TY - JOUR
T1 - A randomized controlled trial of parent-child psychotherapy targeting emotion development for early childhood depression
AU - Luby, Joan L.
AU - Barch, Deanna M.
AU - Whalen, Diana
AU - Tillman, Rebecca
AU - Freedland, Kenneth E.
N1 - Funding Information:
Dr. Luby has received research support from NIMH and royalties from Guilford Press. Dr. Freedland has received research grants from the National Heart, Lung, and Blood Institute and an editorial honorarium from the Society for Health Psychology. The other authors report no financial relationships with commercial interests.
Funding Information:
Supported by NIMH grant 5R01MH098454-04.
Publisher Copyright:
© 2018 American Journal of Psychiatry. All rights reserved.
PY - 2018/11
Y1 - 2018/11
N2 - Objective: Clinical depression in children as young as age 3 has been validated, and prevalence rates are similar to the school-age disorder. Homotypic continuity between early and later childhood depression has been observed, with alterations in brain function and structure similar to those reported in depressed adults. These findings highlight the importance of identifying and treating depression as early as developmentally possible, given the relative treatment resistance and small effect sizes for treatments later in life. The authors conducted a randomized controlled trial of a dyadic parent-child psychotherapy for early childhood depression that focuses on enhancing the child's emotional competence and emotion regulation. Method: A modified version of the empirically tested parent-child interaction therapy with a novel "emotion development" module (PCIT-ED) was compared with a waiting list condition in a randomized controlled trial in 229 parent-child dyads with children 3-6.11 years of age. Both study arms lasted 18 weeks. Results: Children in the PCIT-ED group had lower rates of depression (primary outcome), lower depression severity, and lower impairment compared with those in the waiting list condition (Cohen's d values, 1.0). Measures of child emotional functioning and parenting stress and depression were significantly improved in the PCIT-ED group. Conclusions: The findings from this randomized controlled trial of a parent-child psychotherapy for early childhood depression suggest that earlier identification and intervention in this chronic and relapsing disorder represents a key new pathway for more effective treatment. Manualized PCIT-ED, administered by master's-level clinicians, is feasible for delivery in community health settings.
AB - Objective: Clinical depression in children as young as age 3 has been validated, and prevalence rates are similar to the school-age disorder. Homotypic continuity between early and later childhood depression has been observed, with alterations in brain function and structure similar to those reported in depressed adults. These findings highlight the importance of identifying and treating depression as early as developmentally possible, given the relative treatment resistance and small effect sizes for treatments later in life. The authors conducted a randomized controlled trial of a dyadic parent-child psychotherapy for early childhood depression that focuses on enhancing the child's emotional competence and emotion regulation. Method: A modified version of the empirically tested parent-child interaction therapy with a novel "emotion development" module (PCIT-ED) was compared with a waiting list condition in a randomized controlled trial in 229 parent-child dyads with children 3-6.11 years of age. Both study arms lasted 18 weeks. Results: Children in the PCIT-ED group had lower rates of depression (primary outcome), lower depression severity, and lower impairment compared with those in the waiting list condition (Cohen's d values, 1.0). Measures of child emotional functioning and parenting stress and depression were significantly improved in the PCIT-ED group. Conclusions: The findings from this randomized controlled trial of a parent-child psychotherapy for early childhood depression suggest that earlier identification and intervention in this chronic and relapsing disorder represents a key new pathway for more effective treatment. Manualized PCIT-ED, administered by master's-level clinicians, is feasible for delivery in community health settings.
UR - http://www.scopus.com/inward/record.url?scp=85056323161&partnerID=8YFLogxK
U2 - 10.1176/appi.ajp.2018.18030321
DO - 10.1176/appi.ajp.2018.18030321
M3 - Article
C2 - 29921144
AN - SCOPUS:85056323161
SN - 0002-953X
VL - 175
SP - 1102
EP - 1110
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
IS - 11
ER -