoms and weaken protective factors. The findings, she added, show how depression may affect the way children notice emotional information around them.

A separate study of children aged seven to 13 found that boys at familial risk spotted sadness at a lower emotional intensity than low-risk boys. Its authors cautioned that this sensitivity may not drive later depression.

Signs Parents Should Watch

Depression can look different in children. Ann Rolling, PhD, a licensed professional counsellor, said they may be irritable, moody, clingy or overly sensitive.

Warning signs include withdrawal, slipping grades, lost interest in favourite activities, fatigue, and changes in sleep or appetite, she said. Some children also voice vague thoughts about death or dying.

Erica Lee, PhD, of Harvard Medical School, said irritability is often more common than sadness in children. Children may seem happy with friends but withdrawn at home, she noted.

How Screening Works

Screening for depression in children can begin with a broad measure such as the Pediatric Symptom Checklist, Lee said. It assesses internalising problems, like depression and anxiety, and externalising problems, like disruptive behaviour.

If a child reports depressive symptoms, a more focused tool follows. The Mood and Feelings Questionnaire can be used for young people aged eight to 18, while she called the Patient Health Questionnaire-9 'a nice short 9-item questionnaire for youth ages 12 through 18'.

Results guide the next steps, she said, from close monitoring to coping skills or a behavioural health specialist for more focused recommendations. Rolling suggested starting with the child's paediatrician when symptoms last several weeks or worsen.

The paediatrician can rule out physical causes and refer families to relevant specialists. Seeking help does not reflect poor parenting, she said. Timely care can spare children months or years of suffering.

Researchers say the patterns offer clues about why some children are more vulnerable than others. The Binghamton team is following participants into adolescence, when depression risk rises for many young people.

Read more