Children's Maternal Representations Moderate the Efficacy of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) Treatment For Preschool Depression.
Children's Maternal Representations Moderate the Efficacy of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) Treatment For Preschool Depression.
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DOI：
10.1007/s10802-022-00897-2
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发表时间：
2022-09
影响因子：
2.5
通讯作者：
Luby, Joan
中科院分区：
文献类型：
--
作者：
Donohue, Meghan Rose;Yin, Jenny;Quinones-Camacho, Laura;Hennefield, Laura;Tillman, Rebecca;Gilbert, Kirsten;Whalen, Diana;Barch, Deanna M.;Luby, Joan
关键词：
一项随机对照试验（RCT）表明，一种新型心理疗法——亲子互动疗法——情绪发展（PCIT-ED）可以有效治疗学前抑郁症。然而，对于哪些儿童从 PCIT-ED 中受益最多，我们知之甚少。由于积极的父母层面因素与较少的抑郁症状相关，本研究探讨了积极的养育关系对 PCIT-ED 疗效的潜在调节作用。本研究调查了参加 PCIT-ED RCT 的母亲及其 3-6 岁的孩子 (N=185)。儿童被随机分配接受立即 PCIT-ED 治疗 (n=94) 或等待名单对照条件组 (n=91)，在 18 周后接受治疗。在治疗之前，孩子们完成了一项叙事故事完成任务，该任务被录像并根据孩子对母亲的积极和消极描述进行编码。亲子互动任务也在治疗前完成，并进行录像和编码，以衡量观察到的养育方式。治疗后 MDD 诊断的几率是通过儿童消极母亲表征与治疗组的相互作用（估计值=−.68；SE=.27；χ2=6.45；p=.01）以及儿童相对更积极的母亲表征与治疗组（估计值=.30；SE=.13；χ2=5.27；p=.02）的相互作用来预测的。观察到的养育措施并不能显着预测 MDD 诊断的几率。因此，PCIT-ED 预测，对于母亲表现出较少消极、相对较消极的积极表现的儿童，MDD 诊断会丢失。结果表明，母亲态度相对积极的儿童可能更有可能从 PCIT-ED 中受益，而母亲态度较为消极的儿童可能需要在开始 PCIT-ED 之前进行有针对性的工作，以减少母亲的消极认知，以使治疗最有效。
A randomized controlled trial (RCT) demonstrated that a novel psychotherapy, Parent-Child Interaction Therapy—Emotion Development (PCIT-ED), effectively treats preschool-onset depression. However, little is known about which children benefit most from PCIT-ED. As positive parent-level factors are associated with lesser depressive symptoms, this study explored the potential moderating role of positive parenting relationships on PCIT-ED efficacy. This study examined mothers and their children aged 3–6 (N=185) who participated in the PCIT-ED RCT. Children were randomized to immediate PCIT-ED treatment (n=94) or a waitlist control condition (n=91) that received treatment after 18 weeks. Prior to treatment, children completed a narrative story completion task that was videotaped and coded for children’s positive and negative representations of their mothers. Parent-child interaction tasks were also completed pre-treatment and videotaped and coded to measure observed parenting. Odds of MDD diagnosis post-treatment were predicted by the interaction of children’s negative maternal representations and treatment group (Estimate=−.68; SE=.27; χ2=6.45; p=.01) and the interaction of children’s relatively more positive than negative maternal representations and treatment group (Estimate=.30; SE=.13; χ2=5.27; p=.02). Observed parenting measures did not significantly predict odds of MDD diagnosis. Thus, PCIT-ED predicted loss of MDD diagnosis for children who displayed maternal representations that were less negative, and relatively more positive than negative. Results suggest that children with relatively more positive maternal representations may be more likely to benefit from PCIT-ED, whereas children with more negative maternal representations may need targeted work to decrease negative maternal perceptions before initiating PCIT-ED in order for treatment to be most effective.
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