Craig Leve

Adolescents' relationships with their mothers and fathers : Associations with depressive disorder and subdiagnostic symptomatology

Family relationships across 3 groups of adolescents were compared: (a) those with unipolar depressive disorders (n=82); (b) those with subdiagnostic depressive symptoms (n=78); and (c) those without emotional or behavioral difficulties (n=83). Results based on multisource, multimethod constructs indicated that depressed adolescents, as well as those with subdiagnostic symptomatology, experience less supportive and more conflictual relationships with each of their parents than do healthy adolescents. These findings are notable in demonstrating that adverse father-adolescent relationships are associated with depressive symptomatology in much the same way as mother-adolescent relationships. As well, the findings add to the emerging evidence that adolescents with subdiagnostic symptoms experience difficulties in social relationships similar to those experienced by adolescents with depressive disorder.

Technologies for expanding the reach of evidence-based interventions: Preliminary results for promoting social-emotional development in early childhood

In great demand are efficient mechanisms for delivery of evidence-based interventions for promoting social-emotional development and early positive behavior of all children, and especially for those with or at risk for disabilities. The rise of Internet use has created potentially new avenues for intervention delivery, which, when paired with the many recent advances in computer networking and multimedia technology, is fueling this demand. This article describes the development of an Internet-based, computer-delivered parent-training intervention, Infant Net, with infants at risk for poor social-emotional outcomes. Results of a randomized control trial of the Infant Net intervention with 40 parent-infant dyads showed significant increase, reflecting a medium to large effect size, in infant social engagement and engagement with the environment for infants in the intervention group as compared to the control group. Implications are discussed with regard to future research.

Dynamics of affective experience and behavior in depressed adolescents.

BACKGROUND Depression is often characterized as a disorder of affect regulation. However, research focused on delineating the key dimensions of affective experience (other than valence) that are abnormal in depressive disorder has been scarce, especially in child and adolescent samples. As definitions of affect regulation center around processes involved in initiating, maintaining, and modulating the occurrence, intensity, and duration of affective experiences, it is important to examine the extent to which affective experiences of depressed youth differ on these dimensions from those of healthy youth. METHODS The affective behavior and experience of adolescents with major depressive disorder (MDD; n = 75) were compared to a demographically matched cohort of healthy adolescents (n = 77). Both samples were recruited from community high schools. A multi-source (parents and adolescent), multi-method (interviews, behavioral observations, questionnaires) assessment strategy was used to examine positive and negative affects. RESULTS Depressed youth had significantly longer durations, higher frequency, and greater intensity when experiencing angry and dysphoric affects and shorter durations and less frequency of happy affect when compared to healthy youth. The most consistent, cross-method results were evident for duration of affect. CONCLUSIONS Clinically depressed adolescents experienced disturbances in affective functioning that were evident in the occurrence, intensity, and duration of affect. Notably, the disturbances were apparent in both positive and negative affects.

Cross-Generational Transmission of Aggressive Parent Behavior: A Prospective, Mediational Examination

The intergenerational transmission of aggressive parenting behavior was examined within the context of a prospective longitudinal study of adolescent and young adult adjustment. Thirty-nine young adults (G2; 33 females, 6 males) who had participated in early phases of this study with their parents (G1) continued their involvement with their young children (G3; 17 females, 22 males, mean age = 2.6) several years later. Data included direct observation of parent–adolescent (G1–G2) and parent–child (G2–G3) interactions as well as self-reports. Analyses demonstrated directly observed cross-generational continuity in aggressive parenting from G1 to G2 some 6–7 years later. However, the results also showed that adolescent aggressive behavior served as the mediational link reducing the direct path from G1 to G2 aggressive parenting to nonsignificant levels. The results are consistent with a social interactional model of intergenerational continuity of parenting behavior.

Instruction by mothers and fathers during problem solving with their young children.

Mothers and fathers of 163 5-year-olds were observed interacting with their children in dyads on 2 separate occasions on a familiar and unfamiliar cognitive activity. Within- and between-family comparisons were conducted. Few differences in the instruction provided by mothers and fathers appeared, and those that did were on the unfamiliar task. On this task, instruction by mothers, within and across families, was more responsive to childrens changing skill than was instruction by fathers. Directive and disapproving comments by parents were related to poorer posttest performance by the child. High level of instruction by both parents was related to better posttest performance than was low level of instruction by parents. Contributions of parents to their childrens cognitive development are discussed.

Mom-net: Evaluation of an internet-facilitated cognitive behavioral intervention for low-income depressed mothers.

Objective: Evaluate an Internet-facilitated cognitive–behavioral treatment intervention for depression, tailored to economically disadvantaged mothers of young children. Method: Economically disadvantaged mothers (N = 266) of preschool aged children, who reported elevated levels of depressive symptoms, were randomized to either the 8-session, Internet-facilitated intervention (Mom-Net) or to Motivational Interviewing and Referral to Services (MIRS). Outcomes were measured using the Patient Health Questionnaire 9 (PHQ-9; Spitzer et al., 1999), the Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition-Text Revised (DSM–IV–TR) Axis I Disorders (SCID; First, Spitzer, Gibbon, & Williams, 2002), and the Hamilton Depression Rating Scale (HDRS; Hamilton, 1960). Results: Relative to participants in the MIRS condition, participants in Mom-Net demonstrated significantly greater reduction in depression as indexed by self-report questionnaire (primary outcome), interviewer-rated symptoms, and diagnostic outcomes. Conclusions: Results suggest that the Mom-Net intervention is effective as a remotely delivered intervention for economically disadvantaged mothers.

A Randomized Controlled Trial Examination of a Remote Parenting Intervention: Engagement and Effects on Parenting Behavior and Child Abuse Potential:

Technology advances increasingly allow for access to remotely delivered interventions designed to promote early parenting practices that protect against child maltreatment. Among low-income families, at somewhat elevated risk for child maltreatment, there is some evidence that parents do engage in and benefit from remote-coaching interventions. However, little is known about the effectiveness of such programs to engage and benefit families at high risk for child maltreatment due to multiple stressors associated with poverty. To address this limitation, we examined engagement and outcomes among mothers at heightened risk for child abuse, who were enrolled in a randomized controlled, intent-to-treat trial of an Internet adaptation of an evidence-based infant parenting intervention. We found that engagement patterns were similar between higher and lower risk groups. Moreover, an intervention dose by condition effect was found for increased positive parent behavior and reduced child abuse potential.

Mediation analyses of Internet-facilitated cognitive behavioral intervention for maternal depression

ABSTRACT This study evaluated the putative mediating mechanisms of an Internet-facilitated cognitive-behavioral therapy (CBT) intervention for depression tailored to economically disadvantaged mothers of preschool-age children. The CBT mediators were tested across two previously published randomized controlled trials which included the same measures of behavioral activation, negative thinking, and savoring of positive events. Trial 1 included 70 mothers with elevated depressive symptoms who were randomized to either the eight-session, Internet-facilitated intervention (Mom-Net) or to treatment as usual. Trial 2 included 266 mothers with elevated depressive symptoms who were randomized to either Mom-Net or to a motivational interviewing and referral to services condition. Simple mediation models tested each putative mediator independently followed by tests of multiple mediation that simultaneously included all three mediators in the model to assess the salient contributions of each mediator. The pattern of results for the mediating effects were systematically replicated across the two trials and suggest that behavioral activation and negative thinking are salient mediators of the Mom-Net intervention; significant mediating effects for savoring were obtained only in the simple mediation models and were not obtained in the multiple mediation models.