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 children's 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.

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).

Coping, Negative Cognitive Style and Depressive Symptoms in Children of Depressed Parents.

Coping and negative cognitive style were studied in relation to depressive symptoms in children at risk for depression. In a sample of 165 children (ages 9-15) of depressed parents, the main and interaction effects of coping and negative cognitive style were examined in association with children's depressive symptoms measured by parent and child report on questionnaires and diagnostic interviews. Negative cognitive style was related to three types of coping (primary control, secondary control, and disengagement). Furthermore, coping and negative cognitive style made independent contributions to depressive symptoms. Little support emerged for interactive effects on depressive symptoms. Implications for future research with this high-risk population of children are considered.

The association of maternal depressive symptoms with child externalizing problems: the role of maternal support following child sexual abuse.

This study examines the role of abuse-specific maternal support in the association between parent depressive symptoms and child externalizing problems in a sample of children with a history of sexual abuse. In total, 106 mother-child dyads were studied. The association between maternal depressive symptoms and child delinquency behaviors was found to partially operate through abuse-specific maternal support, which was assessed via parent report. Implications of the findings for parenting programs are discussed, and future research directions are considered.

Family group cognitive-behavioral preventive intervention for families of depressed parents: 18- and 24-month outcomes.

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 intervention 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.

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.

Coping and parenting: Mediators of 12-month outcomes of a family group cognitive-behavioral preventive intervention with families of depressed parents.

OBJECTIVE: In a randomized clinical trial with 111 families of parents with a history of major depressive disorder (86% mothers, 14% fathers; 86% Caucasian, 5% African-American, 3% Hispanic, 1% American Indian or Alaska Native, 4% mixed ethnicity), changes in adolescents' (mean age = 11 years; 42% female, 58% male) coping and parents' parenting skills were examined as mediators of the effects of a family group cognitive-behavioral preventive intervention on adolescents' internalizing and externalizing symptoms. METHOD: Changes in hypothesized mediators were assessed at 6 months, and changes in adolescents' symptoms were measured at a 12-month follow-up. RESULTS: Significant differences favoring the family intervention compared with a written information comparison condition were found for changes in composite measures of parent-adolescent reports of adolescents' use of secondary control coping skills and direct observations of parents' positive parenting skills. Changes in adolescents' secondary control coping and positive parenting mediated the effects of the intervention on depressive, internalizing, and externalizing symptoms, accounting for approximately half of the effect of the intervention on the outcomes. Further, reciprocal relations between children's internalizing symptoms and parenting were found from baseline to 6-month follow-up. CONCLUSION: The present study provides the first evidence for specific mediators of a family group cognitive-behavioral preventive intervention for families of parents with a history of major depressive disorder. The identification of both coping and parenting as mediators of children's mental health outcomes suggests that these variables are important active ingredients in the prevention of mental health problems in children of depressed parents.

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.

Parent Depression and Child Anxiety: An Overview of the Literature with Clinical Implications.

The association of parental depression with child anxiety has received relatively little attention in the literature. In this paper we initially present several reasons for examining this relationship. We then summarize the empirical support for a link between these two variables. Finally, we discuss directions for future research and clinical implications of an association of parental depression with child anxiety.

The Relation of Parental Guilt Induction to Child Internalizing Problems When a Caregiver Has a History of Depression.

The purpose of this study was to examine the relation between parental guilt induction and child internalizing problems in families where a caregiver had experienced depression. A total of 107 families, including 146 children (age 9-15), participated. Child-reported parental guilt induction, as well as three more traditionally studied parenting behaviors (warmth/involvement, monitoring, and discipline), were assessed, as was parent-report of child internalizing problem behavior. Linear Mixed Models Analysis indicated parental guilt induction was positively related to child internalizing problems in the context of the remaining three parenting behaviors. Implications of the findings for prevention and intervention parenting programs are considered.

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.

The specificity of maternal parenting behavior and child adjustment difficulties: a study of inner-city African American families.

The specificity of the association between 2 parenting behaviors (warmth and supervision) and 2 indicators, aggressive behavior and depressive symptoms, of major child outcomes (externalizing problems and internalizing problems) was examined among 196 inner-city African American mothers and their school age children. Given the growing number of African American families affected by HIV/AIDS and demonstrated compromises in parenting associated with maternal infection, the moderating role of maternal HIV/AIDS was also examined. Findings from longitudinal analyses supported the specificity of maternal warmth but not of maternal supervision. Maternal warmth was a stronger predictor of decreases in child aggressive behavior than of decreases in depressive symptoms. In addition, maternal warmth was a stronger predictor of decreases in aggressive behavior than was maternal supervision. Parenting specificity was not moderated by maternal HIV/AIDS. Clinical implications and future research directions are discussed.

Parenting and Child Externalizing Behaviors: Are the Associations Specific or Diffuse?

Building upon the link between inadequate parenting and child noncompliance, aggression, and oppositionality, behavioral parent training has been identified as a well-established treatment for externalizing problems in children. Much less empirical attention has been devoted to examining whether inadequate parenting and, in turn, behavioral parent training programs, have specific effects on child externalizing problems or more diffuse effects on both internalizing and externalizing problems. As an initial attempt to examine the specificity of parenting and childhood externalizing problems, this review examines prior research on the association of three parenting behaviors (parental warmth, hostility, and control) with child externalizing versus internalizing problems. Notably, findings revealed relatively little evidence for the specificity of parenting and child externalizing behaviors in the general parenting literature or in the family context of parent depression. Clinical implications and directions for future research are discussed.

Maternal HIV/AIDS and depressive symptoms among inner-city African American youth: the role of maternal depressive symptoms, mother-child relationship quality, and child coping.

This study was designed to examine interactions between psychosocial risk (i.e., maternal depressive symptoms) and protective (i.e., child coping skills and mother-child relationship quality) correlates of depressive symptoms among inner-city African American children of mothers with and without HIV/AIDS. Two primary hypotheses were tested: (a) whether these correlates interact differently in HIV-infected and noninfected samples and (b) whether child coping skills and a positive mother-child relationship interact to protect children from developing depressive symptoms in the context of maternal HIV infection. Results indicated that (a) a positive mother-child relationship, but not child coping skills, was protective in the HIV-infected sample when maternal depressive symptoms were high and (b) the combination of a positive mother-child relationship and child coping skills was associated with the lowest level of child depressive symptoms in the HIV-infected sample. These findings highlight the differential importance of various risk and protective mechanisms for HIV-infected and noninfected African American samples and, as such, have preventative implications for children of HIV-infected women.