Family Group Cognitive–Behavioral Preventive Intervention for Families of Depressed Parents: 18- and 24-Month Outcomes
Bruce E. Compas Vanderbilt University, Jennifer C. Thigpen, Emily J. Hardcastle, David A. Cole, Jennifer Potts, and Kelly H. Watson, Kristen Reeslund and Jessica Fear, Rex Forehand University of Vermont, Gary Keller, Aaron Rakow and Christina Colletti, Emily Garai, Laura McKee, M. J. Merchant, and Lorinda Roberts
Objective: In a long-term follow-up of a randomized controlled trial (Compas et al., 2009) to examine the effects at 18- and 24-month follow-ups of a family group cognitive– behavioral (FGCB) preventive interven- tion for mental health outcomes for children and parents from families (N 111) of parents with a history of major depressive disorder (MDD). Method: Parents with a history of MDD and their 9- to 15-year-old children were randomly assigned to a FGCB intervention or a written information comparison condition. Children’s internalizing, externalizing, anxiety/depression, and depressive symptoms; episodes of MDD and other psychiatric diagnoses; and parents’ depressive symptoms and episodes of MDD were assessed at 18 and 24 months after randomization. Results: Children in the FGCB condition were significantly lower in self-reports of anxiety/depression and internalizing symptoms at 18 months and were significantly lower in self-reports of externalizing symptoms at 18 and 24 months. Rates of MDD were significantly lower for children in the FGCB intervention over the 24-month follow-up (odds ratio 2.91). Marginal effects were found for parents’ symptoms of depression at 18 and 24 months but not for episodes of MDD. Conclusions: Support was found for a FGCB preventive intervention for children of parents with a history of MDD significantly reducing children’s episodes of MDD over a period of 2 years. Significant effects for the FGCB intervention were also found on internalizing and externalizing symptoms, with stronger effects at 18- than at 24-month follow-up.
REDUCING MAJOR DEPRESSION IN CHILDREN AT HIGH RISK: OPPORTUNITIES FOR PREVENTION*
GARY A. KELLER, M.D., University of Vermont, DIANE T. GOTTLIEB, M.S.W., PH.D. Networks, Inc.
Objective: The profound negative impact of a parent’s Major Depressive Disorder (MDD) on his or her children is of increasing concern to public health and mental health professionals. Children of a depressed parent have a markedly elevated risk for psychiatric illness, including a fourfold increased risk for MDD. The objective is to examine the scientific literature for ways to reduce this high risk to the offspring. First, we consider the relation between effective treatment of a parent’s depression and reduced risk to the offspring, and review the effectiveness of treatments for adult MDD. We then review emerging evidence that risk for psychopathology can be reduced in children of depressed parents by preventive intervention, including targeting two path- ways hypothesized as links between parental MDD and offspring psycho- pathology: parenting skills and child coping. Data Sources: Three 5-year PubMed searches, and a Cochrane Database search, and one Medline and two PsycLit searches (to 1970) were completed (search words in combinations included: depression, prevention, treatments, depression in families, family interaction, adolescents). Study Selection: Randomized controlled studies are included, and review studies and meta-analyses are highlighted to provide a
OTHER PUBLICATIONS OF THE RAISING HEALTHY CHILDREN PROGRAM:
Keller, Gary (2012) Reducing Major Depression in Children at high risk: Opportunities for prevention. Int’l. J. Psychiatry in Medicine, Vol. 44(3) 271-290.
Keller, Gary (1997) Management for Quality: Continuous Quality Improvement to increase access to outpatient mental health services, Psychciatric Services, 48;821-825.
Compas, B. E., Forehand, R., Thigpen, J. C., Keller, G., Hardcastle, E. J., Cole, D. A., Potts, J.,
H. Watson, K., Rakow, A., Colletti, C., Reeslund, K., Fear, J., Garai, E., McKee, L., Merchant, M.
J., & Roberts, L. (2011, June 27). Family Group Cognitive–Behavioral Preventive Intervention
for Families of Depressed Parents: 18- and 24-Month Outcomes. Journal of Consulting and
Clinical Psychology. Advance online publication. doi: 10.1037/a0024254
Compas, B. E., Forehand, R., Keller, G, Depression in Adolescent Girls, Science and Prevention, Strauman, Costanzo, Garber (eds.), Preventive Intervention in Families of Depressed Parents: A Family Cognitive-Behavioral Intervention. 2011.
Compas, B.E., Champion, J., Forehand, R., Cole, D., Reeslund, K., Fear, J., Hardcastle, E., Keller, G., Rakow, A., Garai, E., Merchant, M.J., Roberts, L., (2011). Coping and Parenting: Mediators of 12-month outcomes of a family group cognitive-behavioral preventive intervention with families of depressed parents, Consult Clin Psychol. Oct;78(5):623-6334
Compas, B.E., Forehand, R., Keller, G., Champion, J.E., Rakow, A., Reeslund, K., McKee, L. Fear, J., Collette, C.M.M., Hardcastle, E., Merchant, M.J., Roberts, L., Potts, J., Garai, E., Coffelt, N., Roland, E., Sterba, S. Cole, D.A. (2009). Randomized Controlled Trial of a Family Cognitive-Behavioral Preventive Intervention for Children of Depressed Parents, Journal of Consulting and Clinical Psychology, Vol. 77,6.
Jaser, S.S., Langrock, A.M., Keller, G., Merchant, M.J., Benson, M.A., Reeslund, K., Champion J.E., Compas, B.E., (2005). coping with th stress of Parental Depression II: Adolescent and Parenta Reports of Coping and Adjustment, Journal of Clinical Child and Adolescent Psychology, Vol. 34,1, Mar.
Compas, B., Langrock,A., Keller, G. Merchant, M.J. & Copeland. M. (2002) Children of Depressed Parents, Mechanisms of Risk and Implications for Treatment. Children Coping with Parental Depression: Processes of Adaptation to Family Stress. Chapter 10,227-252.
Langrock, A., Compas, B.E., Keller, G., Merchant. M.J., Copeland, M. (2002). Coping with the stress of parental depression: Parents’ reports of children’s coping and emotional and behavioral problems, Journal of Clinical Child and Adolescent Psychology, Vol. 31, 312-324.
Langrock, A. Compas, B., Keller, G., Merchant, M.J., & Copeland, M., (2001). Coping with the Stress of Parental Depression:Parents’ Reports of Children’s Coping and Emotional/Behavioral Problems. Journal of Clinical Child and Adolescent Psychology.