| Depression is one of the most prevalent mental illnesses worldwide and adolescence is a time of high depression prevalence.The family environment plays an important role in adolescent depression,and family communication is a key factor in the strengths and weaknesses of the family environment.Research has shown that poor family communication is strongly associated with depression,and that equal family communication predicts milder levels of depressive symptoms.As past understanding of the mechanisms behind the association between family communication and depressive symptoms has been more limited,this study will explore the relationship from the perspective of the mechanisms underlying the effects of anger expression.Previous studies have explored the mechanisms behind the association between family communication and adolescent depressive symptoms more in depth from an adult group,gender,and cross-cultural perspective.Irritability,as a unique symptom expression of adolescent depression,is closely linked to poor family communication,but few studies have explored the mechanisms behind the relationship between family communication and depressive symptoms from this perspective.Therefore,the first research question is whether anger expression mediates the relationship between family communication and adolescent depressive symptoms.If anger expression is an underlying psychopathological mechanism in the development of depression,are there differences in anger expression between adolescent clinical and healthy populations?What are the physiological mechanisms underlying anger expression in adolescent depression?Is there a severe impairment in the physiological response to anger expression in clinical adolescent depression,and could this similarly explain the association of family communication with depressive symptoms?Given that respiratory sinus arrhythmia(RSA)is often used as a physiological indicator of anger-regulated expression,angry emotion expression may be associated with RSA inhibition,and stronger RSA inhibition and enhanced,larger response amplitude in anger-related tasks are also associated with better anger regulation skills in individuals.Therefore,the second research question focused on exploring the differences in physiological responses to anger expression between the healthy and clinically depressed groups from the perspective of RSA,exploring the peripheral physiological mechanisms underlying abnormalities in depressed anger expression in clinical adolescents,and validating the mediating role that anger expression plays between family communication and depressive symptoms.There were two experiments in Study 1.Experiment 1 focused on testing the reliability of the Anger Expression Scale for Children(AESC),which recruited 500 adolescents and found good reliability(Cronbach α>0.70,χ2=1101.62,df=293,χ2/df=3.76,RMSEA=0.07,CFI=0.85,TLI=0.83),which is psychometrically sound and has good structure for the measurement of adolescent anger expression.Experiment 2 focused on exploring the mediating role of anger expression in the relationship between family communication and adolescent depressive symptoms.749 adolescents were recruited and all participants were required to complete the Family Communication Patterns Scale(RFCP),the Anger Expression Scale for Children(AESC)and the Childhood Depression Inventory(CDI),and the results found that anger expression significantly mediated the relationship between family communication and adolescent depressive symptoms(χ2=36.67,df=19,χ2/df=1.93,RMSEA=0.04,CF]=0.99,TLI=0.99,SEMR=0.04),with an increase in family communication-conversation-oriented style decreasing adolescent anger expression and thus decreasing depressive symptoms,and on the other hand,an increase in family communication-submission-oriented style elevating On the other hand,an increase in the family communication-conversation orientation increased adolescent anger expression,thereby increasing depressive symptoms.Study 2 focused on characterising changes in the physiological mechanisms of anger expression in adolescents with depression,as well as exploring the differences in the physiological mechanisms of anger expression between the depressed clinical group and the healthy group,and finally verifying the mediating role of anger expression in the relationship between family communication and depressive symptoms.67 adolescents were recruited for the study,and the BIOP AC Physiological Polysomnography and Observer Behavioural Observation System was combined with an anger event discussion task to paradigm to measure physiological responses during anger expression,and found that the group-by-time interaction between the depressed and healthy groups for RSA baseline values on the 5-minute Angry Emotional Event Discussion Task was not significant(F(4,260)=0.64,ps=.637,η=0.01),with a significant main effect of group(F(1,65)=10.46,ps=.002,η=0.14),a non-significant main effect of time(F(4,260)=1.57,ps=.183,η2=0.03),lower mean values in the depressed group than in the healthy group in both the 5-minute task,a trend towards enhanced and then suppressed RSA during the task in both the depressed and healthy groups,with the depressed group showing less change than the healthy group,and non-significant group differences in RSA response values in the anger discussion task between the two groups(t(65)=0.68,ps=.497,Cohen’sd=0.17,η2=0.08).Our two findings suggest that the Childhood Anger Expression Scale is a valid measure of anger expression in adolescents,that increased frequency of anger expression in subclinical groups may be a precursor to their developing depression,and that,in addition,reduced levels of RSA response and dysregulation of the parasympathetic nervous system may be the physiological mechanisms underlying increased anger expression in clinical depression.Future precise prevention and interventions regarding early adolescent depression could also focus more on anger expression to help adolescents reduce depressive symptoms. |
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