Family Cognitive-Behavioral Prevention of Depression

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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.