Mental health resilience in offspring of depressed parents: a systematic literature review protocol

Background Parental depression is associated with a range of mental health conditions and other difficulties in the offspring. Nevertheless, about one in five offspring exposed to parental depression do not develop mental health problems, indicating the presence of protective factors that may buffer parental depression-related risk effects. However, evidence of protective factors that might explain good sustained mental health in offspring of depressed parents is limited and systematic synthesis of these factors is still needed. Therefore, as far as we are aware, this will be the first systematic review that will define mental health resilience in the parental depression context and identify parental/ caregivers’, child, family, and social factors associated with mental health resilience in offspring exposed to parental depression. As a secondary aim, evidence for sex-, developmental stage-, and outcome domain-specific factors associated with mental health resilience will also be examined. Methods A two-step search strategy will be performed. Electronic searches will be performed for articles published up to March 2021 in PsycINFO, Embase, MEDLINE, Web of Science Core Collection, and Cochrane Library. Additional articles will be identified by manually screening the references and citations of included studies. Two reviewers will independently screen titles, abstracts and full texts of articles against pre-determined eligibility criteria, extract data and perform risk of bias assessments. Reviewers will be blinded to the other’s decisions, and discrepancies between reviewers will be resolved during consensus meetings with a senior researcher. Results will be narratively synthesised to address primary and secondary aims. Discussion This systematic review will provide a comprehensive overview of protective factors associated with mental health resilience in offspring exposed to parental depression. Results will help better understand mental health resilience and factors associated with it and identify future research directions. The findings are also expected to identify targets for evidence-based prevention and intervention strategies for those in need. Systematic review registration: This systematic review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (www.crd.york.ac.uk/PROSPERO, CRD42021229955).

Parental Depression and Contextual Selection: The Case of School Choice

Parental depression constricts children’s development, but the mechanisms implicated—beyond daily parenting tactics—remain unknown. Today, parents must evaluate and select environmental contexts for child-rearing within increasingly complex residential and educational markets. Depression may hamper parents’ abilities to navigate this terrain, constraining information collection and impairing child-oriented decision-making. In turn, depressed parents’ children may lack access to developmentally enriching neighborhood, school, and child care settings. K–12 school sorting offers a strategic case to assess these expectations, given proliferating nontraditional options and school quality data. Analyses using the Los Angeles Family and Neighborhood Survey (N = 2,754) linked to administrative data suggest that depressed parents’ children attend magnet, charter, or private schools at lower rates than similarly situated children of nondepressed parents; depression-based disparities appear largest among Latino and Black families. The study motivates future research examining whether the depression-contextual selection link mediates intergenerational processes and exacerbates segregation.