These findings taken together suggest that the young child can validly self-report on some key aspects of depression and anxiety and that self-report of young children should be sought in these domains. Findings also suggested that these self-reports are limited to the core and basic symptoms of these disorders and that direct age appropriate approaches may not be useful beyond that domain.

Background Empirical findings from two divergent bodies of literature illustrate that depression can arise in the preschool period and that the complex self-conscious emotions of guilt and shame may develop normatively as early as age 3. Despite these related findings, few studies have examined whether the emotions of shame and guilt are salient in early childhood depression. This is important to further understand the emotional characteristics of preschool depression. Based on the hypothesis that preschool depression would be uniquely associated with higher levels of shame and maladaptive guilt, these emotions were investigated in a sample that included depressed, anxious, and disruptive disordered preschoolers as well as healthy peers using multiple methods. Method Structured psychiatric diagnoses were derived in a sample of N = 305 preschoolers ascertained from community sites. Pre-schoolers’ tendency to experience shame and guilt were explored using a story stem completion task coded by raters blind to symptoms and diagnosis of the subjects. Guilt experience and reparation behaviors were also measured using parent report. Results Based on preschooler’s emotion themes during the narrative tasks, gender, age, and depression severity predicted unique and significant portions of the variance in preschoolers’ expressions of shame. Parent report measures revealed that increasing depression severity was associated with children’s more frequent experiences of guilt feelings and less frequent attempts at guilt reparation (maladaptive guilt). Conclusions Findings demonstrated that high levels of shame and maladaptive guilt were related to preschool onset depression when using observational measures of children’s internal representations of their self-conscious emotions as well as parent report. These findings demonstrate continuity of these core emotions of depression as early as age 3. These findings suggest that guilt and shame should be explored in clinical assessments of young children and may be an important focus for future studies of the developmental psychopathology of depression.

This study examined diagnostic group differences in children's internal representations of their mothers and mothers' parenting strategies 1 year later. Mother -preschool child dyads (N = 279) were examined. The sample included 151 healthy, 75 depressed, and 53 disruptive disordered preschoolers. The MacArthur Story Stem Battery (MSSB) was administered at baseline. One year later, mothers' caregiving strategies were measured. Results indicated that higher depression severity was associated with preschoolers' greater use of negative and disciplinarian maternal representations. More positive maternal representations had supportive mothers who often expressed positive affect 1 year later. Preschoolers' negative and disciplinarian representations were associated with mothers' later nonsupportive behaviors and negative affect. Results suggest that the MSSB may be a useful child-informant method for interpreting depressed children's internalization of caregiving relationships.

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We investigated whether differences in positive and negative emotional reactivity could be found in depressed preschoolers and preschoolers at risk for later internalizing symptoms relative to nondepressed/low risk comparison groups. Observational measures of emotional reactivity, used to derive a score of the balance between anger and sadness, were obtained and analyzed in independent samples. One study utilized cross-sectional data from preschoolers with a current depressive syndrome and two non-depressed comparison groups. The other study utilized longitudinal data that assessed emotional reactivity at preschool age and later mental health symptoms during the transition to primary school, allowing a retrospective determination of risk. Depressed and at risk boys displayed more anger than sadness in contrast to girls in the same groups and in contrast to no disorder/ low risk controls. This finding was detected in depressed and "at risk for internalizing" boys who were not comorbid for externalizing problems. The validity of these findings, which are consistent with the developmental and theoretical literature, is enhanced by their emergence in two independent samples. Results suggest possible gender specificity in the manifestations of early onset depression.After a long history of skepticism about the possibility that children could experience clinical depression (Digdon & Gotlib, 1985;Rochlin, 1959), empirical data began to demonstrate that children and adolescents manifest symptoms of depression similar to those in the adult disorder as described in the Diagnostic and Statistical Manual (DSM; APA, 2000;Carlson & Cantwell, 1980; Puig-Antich, Blau, Marx, Greenhill, & Chamber, 1978;Ryan, Puig-Antich, & Ambrosini, 1987). Both longitudinal follow-up studies and findings of high genetic risk for affective disorders in adolescent and adult relatives of depressed child probands further emphasized the validity of depression as well as the continuity of the disorder over the lifespan (Todd, Neuman, Geller, Fox, & Hickok, 1993;Weissman et al., 1999). Studies also demonstrated that the presence of sadness and the absence of positive affective states, as evidenced by anhedonia, are primary characteristics of childhood depression (Carlson & Cantwell, 1980;Kovacs & Paulauskas, 1984). Furthermore, the unique importance of irritability or anger in childhood depression was also emphasized, leading to a developmental modification to the DSM criteria for Major Depressive Disorder (MDD) that stipulated that, in children, irritability rather than sadness can serve as a cardinal symptom of depression.In keeping with these findings in older children, Luby and colleagues (2002;2003a) have provided data suggesting that negative emotions characteristic of adult MDD, such as sadness and anhedonia, may also arise as early as age 3. A specific and stable constellation of depressive symptoms, with associated impairment in functioning rated by both parents and teachers, was identified in these young children when core DSM symptom...