Intergenerational Depression and Anxiety Disorders: A Network Analysis of Family Functioning and Depression/Anxiety Symptoms in Offspring

Abstract

Introduction: Depression and anxiety are frequent disorders that commonly develop during youth. The offspring of parents with depression and/or anxiety present a high vulnerability to mental disorders. This study investigates the associations between family functioning and individual symptoms of depression/anxiety in offspring.

Method: Cross-sectional data were collected from 483 offspring (13 to 25 years) of parents treated for depression/anxiety. Family cohesion and flexibility were assessed with the Family Dimensions Scales, depression/anxiety symptoms in offspring were assessed with the DSM- IV questionnaire. A multiple linear regression examined associations of cohesion and flexibility with the number of symptoms in offspring, then logistic regressions were performed for each symptom. A mixed graphical network estimated the direct and indirect links between family functioning dimensions and individual symptoms.

Results: Cohesion was negatively related to total number of symptoms in offspring (ß = - 0.13, p = .007), while flexibility was positively related to symptoms (ß = 0.33, p < .001). Flexibility also had significant individual associations with all symptoms. In the network structure, cohesion showed two negative (anhedonia and suicidality) and one positive link (insomnia), whereas flexibility showed two positive links (guilt and insomnia).

Discussion: High family cohesion has a protective role in offspring depression/anxiety, especially against anhedonia, sadness and worthlessness. Excessive family flexibility is detrimental to offspring, especially via guilt and sleeping problems that are further related to anxiety. Findings suggest that different family factors relate to distinct pathways of symptoms in the offspring and that family interventions should increase cohesion and reduce excessive flexibility.