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Parental Depressive Symptoms as a Predictor of Outcome in the Treatment of Child Depression

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Abstract

Child depression is an impairing condition for which psychotherapies have shown modest effects. Parental depression is a risk factor for development of child depression and might also be negatively associated with child depression treatment outcomes. To explore this possibility, we analyzed data from a study in which children were treated for depression after parental depressive symptoms had been assessed at baseline. Among children treated for depression in a randomized controlled trial, we identified 31 who had child- and parent-report pre- and post-treatment data on child symptoms and parent-report of pre-treatment parental depressive symptoms. Children were aged 8–13, 77% boys, and 52% Caucasian, 13% African-American, 6% Latino, and 29% multi-racial. Analyses focused on differences in trajectories of change (across weekly measurements), and post-treatment symptoms among children whose parents did (n = 12) versus did not (n = 19) have elevated depressive symptoms at baseline. Growth curve analyses showed markedly different trajectories of change for the two groups, by both child-report (p = 0.03) and parent-report (p = 0.03) measures: children of parents with less severe depression showed steep symptom declines, but children of parents with more severe depression showed flat trajectories with little change in symptoms over time. ANCOVAs showed lower post-treatment child symptoms for children of parents with less severe depression versus parents with more severe depression (p = 0.05 by child report, p = 0.01 by parent report). Parental depressive symptoms predict child symptom trajectories and poorer child treatment response, and may need to be addressed in treatment.

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Notes

  1. Analysis of child-reported internalizing symptoms using the Anxious/Depressed scale of the YSR revealed that child symptom levels were significantly lower at post-treatment for children of parents without elevated depressive symptoms (M = 50.89, SD = 2.42) than children of parents with elevated depressive symptoms (M = 56.17, SD = 6.26), F(1,28) = 9.08, p = 0.01, controlling for pre-treatment scores on the Anxious/Depressed scale. Analysis of child-reported internalizing symptoms using the Withdrawn/Depressed scale of the YSR showed that child symptom levels were in the predicted direction, albeit not significantly different at post-treatment for children of parents without elevated depressive symptoms (M = 53.37, SD = 5.33) than children of parents with elevated depressive symptoms (M = 56.75, SD = 7.78), F(1,28) = .81, p = 0.38.

    Analysis of parent-reported child internalizing symptoms using the Anxious/Depressed scale of the CBCL showed a significant difference in the predicted direction. Child symptom levels were lower at post-treatment for children of parents without elevated depressive symptoms (M = 55.37, SD = 5.89) than children of parents who had elevated depressive symptoms (M = 63.50, SD = 8.85), F(1,28) = 10.09, p < 0.01, controlling for pre-treatment scores on the Anxious/Depressed scale. Analysis of parent-reported internalizing symptoms using the Withdrawn/Depressed scale of the CBCL revealed that child symptom levels were in the predicted direction at post-treatment for children of parents without elevated depressive symptoms (M = 57.79, SD = 7.57) than children of parents with elevated depressive symptoms (M = 62.17, SD = 9.17), F(1,28) = 3.19, p = 0.09.

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Acknowledgments

This research was supported by grant K23MH093491 (D. Eckshtain, P.I.) from the National Institute of Mental Health, and the parent study was supported by the John D. and Catherine T. MacArthur Foundation and the Norlien Foundation.

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Authors and Affiliations

  1. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA, 02114, USA

    Dikla Eckshtain

  2. Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St, Cambridge, MA, 02139, USA

    Lauren Krumholz Marchette

  3. Department of Psychology, Harvard University, 1032 William James Hall, 33 Kirkland Street, Cambridge, MA, 02138, USA

    Jessica Schleider

  4. Department of Psychology, Harvard University, 1030 William James Hall, 33 Kirkland Street, Cambridge, MA, 02138, USA

    John R. Weisz

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  1. Dikla Eckshtain
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Correspondence to Dikla Eckshtain.

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John Weisz receives royalties for some of the work cited in this paper, including the MATCH-ADTC treatment manual used in the study.

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Eckshtain, D., Marchette, L.K., Schleider, J. et al. Parental Depressive Symptoms as a Predictor of Outcome in the Treatment of Child Depression. J Abnorm Child Psychol 46, 825–837 (2018). https://doi.org/10.1007/s10802-017-0323-4

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