Project Description (7)

Family Cognitive-Behavioral Prevention of Depression

Study Description

Children of depressed parents are at significantly increased risk for depression and other forms of psychopathology. Three psychosocial mechanisms are associated with increased risk for psychopathology in these children—stressful parent-child interactions and the ways that children respond to and cope with these stressful interactions. Specifically, parenting behavior that is characterized by intrusiveness and withdrawal and children’s negative cognitive style are associated with increased problems in children. In contrast, children’s use of secondary control coping (cognitive restructuring, acceptance, distraction) is related to lower problems. This study examines in a randomized clinical trial the efficacy of a family-based cognitive behavioral intervention to prevent the adverse effects of parental depression on offspring. Depressed parents, their spouses, and their children (ages 9 to 16-years-old) were randomly assigned to a multifamily cognitive behavioral group intervention or to a self-study control condition. The 12 session (8 acute and 4 follow-up) family cognitive behavioral intervention includes coping skills training for children and parenting skills training for depressed parents and their spouses. Families in the comparison condition received only written educational materials about depression and its effects on families. Measures administered at pre-, post- and 6-, 12-, 18-, and 24-month follow-ups include assessment of mood disorders and other psychiatric disorders, internalizing and externalizing problems in children. Possible mediators of the effects of the intervention are also evaluated, including parental depressive symptoms and episodes of depression, parental intrusiveness and withdrawal, and children’s coping and stress responses. Our goal is to determine the efficacy of this intervention that is unique in its focus on helping children of depressed parents to cope with stressful interactions with their parents, and to improve the parenting skills of depressed parents.

Funding:

Grants R01MH069940 and R01 MH069928 from the National Institute of Mental Health

Other Links and Resources

Need help finding mental health treatment? Possible resources include:

Mental Health Association of Middle Tennessee

Publications

• Watson, K. H., Dunbar, J. P., Thigpen, J., Reising, M. M., Hudson, K., McKee, L., Forehand, R., & Compas, B. E. (2014). Observed parental responsiveness/warmth and children’s coping: Cross-sectional and prospective relations in a family depression preventive intervention. Journal of Family Psychology, 28(3), 278-286.
• Parent, J., Forehand, R., Dunbar, J.P., Watson, K.H., Reising, M.M., Seehuus, M., & Compas, B.E. (2014). Parent and adolescent reports of parenting when a parent has a history of depression: Associations with direct observations of parenting. Journal of Abnormal Child Psychology, 42, 173-183.
• McKee, L.G, Parent, J., Forehand. R., Rakow, A., Watson, K.H., Dunbar, J.P., Reising, M.M., Hardcastle, E., & Compas, B.E. (2014). Reducing youth internalizing symptoms: Effects of a family-based preventive intervention on parental guilt induction and youth cognitive style. Development and Psychopathology, 26, 319-332.
• Dunbar, J.P., McKee, L., Rakow, A., Watson, K.H., Forehand, R., & Compas, B.E. (2013). Coping, negative cognitive style and depressive symptoms in children of depressed parents. Cognitive Therapy and Research, 37, 18-28.
• Reising, M., Watson, K.H., Hardcastle, E.J., Merchant, M.J., Roberts, L., Forehand, R., & Compas, B.E. (2013). Parent depression and economics disadvantage: Association with internalizing and externalizing symptoms in children and adolescents. Journal of Child and Family Studies, 22, 335-343.
• Forehand, R., Thigpen, J.E., Parent, J., Hardcastle, E., Bettis, A., & Compas, B. (2012). The role of parent depressive symptoms in positive and negative parenting in a preventive intervention program. Journal of Family Psychology, 26, 532-541.
• Watson, K.H., Potts, J., Hardcastle, E., Forehand, R., & Compas, B.E. (2012). Internalizing and externalizing symptoms in sons and daughters of mothers with a history of depression. Journal of Child and Family Studies, 21, 657-666.
• Cole, D.A., Cai, L., Martin, N.C., Findling, R.L., Youngstrom, E.A., Garber, J., Curry, J.F., Hyde, J.S., Essex, M.J., Compas, B.E., Goodyer, I.M., Rohde, P., Stark, K.D., Slattery, M.J., & Forehand, R. (2011). Structure and measurement of depression in youths: Applying item response theory to clinical data. Psychological Assessment, 23, 819-833.
• Compas, B.E., Forehand, R., Champion, J.E., Keller, G., Hardcastle, E.J., Cole, D.A., Potts, J., Haker, K., Rakow, A., Colletti, C., Reeslund, K., Fear, J., Garai, E., McKee, L., Merchant, M.J., & Roberts, L. (2011). Family group cognitive-behavioral preventive intervention for families of depressed parents: 18- and 24-month outcomes. Journal of Consulting and Clinical Psychology, 78, 488-499.
• Rakow, A., Forehand, R., McKee, L., Roberts, L., Haker, K., Champion, J., Potts, J., Hardcastle, E., & Compas, B. (2011). The association of parental depressive symptoms with child internalizing problems: The role of parental guilt induction. Journal of Family Psychology, 25(1), 147-151.
• Compas, B.E., Forehand, R., & Keller, G. (2011). Prevention of depression in families of depressed parents. In T. Strauman, P.R. Costanzo, & J. Garber (Ed.), Prevention of depression in adolescent girls (pp. 318-339). Duke University Press.
• Parent, J., Garai, E., Forehand, R., Roland, E., Champion, J.E., Haker, K., Hardcastle, E.J., & Compas, B.E. (2010). Parent mindfulness and child outcome: The roles of parent depressive symptoms and parenting. Mindfulness, 1, 254-264.
• Compas, B.E., Champion, J.E., Forehand, R., Cole, D.A., Reeslund, K.L., Fear, J., Hardcastle, J., Keller, G., Rakow, A., Garai, E., Merchant, M.J., & Roberts, L. (2010). Coping and Parenting: Mediators of 12-month outcomes of a family group cognitive-behavioral preventive intervention with families of depressed parents. Journal of Consulting and Clinical Psychology, 78(5), 623-634.
• Colletti, C., Forehand, R., Garai, E., McKee, L., Potts, J., Haker, K., Champion, J., & Compas, B.E. (2010). Associations of parent-child anxious and depressive symptoms when a caregiver has a history of depression. Journal of Child and Family Studies, 19, 762-770.
• Compas, B.E., Jaser, S.S., & Benson, M. (2009). Coping and emotion-regulation: Implications for understanding depression during adolescence. In S. Nolen-Hoeksema (Ed.), Handbook of Adolescent Depression.
• Compas, B.E., Forehand, R., Keller, G., Champion, J.E., Rakow, A., Reeslund, K.L., McKee, L., Fear, J.M., Colletti, C.J.M., Hardcastle, E., Merchant, M.J., Roberts, L., Potts, J., Garai, E., Coffelt, N., Roland, E., Sterba, S.K., & 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, 77, 1007-1020. PMCID: PMC2821830.
• Garai, E.P., Forehand, R., Colletti, C.J.M., Reeslund, K., Potts, J., & Compas, B.E. (2009). The relation of maternal sensitivity to children’s internalizing and externalizing problems within the context of maternal depressive symptoms. Behavior Modification, 33, 559-582.
• Fear, J., Forehand, R., Colletti, C., Roberts, L., Champion, J., Reeslund, K., & Compas, B.E. (2009). Parental depression and interparental conflict: Adolescents’ self-blame and coping responses. Journal of Family Psychology, 23, 762-766.
• Colletti, C.J.M., Forehand, R., Garai, E., Rakow, A., McKee, L., Fear, J.M., & Compas, B.E. (2009). Parent depression and child anxiety: An overview of the literature with clinical implications. Child and Youth Care Forum, 183, 151-160.
• Champion, J.E., Jaser, S.S., Reeslund, K.L., Simmons, L., Potts, J.E., Shears, A.R., & Compas, B.E. (2009). The cost of caring: Caretaking behaviors by adolescent children of mothers with a history of depression. Journal of Family Psychology, 23, 156-166.
• Rakow, A., Forehand, R., McKee, L., Champion, J., Fear, J., & Compas, B.E. (2009). The relation of parental guilt induction to child internalizing problems when a caregiver has a history of depression. Journal of Child and Family Studies, 18, 367-377.
• McKee, L., Forehand, R., Rakow, A., Reeslund, K., Roland, E., Hardcastle, E., & Compas, B.E. (2008). Parenting specificity: An examination of the relation between three parenting behaviors and child problem behaviors in the context of a history of caregiver depression. Behavior Modification, 32, 638-658.
• McKee, L., Colletti, C. Rakow, A., Jones, D.J., & Forehand, R. (2008). Parent and child externalizing behaviors: Are the associations specific or diffuse? Aggressive and Violent Behavior: A Review Journal, 13, 201-215.

In Press