Children of Depressed Parents: Family Based Prevention

描述(由申请人提供)：广泛的研究文件表明，父母抑郁的孩子比父母非抑郁的孩子患各种社会情感困难的风险要高得多。令人惊讶的是，为这一人群制定预防干预措施的研究很少。此外，在这一高危群体中确实存在的发展和治疗研究中，很少包括低收入的城市家庭。这是令人惊讶的，因为经济困难本身就是产妇抑郁和儿童发育不良的一个强大的风险因素。这款R34应用程序将通过支持保护家庭计划(PFP)的开发、手册制作和试点测试来解决这一缺陷，PFP是一种针对低收入、城市、抑郁的父母及其子女的基于家庭的多组成部分预防计划。目标人群是在社区精神卫生诊所接受抑郁症治疗的父母，以及他们9-12岁的孩子。PFP将作为家长个人治疗的10周辅助服务。该计划由三个主要部分组成：1)每节课开始时的社区餐；2)父母技能培训小组；3)针对重点儿童的同时认知行为治疗(CBT)小组。育儿部分将侧重于教育父母有关抑郁症及其对家庭的影响，并促进积极的育儿做法。儿童CBT部分将基于宾夕法尼亚大学乐观主义计划，这是一种针对有抑郁风险的青少年的手动和经过充分验证的预防模式。我们将编写一份完整的多成分干预手册，开发和验证遵守措施，并进行随机试点研究，以评估可行性、可接受性，并收集数据以估计效果大小。这项工作将在当地社区精神卫生中心(Interac)进行，并与其密切合作，以确保干预满足社区提供者及其患者的需求。他的拨款将作为一项更大规模的随机临床试验的基础。

DESCRIPTION (provided by applicant): Extensive research documents that children of depressed parents are at a significantly higher risk for developing a variety of socio-emotional difficulties than children of non-depressed parents. Surprisingly, little research has been conducted to develop prevention interventions for this population. Furthermore, of the developmental and treatment research that does exist with this at-risk group, low income, urban families are rarely included. This is surprising given that the economic hardship itself is a strong risk factor for both maternal depression and poor child development. This R34 application will address this deficit by sup porting the development, manualization and pilot testing of the Protecting Families Program (PFP), a family-based, multi-component prevention program for low-income, urban, depressed parents and their offspring. The target population is parents in treatment for depression in a community mental health clinic, and their children between the ages of 9-12. PFP will serve as a 10 week adjunctive service to the parents' individual treatment. The program consists of three main components: 1) a community meal at the beginning of each session; 2) a parent skills training group; and 3) a concurrent cognitive behavioral therapy (CBT) group for the focal child. The parenting component will focus on educating parents about depression, its impact on the family and on promoting positive parenting practices. The child CBT component will be based on the Penn Optimism Program, a manualized and well-validated prevention model for youth at risk for depression. We will write a full multi-component intervention manual, develop and validate an adherence measure, and conduct a randomized pilot study to assess feasibility, acceptability, and gather data for estimating effect size. This work will be conducted at, and in close collaboration with, a local community mental health center (INTERAC) in order to assure the intervention meets the needs of community providers and their patients. his grant will serve as a foundation for a larger randomized clinical trial.