Youth Depression and Perceived Social Support from Parents: A Meta-Analysis of Gender and Stress-Related Differences

Abstract

The current meta-analysis investigates the parental support-youth depression association and whether this association varies by gender and stress. Studies published from 1983 to February 2021 were gathered via electronic search in 6 databases and a hand search of 14 journals. Studies that measured support from parents and youth depression were included. Depression intervention studies and studies that measured constructs conceptually distinct from social support were excluded. Using a random-effects model, the overall effect size based on 170 studies on N = 114,674 participants was r = .27 (p < .001). Cross-sectional results supported the general benefits model with no evidence of parent gender differences, but results showed stronger associations between depression and support from parents as a unit compared to either mothers or fathers alone. Cross-sectional results also showed larger effect sizes for girls compared to boys in the association between depression and support from parents and mothers. However, there was no evidence for parent or youth gender differences in any of the longitudinal analyses. A significant cross-sectional dampening effect of stress on maternal/paternal support for both boys and girls was uncovered but disappeared in longitudinal analyses, and stress-buffering effects of parental support emerged over time in longitudinal analyses. Finally, bidirectional analyses demonstrated parent and child effects with no youth gender differences. Sensitivity analyses showed little evidence of publication bias or historical influences. Limitations include lack of information about support type and developmental differences. Results underscore the importance of including both mothers and fathers in depression prevention and intervention efforts.

Full text

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This is the final accepted version of the following article:
Rueger, S. Y., Pyun, Y., Coyle, S., Wimmer, J., & Stone, L. B. (in press). Youth depression
and perceived social support from parents: A meta-analysis of gender and stress-related
differences. Psychological Bulletin.
Youth Depression and Perceived Social Support from Parents:
A Meta-Analysis of Gender and Stress-Related Differences
Sandra Yu Rueger1, Yoonsun Pyun1,2, Samantha Coyle3,
Jessica Wimmer3, and Lauren B. Stone1
1 Wheaton College, School of Psychology, Counseling, and Family Therapy, Wheaton, IL
2 Northern Illinois University, Department of Psychology, DeKalb, IL
3 Monclair State University, Department of Psychology, Montclair, NJ
Corresponding Author:
Sandra Yu Rueger
School of Psychology, Counseling, and Family Therapy
Wheaton College
Wheaton, IL 60187
630-752-5753 (telephone)
630-752-7033 (fax)
sandra.rueger@wheaton.edu

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Author Note:
Sandra Y. Rueger: https://orcid.org/0000-0001-9129-5147
Yoonsun Pyun: https://orcid.org/0000-0001-8038-7660
Samantha Coyle: https://orcid.org/0000-0002-3240-5120
Lauren B. Stone: https://orcid.org/0000-0001-6344-7473
We would like to thank the authors of studies who took the time to share additional statistics and
data. We also gratefully acknowledge the research teams at Wheaton College and Montclair
State University for their assistance with the literature search, especially Margaret Kassel and
Emma Batson, who also assisted with database management and supported the coding process.
We are especially grateful for Dr. Christine Malecki at Northern Illinois University for her
emotional, informational, instrumental, and appraisal support, and for the connections each co-
author has to the Malecki Lab both directly and indirectly. We also thank the Wheaton College
Alumni Association for funding this research through the Faculty Research Achievement Award
to Sandra Yu Rueger.
Supplemental materials, including the data and codebook are available at the following link:
https://osf.io/phuj5/.
Correspondence concerning this article should be addressed to Sandra Yu Rueger, School of
Psychology, Counseling, and Family Therapy, Wheaton College, 501 College Avenue, Wheaton,
IL 60187. Email: sandra.rueger@wheaton.edu.

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Abstract
The current meta-analysis investigates the parental support-youth depression association and
whether this association varies by gender and stress. Studies published from 1983 to February
2021 were gathered via electronic search in 6 databases and a hand search of 14 journals. Studies
that measured support from parents and youth depression were included. Depression intervention
studies and studies that measured constructs conceptually distinct from social support were
excluded. Using a random-effects model, the overall effect size based on 170 studies on N =
114,674 participants was r = .27 (p < .001). Cross-sectional results supported the general benefits
model with no evidence of parent gender differences, but results showed stronger associations
between depression and support from parents as a unit compared to either mothers or fathers
alone. Cross-sectional results also showed larger effect sizes for girls compared to boys in the
association between depression and support from parents and mothers. However, there was no
evidence for parent or youth gender differences in any of the longitudinal analyses. A significant
cross-sectional dampening effect of stress on maternal/paternal support for both boys and girls
was uncovered but disappeared in longitudinal analyses, and stress-buffering effects of parental
support emerged over time in longitudinal analyses. Finally, bidirectional analyses demonstrated
parent and child effects with no youth gender differences. Sensitivity analyses showed little
evidence of publication bias or historical influences. Limitations include lack of information
about support type and developmental differences. Results underscore the importance of
including both mothers and fathers in depression prevention and intervention efforts.
Keywords: Parental support; Depression, General Benefits; Stress-Buffering, Stress-Dampening

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Public Significance Statement: This meta-analysis demonstrated the importance of perceived
social support from both mothers and fathers in relation to lower levels of depression in children
and adolescents with modest youth gender differences. Results also showed that both mothers
and fathers may be impacted in their capacity to provide social support to their daughters and
sons in certain stressful contexts, and provided clarification on the types of stressors that might
lead to diminished effectiveness of parental social support. The results of the current meta-
analysis have implications for further theory testing as well as clinical application and policy
development to prevent and intervene in youth depression and reduce the burden of this serious
and debilitating disorder through the lifespan.

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Youth Depression and Perceived Social Support from Parents:
A Meta-Analysis of Gender and Stress-Related Differences
The literature has firmly established social support from parents as a robust predictive
factor in relation to depression in children and adolescents (e.g., Auerbach et al., 2011; Colarossi
& Eccles, 2003; Rueger et al., 2010; Sheeber et al., 2007). However, the role of gender and stress
in modifying the parental support-depression association remains unclear. Specifically, a recent
meta-analysis investigated the association between social support and depression in youth across
over 340 studies. Results demonstrated strong evidence across four sources of support (i.e.,
families, teachers, peers, and friends) for the general benefits model of social support (Rueger et
al., 2016), which suggests that everyone benefits from positive, supportive relationships.
However, unexpected results emerged related to the stress-buffering model (Cohen & Wills,
1985), or the idea that social support may be especially protective for youth experiencing stress.
Specifically, when considering social support from families, contrary to the stress-buffering
hypothesis, the beneficial effects of social support were smaller for youth in certain stressful
contexts compared to the general population. The ways in which stress diminishes the strength of
the beneficial effects of social support from families requires more careful consideration as to
what sources of support within the family, such as mothers and fathers, may drive this reduction
in protective benefits for stressed youth.
In addition, this previous meta-analysis suggested that youth gender differences in social
support were minimal. In fact, gender differences only emerged when family support was
considered. The association between family support and depression was stronger for girls
compared to boys. However, because this global “family support” category included other family
members, such as siblings and non-parental caregivers, it is unclear whether gender effects

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would emerge when support from only parents is considered. A study with a specific focus on
perceived support from parents would help to further tease apart potential gender differences,
especially in relation to stress. Thus, the goal of the current study is to provide a meta-analytic
review to quantitatively synthesize the literature investigating the relation between parental
support and depression in children and adolescents and consider the role of gender and stress in
explaining the social support-depression association.
Depression in Children and Adolescents
Depression is a debilitating psychological disorder experienced by many youth that poses
a serious public health concern. Epidemiologic studies show that the point prevalence rate of
major depressive episodes in adolescents has increased from 8.7% in 2005 to 11.3% in 2014
(Mojtabai et al., 2016). Lifetime prevalence rates suggest that major depression increases across
development, with rates of about 2-3% in childhood (Costello et al., 2008) to nearly 15% in
adolescence (Weinberger et al., 2018). One large representative study of adolescent depression
including almost 10,000 adolescents found that depressive cognitions occurred in 10% of sixth
graders, 20% of seventh graders, and 24% of eighth graders, suggesting that this is a common
concern affecting many of today’s youth (Saluja et al., 2004). In addition, gender differences in
depression have been found, with higher levels in girls that begin in early adolescence and
lifetime prevalence rates at a 2:1 ratio by late adolescence and early adulthood (Hyde, 2005;
Thapar et al., 2012). These prevalence rates are especially concerning because youth depression
is associated with a variety of negative consequences, including an increased risk for impairment
in school functioning, social relationships, harmful behaviors, and suicide (Birmaher et al., 2004;
Cohen et al., 2015; Kessler et al., 1999; McKowen et al., 2013; Thapar et al., 2012). Further,
depression in adolescence increases the risk for subsequent depression and anxiety in adulthood

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(Johnson et al., 2018), which highlights the potential to reduce the rate of lifelong suffering from
depressive disorder through prevention efforts in childhood and adolescence.
Two of the most well-established risk factors for depression in childhood and
adolescence are exposure to environmental stress and family history of depression (Thapar et al.,
2012). Three aspects of environmental stress that are relevant for understanding depression
include acute life events (e.g., physical injury, relationship loss), chronic stressors (e.g., medical
illness, poverty), and early life adversity (e.g., abuse, family dysfunction; Hammen, 2016). While
these categories of stress may differentially impact youth, it is also possible that chronic and
acute stress can act in tandem. For example, previous research has suggested that chronic stress
may act as a risk factor for depression, while acute stress may precipitate a depressive episode.
Alternatively, it is possible that chronic stressors may occur and put individuals at further risk for
the occurrence of acute stress (Conway et al., 2012). Research suggests that chronic stressors
involving relationships with others (e.g., family discord, maltreatment, and bullying
victimization) are particularly relevant for youth depression (Thapar et al., 2012), with
detrimental effects especially for girls (Hammen, 2012; Rudolph & Hammen, 1999).
Regarding family history, research shows strong evidence that parental depression is a
risk factor for depression in youth (Garber et al., 2009; Goodman et al., 2011; Kane & Garber,
2004). For instance, offspring of depressed parents have a two-to-three-fold increased risk of
developing a depressive disorder with the highest incidence in mid-to-late adolescence
(Weissman et al., 2006). Further, there is evidence that the maternal-youth depression association
is stronger for girls compared to boys (Goodman et al., 2011). However, the relationship between
parent depression and youth depression is complex. For example, studies show that maternal
depression (Lovejoy et al., 2000) and parental negative affect (Crandall et al., 2015; Rueger et

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al., 2011) are more likely to influence negative parenting behaviors, such as harsh and critical
parenting, and less likely to influence positive parenting behaviors, such as warm and supportive
parenting. Related, the intergenerational transmission of depression from depressed mothers to
youth was found to be fully mediated by family and interpersonal stress (Hammen et al., 2004).
Considering the increasing prevalence rates of youth depression, it is crucial to better understand
important risk and protective factors, such as stress and parental support, as well as gender
differences, to inform depression prevention and intervention efforts.
Conceptual and Theoretical Considerations of Social Support
Social Support Conceptualization
Social support is a multidimensional construct (House, 1981; Tardy, 1985) that refers to
the supportive or caring behaviors experienced by individuals within one’s social network that
promote well-being and protect youth from adverse outcomes of stress (Cohen, 2004; Demaray
& Malecki, 2002). While most of the literature investigates emotional support, social support
includes several additional types of social resources, such as instrumental support (providing
goods or assistance), informational support (providing information or advice), and appraisal
support (constructive or performance feedback; Malecki & Demaray, 2003). In addition,
theorists have suggested that other aspects of social support are important to consider, such as
functional qualities of social support versus social support network size (Cohen & Wills, 1985)
and whether the support is received versus given, or perceived as available versus actually
utilized (Tardy, 1985). Research has suggested that perceived availability of support is especially
helpful–just knowing that there are supportive individuals available to help youth can be enough
to be protective without actually utilizing the support available (Demaray & Malecki, 2014).

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It is important to note that while social support is closely related to other constructs
associated with parents and parenting, it remains distinct. For example, attachment includes
bidirectional relational elements, such as trust, and often includes negative qualities of the
parent-child relationship, such as alienation (e.g., Armsden & Greenberg, 1987; Greenberg &
Armsden, 2009). Social support is also distinct from constructs in the parenting literature, such
as warmth, which is considered the emotional climate of the family (Darling & Steinberg, 1993).
However, Barber et al. (2005) noted that the conceptualization of parental warmth in some
measures (e.g., the 10-item subscale of the Children’s Report of Parenting Behavior Inventory;
Schludermann & Schludermann, 1988) captures positively worded supportive behaviors that
could be defined as parental support. There are complexities in the overlap between social
support from parents and parenting constructs that require careful consideration in a study
focused on parental support.
Social Support Theories
Two main theoretical models have traditionally been used to understand the benefits of
social support in the lives of youth. The general benefits model of social support suggests that
social support is directly related to psychosocial well-being (Rueger et al., 2016). In other words,
social support is a fundamental construct that promotes positive adjustment for all individuals.
This model, also referred to as the main effects model (Cohen & Wills, 1985), has been widely
supported in the literature, with social support from parents and family associated with lower
levels of depression across cross-sectional and longitudinal studies (Rueger et al., 2016). The
second model of social support describes how social support provides unique benefits during
times of stress and is referred to as the stress-buffering model of social support (Cohen & Wills,

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1985). According to this model, higher levels of social support would be expected to reduce an
individual’s vulnerability to depressive symptoms following a stressor.
Traditionally, tests of stress-buffering are focused on the stress-depression association as
primary with social support as the moderator. An alternative model for testing stress effects
involves a focus on the social support-depression association as primary with stress as the
moderator (Rueger et al., 2016). Both models of stress effects are focused on the interactive
relationship between social support and stress in predicting depression, but the alternative model
is conceptually well suited to test the effects of chronic stressful contexts. For example, Rueger
and colleagues (2016) suggested that stress-buffering with this alterative conceptualization can
be tested by comparing youth in stressful contexts with youth in the general population on the
strength of the association between social support and youth depression. They found evidence for
stress-buffering effects of social support from teachers and peers for youth with medical illness.
However, for family support, they found that the inverse association between family support and
depression was weaker for youth in at-risk populations (i.e., sexual minority youth and those
experiencing the chronic stressors of medically ill family/family loss or abuse) compared to
those in the general population. They noted that these “reverse stress-buffering effects”
demonstrate that family support was less protective in relation to depression within the context of
these chronic stressors. We refer to this reduced effectiveness of support under stressful
conditions as stress-dampening effects on social support, as this is more consistent with the
alternative conceptualization of stress as the moderator to the social support-depression
association. The current study will further investigate this interesting finding, specifically in the
parent-child relationship, and consider parent and youth gender differences in these stress effects.

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Gender Differences in the Parental Support-Depression Association
Despite the central role of gender in understanding parent-child relationships (Furman &
Buhrmester, 1985), there is little theory in the social support literature to guide this specific
investigation. Thus, several theoretical perspectives from the family process and parenting
literature guide this study.
Gender of Parent
Although much of the parenting research suggests that mothering and fathering are
conceptually different (Halme et al., 2010; Matthewson et al., 2011; Russell & Russell, 1987),
recent arguments in the parenting literature have focused on the fact that there are more
similarities than differences between mothers and fathers, such as how parenting behaviors are
provided. For example, Fagan and colleagues (2014) argue that parenting by mothers and by
fathers have become more similar over time with similar effects on their children’s behavior.
Recent historical factors, such as societal trends related to increased employment of mothers and
increased involvement of fathers, may explain the body of research suggesting that mothers and
fathers fulfill similar roles in the lives of their children (Cabrera et al., 2014). We refer to this
proposed similarity between mothers and fathers as the parenting similarity hypothesis, which is
consistent with the gender similarities hypothesis (Hyde, 2005) that more broadly posits that
males and females are similar on most psychological variables.
Several studies have found support for the parenting similarity hypothesis. For instance,
Sheeber and colleagues (2007) examined the relation between social support and depression with
243 adolescents and their parents and found that this association displayed a similar pattern for
mothers and fathers. In a longitudinal study of 375 adolescents, higher levels of both maternal
and paternal support predicted lower depressive symptoms in youth (Anderson et al., 2015).

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These results support the idea that the role of social support from both parents functions similarly
and that social support from mothers and from fathers may provide similar protective benefits in
relation to depression. Other researchers have argued against the parenting similarity hypothesis
and highlight differences in the ways that mothers and fathers interact with their children that
offer unique and conceptually different supports (Crockett et al., 2007; Hombrados-Mendieta et
al., 2012). For example, one study of 217 high school students found that social support from
mothers was inversely associated with depression, but social support from fathers was not
(Colarossi & Eccles, 2003). Interestingly, in a study investigating the role of emotional
availability and depression with a sample of 594 early adolescents, both maternal and paternal
emotional availability were inversely linked with depression, but the link was slightly greater for
mothers than for fathers (Babore et al., 2016). Overall, the mixed findings in this limited body of
work investigating parent gender differences in the social support literature highlight the need for
more studies to explore how mothers and fathers support their children and how these behaviors
relate to child development.
Gender of Youth
While it is important to consider how parent gender impacts the support-depression
association, it is also important to explore how youth gender may impact this association.
According to social role theory, parents may engage in different parenting practices due to
gender norms and expectations. In addition, gender differences in how boys and girls value or
emphasize social support as part of their social relationships may impact how social support
relates to youth depression (Eagly & Wood, 2012). This theory is grounded in research
suggesting that girls’ self-concept is greatly influenced or defined by their social relationships
(Nolen-Hoeksema, 2001). Specifically, research has found that there are gender differences in

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how youth engage in various interpersonal relationships: Girls emphasize relational qualities
such as intimacy and emotional support, whereas boys tend to form relationships around various
activities or interests (Maccoby, 1990; Nolen-Hoeksema, 2001). Related, some studies have
found that girls report greater frequency of both positive and negative interpersonal events, as
well as greater reactivity to interpersonal events (Flook, 2011). However, support for social role
theory has been mixed, with some studies demonstrating stronger inverse associations between
parental support and depression for girls (Colarossi & Eccles, 2003; Rueger et al., 2008) but
others showing more consistency between genders (del Barrio et al., 2016; Rueger et al., 2010).
As such, more work is needed to investigate how parental support may differentially relate to
depression for boys and for girls.
Gender of Parent and Youth
Gender unity theory further posits that social support from mothers and fathers may be
different depending on the parent-child dyad. In other words, paternal support may play a more
critical role in psychosocial development for sons, while maternal support may be more
important for daughters (Furman & Buhrmester, 1985, 1992). While few studies have explicitly
assessed this theory, some work has found support for the idea that there may be qualitative
differences in parental support within same-gender parent dyads. For example, in one study that
investigated parents’ involvement in adolescent peer relationships with a sample of 187 families,
mothers and fathers spent more time with their same-gender child and their child’s peers than
opposite-gender parents (Updegraff et al., 2001). Other studies have found parent gender
differences but no support for gender unity (Matthewson et al., 2011) or partial but conflicting
support. For example, in a large longitudinal study including over 1,300 Dutch adolescents,
positive relationships with fathers predicted longitudinal associations with lower depression for

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boys only, but no youth gender differences were found between lower depression and positive
relationships with mothers (Branje et al., 2010). In contrast, a longitudinal study using the
National Longitudinal Study of Adolescent Health dataset showed that the inverse association
between maternal support and depression was stronger for girls than boys, but no youth gender
differences were found for paternal support (Meadows et al., 2006). More research is needed to
bring clarity to these inconsistent results.
The Role of Stress
Consideration for the role of stress is important to gain a deeper understanding of the
association between parental support and youth depression. The interactive relationship between
parental support and stress in predicting depression in the stress-buffering theory of social
support (Cohen & Wills, 1985) suggests that youth experiencing stress can benefit more from
having supportive individuals in their lives compared to youth not experiencing stress.
Environmental Stress as the “Silent Player”
In a recent review of the stress literature, Hammen (2016) noted that environmental
stressors have been neglected in previous research and emphasized a significant need to increase
efforts to include environmental stressors in models of depression. Consideration of this “silent
player in contemporary stress-depression research” (p. 336) may help to clarify the mixed
findings that exist in relation to stress-buffering effects. For example, some studies show a
stronger parental support-depression association in high-stressed youth compared to low-stressed
youth (e.g., Fernandez et al., 2020; Hazel et al., 2014) but other studies fail to demonstrate these
stress-buffering effects (e.g., Bilsky et al., 2013; Burke et al., 2017; Wang & Kenny, 2014). We
propose that studies that find significant effects of parental support on depression in the context
of a chronic environmental stressor could offer insights into the protective nature of social

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support (e.g., Alderfer & Hodges, 2010; Arora et al., 2017; Vyncke et al., 2014). However,
studies focused on at-risk populations without a low-stress comparison group cannot be used to
evaluate stress-buffering effects. In fact, as mentioned previously, there is evidence that the
social support-youth depression association is weaker in some stressful environments when
compared to the general population of youth (Rueger et al., 2016). These stress-dampening
effects, as well as the overall mixed findings in relation to stress-buffering effects, highlight a
need for meta-analytic work to explore the role of stress in the parental support-depression
association. We aim to fill this gap with an intentional focus on chronic stressful contexts in
exploring stress-buffering and stress-dampening effects.
Moderators to Stress-Buffering Effects
Inconsistent findings in relation to stress also may be related to differences in a number
of possible moderators to the stress-buffering effects of social support, such as the type of
stressor and gender differences in stress effects. For example, it is possible that parental support
could serve as a protective factor in some stressful contexts more than others. In one study
investigating the relation between parent social support and youth depression with a sample of 53
pregnant African American adolescents, maternal and paternal support were both inversely and
significantly related to youth depression (Davis et al., 1997). However, the pregnant adolescents
in this sample reported that their mothers were more supportive than their fathers. This study
suggests that adolescents in some stressful contexts may benefit more from increased support
from fathers.
Regarding possible gender differences in stress effects, some studies highlight potential
negative effects of maternal support in times of stress. For example, one longitudinal study
showed that paternal support was linked with less depressive symptomology over time for those

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experiencing relational victimization, but maternal support had a vulnerability-enhancing effect
where victimized youth with greater maternal social support reported increased depression
symptoms over time (Desjardins & Leadbeater, 2011). The researchers attributed this finding to
the possibility that youth may engage in more co-rumination over their victimization experiences
with their mothers than with their fathers (Calmes & Roberts, 2008) and that fathers may provide
a different type of support (e.g., offering coping strategies) that can protect victimized youth
from developing internalizing problems such as depression. Another longitudinal study found
that high levels of support from mothers were associated with more depressive symptoms over
time for boys (but not girls) with a high genetic vulnerability to depression (Brouillard et al.,
2018). These authors speculated gender role norms that emphasize autonomy and discourage
emotional expression for boys that may explain why high levels of social support may be less
protective for boys (Oransky & Marecek, 2009; Rose & Rudolph, 2006). These studies provide
evidence that stress may not only dampen the association between social support and depression
but perhaps even increase risk for youth experiencing stress. A summary of the literature
exploring these associations can help provide more clarity on the nature of the support-
depression association for stressed youth.
Bidirectional Effects
Another important consideration is the potential for bidirectional effects in the
association between parental support and youth depression. As summarized to this point, there is
theory and clear evidence to support the important role that parents play in protecting youth from
the development of depression. In spite of these protective effects of parental support, there is
theory and growing evidence for possible reverse causation, or child effects (Bell, 1968), as well
as negative parent effects as part of a bidirectional process (i.e., lower parental support predicts

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greater youth depression, and greater youth depression predicts lower parental support) that have
been found across cultures (Hale et al., 2020; Needham, 2008; Rothenberg et al., 2020). These
findings are consistent with the stress-generation theory of depression, which highlights
depression as a risk factor that can create negative experiences and stressors for individuals,
including loss of social support (Hammen, 1991; Rudolph & Hammen, 1999). Interpersonal
stressors, in particular, have been found to contribute to the development of depression through a
bidirectional process (Hammen, 2012; Rudolph et al., 2009), both through episodic stressful life
events and chronic stressful life contexts (Hammen, 2006; 2016). Additionally, interpersonal
theories of depression also suggest that there may be bidirectional associations between
depression and social support. Depressed youth may have a tendancy to engage in behaviors that
may erode their social support networks, leading to reduced support and as a result, increased
depressive symptoms (Coyne, 1976). These theories and empirical findings highlight the
importance of exploring potential bidirectional effects in the parental support-depression
association and consider parent and youth gender differences.
Current Investigation
The review of the parent social support literature highlights many contradictions in
understanding the beneficial parameters for parental support in relation to youth depression.
While there is robust support for the general benefits model of social support (Rueger et al.,
2016), it remains unclear whether parental support offers stress-buffering effects. Further,
evidence that social support may be less beneficial in some stressful contexts warrants further
explication. The role of gender also remains unclear. Thus, the goal of this current study is to
address the uncertainties that remain (Wood & Eagly, 2009) about gender differences and the

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role of stress in the parental support-youth depression association. The research questions
guiding the current study include:
(1) What is the magnitude of the association between parental support and depression in
children and adolescents? Based on the current literature review and strong support
for the general benefits model (Rueger et al., 2016), it is predicted that the effect size
for this association will be statistically significant and moderate in magnitude.
(2) Does gender of the parent moderate the association between parental support and
youth depression? Based on the parenting similarity hypothesis, it is predicted that the
pattern of associations between depression and social support will be similar for
mothers and fathers.
(3) Does gender of the youth moderate the associations between parental support and
youth depression? Social role theory will be supported if youth gender differences are
demonstrated in the association between parental support and youth depression.
Gender unity theory will be supported if these youth gender differences are
specifically manifested in stronger associations for same-sex parent-child dyads.
(4) Does stress moderate the association between parental support and youth depression?
Evidence for stress-buffering effects of social support will be demonstrated if the
inverse association between parental support and youth depression is stronger in high-
stressed populations compared to low-stressed populations of youth. Evidence for
stress-dampening effects on social support (i.e., reverse stress-buffering) will be
demonstrated if the inverse association between parental support and depression is
weaker in high-stressed populations compared to low-stressed populations of youth.
Evidence for vulnerability-enhancing effects of social support will be demonstrated if

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the association between parental support and youth depression is positive in high-
stressed populations.
(5) Are there gender differences in the role of stress in the parental support-depression
association? Parenting similarity hypothesis, social role theory, and gender unity
theory will be tested within stress groups in an exploratory fashion.
(6) Are there bidirectional effects in the association between parental support and youth
depression? Evidence for bidirectional effects will be demonstrated if longitudinal
inverse correlations are significant for both parent effects and child effects.
Method
Literature Search
A comprehensive literature search of electronic databases was conducted for all
published and unpublished studies through February 2021 using EBSCOhost (which includes
PsycINFO, Academic Search Complete, SocINDEX, Educational Resources Information Center,
and ProQuest) and PubMed (which includes MEDLINE). Keywords used to complete this search
included the truncated “depress*” and the following parent and general social support terms
using the Boolean “AND”: (“maternal,” “mother,” “paternal,” “father,” “parent*”) AND
(“perceived support,” “social network,” “support* relation,*” “social support”). In addition, the
truncated “depress*” term was combined with “maternal support,” “paternal support,” “parental
support,” “maternal warmth,” “paternal warmth.” or “parental warmth” using the Boolean
“AND.” For each subsequent search, the Boolean “NOT” was used with all previous search
terms to eliminate duplicates. The searches were limited to articles that included only human
participants within a child or adolescent population. A hand search of the following fourteen
journals from 1980 to February 2021 was completed to supplement the electronic search:

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American Journal of Community Psychology, Child Development, Developmental Psychology,
Journal of Abnormal Child Psychology, Journal of Adolescent Research, Journal of Child
Psychology and Psychiatry, Journal of Clinical Child and Adolescent Psychology, Journal of
Early Adolescence, Journal of School Psychology, Journal of the American Academy of Child
and Adolescent Psychiatry, Journal of the American Medical Association–Psychiatry, Journal of
Youth and Adolescence, Lancet Psychiatry, and School Psychology Quarterly.
In total, 4,214 articles were accessed, and 2,815 unique abstracts were reviewed for
eligibility evaluation. A broad review of abstracts was completed to assess whether potential
studies included the two constructs of interest for the current meta-analysis (i.e., social support
provided by parents, mothers, or fathers to a child or adolescent, and depression/depressive
symptoms of the same child or adolescent). Studies that potentially included these two constructs
were retrieved for a more detailed review. This process resulted in 696 articles that were
identified for full-text review based on the inclusionary/exclusionary criteria below.
Inclusionary and Exclusionary Criteria
Inclusionary criteria for the current study included: (1) youth as recipients of parental
support, and (2) youth depression or depressive symptoms. Studies that focused on children and
adolescents under the age of 20 were included, but college samples with students under the age
of 20 were excluded. The majority of studies included in this study focused exclusively on
parents, including stepparents and non-resident parents. However, studies that focused on
caregivers were included if the majority of caregivers (more than 75%) were parents (Sacco &
Macleod, 1990) or were considered parent figures by the primary authors (Rosenthal et al.,
2003). In one study that focused on youth who experienced the loss of parents through death, we

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21
coded the effect size for the subgroup of single orphans (one parent deceased) but did not include
the subgroup of double orphans (both parents deceased; Puffer et al., 2012).
Studies that focused on constructs related to but conceptually distinct from social support
(e.g., attachment, parenting style, reverse-scored items of relational conflict) were also excluded.
However, studies that used a measure of parenting but reported that the focus of the study was on
parental, maternal, or paternal support as a construct of interest (based on the use of these terms
in the title, abstract, or description of the measure) were evaluated by retrieving the measures
used by the researchers and examining the items in the scale. Studies were included if there were
no items in the scale that were reflective of constructs that were broader than the construct of
social support as described by Barber et al. (2005) and Tardy (1985). There were 246 articles that
met inclusionary criteria and were considered conceptually appropriate for the study.
Accounting for Missing Data
Of the 246 studies meeting inclusionary criteria, 143 studies reported the statistics needed
to calculate an effect size and 26 studies were fully codeable (i.e., no other correlations could be
coded from the data). To recover as much missing data as possible, the corresponding authors of
103 articles were contacted and requested to provide the needed statistics to be included in the
current meta-analysisas well as additional correlations for moderator analyses. In addition,
emails were sent to the 117 primary authors of studies already included in the meta-analysis to
request additional data for moderator analyses. All emails were written with specific requests for
data relevant for each study (e.g., youth gender for mixed samples, parent gender if it appeared
that the measure assessed support from mothers and fathers separately, and correlations by
high/moderate/low stress group if a measure of stress was included in the study). In addition, if it
appeared that the data were part of a longitudinal study, we also requested a full correlation

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
22
matrix of all timepoints in order to code for bidirectional effects. We also sent 15 emails to
authors of studies published in a foreign language. Out of three authors who responded to our
initial request for information about their study to determine eligibility for inclusion, two did not
follow up with subsequent emails to provide necessary data, and one article did not meet
inclusionary criteria. A total of 39% of the authors responded to our emails to provide data
needed to be included in the meta-analysis and 59% of the authors provided additional
information for moderator analyses
1
. A PRISMA flow diagram of the search strategy (Moher et
al., 2009) is offered in Figure 1. The emailing strategy resulted in additional effect sizes by youth
gender (k = 108), parent gender (k = 70), and stress groups based on a measure (k = 24), as well
as longitudinal data (k = 40).
Coding Procedures
Coding of Studies
Each article was reviewed and coded for descriptive information about the study and
measures used in the study. Study characteristics that were coded include title, year of
publication, first two authors, and sample characteristics, including age/grade, race/ethnicity, and
country of data collection. Additional information about the studies included whether the main
focus of the study assessed the association between parental support and youth depression.
Several characteristics of the measures used to assess the social support-depression
relationship also were coded. For both depression and social support measures, studies were
coded to assess the type of measure (e.g., objective rating scale or subjective assessment, such as
1
There were 54 studies that were included in the current meta using data from emails sent from
our previous meta-analysis (Rueger et al., 2016). These authors were not emailed again for the
current study because the study was fully codeable, or no additional moderator data were
provided in response to the email for the current meta.

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
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an interview or observational measure), rater (e.g., self-report or other-report), and psychometric
support. For psychometric support, measures were coded as Adequate if alpha ≥ .65 (DeVellis,
2016) or had a previously published report offering psychometric support, or Inadequate if alpha
< .65 or no psychometric support for the instrument was cited. Several additional characteristics
were coded that were unique to the measures of depression and social support. Depression
measures were coded as to whether they assessed depressive Symptoms or whether the study
used a depression Diagnosis. Parental support measures were coded for Function versus
Structure, as well as type of support based on Tardy’s (1985) framework: (1) Emotional (caring,
empathy); (2) Instrumental (helping behaviors, financial support); (3) Informational (relevant
information); (4) Appraisal (evaluative information, such as feedback); (5) Global with
emotional support (i.e., instrument assessed various types, including emotional support); (6)
Global without emotional support (i.e., instrument assessed various types excluding emotional
support); and (7) Other (not enough information to code).
In addition, all studies were reviewed to determine whether the study included a potential
stressor. Stressors were identified and coded at the study level (Stress 1) and at the measure level
(Stress 2). Study level stress was coded for studies in which the entire sample was an at-risk
sample (e.g., trauma-exposed), or the study included an at-risk sample and comparison control
group. In addition, measures of stress (e.g., victimization, general stress scales, etc.) were coded
at high/low or high/moderate/low levels, depending on how authors provided the data. Finally,
temporal design was coded as Cross-Sectional (CS) or Longitudinal (LG), and longitudinal
studies were further coded for time lags less than 1 month, 3 months to 1 year, and more than 1
year. Studies were coded for inclusion in bidirectional analyses if they contributed longitudinal
correlations in both directions.

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Reliability of Coding
All articles were coded by the first, second, and third authors following a detailed coding
manual that was developed by the first author. The current manual was based on the coding
manual for our previous meta (Rueger et al., 2016) and modifications included more detailed
information for coding parental support and stress measures. The three coders had previously
coded to high reliability for our previous meta after a rigorous process of training and calibration
of coding (see Rueger et al., 2016, for details). The coding process in the current meta-analysis
involved an iterative process of decision-making as new information is brought to light through
the review process (Johnson & Hennessy, 2019; Moher et al., 2009), any changes to the coding
manual that required recoding of study characteristics were recoded to ensure consistency across
raters. Final coding sheets were then used to assess the reliability of coding in the current
investigation. Articles that presented with challenging coding decisions (k = 30) were considered
consensus articles and coded with a second coder. One-fourth of the remaining articles (k = 43)
were randomly selected for reliability coding and coded by a second coder. Disagreements were
coded by consensus between the coding pair.
Across studies, reliability estimates ranged from .79 to 1.0, which are considered
acceptable to perfect agreement (McHugh, 2012; Orwin & Vevea, 2009). Specifically, there was
100% agreement on methodological moderators including all coding characteristics for the
depression measures (ie., depression instrument, depression scale, psychometric properties,
rater), definition of support (i.e., functional or structural), social support instrument, and time
point. The kappa coefficient for psychometric quality of social support and type of social support
were .91 and .79, respectively. Kappa for study design and whether the effect size was in the
predicted direction were .95 and .97, respectively. Kappas for theoretical moderators included:

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
25
source of parental support (1.0) and youth gender (1.0). Kappa coefficients for stress codes
were .94 (Stress 1) and 1.0 (Stress 2). Interrater reliability for effect size statistics (r) and sample
size were excellent with 100% agreement and perfect ICC for effect size statistics and a kappa
of .99 for sample size (DeVellis, 2016).
Meta-Analytic Strategy
All coded data were entered into an Excel spreadsheet for data management and
transferred to Comprehensive Meta-Analysis (CMA; Borenstein et al., 2013) for analyses. Data
in the main CMA database included all cross-sectional and longitudinal ESs that included data
for stress coded at the study level (i.e., the entire sample represented a stressful context/at-risk
population). A separate CMA database was created for stress group analyses using additional
stress data from studies that included measures of stress coded into high, moderate, and low
stress. The moderate subgroup was excluded from stress analyses to avoid confounding due to
misclassification (Wiernik & Dahlke, 2020). Multiple effect sizes from a single study were
averaged to provide a single effect size per study per analysis. In addition, effect sizes from
separate studies that included the same sample were entered as a single study so that the multiple
effect sizes would be averaged to provide a single effect size for the group of studies (Borenstein
et al., 2009). Effect sizes were weighted with the inverse of the variances by CMA so that larger
samples sizes were weighted more heavily in the analyses. The random-effects model was used
for all analyses with the assumption that there would be variation across the studies due to real
differences from unmeasured moderators, such as various settings, samples, and conditions. The
use of a random-effects model also assumes that the set of studies represents a random sample
from a larger population of studies, which allows for interpretation of results as generalizable to
future studies (Borenstein et al., 2009; Raudenbush, 2009).

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
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Point Estimate
Effect sizes for the current study were based on the correlation coefficient, r, which were
converted to Fisher’s z to account for the skewed distribution of r, and then reconverted back to r
for the point estimate. When the bivariate correlation was not available, CMA converted other
available statistics, such as means/standard deviations/sample sizes of subgroups, or exact p-
value for an unreported correlation, to calculate the effect size. Statistical significance of the
point estimate was evaluated with a two-tailed z-test, and the magnitude of the correlation was
interpreted (Cohen, 1992) as small (r = .10), moderate (r = .30), and large (r = .50). It should be
noted that the effect sizes are reported as positive when in the predicted direction, even though
social support is inversely related to depression.
Heterogeneity
Heterogeneity within studies was measured using the within-class goodness-of-fit
statistic (Qw) and the degree of inconsistency statistic (I2), which is a ratio that estimates the
magnitude of the true variance. A significant Qw suggests that significant variability remains
unexplained (Lipsey & Wilson, 2001), and I2 values of 25%, 50%, and 75% are considered mild,
moderate, and high degrees of heterogeneity (Higgins, 2003). Moderator analyses were
conducted if k ≥ 6 to reduce the risk for Type II error (Matt & Cook, 2009) and avoid problems
in statistical synthesis (Davey et al., 2011).
Heterogeneity between studies was investigated through the use of separate subgroup
analyses, and the 85% confidence interval (CI) around a point estimate was evaluated to test for
between-group differences (Goldstein & Healy, 1995; Knol et al., 2011)
2
. Many of the studies in
2
Statistical demonstrations have shown that the proper way to test for subgroup differences with
a probability of a Type 1 error of 0.05 is to test the overlap in CIs at 83.4% (Goldstein & Healy,

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
27
the current meta-analysis contributed effect sizes for more than one of the moderating variables,
and handling the nonindependence of data with the use of separate subgroup analyses allowed us
to retain as many effect sizes as possible in moderator analyses (Borenstein et al., 2009). For
moderator analyses in which each participant contributed to the effect size in only one of the
subgroups (e.g., youth gender and stress), non-overlapping CIs were interpreted as statistically
significant differences between subgroups. For moderator analyses in which participants may
have contributed to the effect size in both subgroups (e.g., mother/father comparisons), the 85%
CIs were used to describe the pattern of differences without making conclusive interpretations
about statistical significance (Rueger et al., 2016).
Sensitivity Analyses
Consideration for potential confounding of results due to publication bias and
methodological artifacts was handled through our literature search and coding strategy. This was
also handled statistically with moderator analyses and sensitivity analyses. Publication bias is a
potential problem in any meta-analysis, as there is a greater likelihood that studies with
significant results are more likely to be published, which would lead to an overestimation of the
mean effect. We aimed to address the potential for this bias by using a broad search strategy that
included studies that were published and unpublished, as well as those that did not focus on the
parental support-depression association as a primary research question (Mezulis et al., 2004;
Rueger et al., 2016). Inclusion of such studies should not affect whether the study was published
due to statistically significant findings related to the association between social support and
1995; Knol et al., 2011). Other studies have followed these recommendations (Cho et al., 2020;
Estrada-Barranco et al., 2019), but because of software limitations, the 85% CI around a point
estimate was evaluated to test for heterogeneity between groups, as has been done in other
studies (Lizotte & Carey, 2021; Rueger et al., 2016; van IJzendoorn et al., 2005).

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
28
depression, which in turn, would lessen the publication bias. In addition, sensitivity analyses
were conducted that included a visual inspection of the funnel plot and a quantitative evaluation
of asymmetry in the data using Begg and Mazumdar’s (1994) rank correlation test. The inverse
rank correlation between the study size and effect size will be significant if there is publication
bias. However, a non-significant p-value may result from low power, so it cannot be interpreted
that bias is absent. Thus, Duval and Tweedie’s (2000) Trim and Fill procedure was also included
to estimate the effect size after adjusting for publication bias.
Methodological artifacts introduce error and often attenuate the effect size (Schmidt et
al., 2009; Wiernik & Dahlke, 2020). We sought to address bias associated with measurement
error variance by coding for psychometric quality of measures and conducting analyses only
with studies that used measures with adequate psychometric qualities. We aimed to address
biases associated with sample selection and range restriction by excluding depression treatment
studies. Sample selection bias also was addressed in our stress analyses by assessing the parent
support-depression relationship in general population samples with measures of stress at high
and low levels as well as stressed samples. Sensitivity analyses tested for potential reporter
biases and shared method variance by comparing the magnitude of effect size based on reporter
match of social support and depression measures. Sensitivity analyses also addressed the
potential effects of historical factors by testing for differences in studies based on publication
year using meta-regression on the continuous variable of publication year. Subgroup analyses
also were conducted by categorizing publication year into three groups (Early Studies = 1988 to
2006, Recent Past Studies = 2007 to 2014, and Current Studies = 2015 to 2021) in order to
minimize error related to misclassification (Wiernik & Dahlke, 2020) because publication year is
a proxy measure of the date of data collection.

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Transparency Statement
We followed the PRISMA Statement (Moher et al., 2009) when preparing the protocol
and the PRISMA-P checklist and reporting guidelines (Shamseer et al., 2015) for the final report.
Data were analyzed using Comprehensive Meta-Analysis Version 3 (Borenstein et al., 2013).
This review was not preregistered. Data used in all analyses and the codebook are available at
osf.io/phuj5.
Results
Overall Analysis
The current meta-analysis includes a sample of k = 170 studies focused on the association
between youth depression and social support from parents published from 1988 through
February 2021, including k = 13 published studies that did not explicitly focus on this relation
and k = 17 studies from unpublished sources. This resulted in a total of 1793 effect sizes (ESs)
and N = 114,674 participants. A list of all studies with effect sizes, sample characteristics, and
codes for the theoretical moderators are presented in the Supplemental Table.
The overall ES for the association between social support from parents and depression in
children and adolescents was significant and moderate in magnitude [r = .27, z = 27.72,
p < .001], which supports Hypothesis 1. The within-class goodness of fit statistic [Qw(169) =
1607.63, p < .001] indicated significant heterogeneity remaining, and the I2 value indicated that
89% of the variance remained. In order to explain variance related to the measurement of social
support and depression, methodological moderator analyses were conducted before the
hypothesized theory-based moderator analyses.
Methodological Moderator Analyses

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
30
The first set of methodological moderator analyses focused on the measurement of
parental support and depression. The difference between studies that assessed self-report of
Parent support [r = .28(165), z = 28.27, p < .001; 85% CI = .27 to .29; Qw(166) = 1564.27,
p < .001] versus other-report of Parent support [r = .12(9), z = 6.50, p < .001; 85% CI = .10
to .15; Qw(10) = 17.28, p = .07] was significant based on the non-overlapping 85% CIs. The
within-class goodness-of-fit statistic showed significant heterogeneity remaining for self-report
measures but not for other-report measures, so all remaining analyses were conducted with
studies that utilized self-report measures of parental support. The effect size for studies that used
adequate psychometric measures of social support [r = .29(152), z = 30.60, p < .001; 85% CI
= .28 to .30; Qw(153) = 1019.30, p < .001] was significantly different from studies that utilized
inadequate psychometric measures [r = .18(6), z = 3.72, p < .001; 85% CI = .11 to .24; Qw(7) =
199.46, p < .001] and single-item measures [r = .17(3), z = 5.45, p < .001; 85% CI = .13 to .21;
Qw(4) = 21.72, p < .001] based on the non-overlapping 85% CIs, and the within-class goodness-
of-fit statistic showed significant heterogeneity remaining. All remaining moderator analyses
were conducted with studies that assessed social support using measures that demonstrated
adequate psychometric evidence. All studies assessed functional (versus structural) perceived
parental support, so no moderator analyses were conducted for this aspect of support, but
differences between studies that assessed different types of support were compared. There were
no significant differences between Emotional support [r = .31(42), 85% CI = .28 to .33], Global
with Emotional support [r = .29(98), 85% CI = .27 to .31] and Unspecified support [r = .24(9),
85% CI = .20 to .28], so all studies were collapsed across type of perceived parental support.
Regarding the measurement of depression, all studies used instruments that demonstrated
adequate psychometric evidence. There were no significant differences between studies that

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
31
utilized self-report [r = .29(148), 85% CI = .28 to .30] versus other-report [r = .26(6), 85% CI
= .20 to .32] of depression and no significant differences between studies that assessed
depression symptoms [r = .29(149), 85% CI = .28 to .30] versus depression diagnosis [r = .31(1),
85% CI = .23 to .40]. Thus, all remaining analyses were conducted collapsed across these
categories.
The second set of methodological moderator tests focused on temporal design. The effect
size for both cross-sectional [r = .30(149), z = 32.54, p < .001; 85% CI = .29 to .31; Qw(150) =
915.31, p < .001] and longitudinal [r = .20(34), z = 13.62, p < .001; 85% CI = .18 to .22; Qw(35)
= 112.21, p < .001] studies were significant. The within-class goodness-of-fit statistic showed
significant heterogeneity remaining in both subgroups of studies. The non-overlapping 85% CIs
supported continued moderator analyses on cross-sectional and longitudinal studies separately.
The longitudinal association between parental support and youth depression was significant for a
time lag less than 3 months [r = .30(1), z = 5.32, p < .001], between 3 months and 1 year [r
= .21(26), z = 13.38, p < .001], and beyond 1 year [r = .14(14), z = 8.39, p < .001]. In order to
retain as many studies as possible in the longitudinal analyses, all time lags were collapsed.
Theoretical Moderator Analyses
Table 1 provides descriptive overviews of study characteristics and moderators to test
hypotheses about gender of parent, gender of youth, and stress in the following cross-sectional
and longitudinal analyses. Figure 2 offers an overview of the hypothesis testing results.
Cross-sectional Analyses
Gender as moderator. Research Question Two explored whether parent gender would
moderate the association between social support and depression. Results indicated that Parent
support (i.e., nonspecific to parent gender), Mother support, and Father support, were

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32
significantly associated with Depression (see Table 2). An examination of 85% CIs revealed a
significant difference between Parent support and Mother support, as well as Parent support and
Father support in their association with youth depression. Notable are the comparable point
estimates and the complete overlap between the 85% CIs for Mother and Father support, which
provides evidence for the parenting similarity hypothesis (Hypothesis 2). The within-class
goodness of fit statistic indicated significant heterogeneity for all subgroups, and the respective I2
values indicated that 75% to 86% of the variance remained, warranting exploration of additional
moderators in each parental support subgroup.
Research Question Three explored whether gender of the youth would moderate the
parental support-depression association. Results indicated that all three parental sources of
support were associated with depression for both boys and for girls. A comparison of 85% CIs
between Boys and Girls within parental subgroups revealed a larger effect size for Girls than
Boys that reached statistical significance for Parent and Mother support. This pattern of
Girls > Boys was evident for Father support as well but did not reach statistical significance
(Table 2). These results partially support social role theory. The effect size of same-sex versus
opposite-sex parents for both Boys (ESs = .23 for both) and Girls (ES = .29 and .26,
respectively) was comparable, which does not support gender unity theory. Significant
heterogeneity within all subgroups warranted further exploration of moderators.
Stress as moderator. Research Question Four focused on stress as a moderator in the
association between parental sources of support and youth depression. Stress analyses were
conducted first collapsed across youth gender. The association between perceived social support
(from all parental sources) and youth depression was significant across studies coded globally as
representing youth in a stressful context (i.e., High Stress) and the general population (i.e., Low

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
33
Stress) (Table 2). A comparison of 85% CIs between the High Stress and Low Stress subgroups
revealed no evidence of stress-buffering effects. Instead, results with Parent support were
consistent with the general benefits model: there was no significant difference in the magnitude
of effect for High Stress versus Low Stress subgroups. However, results with Mother and Father
support were consistent with stress-dampening effects: there was a stronger effect in the Low
Stress subgroup compared to the High Stress subgroup. Significant within-group heterogeneity
warranted further exploration of moderators (Table 2).
Follow-up analyses were conducted to explore the nature of stress included in the study-
level stressful context moderator analyses. Stressors were grouped into broad categories of
stressful contexts, and the effect size for youth experiencing various stressful contexts was
compared with youth in the general population. Due to the limited number of studies per stressful
context, these analyses were conducted collapsing across parent and youth gender, and a
comparison of the 85% CIs between the general population subgroup (i.e., Low Stress) and each
of the stressful context subgroups (i.e., High Stress) demonstrated no evidence of stress-
buffering (Table 3). However, there was evidence of stress-dampening on parental support with
Pregnant/Parenting, Family Medical/Loss, Sexual Minority, and Parent-Child Relationship
stressful contexts subgroups. Specifically, the association between parental support and
depression was weaker for youth in these stressful contexts compared to youth in the general
population. Support for the general benefits model was demonstrated in the remaining
subgroups. Youth Medical and Sexual Minority subgroups demonstrated a low level of
heterogeneity that was no longer significant (Table 3).
Youth gender and stress. Research Question Five explored whether there would be
youth gender differences in the parental support-depression association among high-stressed and

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34
low-stressed youth. See Table 4, as well as Figure 3 for stem and leaf plots of stress effects by
gender. A comparison of 85% CIs between Mother and Father support within youth gender
showed support for the parenting similarity hypothesis. The effect sizes for mothers and fathers
with Boys in High Stress (ESB/HS = .13 for Mother versus ESB/HS = .14 for Father) and Low Stress
(ESB/LS = .25 for Mother and ESB/LS = .25 for Father) subgroups and Girls in High Stress (ESG/HS
= .21 for Mother versus ESG/HS = .18 for Father) and Low Stress (ESG/LS = .32 for Mother versus
ESG/LS = .29 for Father) subgroups were similar in magnitude.
In addition, a comparison between youth gender showed support for social role theory in
that the association between Mother support and Depression was stronger for Girls than Boys
across both High Stress (ESG/HS = .21 versus ESB/HS = .13) and Low Stress (ESG/LS = .32 versus
ESB/LS = .25) subgroups. The same youth gender difference for Parent support and Low Stress
subgroups approached statistical significance (overlap of .001 in the 85% CI). All other
comparisons also demonstrated this pattern of stronger associations for Girls compared to Boys
that did not reach statistical significance. Further, gender unity theory was not supported, as the
association between parental support and youth depression was comparable in magnitude for
same-sex versus opposite-sex parents for High Stress Boys (ES = .14 and .13, respectively), Low
Stress Boys (ES = .25 for both), High Stress Girls (ES = .21 and .18, respectively), and Low
Stress Girls (ES = .32 and .29, respectively; Table 4).
Finally, a comparison of 85% CIs between High Stress and Low Stress subgroups within
youth gender showed stress-dampening effects on parental support, for both Mother and Father
support for both Boys (ESB/HS = .13 versus ESB/LS = .25 for Mother support, and ESB/HS = .14
versus ESB/LS = .25 for Father support) and Girls (ESG/HS = .21 versus ESG/LS = .32 for Mother
support, and ESG/HS = .18 versus ESG/LS = .29 for Father support). In other words, high levels of

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35
stress reduced the strength of the association between parental support and youth depression,
with no evidence of parental or youth gender difference in this stress-dampening effect.
Longitudinal Moderator Analyses
In addition to testing theoretical moderators with cross-sectional effect sizes, the same set
of analyses testing theoretical moderators were conducted with longitudinal effect sizes.
Gender as moderator. Research Question Two focused on parent gender, and consistent
with cross-sectional analyses, all sources of parental support were associated with youth
depression in longitudinal studies (Table 2). An examination of 85% CIs revealed a trend toward
significant differences between Parent support and Mother support, as well as Parent support and
Father support in their association with subsequent youth depression. It is notable that the point
estimates for Mother and Father support were the same, with a complete overlap in 85% CIs,
offering longitudinal support for the parenting similarity hypothesis (Hypothesis 2). The within-
class goodness of fit statistic indicated significant heterogeneity for all subgroups, and the
respective I2 values indicated that 65% to 75% of the variance remained, warranting exploration
of youth gender as a moderator.
Research Question Three explored whether the parent support-depression association
would differ by youth gender. Results with longitudinal data indicated that the association
between social support and youth depression was significant for both boys and girls across all
parental subgroups (Table 2). A comparison of 85% CIs between Boys and Girls for Parent,
Mother, and Father support subgroups showed no statistically significant youth gender
differences in the association between parental support and depression. Although the pattern of
results showed larger effect sizes for girls compared to boys for all parental support sources,
social role theory was not statistically supported. Further, the effect size of same-sex versus

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36
opposite-sex parents for both Boys (ES = .14 and .15, respectively) and Girls (ES = .20 and .19,
respectively) were comparable, which provides no support for gender unity theory. The within-
group heterogeneity results showed a low degree of heteroegeneity (I2 = 8% to 40%) that was
non-significant for Boys but a moderate to high degree of heterogeneity (I2 = 50% to 81%) for
Girls (see Table 2).
Stress as moderator. Finally, stress was explored as a moderator in the association
between parental sources of support and depression in longitudinal studies (Research Question
Four). There was a significant association between all sources of parental support regardless of
whether youth were categorized in the High Stress or Low Stress subgroups. A comparison of
85% CIs between the High Stress and Low Stress subgroups revealed evidence of stress-
buffering effects for Parent support (Table 2; see also Figure 3 for stem and leaf plot). However,
there were no significant differences between the stress subgroups for Mother and Father
support, which is consistent with the general benefits model. Interestingly, there was significant
within-group heterogeneity remaining for the Low Stress but not the High Stress subgroups. Due
to the small sample size of studies, youth gender moderator analyses were not conducted.
Bidirectional effects. Lastly, to explore the final research question and assess whether
potential bidirectional effects may be evident within the parental support-depression association,
the influence of parental support on youth depression across time (i.e., parent effects), as well as
the evocative effects of youth depression on parental support across time (i.e., child effects) were
tested in parallel analyses using longitudinal data from studies that contributed data in both
directions. These analyses were conducted with studies using measures with adequate
psychometric support or a single-item measure of parental support, given that results indicated
no significant differences in longitudinal effect sizes between studies assessing parental support

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
37
with a psychometrically adequate measure or a single-item measure. Thus, there were a total of
22 studies with 478 effect sizes for each of the parallel analyses.
Results indicated that the effect size for both parent effects (i.e., lower parental support
predicted higher subsequent youth depression) and child effects (i.e., higher youth depression
predicted lower subsequent parental support) were moderately small to small in magnitude and
statistically significant. Specifically, each subgroup analysis going in both directions
demonstrated a statistically significant association between a parental support subgroup (i.e.,
Parent, Mother, and Father) and youth subgroup (i.e., Boys and Girls). Further, the overlap in
85% CIs between Boys and Girls indicated no significant youth gender differences for any of the
parental subgroups in either direction (Table 5). Interestingly, the longitudinal effect size
representing parent effects with Boys and all parental subgroups showed nonsignificant within-
group heterogeneity, with 0% to 29% variance that remained. This low level of heterogeneity
was not evidenced in the results with Girls (I2 = 56% to 82%). Further, longitudinal child effects
for Girls with Father support evidenced 10% variance that remained, but all other gender
analyses for child effects showed moderate to high proportions of variance remaining (I2 = 48%
to 82%).
Sensitivity Analysis
Sensitivity analyses for potential publication bias included visual inspection of the funnel
plots, rank correlation tests, and trim and fill estimates of adjusted effect sizes to test for
publication bias. These analyses showed limited to no significant effect of publication bias in
cross-sectional and longitudinal analyses. For the overall meta-analysis (k = 170) that included
all coded ESs, visual inspection of the funnel plot showed that it was mostly symmetrical, and
the rank correlation test was not significant (p = .15). In addition, the adjusted effect size for the

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
38
overall analysis after estimating the number of missing studies due to publication bias was ES(adj)
= .25, which is slightly smaller than the calculated effect size of ES = 27. For the cross-sectional
theoretical moderator analyses conducted with studies that used adequate measures of perceived
social support that were self-reported by youth (k = 151), the adjusted overall effect size using
trim and fill remained unchanged (ESadj = .30). The results for the three parental support sources
demonstrated similar results: The trim and fill estimates either remained unchanged (ESadj = .26
for Mother, and ESadj = .25 for Father) or slightly decreased (ESadj = .31 for Parents). Further, the
visual inspection of the funnel plot for the overall cross-sectional analysis and all three sources
demonstrated a mostly symmetrical pattern (Figure 4), and the rank correlation test suggested no
significant small-study effects (p = .26 for Overall Analysis, p = .18 for Parents, p = .16 for
Mother, and p = .35 for Father). Similar results were found for the studies included in the
longitudinal analyses (see Figure 5 for funnel plots). The trim and fill estimates either remained
unchanged (ESadj = .18 for Father) or slightly decreased (ESadj = .18 for Overall, ESadj = .19 for
Parents, ESadj = .17 for Mother), and the rank correlation test suggested no significant small-
study effects (p = .35 for Overall, p = .47 for Parents, p = .50 for Mother, and p = .33 for Father).
Sensitivity analyses to test for reporter bias in the overall analysis on the full sample of
170 studies investigated differences between studies that utilized child self-report of social
support and other-report of child depression (i.e., interview-based assessment, parent-report) and
other-report of parental support (i.e., observer ratings, parent report on surveys) and child self-
report of depression. Inspection of 85% CIs revealed a statistically significant difference between
match [r = .28(163), z = 28.03, p < .001; 85% CI = .27 to .29; Qw(164) = 1570.18, p < .001; I2 =
89.56] and mismatch [r = .15(13), z = 7.45, p < .001; 85% CI = .12 to .18; Qw(14) = 26.50, p
< .05; I2 = 47.18] of reporters, demonstrating evidence for potential reporter bias. However, after

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
39
effect sizes for other-report of social support were removed for the theoretical moderator
analysis, there was no statistically significant difference between match [r = .28(162), z = 28.06,
p < .001; 85% CI = .27 to .29; Qw(163) = 1569.83, p < .001; I2 = 89.62] and mismatch [r
= .23(5), z = 6.52, p < .001; 85% CI = .18 to .28; Qw(6) = 7.74, p = .258; I2 = 22.46] of reporters.
Results of meta-regression analyses using publication year to predict effect sizes showed no
significant historical effects in analyses for Parent (b = -.003, z = -1.74, p = .082) or Father (b
= .002, z = 1.00, p = .316) support. There was a significant effect of publication year for Mother
support (b = .004, z = 2.12, p < .05) that showed stronger effect sizes in more current years.
However, results comparing the 85% CI in subgroup analyses with studies grouped into thirds
(i.e., E = early studies: 1988 to 2006; R = recent past studies: 2007 to 2014; and C = current
studies: 2015 to 2021) showed no significant difference in historical effects for Mother support
(rE(16) = .22, 85% CI = .19 to .26; rR(19) = .25, 85% CI = .22 to .28; rC(16) = .30, 85% CI = .27
to .33). The same was true for Parent support (rE(28) = .34, 85% CI = .30 to .37; rR(32) = .34,
85% CI = .31 to .37; rC(25) = .31; 85% CI = .27 to .34) and Father support (rE(12) = .24, 85% CI
= .21 to .28; rR(15) = .23, 85% CI = .20 to .26; rC(12) = .28, 85% CI = .24 to .31).
Discussion
The current study quantitatively summarized the state of the literature focused on parental
support to generate a better understanding of how social support from both mothers and fathers
relates to depression in their daughters and sons and to clarify the moderating role of stress in the
parental support-depression association. Results of this meta-analysis, which included a total of
170 studies published between 1988 and February 2021, found an overall effect size of r = .27,
which is moderate in magnitude. Moderator analyses uncovered differences regarding gender of
youth and stress effects but consistent evidence of similarities across parent gender (see Figure 2

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
40
for an overview of findings). In general, gender findings were consistent across time, but stress
effects changed over time. Regarding gender differences, similar patterns in the association
between maternal and paternal support with youth depression were demonstrated both cross-
sectionally and longitudinally. Youth gender differences were demonstrated cross-sectionally,
with stronger associations for girls compared to boys. This pattern of findings was found in
longitudinal analyses, albeit no longer statistically significant. Similarly, a stronger cross-
sectional association between parental support and depression compared to both maternal and
paternal support was no longer significant in longitudinal analyses, although the trend remained.
Regarding stress effects, there was evidence supporting stress-dampening effects of
maternal and paternal support in cross-sectional studies that dissipated in longitudinal analyses.
In fact, longitudinal analyses revealed stress-buffering effects between parental support (as a
unit) and youth depression. Interestingly, there was no significant within-group heterogeneity for
any of the high-stressed groups in the longitudinal analyses. In other words, stress helped to
explain the remaining variance in the longitudinal association between social support from
parents, mothers and fathers and depression for boys and girls. Finally, bidirectional effects were
demonstrated, supporting a transactional process involving both parent and child effects. In
replicating and extending a previous meta-analysis on social support from the family (Rueger et
al., 2016), the current meta-analysis provided valuable new information about possible
moderators to the parental support-youth depression association to address questions about
equivocal findings in the literature in a theory-guided manner (Maxwell et al., 2015).
Gender Differences
Parent Gender

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
41
The current study provided an important overview of the state of the research to address
the mixed findings in the extant literature regarding the relationship between social support from
parents in relation to depression. Notably, in both cross-sectional and longitudinal studies, when
perceived social support from mothers and fathers was measured separately, the association
between support from each source and depression was similar in magnitude, which supports our
parenting similarity hypothesis. The complete overlap in the 85% confidence intervals in these
analyses highlights the robustness of this finding and suggests that social support from both
parents is equally important in understanding youth depression. These results suggest that the
commonly held belief that fathers have a role of “provider” but are considered “secondary”
caregivers (Cabrera et al., 2014) may cause researchers to miss out on important opportunities to
understand how to address depressive symptoms for children and adolescents. It has been
proposed that changes in social norms have led to shifts in parenting roles and expectations and
stronger influence of fathers in the lives of their children (Fagan et al., 2014), which could
explain the lack of parent gender differences found in our study. However, the lack of significant
historical effects in our results provides evidence that the importance of fathers as support
providers over time has not changed and instead has simply gone unrecognized. The importance
of support from both mothers and fathers in relation to youth depression has not changed in over
three decades.
Interestingly, the effect size for support from parents considered together was larger than
the effect size for support from either parent individually. This pattern of results was clearly
evident in cross-sectional analyses but also notable longitudinally. These findings suggest that
social support from parental sources can have an additive effect and build upon one another. This
is consistent with the literature that has shown that having multiple, supportive figures is

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
42
important in promoting positive outcomes and reducing depression in youth (Helsen et al., 2000).
The stronger link for parental support measured together may be explained by the possibility that
each parent provides a unique type of support that complements one another. When measured
together in a global “parent” category, support from mothers and fathers providing youth with a
wider range of types of support (Tardy, 1985) may be captured that more fully addresses the
variety of socially supportive behaviors that youth need to be successful. It is notable that most
studies in the current meta-analysis focused on emotional support, which suggests that maternal
and paternal support that is emotional in nature is related to lower levels of youth depression to a
similar degree. It remains to be seen if parent gender differences would emerge if studies
captured different types of support. Future research should investigate this possibility.
Youth Gender
The results of this meta-analysis also provide important information in regard to how
parental support is associated with depression for boys and for girls. When considering social
support from parents (as a unit) and mothers, the associations with depression were larger for
girls compared to boys in cross-sectional studies. This gender difference was evident, albeit not
statistically significant, for paternal support and with longitudinal associations across all parental
sources of support and youth depression. These findings are similar to a study by Rueger and
colleagues (2016), which found a significantly stronger effect size in family social support for
girls compared to boys. Although the effect size difference was modest in these analyses, our
findings offer support for social role theory (Eagly & Wood, 2012) in relation to perceived social
support from parents and youth depression. Contrary to gender unity theory, there was no
evidence for stronger associations between parental support and youth depression in same-sex
compared to opposite-sex parent-youth dyads.

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
43
Given that emotional intimacy is considered fundamental to the interpersonal
relationships of girls, the benefits of social support (e.g., intimacy that is inherent to their social
relationships) may be especially important (Cyranowski et al., 2000; Eagly & Wood, 2012;
Maccoby, 1990; Rose & Rudolph, 2006). It is also possible that these differences are also
reflective of gender differences in prevalence rates of depression (i.e., higher rates for girls
compared to boys) that have been documented in the literature (Weinberger et al., 2018). In fact,
transactional models of depression have suggested that gender differences in depression may be
a function of greater reactivity to interpersonal stressors for girls and that depression may cause
further interpersonal difficulties (Maccoby, 1990; Nolen-Hoeksema, 2001). However, although
youth gender differences did emerge, it is essential to emphasize that parental support was
significantly associated with lower depression for both boys and girls.
The Role of Stress
The current investigation addressed an important gap in the literature by testing the
stress-buffering model of social support focused on the parental support-depression association
within the context of chronic stressors. Consistent with previous meta-analytic findings focused
on support from family (Rueger et al., 2016), evidence of the dampening effects of stress on
social support (i.e., reverse stress-buffering effects) was replicated with maternal and paternal
support when stress was conceptualized globally as stressful social context. Notable was the lack
of youth gender differences demonstrated for these effects. Specifically, for boys and girls alike,
the cross-sectional association between maternal/paternal support and youth depression was
weaker within the context of chronic stressors compared to the general population. Follow-up
analyses showed that stress-dampening effects on parental support were evident for youth

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
44
enduring chronic stress related to family medical illness and loss, pregnancy and parenting
during adolescence, sexual minority status, and parent-child relationship problems.
These results are consistent with family systems theories that suggest that the effects of a
stressor on one individual within a family will have an impact on the system, i.e., the family as a
whole (Hughes & Gullone, 2008; Minuchin, 1985). Thus, parental support alone may not be
protective enough for youth when stressors affect the parent as well as the child. For example, a
meta-analysis of the influence of pediatric cancer patients on family functioning showed that
parents of children with cancer reported greater distress and higher levels of family conflict (Pai
et al., 2007). The impact of pediatric cancer on the parents’ functioning was especially
pronounced within the first year following their child’s diagnosis. These results suggest that
parents who may be struggling emotionally themselves, especially when medical illness affects
the family, could be limited in their capacity to provide the necessary supports. Relatedly, youth
and their parents encountering similar stressors may engage in maladaptive coping strategies,
such as co-rumination, that could offset the possible protective benefits of social support (Calmes
& Roberts, 2008; Desjardins & Leadbeater, 2011).
It is possible that excessively “supportive” relationships, e.g., helicopter parenting, can
actually hinder autonomy and independence and lead to more problematic behavior for youth
(Schiffrin et al., 2019). Relatedly, stress-dampening effects may occur when children are put in
the position of providing support to parents in an inappropriate manner and/or to an inappropriate
degree. Specifically, parentification, which involves the child taking on emotional and/or
instrumental support roles that are more appropriate for adults in the family (Boszormenyi-Nagy
& Spark, 2014; Minuchin et al., 1967) has been associated with mood disorders in adulthood
(Hooper et al., 2011). Most recently conceptualized as role confusion (Macfie et al., 2015), there

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
45
is evidence of potential beneficial effects (e.g., greater maturity and increased self-efficacy)
when the demands in the family do not exceed the youth’s ability to cope. Thus, when
considering the direction of support, the appropriateness of social support from youth to parents
should be examined in relation to youth’s coping capacities.
Our meta-analytic results highlighting stress-dampening effects are different from
findings that suggest that social support may enhance the vulnerability related to stress and lead
to increases in depression (Brouillard et al., 2018; Desjardins & Leadbeater, 2011). The stress-
dampening model suggests that stress impacts the social support-depression association
negatively but is not necessarily harmful. Although the current study suggests that the benefits of
parental social support for both boys and girls may be dependent on the context in which social
support is occurring, there was no evidence for adverse effects of parental support in these
analyses. The demonstration of stress-dampening effects on social support in the current study
suggests that both sons and daughters may need support from other individuals outside of
parental figures in certain stressful contexts. However, it is critical to note that despite evidence
of stress-dampening, social support from mothers and fathers and parents as a unit was inversely
associated with depression across all analyses, which underscore the importance of support from
all parental sources for all youth.
Finally, it is noteworthy that the dampening effects of stress on parental support were not
evident longitudinally. This pattern of findings related to cross-sectional and longitudinal stress
effects highlights that, while parental support in stressful contexts may be dampened in a
snapshot of time, parental support was protective when this association was considered over
time. It is possible that parents need time to adjust to a stressful situation before they can fully
engage in providing support to their children. It is also possible that when parents experience a

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
46
stressor that impacts the family, they experience growth over time that allows them to learn from
their experiences and ultimately better support their children. This possibility is similar to the
research on the concept of post-traumatic growth, which suggests that individuals who go
through a traumatic experience may undergo a period of growth in response to the event
(Tedeschi & Calhoun, 1996; Xiaoli et al., 2019). It is also possible that the youth undergo a
period of growth that leads to better adjustment over time. This is consistent with research that
has found that post-traumatic growth is more common in youth directly experiencing a stressor
than indirectly through their parents’ experience of a stressor (Xiaoli et al., 2019). Importantly,
the findings from the current study provide robust evidence that supportive parents are essential
resources for youth, given the longitudinal benefits of support demonstrated.
Bidirectional Effects
Longitudinal analyses conducted using studies that contributed correlations in both
directions offered robust support for bidirectional processes in the association between parental
support and youth depression. Specifically, lower levels of parental support were associated with
higher levels of subsequent depression, and higher levels of youth depression were associated
with lower levels of subsequent parental support. In other words, our results demonstrated both
parent effects, i.e., the impact of parental support (or lack thereof) on youth depression, and child
effects, i.e., the impact of youth depression on the parent-child relationship (Bell, 1968; Coyne,
1976). These results are consistent with the coercive cycle in the parent-child relationship
demonstrated with externalizing behaviors (Patterson, 1982) and support the stress generation
theory of depression (Hammen, 1991; 2006). These bidirectional findings underscore the
complex dynamic that exists when considering the parent-child relationship and support the need

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
47
for intervention approaches that aim to build strong relationships within a family in order to
adequately treat youth with depression.
Implications for Theory, Clinical Practice, and Policy
Results of the current investigation have important implications related to theory, clinical
practice, and policy. The theoretical certainties highlighted in this study include support for the
general benefits model of social support (Rueger et al., 2016), as well as social role theory
(Eagly & Wood, 2012), the gender similarities hypothesis (Hyde, 2005) as it relates to parenting
(i.e., parenting similarity hypothesis), and additive parenting effects. Results were clear that
parents are an essential support provider and should be an integral source of support to consider
in the treatment of depression in youth. Further, the current research findings suggest that
depression prevention and intervention efforts should focus on modifying the parent-child
relationship (e.g., Diamond et al., 2002) with both mothers and fathers. Helping parents avoid
engaging in behaviors that may lead to more negative coping strategies, such as co-rumination
and reinforcement of negative cognitions, may be especially important for parents experiencing
the same stressors as their youth. It may also be helpful to provide parents with resources that
allow them to manage their own stress in more adaptive ways, which can help to promote more
positive, supportive parenting (Rueger et al., 2011). Just as prevention and treatment
interventions for youth depression with children of depressed parents are not effective unless
efforts are made to also reduce parental depression (Garber et al., 2009), interventions with youth
whose parents are enduring significant stress should seek to attend to the needs of the parents as
well as the youth.
Our results also suggest that it may be especially important to ensure that youth
experiencing stressful contexts that affect the parent-child relationship have access to other

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48
trusted individuals to supplement the support that youth receive from parents. Parents should be
encouraged to find ways of helping their children build a healthy, appropriate social network.
This is consistent with developmental theory and processes that involve increasing levels of
autonomy and independence from parents during adolescence (Steinberg, 2019). This is not to
minimize the importance of parents but rather a call to broaden the network of support providers
beyond the parents, especially in times of stress. Further, our longitudinal results suggest that
parents are able to provide support in ways that are not dampened by shared stressors in due
time, perhaps as they adjust to the stressful context. Thus, parents should be encouraged to
continue to do what they can to support their youth, even when they feel less confident in their
ability to provide support because of their own stress.
Regarding policy implications and changes in broader systems beyond the family, the
similar patterns between youth depression and support from mothers and fathers, along with the
lack of historical effects on study results, offer compelling evidence that policy decisions that
affect public health should include a consideration for the important role that fathers play in the
lives of their daughters and sons. In addition, the stronger association between youth depression
and support from parents when evaluated together as a unit compared to either mother or father
support measured individually suggests that the number of parental figures from which support
may be drawn can make a difference. Further, the stress-dampening effects on parental support,
which replicated findings in a previous meta focused on the broader family (Rueger et al., 2016),
suggest the need for changes in larger systems beyond the family to provide much needed
support to youth and families enduring chronic stressors.
Strengths, Limitations, and Future Directions

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There are several strengths of the current meta-analysis, including a protocol that
followed PRISMA recommendations (Moher et al., 2015; Shamseer et al., 2015) and additional
methodological recommendations (Johnson & Hennessy, 2019) needed to conduct a rigorous
quantitive systematic review of the parental support literature. First, the search strategy included
the gray literature, as well as studies that did not investigate the association between social
support and depression as a primary research question, which functionally provided another way
to include unpublished studies. This broad search strategy resulted in a quantitative synthesis
with very little publication bias. Second, the comprehensive effort to contact study authors for
obtaining missing data resulted in a sample that was large enough to investigate our three
theoretical moderators in a sequential fashion. This allowed us to test for nuanced differences
related to parent and youth gender, as well as stress effects. Third, the inclusion of various
sensitivity analyses beyond tests for publication bias (e.g., historical effects on parent gender
findings) addressed alternative explanations for findings related to artifacts. Related, several
methodological artifacts were considered in study eligibility requirements, as well as coding and
analysis decisions, in efforts to reduce bias in the analyses. Finally, our meta-analysis is
representative of various cultures and geographic regions, including 33 studies from countries
other than the U.S., as well as 22 studies focused on ethnic minorities, to allow generalizability
to a diversity of youth and their parents.
There are also limitations that suggest a need for cautious interpretation of findings and
highlight future research needs. First, there were limitations in the literature and methodology in
primary studies that prevented us from teasing apart the effects of other potential moderators to
the parental support-depression association. For example, the majority of studies focused on
adolescents or a wide age range that encompassed both children and adolescents, with relatively

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
50
fewer studies focused solely on child populations. In addition, the majority of studies did not
distinguish or specify the type of support being studied or focused on emotional support. In fact,
over 90% of studies in the current meta-analysis focused on emotional support or a global
assessment that included emotional support. Related, although our extensive email strategy
allowed for exploration of the association between parental support and youth depression in the
context of specific categories of stress, the smaller number of studies in these analyses prevented
exploration of gender differences and limit the generalizability of these findings. Similarly, the
relatively small number of longitudinal studies prevented full exploration of gender and stress
effects, including in the bidirectional analyses. In addition, all analyses in the current study were
based on Pearson’s r as the measure of effect size, so prior depression is not accounted for in the
longitudinal meta-analysis.
Further, the results of our stress analyses, especially the lack of findings in support of
stress-buffering, should be interpreted with caution because of unmeasured stressors in the
general population, which was conceptualized as the low-stress comparison group to chronically
stressed populations. Related, individuals within the chronically stressed groups (as well as the
general population) may have experienced multiple chronic and episodic stressors that were not
possible to tease apart in our meta-analysis. Thus, these unmeasured stressors may have reduced
power in these analyses, and stress-buffering effects may occur more often than was captured in
our study. Despite this limitation, the current study adds to initial efforts to explore stress-
buffering within the context of environmentally stressful contexts (Hammen, 2016; Rueger et al.,
2016) and helps to gain insight into how youth experiencing specific chronic stressors compare
to the general population. Overall, more work is needed to understand additional moderators to
the parental support-depression association, such as multiple stressors in interaction,

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developmental level of youth, and type of support, as well as the long-term benefits for parental
support to children and adolescents.
Second, although the current study addressed potential biasing confounds in several
ways, more could have been done to correct for artifacts, such as attenuation of effect sizes due
to measurement error (Schmidt et al., 2009). However, correcting for error also includes the
potential to impose error in the correction process (e.g., estimating alphas for studies that do not
report sample alphas; Wiernik & Dahlke, 2020). Results should be interpreted with the
understanding that the magnitude of effect sizes is likely larger than those reported in the current
study. Related, while conducting our meta-analysis with multiple effect sizes from a single study
using subgroup analyses allowed for use of all data available, and care was taken in statistically
comparing across subgroups only when effects sizes were independent, using new methods to
address nonindependence of data in meta-analytic work would lead to more powerful analyses
(Cheung, 2019; Pigott & Polanin, 2020). In addition, sensitivity analyses on reporter match
showed the potential for bias related to shared method variance and rater bias when comparing
self- and other-report of social support, which suggests that youth who are depressed may be
more likely to report lower levels of parental support. Thus, although there is a strong rationale
in the social support literature to seek understanding of the receivers’ perceptions of support
(Demaray et al., 2005), the reporter bias demonstrated suggests caution is warranted in
interpretations of research using mono-reporter designs in research focused on parental support.
It is noteworthy that there was no significant difference between match and mismatch of reporter
when comparing self- and other-report of depression, which suggests that shared method
variance and social desirability bias related to self-report of depression did not influence the
analyses in the current study.

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Third, although studies in foreign languages were not excluded from the literature review,
most authors did not respond to our email request for information to determine inclusionary
criteria, and ultimately none of these studies were included. Questions have been raised about
whether language restrictions cause systematic bias in meta-analysis (Moher et al., 2000;
Morrison et al., 2012), and the inclusion of studies with diverse youth in our meta allows for
generalization beyond English-speaking populations. However, future research is needed to
consider the role of culture and better understand the association between parental support and
youth depression across a broader range of international samples (e.g., Henrich et al., 2010). This
is especially important as efforts are made toward greater understanding of risk and protective
factors in the face of disasters, violence, and other stressful contexts experienced globally
(Masten, 2014; Ungar, 2006).
In light of the limitations of the current study and the uncertainties that remain after our
meta-analytic review, we offer the following recommendations to guide future research on the
association between parental support and youth depression:
1. Parents are a central support provider during childhood before social networks expand
(Bokhorst et al., 2010). Although the current findings emphasize a need to focus on both
parents in understanding the parental support depression association, relatively few
studies focused specifically on children under the age of 12. Future research is needed to
focus on younger-aged youth in order to explore developmental differences and possible
youth gender differences throughout development in the association between parental
support and youth depression.
2. A consideration of different types of support, including instrumental, informational, and
appraisal support, as well as emotional support (Tardy, 1985), is needed for a deeper

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53
understanding of potential gender differences, particularly whether mothers and fathers
may provide qualitatively different types of support for their children. Furthermore,
exploration of types of support may provide greater clarity into what types of supportive
behaviors may be dampened in the face of stress and what types of supportive behaviors
may provide effective buffering from the effects of stress. The use of psychometrically
sound instruments that assess type of support with high validity and reliability evidence
(e.g., Malecki & Demaray, 2003) is recommended.
3. In addition to type of support, research should also consider how other aspects of social
support (House, 1981; Tardy, 1985), such as direction of support (e.g., the child
providing support to the parent versus receiving support) and utilization of support (i.e.,
actual enactment of support versus perceptions of available support), might influence
youth depression to gain a better understanding of the multidimensional nature of social
support. In addition, since there is both theory (Boszormenyi-Nagy, 2014; Minuchin et
al., 1967) and empirical evidence (Haber et al., 2007; Hooper et al., 2011) that suggest
that support that is given by youth to parents and support that is actually utilized may
demonstrate positive associations with depression, a thoughtful consideration of issues
related to this multidimensional construct is needed when utilizing a global assessment of
parental support.
4. Additional research is needed to explore the potential for specific stressful contexts to
dampen the protective effects of parental support. In particular, more research should
focus on investigating parental support within the context of stressors that impact the
quality of the parent-youth relationship, such as high relational conflict and family
medical illness (including parental depression), with a consideration for parent and youth

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gender. In addition, despite mostly null findings, continued research on the potential
stress-buffering and vulnerability-enhancing effects of parental support is encouraged.
Explorations beyond the reaches of the current meta-analysis are warranted to investigate
potential moderators to these interactive effects. Specific recommendations previously
offered for testing interactive effects of stress and social support in future primary studies
include a focus on functional versus structural (i.e., network size) assessment of support
and an assessment of stress that fully captures the range of stressful experiences that
youth may be enduring (Cohen & Wills, 1985). We also recommend consideration of
chronic stressful contexts as well as discrete stressful events and the ways that different
types of stressors may act in tandem, additively, or interactively to present heightened
risk (Cohen & Wills, 1985; Hammen, 2016).
5. There is robust support for a transactional process of parent effects and child effects in
the development of depression in the current study that replicated results from primary
studies (Hale et al., 2020; Needham, 2008; Rothenberg et al., 2020) and theory (Bell,
1968; Hammen, 2006). Future research should continue to investigate bidirectional
influences and focus on differences across parent and youth gender, as well as the effects
of chronic and episodic stressors in these transactional associations.
Summary and Conclusions
The results from the current meta-analysis add significant new knowledge to our
understanding of the complex relationship between social support from mothers and fathers with
youth depression across gender and stressful circumstances. Unequivocally, our results show that
parents are a critical source of support for children and adolescents in relation to lower
depression. Further, our results suggest that both parents are important to youth and that there

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
55
may be an additive effect of receiving support from both mothers and fathers. Against commonly
held beliefs, our results consistently showcased that support from fathers as well as mothers is
important for all youth, regardless of youth gender. In addition, although there was a consistent
pattern of youth gender differences whereby the association between parental support and youth
depression was stronger for girls than boys, this study demonstrated no gender differences in the
dampening effects of stress on parental support. In addition, even when stress dampening
occurred, there was still evidence demonstrating that parental support is protective and inversely
associated with depression. Interestingly, there was evidence demonstrating stress-buffering
effects of support over time for youth when parents were considered together as a unit.
Collectively, our results show that, in the context of the parent-child relationship, it may be that
the number of parental figures from which support may be drawn can make a difference. Finally,
our results demonstrate the importance of larger systems to support families who are enduring
chronic stressors, especially as parents are adjusting to the stressor and possibly needing
additional support themselves before they can adequately provide support to their children. The
next generation of social support research can build on the knowledge gained in the current study
and help to deepen our understanding of the association between parental support and youth
depression. Continued exploration in these areas can strengthen our capacity to prevent and
intervene in youth depression and reduce the burden of this serious and debilitating disorder
through the lifespan.

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https://doi.org/10.1177/0095798411433842
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behaviors and mental health. Journal of Community Psychology, 28(1), 17–33.
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PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
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Table 1
Descriptive Overview of Study Characteristics and Moderators Included in the Cross-Sectional
and Longitudinal Theoretical Moderator Analyses
Study Characteristics
Theoretical Moderators
CS
LG
CS
LG
Year of Publication
Gender of Parent
1989-2006
48
10
Parents (did not distinguish)
91
18
2007-2014
56
13
Both Mother and Father
42
13
2015-2021
47
13
Mother Only
15
5
Publication Status/Focus
Father Only
3
0
Published
135
33
Gender of Youth
Unpublished
16
3
Boys
84
25
Different Primary Focus
10
1
Girls
94
26
Sample Origin
Mixed (did not distinguish)
53
9
North America
98
24
Stress
Europe
24
6
Low Stress
87
23
Asia
10
1
High Stress
66
13
Africa
2
0
Stressful Contexts
South America
1
0
Youth Medical
18
Mixed Countries
3
1
Family Medical/Loss
5
Developmental Level
Pregnant/Parenting
7
Child
9
1
Environmental
10
Child/Younger Adolescents
14
6
Ethnic Minority
21
Child/Adolescents
11
9
Sexual Minority
4
Younger Adolescents
39
12
Low Income
10
General Adolescents
36
11
Peer Relationship
6
Older Adolescents
50
9
Parent Relationship
5
Other
7
Note. CS = Cross-sectional; LG = Longitudinal; Total k = 154; Cross-sectional k = 151;
Longitudinal k = 36); Developmental level age was coded into categories representing
developmental time periods based on the primary study’s report of age or grade range: Child =
up to 12 years (up to 6th grade); Child/Younger Adolescents = up to 14 years (up to 8th grade);
Child/Adolescents = up to 19 years (though 12th grade); Younger Adolescents = 11 to 14 years
(6th – 8th grade); General Adolescents = 11 to 18 years (6th – 12th grade); Older Adolescents = 14
to 19 years (9th – 12th grade).

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102
Table 2
Comparison of Parent and Child Gender for Cross-Sectional and Longitudinal Analyses
Cross-Sectional
Longitudinal
Overall
Results
ES = .30***, k = 151
Qw(150) = 915.31***
I2 = 83.61
85% CI = .29 to .31
ES= .20***, k = 36
Qw(35) = 112.21***
I2 = 68.81
85% CI =.18 to .22
Parents
Mother
Father
Parents
Mother
Father
Parent
Gender
ES = .33***, k = 91
Qw(90) = 653.80
I2 = 86.23
85% CI = .31 to .35
ES = .26***, k = 57
Qw(56) = 265.93***
I2 = 78.94
85% CI = .24 to .28
ES = .25***, k = 45
Qw(44) = 175.16
I2 = 74.88
85% CI = .23 to .27
ES = .23***, k = 18
Qw(17) = 67.03***
I2 = 74.64
85% CI = .19 to .27
ES = .18***, k = 18
Qw(17) = 48.08***
I2 = 64.64
85% CI = .15 to .20
ES = .18***, k = 13
Qw(12) = 37.00***
I2 = 67.57
85% CI = .15 to .20
Child Gender
Boys
ES = .30***, k = 47
Qw(46) = 194.85***
I2 = 76.39
85% CI = .28 to .33
ES = .23***, k = 37
Qw(36) = 155.73***
I2 = 76.88
85% CI = .20 to .25
ES = .23***, k = 30
Qw(29) = 104.93***
I2 = 72.36
85% CI = .20 to .26
ES = .18***, k = 10
Qw(9) = 9.78
I2 = 7.99
85% CI = .14 to .21
ES = .15***, k = 15
Qw(14) = 23.34
I2 = 40.01
85% CI = .12 to .18
ES = .14***, k = 12
Qw(11) = 12.19
I2 = 9.75
85% CI = .12 to .16
Girls
ES = .37***, k = 50
Qw(49) = 247.92***
I2 = 80.24
85% CI = .34 to .39
ES = .29***, k = 42
Qw(41) = 113.40***
I2 = 63.84
85% CI = .27 to .31
ES = .26***, k = 35
85% CI = .24 to .29
Qw(34) = 94.16***
I2 = 63.89
ES = .22***, k = 10
Qw (9) = 48.27***
I2 = 81.35
85% CI = .14 to .30
ES = .20***, k = 16
Qw(15) = 36.02**
I2 = 58.36
85% CI = .16 to .23
ES = .19***, k = 12
Qw(11) = 21.93*
I2 = 49.84
85% CI = .16 to .22
Stress
Low
Stress
ES = .33***, k = 40
Qw(39) = 116.08***
I2 = 66.40
85% CI = .30 to .36
ES = .21***, k = 24
Qw = 58.38***
I2 = 60.60
85% CI = .17 to .24
ES = .19***, k = 15
Qw(14) = 58.36***
I2 = 76.01
85% CI = .15 to .23
ES = .31***, k = 8
Qw (7) = 4.66
I2 = 0.00
85% CI = .27 to .34
ES = .13***, k = 5
Qw (4) = 2.92
I2 = 0.00
85% CI = .08 to .17
ES = .13**, k = 2
Qw(1) = .35
I2 = 0.00
85% CI = .07 to .18
High
Stress
ES = .32***, k = 52
Qw(51) = 535.54***
I2 = 90.48
85% CI = .30 to .35
ES = .28***, k = 35
Qw(34) = 193.12***
I2 = 82.39
85% CI = .26 to .31
ES = .27***, k = 30
Qw(29) = 95.95***
I2 = 69.78
85% CI = .25 to .29
ES = .19***, k = 10
Qw (9) = 44.91***
I2 = 79.96
85% CI = .14 to .23
ES = .19***, k = 13
Qw (12) = 44.05***
I2 = 72.76
85% CI = .16 to .22
ES = .18***, k = 11
Qw(10) = 34.81***
I2 = 71.27
85% CI = .15 to .21

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
103
Note. The positive effect sizes represent the magnitude of correlations in the predicted direction, i.e., inverse associations. The effect
size (ES) and number of studies (k) for each analysis are reported, followed by Qw!and!I2!to test for within-group heterogeneity and
85% CIs to test for between-group heterogeneity; longitudinal correlations include all time lags (< 3 mon; 3 mon to 1 year; > 1 year)
collapsed into a single ES per study; *p < .05, **p < .01, ***p < .001.!

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
104
Table 3
The Association between Youth Depression and Support from Parents in Nine Stressful Contexts and the General Population
Note. The positive effect sizes represent the magnitude of correlations in the predicted direction, i.e., inverse associations; ES = effect
size based on the correlation coefficient; k = number of studies; Qw = Within-class goodness-of-fit statistic; I2 = Degree of
inconsistency statistic; *p < .05, **p < .01, ***p < .001.
Stress Groups
Point Estimate
Heterogeneity
ES
k
z-test
Within Groups
Between Groups
Qw(df)
I2
85% CI
General Population
.33
87
14.08***
3016.74(86)***
97.15
.30 to .36
Youth Medical
.31
18
11.22***
24.85(17)
31.60
.27 to .34
Family Medical/Loss
.19
5
3.70***
9.69(4)*
58.71
.12 to .26
Pregnant/Parenting
.15
7
2.34*
16.79(6)*
64.27
.06 to .24
Environmental
.29
10
9.52***
19.48(9)*
53.81
.25 to .33
Ethnic Minority
.29
21
8.31***
99.35(20)***
79.87
.24 to .34
Sexual Minority
.20
4
4.34***
1.68(3)
0.00
.13 to .26
Low Income
.28
10
4.13***
47.02(9)***
80.86
.18 to .36
Peer Relationship
.34
6
6.61***
13.28(5)*
62.34
.27 to .41
Parent Relationship
.20
5
3.32**
16.82(4)**
76.22
.11 to .28

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
105
Table 4
Youth Gender Differences in the Effects of Stress on the Association between Youth Depression and Support from Parents, Mothers,
and Fathers
Gender
Stress
Point Estimate
Heterogeneity
ES
k
z-test
Within Groups
Between Groups
Qw(df)
I2
85% CI
Parent
Boys
Low Stress
.31
30
14.05***
165.87(29)***
82.52
.28 to .34
High Stress
.27
18
7.66***
30.22(17)**
43.74
.22 to .32
Girls
Low Stress
.37
33
17.75***
200.11(32)***
84.01
.34 to .39
High Stress
.36
18
9.27***
47.19(17)***
63.98
.30 to .41
Mother
Boys
Low Stress
.25
25
10.70***
129.87(24)***
81.52
.22 to .29
High Stress
.13
14
4.88***
6.08(13)
0.00
.09 to .17
Girls
Low Stress
.32
26
18.12***
76.66(25)***
67.39
.30 to .35
High Stress
.21
18
7.99***
26.06(17)
34.76
.18 to .25
Father
Boys
Low Stress
.25
23
12.90***
69.38(22)***
68.29
.23 to .28
High Stress
.14
8
2.80**
14.56(7)*
51.91
.07 to .20
Girls
Low Stress
.29
24
18.12***
49.21(23)**
53.26
.27 to .31
High Stress
.18
11
5.76***
18.07(10)
44.65
.14 to .22
Note. The positive effect sizes represent the magnitude of correlations in the predicted direction, i.e., inverse associations. ES = effect
size based on the correlation coefficient; k = number of studies; Qw = Within-class goodness-of-fit statistic; I2 = Degree of
inconsistency statistic; *p < .05, **p < .01, ***p < .001. !

PARENTAL SOCIAL SUPPORT AND YOUTH DEPRESSION
Table 5
Bidirectional Analyses of Parent and Child Effects in the Association between Parental Support and Youth Depression
Parent Effects:
Parental Support as Predictor
Child Effects:
Youth Depression as Predictor
Overall
Results
ES = .17***, k = 22
Qw(21) = 57.19***
I2 = 63.28
85% CI = .15 to .20
ES = .19***, k = 22
Qw(21) = 53.91***
I2 = 61.05
85% CI = .16 to .21
Parents
Mother
Father
Parents
Mother
Father
Parent
Gender
ES = .19***, k = 9
Qw(8) = 35.80***
I2 = 77.66
85% CI = .14 to .24
ES = .17***, k = 13
Qw(12) = 28.24**
I2 = 57.51
85% CI = .14 to .20
ES =/ .15***, k = 9
Qw(8) = 16.51*
I2 = 51.54
85% CI = .12 to .18
ES = .22***, k = 9
Qw(8) = 31.41***
I2 = 74.53
85% CI = .17 to .26
ES = .19***, k = 13
Qw(12) = 33.96***
I2 = 64.66
85% CI = .15 to .22
ES = .15***, k = 9
Qw(8) = 10.77
I2 = 25.74
85% CI = .12 to .17
Child Gender
Boys
ES = .16***, k = 7
Qw(6) = 4.54
I2 = 0.00
85% CI = .12 to .19
ES = .15***, k = 12
Qw(11) = 15.38
I2 = 28.50
85% CI = .12 to .18
ES = .15***, k = 9
Qw(8) = 3.75
I2 = 0.00
85% CI = .13 to .17
ES = .16**, k = 7
Qw(6) = 17.34**
I2 = 65.41
85% CI = .09 to .24
ES = .16***, k = 12
Qw(11) = 25.74**
I2 = 57.26
85% CI = .12 to .21
ES = .12**, k = 9
Qw(8) = 23.81**
I2 = 66.40
85% CI = .07 to .18
Girls
ES = .16*, k = 7
Qw(6) = 33.71***
I2 = 82.20
85% CI = .07 to .25
ES =. 20***, k = 12
Qw(11) = 24.92**
I2 = 55.85
85% CI = .15 to .24
ES = .17***,k = 9
Qw(8) = 21.54**
I2 = 62.86
85% CI = .13 to .22
ES = .24**, k = 7
Qw(6) = 32.92***
I2 = 81.77
85% CI = .16 to .33
ES = .19***, k = 12
Qw(11) = 21.26*
I2 = 48.26
85% CI = .16 to .23
ES = .16***, k = 9
Qw(8) = 8.88
I2 = 9.94
85% CI = .14 to .19
Note. The positive effect sizes represent the magnitude of correlations in the predicted direction, i.e., inverse associations for parent
effects and for child effects. The effect size (ES) and number of studies (k) for each analysis are reported, followed by Qw and I2 to test
for within-group heterogeneity and 85% CIs to test for between-group heterogeneity; *p < .05, **p < .01, ***p < .001.

PARENTAL SOCIAL SUPPORT AND YOUTH DEPRESSION
Figure 1
PRISMA Chart of the Data Screening Process
Records identified through database search
(k = 4214)
Screening
Included
Eligibility
Identification
Additional records identified through hand
search
(k = 31)
Records after duplicates removed
(k = 2815)
Records screened and full-text
articles assessed for eligibility
(k = 696)
Records excluded
(k = 2119)
Studies included
(k = 143)
Studies coded
(k = 172)
Emailed Authors
(k = 103)
Full-text articles exclud ed
(k = 450)
Full-text articles exclud ed,
after unproductive emails
(k = 524)
•Adult sample (k = 39)
•No SS to children (k = 280)
•No child depression (k = 58)
•Not empirical (k = 18)
•Same sample (k = 25)
•Depressed sample (k = 10)
•Other (k = 20)
Reasons for rejection:
•Correlations received (k = 29)
•Unproductive emails (k = 74)
Emailed for data: k = 103
•Additional correlations (k = 49)
•No additional correlations (k = 83)
Emailed for additional data: k = 117
Studies combined
(k = 170)

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
108
Figure 2
Overview of Hypothesis Testing Results
Research Question 1: Association between Parental Support and Youth Depression
Overall ES with Cross-sectional and Longitudinal data
• General Benefits: r (169) = .27, p < .001
Research Question 2: Parent Gender as Moderator (Table 2)
Cross-sectional Test of Parenting Similarity Hypothesis
• Parent > Mother
• Parent > Father
• Comparable effects sizes for Mother and Father
Longitudinal Test of Parenting Similarity Hypothesis
• Parent = Mother
• Parent = Father
• Comparable effects sizes for Mother and Father
Research Question 3: Youth Gender as Moderator (Table 2)
Cross-sectional Test of Social Role Theory
• Parent (Girl > Boy)
• Mother (Girl > Boy)
• Father (Girl = Boy)
Cross-sectional Test of Gender Unity Theory
• No evidence of Gender Unity Theory
Longitudinal Test of Social Role Theory
• Parent (Girl = Boy)
• Mother (Girl = Boy)
• Father (Girl = Boy)
Longitudinal Test of Gender Unity Theory
• No evidence of Gender Unity Theory
Research Question 4: Stress as Moderator (Table 2)
Cross-sectional Stress Effects
• General Benefits: Parents/High Stress = Parents/Low Stress
• Stress-Dampening: Mother/High Stress < Mother/Low Stress
• Stress-Dampening: Father/High Stress < Father/Low Stress
Longitudinal Stress Effects
• Stress-Buffering: Parents/High Stress > Parents/Low Stress
• General Benefits: Mother/High Stress = Mother/Low Stress
• General Benefits: Father/High Stress = Father/Low Stress

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
109
Research Question 5: Gender and Stress as Sequential Moderators (Table 4)
Cross-sectional Gender/Stress Analyses
• Parent Similarity hypothesis
o Comparable effects sizes for Mother and Father
§ Boys in High/Low Stress groups
§ Girls in High/Low Stress groups
• Social Role Theory
o Parents (Girl = Boy) in High/Low Stress groups
o Mother (Girl > Boy) in High/Low Stress groups
o Father (Girl = Boy) in High/Low Stress groups
• No evidence of Gender Unity Theory
• Stress-Dampening for Boys and Girls:
o Mother/High Stress < Mother/Low Stress
o Father/High Stress < Father/Low Stress
Longitudinal Gender/Stress Analyses
• N/A: Sample size too small
Research Question 6: Bidirectional Effects (Table 5)
Longitudinal Parent Effects
• Parent/Mother/Father à Youth Depression
Longitudinal Child Effects
• Youth Depression à Parent/Mother/Father
Notes. Results of theory-testing of gender and stress as moderators to the parental stress-youth
depression association are summarized in this figure, separately for each research question.

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
110
Figure 3
Stem and Leaf Plot of Cross-Sectional and Longitudinal Associations between Youth Depression and Parental Support in Stressful
and Non-Stressful Contexts
Stem
Parents
Mothers
Fathers
Cross-Sectional Association for Boys
Low Stress
ES = .31; k = 30
High Stress
ES = .27; k = 18
Low Stress
ES = .25; k = 25
High Stress
ES = .13; k = 14
Low Stress
ES = .25; k = 23
High Stress
ES = .14; k = 8
.5
026
2
.4
23468
8
0
2
.3
0123479
234567
0679
0
002568
0
.2
023377999
14689
00122335566899
0036
122333345679
188
.1
0367
26
5999
002458
467
.0
79
46
15
16
9
1455
-.0
4
-.1
7
Cross-Sectional Association for Girls
Low Stress
ES = .37; k = 33
High Stress
ES = .36; k = 18
Low Stress
ES = .32; k = 26
High Stress
ES = .21; k = 18
Low Stress
ES = .29; k = 24
High Stress
ES = .18; k = 11
.5
256667
127
1
.4
002278
1667
12347
08
14
.3
012222344599
01478
011223445777889
7
113356689
02
.2
224568
2589
038
012249
014567889
29
.1
2
269
1233349
39
489
.0
2
66
8
9
799
-.0
3
-.1
1
0
Longitudinal Association for Boys and Girls
Low Stress
ES = .19; k = 10
High Stress
ES = .31; k = 8
Low Stress
ES = .19; k = 13
High Stress
ES = .13; k = 5
Low Stress
ES = .18; k = 11
High Stress
ES = .13; k = 2

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
111
Note. The positive effect sizes represent the magnitude of correlations in the predicted direction, i.e., inverse associations; ES = effect
size based on the correlation coefficient; k = number of studies.!
.5
.4
.3
8
168
6
0
.2
0558
25779
0114558
0
335
.1
09
005
36
045889
27
.0
577
59
4
0
-.0
5
-.1

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
112
Figure 4
Funnel Plot of Standard Error by Fisher’s Z for Cross-Sectional Studies
Note. Studies included in these funnel plots were those that used psychometrically adequate and self-report measures of social support.
kOverall = 151; kParent = 91; kMother = 57; kFather = 45.

PARENTAL SOCIAL SUPPORT AND YOUTH DEPRESSION
Figure 5
Funnel Plot of Standard Error by Fisher’s Z for Longitudinal Studies
Note. Studies included in these funnel plots were those that used psychometrically adequate and self-report measures of social support.
kOverall = 36; kParent = 18; kMother = 18; kFather = 13.

PARENTAL SOCIAL SUPPORT AND YOUTH DEPRESSION
Supplemental Table
Overall Mean Weighted Effect Size, Sample Characteristics, Measures and Coding Decisions for Moderators
Study Characteristics
Measures
Theoretical Moderators
ES
Author
(Publication Year)
N
%
Female
Age /
Grade
Sample
Origin
Temp
Design
SS
Measure
Depr
Measure
Stressful
Context
Stress
Measure
Parent
Gender
Youth
Gender
Alderfer & Hodges (2010)
161
53%
8-18 yrs
U.S.A.
C
CASSS
CDI
Siblings Of Cancer
Patients2
None
P
B, G
0.32
Anderson et al. (2015)
249
56%
13 yrs
U.S.A.
C, L+, ++
NRI
CDI
General Population
None
M, F
B, G
0.31
Appleton et al. (1997)
136
51%
9-18 yrs
U.K.
C
SSSC
DDPCA
Spina Bifida1/Able-
Bodied
None
P
Mixed
0.38
Armstrong & Boothroyd (2008)
107
100%
13-17 yrs
U.S.A.
C
SSSC
CESD
Low-Income7
None
P
G
0.31
Arora et al. (2017)
186
49%
5th-8th
U.S.A.
C, L+
Novel
CESD
Asian American5
None
P
B, G
0.40
Asgeirsdottir et al. (2010)
7903
53%
16-19 yrs
Iceland
C
Novel*
SCL-90 R*
Sexual Abused10/Non-
Abused
Sexual Abuse*
P
B, G
0.26
Auerbach et al. (2011)
194
60%
12-18 yrs
Canada
C, L+
SSSC
CESD
General Population
None
P
B, G
0.28
Babore et al. (2016)
594
50%
10-13 yrs
Italy
C
Other
CDI
General Population
None
M, F
B, G
0.35
Banis (1988) - D
181
60%
8-13 yrs
U.S.A.
C
SSSC
CDI
General Population:
Public H.S.
None
P
B, G
0.52
Barzilay et al. (2017)
8566
59%
15 yrs
Europe
C
Other
BDI
General Population8
Victimization
P
B, G
0.36
Bean et al. (2006)
185
54%
5th, 8th,
10th
Sweden
C
CRPBI
YSR
African American5
None
M, F
Mixed
0.16
Bèdard et al. (2014)
533
50%
13-17 yrs
France
C
SSSC
CESD
General Population
None
P
B, G
0.38
Behnke et al. (2011)
328
52%
14-16 yrs
U.S.A.
C
PBM
CESD
Latino3, 5, 9, 10
Parent Conflict,
Neighborhood,
Discrimination
M, F
B, G
0.26
Bettge et al. (2008)
2863
49%
7-17 yrs
Germany
C
Other
CESD
General Population
None
P
Mixed
0.23
Bilsky et al. (2013)
898
57%
8-14 yrs
U.S.A.
C
Other
CDI
General Population
None
P
B, G
0.46
Bogard (2005)
374
46%
12.6 yrs
U.S.A.
C
Novel*
CDI
General Population
None
M, F
B, G
0.21
Bokszczanin (2003)
387
71%
11-20 yrs
Poland
C
Novel
CESD
Exposure To Flood4
None
P
B, G
0.31
Brausch & Gutierrez (2010)
324
46%
9th-12th
U.S.A.
C
CASSS
RADS
General Population
None
P
B, G
0.50
Brouillard et al. (2018)
396
52%
8th-9th
Canada
C, L+
NRI
CDI
General Population
None
M, F
B, G
0.27
Buitron et al. (2020a)
75
44%
9-17 yrs
Italy
C
CRPBI
CDI
Anxious1; Hispanic5
None
P
Mixed
0.49
Buitron et al. (2020b)
150
51%
9-17 yrs
Italy
C
CRPBI
CDI
Anxious1; Hispanic5
None
P
Mixed
0.39
Burke et al. (2017)
818
49%
11-15 yrs
Switzerland
C, L+, ++
Other
Other
General Population
None
P
Mixed
0.19

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
115
Butterfield et al. (2021)
29
59%
9-14 yrs
U.S.A.
C, L+, ++
CRPBI
MFQ
Anxious1
None
M
B, G
0.30
Calandri et al. (2019)
386
48%
12-14 yrs
Italy
C
Novel
CESD
General Population
None
M, F
B, G
0.28
Carter et al. (2015)
607
100%
13-17 yrs
U.S.A.
C
Novel
CESD
African American5
None
M, F
G
0.21
Chang et al. (2015)
225
50%
12-18 yrs
U.S.A.
C
Other
CESD
Korean American5
None
P
Mixed
0.54
Chang et al. (2018)
1493
48%
9-14 yrs
China
C
CASSS
Other
General Population
None
P
B, G
0.32
Chapman (2003)
469
58%
6th-12th
U.S.A.
C
Novel
Novel
Death of Relative or
Friend2
None
P
Mixed
0.23
Chen (1997) - D
422
28%
14-15 yrs
Taiwan
C
Novel
CESD
General Population
None
P
Mixed
0.25
Cheng et al. (2008)
712
46%
7th-13th
Hong Kong
C
CASSS
CESD
General Population
None
P
B, G
0.23
Cho & Haslam (2010)
227
57%
16 yrs
U.S.A. and
South Korea
C
MSPSS
BDI
Immigrants and
Indigenous Youth
None
P
Mixed
0.41
Claes et al. (2015)
929
44%
12-19 yrs
Belgium and
Netherlands
C
RSI
DML
General Population8
Victimization
M, F
B, G
0.29
Clark-Lempers et al. (1990)
105
60%
6th-8th
U.S.A.
C
NRI
Novel
General Population:
Rural
None
M, F
Mixed
0.12
Colarossi & Eccles (2003)
217
58%
15-18 yrs
U.S.A.
C, L+
Other
SCL-90 R
General Population
None
M, F
B, G
0.25
Conners-Burrow & Johnson
(2009)
923
51%
9-18 yrs
U.S.A.
C
CASSS
CDI
Teen Mother
None
P
B, G
0.54
Connor & Rueter (2006)
451
52%
12-13 yrs
U.S.A.
C
Other
SCL-90 R
General Population:
Rural
None
M, F
Mixed
0.05
Cooper et al. (2013)
1942
59%
12-18 yrs
U.S.A.
C
Novel**
CESD
African American5
None
M, F
B, G
0.17
Costin (1994) - D
250
52%
5th, 8th
U.S.A.
C, L+
NRI
CDI
School Transition10
None
P
Mixed
0.47
Crean (2008)
256
64%
6th-8th
U.S.A.
C
Other
YSR
Latino5
None
M, F
B, G
0.11
Cupito et al. (2016)
180
53%
7th-10th
U.S.A.
C
NRI
MFQ
Latino5
None
M
Mixed
0.26
Cutrona (1989)
115
100%
14-18 yrs
U.S.A.
C, L+
Novel*
BDI
Pregnant Adolescents3
None
P
G
0.25
Danielson et al. (2017)
341
55%
12-17 yrs
U.S.A.
C
SSMS
Other
Tornado Experience4
None
M, F
B, G
0.22
Degirmencioglu (1995) - D
618
48%
8th-10th
U.S.A.
C
SSQ
CESD
General Population
None
M, F
Mixed
0.32
DeLay et al. (2012)
398
57%
11-14 yrs
Brazil
C
Other
CDI
General Popuilation
None
P
Mixed
0.22
Demaray & Malecki (2002)
274
57%
3rd-12th
U.S.A.
C
CASSS
BASC
General Population
None
P
B, G
0.24
Demidenko et al. (2015)
116
100%
13-19 yrs
U.S.A.
C
PARQ
Other
Depr/Non-depr Youth
None
F
G
0.24
Desjardins & Leadbeater (2011)
594
52%
12-19 yrs
Canada
C, L+
CRPBI
Other
General Population
None
M, F
B, G
0.24
Dev Path Proj (2008-2012)a
509
48%
11-13 yrs
U.S.A.
C
SSSC
MFQ
Epidemiological Study
None
P
Mixed
0.41
Duprey et al. (2020)
159
55%
13-16 yrs
U.S.A.
C
Other
CESD
General Population5
Discrimination
P
B, G
0.41
El-Khodary & Samara (2019)
1029
52%
11-17 yrs
Gaza Strip
C
CRPBI
CDI
War Experience4
None
M, F
Mixed
0.34

PARENT SOCIAL SUPPORT AND YOUTH DEPRESSION
116
EPADb
257
44%
9-17 yrs
U.K.
C, L+
Other
Other
Children of Depressed
Mothers2
None
M, F
Mixed
0.17
Fernandez et al. (2020)
189
62%
11-15 yrs
U.S.A.
C
CASSS
CESD
Hispanic5
None
P
Mixed
0.43
Forrest (1989) - D
191
57%
14-18 yrs
U.S.A.
C
SSSC
DDPCA
General Population:
Rural
None
P
Mixed
0.32
Fredrick et al. (2018)
372
51%
13-16 yrs
U.S.A.
C
CASSS
CDI
General Population
None
P
B, G
0.48
Galambos et al. (2018)
621
51%
18 yrs
Canada
C, L+, ++
Novel**
CESD
General Population9
Novel*
M, F
B, G
0.16
Garber & Little (1999)
195
63%
6th
U.S.A.
C
NRI
BDI
Children of Depressed
Mothers2/Children of
Non-Depressed
Mothers
None
M, F
B, G
0.16
Geosling (2017) - D
639
52%
7th-8th
U.S.A.
C
CASSS
BASC
General Population
None
P
B, G
0.51
Gore et al. (2001)
1036
58%
9th-11th
U.S.A.
C
PSS-FaFr
CESD
General Population
None
P
B, G
0.31
Graziano et al. (2009)
2098
50%
14-18 yrs
Italy
C
Other
Other
General Population
None
P
Mixed
0.34
Grills (2003) - D
145
51%
9-13 yrs
U.S.A.
C, L+, ++
SSSC
RADS
General Population8
Victimization
P
B, G
0.18
Guan et al. (2016)
316
57%
10-11th
U.S.A.
C
NRI
CESD
General Population
None
P
Mixed
0.23
Guimond et al. (2016)
163
52%
13 yrs
Canada
C, L+, ++
NRI
CDI
Twins
None
M
Mixed
0.23
Hafen & Laursen (2009)
313
63%
11-12 yrs
U.S.A.
C, L+, ++
NRI
YSR
General Population
None
M, F
B, G
0.08
Hale et al. (2020)
427
43%
12-13 yrs
Netherlands
C, L+, ++
NRI
RADS
General Population
None
M
B, G
0.20
Harper et al. (2006)
233
50%
10-12 yrs
U.S.A.
C
Other
CESD
General Population9
Parent
Corporal
Punishment
M, F
B, G
0.21
Harter et al. (1992)
346
49%
12-15 yrs
U.S.A.
C
Other
DDPCA
General Population
None
P
Mixed
0.66
Hazel et al. (2014)
558
55%
7-16 yrs
U.S.A.
C
NRI
CDI
General Population
None
M, F
B, G
0.14
Hidalgo et al. (2019)
258
72%
12-17 yrs
U.S.A.
C
MSPSS,
Other
Other
TGNC Youth6
None
P
Mixed
0.22
Humm et al. (2018)
493
54%
12-15 yrs
South Africa
C
Novel
Other
General Population 4,7
Community
Violence
M, F
B, G
0.11
Hunter et al. (2015)
933
50%
5th, 8th
U.S.A.
L+
CRPBI
CDI
General Population
None
M, F
Mixed
0.26
Hutcherson & Epkins (2009)
100
100%
9-12 yrs
U.S.A.