Arin M. Connell

Maternal Depression and Child Psychopathology: A Meta-Analytic Review

Although the association between maternal depression and adverse child outcomes is well established, the strength of the association, the breadth or specificity of the outcomes, and the role of moderators are not known. This information is essential to inform not only models of risk but also the design of preventive interventions by helping to identify subgroups at greater risk than others and to elucidate potential mechanisms as targets of interventions. A meta-analysis of 193 studies was conducted to examine the strength of the association between mothers’ depression and children’s behavioral problems or emotional functioning. Maternal depression was significantly related to higher levels of internalizing, externalizing, and general psychopathology and negative affect/behavior and to lower levels of positive affect/behavior, with all associations small in magnitude. These associations were significantly moderated by theoretically and methodologically relevant variables, with patterns of moderation found to vary somewhat with each child outcome. Results are interpreted in terms of implications for theoretical models that move beyond main effects models in order to more accurately identify which children of depressed mothers are more or less at risk for specific outcomes.

The association between psychopathology in fathers versus mothers and children's internalizing and externalizing behavior problems: a meta-analysis.

In light of the selective focus on maternal (vs. paternal) psychopathology as a risk factor for child development, this meta-analysis examines the relative strength of the association between psychopathology in mothers versus fathers and the presence of internalizing and externalizing disorders in children. Associations were stronger between maternal than paternal psychopathology and the presence of internalizing (but not externalizing) problems in children, with all average effect sizes being small in magnitude. Relations were moderated by variables that highlight theoretically relevant differences between psychopathology in mothers versus fathers (e.g., age of children studied, type of parental psychopathology) and by variables related to methodological differences across studies (e.g., method of assessing psychopathology in parents and children, type of sample recruited, familial composition).

Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior

Maternal depression has been consistently linked to the development of child problem behavior, particularly in early childhood, but few studies have examined whether reductions in maternal depression serve as a mediator in relation to changes associated with a family-based intervention. The current study addressed this issue with a sample of 731 families receiving services from a national food supplement and nutrition program. Families with toddlers between ages 2 and 3 were screened and then randomized to a brief family intervention, the Family Check-Up, which included linked interventions that were tailored and adapted to the families needs. Follow-up intervention services were provided at age 3 and follow-up of child outcomes occurred at ages 3 and 4. Latent growth models revealed intervention effects for early externalizing and internalizing problems from 2 to 4, and reductions in maternal depression from ages 2 to 3. In addition, reductions in maternal depression mediated improvements in both child externalizing and internalizing problem behavior after accounting for the potential mediating effects of improvements in positive parenting. The results are discussed with respect to targeting maternal depression in future intervention studies aimed at improving early child problem behavior.

An ecological approach to promoting early adolescent mental health and social adaptation: family-centered intervention in public middle schools.

This study examined the impact of the Family Check-Up (FCU) and linked intervention services on reducing health-risk behaviors and promoting social adaptation among middle school youth. A total of 593 students and their families were randomly assigned to receive either the intervention or middle school services as usual. Forty-two percent of intervention families engaged in the service and received the FCU. Using complier average causal effect analyses, engagement in the intervention moderated intervention outcomes. Families who engaged in the intervention had youth who reported lower rates of antisocial behavior and substance use over time than did a matched control sample. Results extend previous research indicating that a family-centered approach to supporting youth in the public school setting reduced the growth of antisocial behavior, alcohol use, tobacco use, and marijuana use throughout the middle school years.

Moderators of Outcome in a Brief Family-Centered Intervention for Preventing Early Problem Behavior

This study investigated moderators of change in an empirically supported family-centered intervention (the Family Check-Up) for problem behavior in early childhood. Participants were 731 2- to 3-year-olds (49% girls; 28% African American, 50% European American, 13% biracial) from low-income families and had been screened for risk of family stress and early-onset problem behavior. They were randomized to the Family Check-Up intervention or to a no-intervention control group. Latent growth models examined sociodemographic and parent psychological risk factors as potential moderators of change in problem behavior between ages 2, 3, and 4. Results revealed 2 moderators of intervention effectiveness. Caregivers with the lowest educational levels were more responsive to the family-centered intervention, and 2-parent families were more responsive to the intervention. Other risk factors showed no predictive effects. Overall, findings suggest that this brief family-centered intervention can be equally effective in reaching the most distressed and most disadvantaged families, compared to those who are more advantaged. However, results suggest that more attention may be needed to address the intervention needs of single parent families in reducing problem behavior in early childhood.

Adolescents' resilience as a self-regulatory process: promising themes for linking intervention with developmental science.

Abstract:  This chapter focuses on the concept of self‐regulation as a measure of resilience in children and adolescents. Developmental psychology and neuroscience are converging on the role of attention control as a central ability underlying self‐regulation. We collected measures of adolescent attention control from parents and youth, and a measure of self‐regulation from teachers. The measures of effortful attention correlated highly with teacher ratings of self‐regulation. The composite measure of self‐regulation (youth, parent, teacher report) was found to moderate the impact of peer deviance on adolescent antisocial behavior, as well as stress on adolescent depression. These findings suggest that self‐regulation is a promising index of adolescent resilience. The construct of self‐regulation also provides an excellent target for strategies aimed to improve child and adolescent adjustment in problematic environments and stressful circumstances.

An Adaptive Approach to Family-Centered Intervention in Schools: Linking Intervention Engagement to Academic Outcomes in Middle and High School

This study examined the impact of an adaptive approach to family intervention in public schools on academic outcomes from age 11 to 17. Students were randomly assigned to the three-session Family Check-Up (FCU), which is designed to motivate change in parenting practices by using an assessment-driven approach and strengths-based feedback. All services were voluntary, and approximately 25% of the families engaged in the FCU. Compared with matched controls, adolescents whose parents received the FCU maintained a satisfactory GPA into high school, and intervention engagement was associated with improved attendance. The highest-risk families were the most likely to engage in the family-centered intervention, suggesting the efficacy of integrating supportive services to families in the context of other schoolwide approaches to promote the success and achievement of vulnerable students.

Variable- and Person-Centered Approaches to the Analysis of Early Adolescent Substance Use: Linking Peer, Family, and Intervention Effects With Developmental Trajectories

This 4-year study of 698 young adolescents examined the covariates of early onset substance use from Grade 6 through Grade 9. The youth were randomly assigned to a family-centered Adolescent Transitions Program (ATP) condition. Variable-centered (zero-inflated Poisson growth model) and person-centered (latent growth mixture model) approaches were taken to examine treatment effects on patterns of substance-use development across early adolescence. Variable-centered analyses revealed treatment effects both on decreasing the likelihood of initiating substance use and on the rate of growth in substance use among those who initiated use. Person-centered analyses revealed the following five trajectories of early substance use: (1) no use, (2) low/rare use, (3) early accelerating use, (4) late-accelerating use, and (5) early high but decreasing use. Of note, random assignment to the ATP intervention was strongly predictive of following the decreasing-use trajectory. In addition, the early high but decreasing group was most likely to engage in the Family Check-Up and linked intervention services. These findings suggest that covariates of early adolescent substance us, as well as the effectiveness of prevention strategies, vary as a function of the developmental pattern underlying early adolescent risk. [End Page 421]

The contribution of peers to monthly variation in adolescent depressed mood: A short-term longitudinal study with time-varying predictors

This study examined peer predictors of variation and growth in depressed mood among high-risk adolescents, using child and parent reports of monthly symptoms. One hundred seventy-six parents and their 10- to 14-year-old children separately took part in a series of up to nine monthly interviews. Multilevel growth models examined both time-varying peer predictors of parent and child reports of the childs depressive symptoms, controlling for age, gender, and treatment status. Deviant peer affiliation significantly predicted elevated depressive symptoms in the monthly child-report of depressed mood, especially for younger adolescents. Childrens level of delinquency was significantly related to parent-reported depressive symptoms, and to child-reported symptoms in older adolescents only. As expected, depressed mood was higher for girls and more prevalent among older adolescents. The results suggest that peer processes may be linked in time to the development of depression, especially among high-risk adolescents.

Employing Complier Average Causal Effect analytic methods to examine effects of randomized encouragement trials.

Aims: This article details the application of Complier Average Causal Effect (CACE) analysis to the examination of youth outcomes from adaptive substance use prevention trials. Methods: CACE analysis is illustrated using youth-reports of tobacco-use from ages 11 to 22, from the Adolescent Transitions Program, a family-focused randomized encouragement trial designed for delivery in the school setting Results: Female gender and early peer deviance predicted family engagement with active intervention components. Further, long-term reductions in youth tobacco use from age 11 to age 22 were found for families that engaged with treatment. Conclusions: CACE modeling techniques enable researchers to examine factors that predict engagement with core intervention components and to examine intervention effects specifically for youth who engaged with those components.