The study recruited fourteen Dutch-speaking parents, eight mothers and six fathers with an average age of about fifty-one, all living with an adolescent aged twelve to eighteen who was experiencing depressive symptoms. The adolescents themselves, seven girls and seven boys with an average age of roughly fifteen, were rated by their parents as having moderate to severe depressive symptoms on a standard screening questionnaire. Nine of the fourteen young people were receiving treatment for their symptoms during the study period. Every parent in the sample was a biological parent, and most participated in couples, allowing the researchers to compare how two parents in the same household responded to the same child on the same days.

Methodologically, the study stands out for its use of ecological momentary assessment, a technique in which participants answer brief surveys on their phones in their natural environment rather than recalling events weeks later. Parents received four surveys a day, but the analyses focused on the evening survey, which asked each parent to rate how worried they had been about their child that day, how confident they had felt in their role as a parent, and how warm and how critical they had been toward their child, all on seven-point scales. Crucially, the surveys also asked open-ended follow-up questions: what was the direct cause of the worry, what made the parent feel insecure, and what made them feel confident. Parents could select predefined answers or type their own, and their custom responses were carried forward into later surveys.

On the quantitative side, the team estimated a Gaussian graphical model, a type of network analysis in which variables are represented as nodes and the statistical associations between them as edges, with each edge representing a partial correlation that controls for all other variables in the network. To avoid spurious connections, the researchers applied LASSO regularization with model selection via the Extended Bayesian Information Criterion, and they checked the stability of the estimated edges with a non-parametric bootstrap of one thousand resamples. Across 446 evening observations, the resulting network replicated and extended earlier findings from the RE-PAIR study. Parental worry was positively correlated with parental criticism, with an edge weight of 0.349, the strongest connection in the network. Parental worry and self-efficacy were negatively correlated, meaning that on days when parents worried more, they tended to feel less confident as parents.

Self-efficacy, in turn, showed a positive correlation with parental warmth, at 0.289, and a small negative correlation with criticism. Warmth and criticism themselves were negatively related. Because parental criticism has repeatedly been linked in prior research to elevated depressive symptoms in adolescents, these connections matter: they sketch a plausible pathway in which a parent’s anxiety about a child’s condition could feed into harsher or more critical interactions, while a parent’s confidence could support warmer ones. What the network cannot yet establish is direction. Whether worry drives criticism, or criticism amplifies worry, or whether confidence fosters warmth or warmth fosters confidence, remains an open question that the authors flag for future research.

The qualitative half of the study tackled that blind spot from a different angle. Using thematic analysis, the researchers coded the reasons parents gave for their worry and self-efficacy into six overarching themes: adolescent behavior, adolescent well-being, family interaction, the parent, the future, and parenting behavior. For worry, the most frequently reported themes were adolescent behavior, adolescent well-being, and family interaction. Within adolescent behavior, the dominant subthemes were a lack of activities, school absence, and eating habits. Parents described children staying in bed, canceling appointments, and refusing to discuss school, and several linked eating problems to physical complaints such as fainting. Within well-being, the runaway leader was the adolescent’s negative mood, selected by all fourteen parents a combined 137 times. One parent even reported worry tied to a child who kept thinking of death, a stark reminder of the suicidality that shadows adolescent depression.

Family interaction emerged as the third major worry theme, driven overwhelmingly by a lack of contact with the child. Parents wrote that it was difficult to really discuss anything, that their child avoided contact, or that their child would not leave their room. Notably, when the researchers mapped which reasons co-occurred on the same evening, a child’s lack of activities frequently appeared alongside negative mood, and school absence frequently appeared alongside withdrawal, suggesting that parents experience these symptoms not as isolated problems but as a clustered, mutually reinforcing picture of their child’s decline.

The drivers of self-efficacy told a complementary story. The most selected reason for feeling less confident as a parent was, again, lack of contact with the child, followed by the adolescent’s negative mood and doubts about parenting behavior itself. Parents reported not knowing how to help or support their child, wondering whether to raise difficult topics such as school attendance or substance use, and feeling constantly insecure in their role. One parent captured the ambivalence poignantly, writing that they knew they were a good parent even though it did not always feel that way. On the positive side, the strongest booster of self-efficacy was contact with the child, including fun conversations and shared activities, followed by a good family atmosphere and feeling supported by a partner. The contrast is striking: the same domain, parent-child connection, sits at the heart of both the parents’ distress and their resilience.

Zooming in on one couple, the researchers estimated individual time-series networks for each parent, revealing that the group-level patterns did not hold uniformly within families. One parent showed the expected positive link between self-efficacy and warmth, while the other did not, and the two parents cited overlapping but distinct reasons for their worry, with one pairing negative mood with lack of contact and the other pairing school absence with mood. The couple’s weekly patterns also showed that worry and its reasons fluctuated together across the intervention, generally easing from the first week to the last, though the same core concerns persisted. This within-family variation, the authors argue, underscores the case for personalized, family-level approaches rather than one-size-fits-all advice.

The practical implications are direct. The authors conclude that parents of adolescents with depression need specialized care focused on the adolescent-parent interaction, including concrete guidance on managing a child’s negative affect and behaviors such as social withdrawal, eating problems, and screen use. They also highlight the power of simply asking parents, in the moment, what is driving their worry and insecurity, a low-burden diary method that parents in the study said helped them reflect on their own daily behavior. Strengthening support between partners and within the wider family, the study suggests, could be a fruitful clinical target, since perceived partner support reliably lifted parental confidence. As adolescent depression rates continue to climb worldwide, this research makes a compelling case that treating the teenager alone is not enough: the worried parent behind the withdrawn child is part of the system, and helping that parent may be one of the most effective ways to help the child.

Subject of Research: Daily diary study of parental worry, self-efficacy, and parenting behaviors in families raising adolescents with depression

Article Title: Parental Worry, Self-Efficacy, and Parenting Behaviors when Raising Adolescents with Depression: A Mixed-Method Daily Diary Study

Article References: Veenman, M., Kullberg, M. L. J., Kielstra- van der Schalk, C., van den Nouweland- van Baars, R., Ruys- Zonnenberg, M., Fried, E. I., & Elzinga, B. M. (2026). Parental Worry, Self-Efficacy, and Parenting Behaviors when Raising Adolescents with Depression: A Mixed-Method Daily Diary Study. Journal of Child and Family Studies. https://doi.org/10.1007/s10826-026-03369-z

Image Credits: AI Generated

DOI: 10.1007/s10826-026-03369-z

Keywords: adolescent depression, parental worry, parental self-efficacy, parenting behavior, ecological momentary assessment, network analysis, family systems, parental criticism, parental warmth, mixed methods, daily diary study, parenting intervention