Family Cognitive-Behavioral Prevention of Depression

抑郁症的家庭认知行为预防

• 批准号: 7054633
• 负责人: REX FOREHAND
• 金额: $ 29.96万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-01 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7054633
• 关键词: adolescence (12-20); behavioral /social science research tag; child behavior disorders; child mental disorders; clinical depression; clinical research; clinical trials; cognitive behavior therapy; coping; depression; family therapy; group therapy; human subject; human therapy evaluation; longitudinal human study; major depression; mental disorder diagnosis; mental disorder prevention; middle childhood (6-11); mood disorders; parent offspring interaction; parents; patient oriented research; psychological stressor; psychopathology; psychosocial separation

DESCRIPTION (provided by applicant): 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, the ways that children respond to and cope with these stressful interactions, and children's negative cognitions. Specifically, parenting behavior that is characterized by intrusiveness and withdrawal and children's negative attributional 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. Based on these findings, we have established the feasibility and acceptability of a preventive intervention for depressed parents and their families. This study will examine 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) will be 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 will include coping skills training for children and parenting skills training for depressed parents and their spouses. Families in the control condition will receive 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 will include assessment of mood disorders and other psychiatric disorders, internalizing and externalizing problems in children. Possible mediators of the effects of the intervention will also be 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.

描述(由申请人提供)：父母抑郁的孩子患抑郁症和其他形式的精神病理的风险显著增加。三种心理社会机制与这些儿童患精神疾病的风险增加有关-应激性亲子互动，儿童对这些应激性互动的反应和应对方式，以及儿童的负面认知。具体地说，以侵扰和退缩为特征的父母行为和儿童的负面归因风格与儿童问题的增加有关。相比之下，儿童使用次级控制应对(认知重组、接受、分心)与较低的问题有关。基于这些发现，我们确定了对抑郁父母及其家庭进行预防性干预的可行性和可接受性。这项研究将在一项随机临床试验中检验以家庭为基础的认知行为干预的有效性，以防止父母抑郁对子女的不利影响。抑郁的父母、他们的配偶和他们的孩子(9到16岁)将被随机分配到多家庭认知行为小组干预或自学控制条件下。12期(8期急性和4期后续)家庭认知行为干预将包括针对儿童的应对技能培训和针对抑郁的父母及其配偶的育儿技能培训。处于控制状态的家庭将只收到关于抑郁症及其对家庭影响的书面教育材料。在前、后和6个月、12个月、18个月和24个月的随访中实施的措施将包括对儿童的情绪障碍和其他精神障碍、内在性和外在性问题的评估。还将评估干预效果的可能中介因素，包括父母抑郁症状和抑郁发作、父母干预和退缩，以及儿童的应对和压力反应。我们的目标是确定这种干预的有效性，这种干预的独特之处在于帮助抑郁父母的孩子应对与父母的压力互动，并提高抑郁父母的育儿技能。