Anxiety and Depression in Children of Depressed Parents: Dynamics of Change in a Preventive Intervention

Abstract

Objective The current study examined effects of a preventive intervention on patterns of change in symptoms of anxiety and depression in a sample of children of depressed parents. Method Parents with a history of depression (N = 180) and their children (N = 242; 50% female; Mage = 11.38; 74% Euro-American) enrolled in an intervention to prevent psychopathology in youth. Families were randomized to a family group cognitive behavioral intervention (FGCB) or a written information (WI) control condition. Parents and youth completed the Child Behavior Checklist and Youth Self Report at baseline, 6-, 12-, 18-, and 24-month follow up. Results Youth in the FGCB intervention reported significantly greater declines in symptoms of both anxiety and depression at 6-, 12-, and 18-months compared to youth in the WI condition. Youth with higher baseline levels of each symptom (e.g., anxiety) reported greater declines in the other symptom (e.g., depression) from 0 to 6-months for in the FGCB intervention only. Changes in anxiety symptoms from 0–6 months predicted different patterns of subsequent changes in depressive symptoms from 6–12 months for the two conditions, such that declines in anxiety preceded and predicted greater declines in depression for FGCB youth but lesser increases in depression for WI youth. Conclusions Findings inform transdiagnostic approaches to preventive interventions for at-risk youth, suggesting both initial symptom levels and initial magnitude of change in symptoms are important to understand subsequent patterns of change in response to intervention.

Clinical Considerations When Treating Adults Who Are Parents

“…A meta‐analysis reports that, on average, preventive interventions decrease the risk of onset of new disorders in offspring by 40%, such that an estimated 17 families would need to be treated to offset the emergence of psychopathology in one child (Siegenthaler et al., ). More recently, an RCT comparing a family group CBT‐oriented prevention for families with a no treatment control reports that children in the intervention group have a significant reduction in both depressive and anxiety symptoms through an 18‐month follow‐up (Bettis, Forehand, Sterba, Preacher, & Compas, ).…”

Prevention programmes for children of parents with a mood/anxiety disorder: Systematic review of existing programmes and meta‐analysis of their efficacy

“…In persons with few symptoms, these distortions may not be present and as such these techniques may be difficult to internalize. Studies indicate that prevention programmes may be more beneficial for offspring with higher baseline severity levels (Bettis, Forehand, Sterba, Preacher, & Compas, 2018;Ginsburg, Drake, Tein, Teetsel, & Riddle, 2015); however, as programmes have been evaluated as a whole, it remained unclear whether this cognitive restructuring technique was a contributing factor herein.…”

Clinical considerations when treating adults who are parents.

“…A meta-analysis reports that, on average, preventive interventions decrease the risk of onset of new disorders in offspring by 40%, such that an estimated 17 families would need to be treated to offset the emergence of psychopathology in one child (Siegenthaler et al, 2012). More recently, an RCT comparing a family group CBT-oriented prevention for families with a no treatment control reports that children in the intervention group have a significant reduction in both depressive and anxiety symptoms through an 18-month follow-up (Bettis, Forehand, Sterba, Preacher, & Compas, 2016).…”