Family-Based Interventions for Youth Depression: Meta-Analysis of Randomized Clinical Trials

Eckshtain, Dikla; Horn, Rachel L.; Weisz, John R.

doi:10.1007/s10578-022-01375-y

Cited by 4 publications

(3 citation statements)

References 53 publications

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“…Individual psychotherapy is unlikely to modify the family dynamics. Until now, however, the literature on the efficacity of family-based interventions is scarce [116], and only a small positive effect of involving family/caregivers in the therapy was proven [117]. Of note, most of the studies documenting the effects of family-based interventions used cognitive-behavioural therapy approaches, while attachment-based interventions show particular promise in repairing parent-child communication [118,119].…”

Section: Discussionmentioning

confidence: 99%

Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study

Urbańska-Grosz,

Sitek,

Pakalska

et al. 2024

Children

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Background: This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents’ cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers. Methods: The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children’s Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews. Results: Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents’ and mothers’ perspectives as associated with adolescents’ MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility. Conclusions: This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence.

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Section: Discussionmentioning

confidence: 99%

Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study

Urbańska-Grosz,

Sitek,

Pakalska

et al. 2024

Children

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“…It is well known that family interventions can help reduce risk of relapse for people with psychosis 420,421 . They also appear to reduce depression and suicidal ideation in young people 422,423 , though these effects could be restricted to older adolescents and may be affected by risk of bias concerns 424 . Secondary and tertiary family interventions can also lead to reductions in parental stress and depression, and improvements in parenting behaviours 422,425 , which may be particularly relevant to interrupting intergenera tional transmission of familial risks for mental health problems 424 .…”

Section: Family Interventionsmentioning

confidence: 99%

The social determinants of mental health and disorder: evidence, prevention and recommendations

Kirkbride,

Anglin,

Colman

et al. 2024

World Psychiatry

141

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People exposed to more unfavourable social circumstances are more vulnerable to poor mental health over their life course, in ways that are often determined by structural factors which generate and perpetuate intergenerational cycles of disadvantage and poor health. Addressing these challenges is an imperative matter of social justice. In this paper we provide a roadmap to address the social determinants that cause mental ill health. Relying as far as possible on high‐quality evidence, we first map out the literature that supports a causal link between social determinants and later mental health outcomes. Given the breadth of this topic, we focus on the most pervasive social determinants across the life course, and those that are common across major mental disorders. We draw primarily on the available evidence from the Global North, acknowledging that other global contexts will face both similar and unique sets of social determinants that will require equitable attention. Much of our evidence focuses on mental health in groups who are marginalized, and thus often exposed to a multitude of intersecting social risk factors. These groups include refugees, asylum seekers and displaced persons, as well as ethnoracial minoritized groups; lesbian, gay, bisexual, transgender and queer (LGBTQ+) groups; and those living in poverty. We then introduce a preventive framework for conceptualizing the link between social determinants and mental health and disorder, which can guide much needed primary prevention strategies capable of reducing inequalities and improving population mental health. Following this, we provide a review of the evidence concerning candidate preventive strategies to intervene on social determinants of mental health. These interventions fall broadly within the scope of universal, selected and indicated primary prevention strategies, but we also briefly review important secondary and tertiary strategies to promote recovery in those with existing mental disorders. Finally, we provide seven key recommendations, framed around social justice, which constitute a roadmap for action in research, policy and public health. Adoption of these recommendations would provide an opportunity to advance efforts to intervene on modifiable social determinants that affect population mental health.

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“…Dippel, Szota, Cuijpers, Christiansen, and Brakemeier (2022), in their meta‐analysis of youth depression RCTs, compared interventions involving caregivers or families against control and comparison groups, and found only 17 studies, with a mean effect size ( d = 0.34) quite like the means reported elsewhere for youth depression treatment in general. Using somewhat different inclusion criteria, Eckshtain, Horn, and Weisz (2022) found 11 RCTs testing family‐based treatments and similarly found no evidence that family‐based treatment had outperformed other youth depression treatments. Eckshtain et al.…”

Section: Treatment Strategies For Addressing the Internalizing Paradoxmentioning

confidence: 99%

Research Review: The internalizing paradox – youth anxiety and depression symptoms, psychotherapy outcomes, and implications for research and practice

Weisz

Fitzpatrick

Venturo‐Conerly

et al. 2023

Child Psychology Psychiatry

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BackgroundYouth anxiety and depression have long been combined within the empirically derived internalizing syndrome. The two conditions show substantial comorbidity, symptom co‐occurrence, and overlap in treatment procedures, but paradoxically diverge in psychotherapy outcomes: strong, positive effects for anxiety and weak effects for depression.MethodsDrawing on recent research, we examine candidate explanations for this paradox to help identify strategies for addressing it by improving outcomes for youth depression.ResultsCandidate explanations include that youth depression, compared with youth anxiety, has more varied comorbidities and more heterogeneous symptom combinations, has greater uncertainty regarding mediators and mechanisms of change, is treated with more complex and potentially confusing protocols, and has characteristics that may impede client engagement. Candidate strategies for shrinking the psychotherapy effectiveness gap include personalizing through transdiagnostic modular treatment, simplifying therapy by focusing on empirically supported principles of change, developing effective strategies for engaging family members as intervention allies, using shared decision‐making to inform clinical decisions and boost client engagement, capitalizing on youth‐friendly technological advances, and shortening and digitizing treatments to enhance their accessibility and appeal.ConclusionsRecent advances suggest explanations for the internalizing paradox, which in turn suggest strategies for shrinking the youth anxiety–depression psychotherapy outcome gap; these form an agenda for a promising new era of research.

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Family-Based Interventions for Youth Depression: Meta-Analysis of Randomized Clinical Trials

Cited by 4 publications

References 53 publications

Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study

Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study

The social determinants of mental health and disorder: evidence, prevention and recommendations

Research Review: The internalizing paradox – youth anxiety and depression symptoms, psychotherapy outcomes, and implications for research and practice

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