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Book and Media Reviews
December 2, 2009

Adolescent Emotional Development and the Emergence of Depressive Disorders

JAMA. 2009;302(21):2371-2372. doi:10.1001/jama.2009.1766

In 1945, Spitz described a syndrome of developmental retardation that involved metabolic slowing and distress in children older than 8 months who were separated for an extended period from their mothers. Spitz called this “anaclitic depression.”1 In the 1960s, British psychiatrist Bowlby integrated primate, anthropological, and clinical research to describe what he called “attachment”: a child's biological, goal-correcting, emotion-driven behavior that elicits protection and nurturing from caregivers—primarily the mother.2 From Bowlby's work were born the multidisciplinary, scientifically robust fields of infant attachment and developmental psychopathology. These fields stretch from the micro (the molecular neurobiology of affect regulation) to the macro (the negative effects of poverty and war)3,4; stress that mother-child and family relationships are the sine qua non of mood stability; and have produced clinically effective interventions.5 A second major clinical breakthrough in treating depression in youth has been the adaptation of cognitive-behavior therapy for teens.