Emily Hardcastle

Randomized controlled trial of a family cognitive-behavioral preventive intervention for children of depressed parents.

A family cognitive-behavioral preventive intervention for parents with a history of depression and their 9-15-year-old children was compared with a self-study written information condition in a randomized clinical trial (n = 111 families). Outcomes were assessed at postintervention (2 months), after completion of 4 monthly booster sessions (6 months), and at 12-month follow-up. Children were assessed by child reports on depressive symptoms, internalizing problems, and externalizing problems; by parent reports on internalizing and externalizing problems; and by child and parent reports on a standardized diagnostic interview. Parent depressive symptoms and parent episodes of major depression also were assessed. Evidence emerged for significant differences favoring the family group intervention on both child and parent outcomes; strongest effects for child outcomes were found at the 12-month assessment with medium effect sizes on most measures. Implications for the prevention of adverse outcomes in children of depressed parents are highlighted.

Parenting specificity: an examination of the relation between three parenting behaviors and child problem behaviors in the context of a history of caregiver depression.

The aim of this study was to advance our understanding of the relations between three specific parenting behaviors (warmth, monitoring, and discipline) and two child outcomes (internalizing and externalizing problems) within the context of parental depression. Using an approach recommended by A. Caron, B. Weiss, V. Harris, and T. Carron (2006), unique and differential specificity were examined. Ninety-seven parents with a history of depression and 136 of their 9- to 15-year-old children served as participants. Children reported parenting behaviors and parents reported child problem behaviors. The findings indicated that warmth/involvement, but not monitoring or discipline, was uniquely related to externalizing problems and differentially related to internalizing and externalizing problems. The findings suggest that parental warmth has implications for interventions conducted with children living in families with a history of parental depression.

Efficacy and moderators of a family group cognitive-behavioral preventive intervention for children of parents with depression.

OBJECTIVE Building on an earlier study (Compas, Forehand, Thigpen, et al., 2011), tests of main effects and potential moderators of a family group cognitive-behavioral (FGCB) preventive intervention for children of parents with a history of depression are reported. METHOD Assessed a sample of 180 families (242 children ages 9-15 years) in a randomized controlled trial assessed at 2, 6, 12, 18 and 24 months after baseline. RESULTS Significant effects favoring the FGCB intervention over a written information comparison condition were found on measures of childrens symptoms of depression, mixed anxiety/depression, internalizing problems, and externalizing problems, with multiple effects maintained at 18 and 24 months, and on incidence of child episodes of major depressive disorder over the 24 months. Effects were stronger for child self-reports than for parent reports. Minimal evidence was found for child age, child gender, parental education, parental depressive symptoms, or presence of a current parental depressive episode at baseline as moderators of the FGCB intervention. CONCLUSIONS The findings provide support for sustained and robust effects of this preventive intervention.

Use of parental guilt induction among depressed parents.

This study builds on prior research by Rakow et al. (2009) by examining the role of parental guilt induction in the association between parent depressive symptoms and child internalizing problems in a sample of parents with a history of major depressive disorder. One hundred and two families with 129 children (66 males; Mage = 11.42 years) were studied. The association of parental depressive symptoms with child internalizing problems was accounted for by parental guilt induction, which was assessed by behavioral observations and child report. Implications of the findings for parenting programs are discussed and future research directions are considered.

Structural Equation Modeling Approaches for Analyzing Partially Nested Data

Study designs involving clustering in some study arms, but not all study arms, are common in clinical treatment-outcome and educational settings. For instance, in a treatment arm, persons may be nested in therapy groups, whereas in a control arm there are no groups. Methodological approaches for handling such partially nested designs have recently been developed in a multilevel modeling framework (MLM-PN) and have proved very useful. We introduce two alternative structural equation modeling (SEM) approaches for analyzing partially nested data: a multivariate single-level SEM (SSEM-PN) and a multiple-arm multilevel SEM (MSEM-PN). We show how SSEM-PN and MSEM-PN can produce results equivalent to existing MLM-PNs and can be extended to flexibly accommodate several modeling features that are difficult or impossible to handle in MLM-PNs. For instance, using an SSEM-PN or MSEM-PN, it is possible to specify complex structural models involving cluster-level outcomes, obtain absolute model fit, decompose person-level predictor effects in the treatment arm using latent cluster means, and include traditional factors as predictors/outcomes. Importantly, implementation of such features for partially nested designs differs from that for fully nested designs. An empirical example involving a partially nested depression intervention combines several of these features in an analysis of interest for treatment-outcome studies.

Reducing youth internalizing symptoms: Effects of a family-based preventive intervention on parental guilt induction and youth cognitive style

This study utilized structural equation modeling to examine the associations among parental guilt induction (a form of psychological control), youth cognitive style, and youth internalizing symptoms, with parents and youth participating in a randomized controlled trial of a family-based group cognitive-behavioral preventive intervention targeting families with a history of caregiver depression. The authors present separate models utilizing parent report and youth report of internalizing symptoms. Findings suggest that families in the active condition (family-based group cognitive-behavioral group) relative to the comparison condition showed a significant decline in parent use of guilt induction at the conclusion of the intervention (6 months postbaseline). Furthermore, reductions in parental guilt induction at 6 months were associated with significantly lower levels of youth negative cognitive style at 12 months. Finally, reductions in parental use of guilt induction were associated with lower youth internalizing symptoms 1 year following the conclusion of the intervention (18 months postbaseline).

The Role of Parent Depressive Symptoms in Positive and Negative Parenting in a Preventive Intervention

This study examined the role of parent depressive symptoms as a mediator of change in behaviorally observed positive and negative parenting in a preventive intervention program. The purpose of the program was to prevent child problem behaviors in families with a parent who has current or a history of major depressive disorder. One hundred eighty parents and one of their 9- to 15-year-old children served as participants and were randomly assigned to a family group cognitive-behavioral (FGCB) intervention or a written information (WI) comparison condition. At two months after baseline, parents in the FGCB condition had fewer depressive symptoms than those in the WI condition, and these symptoms served as a mediator for changes in negative, but not positive, parenting at 6 months after baseline. The findings indicate that parent depressive symptoms are important to consider in family interventions with a parent who has current or a history of depression.

Behavioral interventions for HIV infected and uninfected mothers with problem drinking

This article evaluates the efficacy of a 14-session social-cognitive behavioral intervention on problem drinking (and where applicable, drug use) among urban HIV-infected and uninfected mothers, in comparison to a single-session social/motivational intervention, and explores the relationships of initial substance use problem severity and HIV status to efficacy. A randomized controlled trial design was used. Participants (N = 118) were mothers with problem drinking, both HIV-infected (55%) and uninfected, and primarily from racial/ethnic minority and low socioeconomic status backgrounds. Participants were interviewed five times over 18 months. Both intervention arms yielded reductions in alcohol and drug use frequency, alcohol quantity, and alcohol/drug problems, with moderate effect sizes. Those with greater initial substance use maintained reductions over a longer period of time in response to the more intensive social-cognitive intervention. Treatment efficacy did not vary by HIV status. The utility of targeting intervention intensity to the level of substance use is supported.