Journal of Clinical Psychology in Medical Settings

, Volume 23, Issue 3, pp 240–246 | Cite as

Maternal Depression and Parent Management Training Outcomes

  • Jack Dempsey
  • Samuel McQuillin
  • Ashley M. Butler
  • Marni E. Axelrad


This study examines the impact of maternal depression on reductions in children’s behavior problems severity following implementation of the Brief Behavioral Intervention—a brief, manualized parent management training treatment. The parents of 87 children aged 2–6 years of age received parent management training at a metropolitan hospital. Parents of participants completed measures of externalizing behavior and maternal depression. The association between pre-post treatment change in externalizing behavior and maternal depression was examined using an autoregressive cross-lagged model. Results showed that self-reported maternal depressive symptoms at pre-treatment negatively influenced the overall magnitude of reduction of reported externalizing behaviors in children following treatment. Results indicate that aspects of family functioning not specifically targeted by parent management training, such as maternal depression, significantly affect treatment outcomes. Clinicians providing parent management training may benefit from assessing for maternal depression and modifying treatment as indicated.


Treatment outcome Parent management training Externalizing Maternal depression Brief behavioral intervention 



We would like to thank the families that participated in this study.

Compliance with Ethical Standards

Conflict of Interest

Jack Dempsey, Samuel McQuillin, Ashley M. Butler, and Marni E. Axelrad declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.


  1. Abidin, R. R. (1995). Parenting stress index (3rd ed.). Charlottesville, VA: Pediatric Psychology Press.Google Scholar
  2. Axelrad, M., Butler, A., Dempsey, J., & Chapman, S. (2013). Treatment effectiveness of a brief behavioral intervention for preschool disruptive behavior. Journal of Clinical Psychology in Medical Settings, 20(3), 323–332. doi: 10.1007/s10880-013-9359-y.CrossRefPubMedGoogle Scholar
  3. Axelrad, M. E., Garland, B. H., & Love, K. B. (2009). Brief behavioral intervention for young children with disruptive behaviors. Journal of Clinical Psychology in Medical Settings, 16(3), 263–269.CrossRefPubMedGoogle Scholar
  4. Beauchaine, T. P., Webster-Stratton, C., & Reid, M. (2005). Mediators, moderators, and predictors of 1-year outcomes among children treated for early-onset conduct problems: A latent growth curve analysis. Journal of Consulting and Clinical Psychology, 73(3), 371–388. doi: 10.1037/0022-006X.73.3.371.CrossRefPubMedGoogle Scholar
  5. Burt, D., Zembar, M., & Niederehe, G. (1995). Depression and memory impairment: A meta-analysis of the association, its pattern, and specificity. Psychological Bulletin, 117(2), 285–305. doi: 10.1037/0033-2909.117.2.285.CrossRefPubMedGoogle Scholar
  6. Chronis, A. M., Chacko, A., Fabiano, G. A., Wymbs, B. T., & Pelham, W. E, Jr. (2004). Enhancements to the behavioral parent training paradigm for families of children with ADHD: Review and future directions. Clinical Child and Family Psychology Review, 7(1), 1–27.CrossRefPubMedGoogle Scholar
  7. Chronis-Tuscano, A., Clarke, T. L., O’Brien, K. A., Raggi, V. L., Diaz, Y., Mintz, A. D., … Thomas, S. R. (2013). Development and preliminary evaluation of an integrated treatment targeting parenting and depressive symptoms in mothers of children with attention-deficit/hyperactivity disorder. Journal of consulting and clinical psychology, 81(5), 918. doi: 10.1037/a0032112.
  8. Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8(3), 430–457. doi: 10.1207/S15328007SEM0803_5.CrossRefGoogle Scholar
  9. Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology, 37(1), 215–237. doi: 10.1080/15374410701820117.CrossRefPubMedGoogle Scholar
  10. Gartstein, M. A., Bridgett, D. J., Dishion, T. J., & Kaufman, N. K. (2009). Depressed mood and maternal report of child behavior problems: Another look at the depression–distortion hypothesis. Journal of Applied Developmental Psychology, 30(2), 149–160. doi: 10.1016/j.appdev.2008.12.001.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Griest, D., Wells, K. C., & Forehand, R. (1979). An examination of predictors of maternal perceptions of maladjustment in clinic-referred children. Journal of Abnormal Psychology, 88, 277–281. doi: 10.1037/0021-843X.88.3.277.CrossRefPubMedGoogle Scholar
  12. Hartman, R. R., Stage, S. A., & Webster-Stratton, C. (2003). A growth curve analysis of parent training outcomes: Examining the influence of child risk factors (inattention, impulsivity, and hyperactivity problems), parental and family risk factors. Journal of Child Psychology and Psychiatry, 44(3), 388–398. doi: 10.1111/1469-7610.00129.CrossRefPubMedGoogle Scholar
  13. Heiligenstein, E., Guenther, G., Hsu, K., & Herman, K. (1996). Depression and academic impairment in college students. Journal of American College Health, 45(2), 59–64.CrossRefPubMedGoogle Scholar
  14. Kazdin, A. E. (1995). Child, parent and family dysfunction as predictors of outcome in cognitive-behavioral treatment of antisocial children. Behaviour Research and Therapy, 33(3), 271–281. doi: 10.1016/0005-7967(94)00053-M.CrossRefGoogle Scholar
  15. Kazdin, A. E., & Whitley, M. K. (2006). Comorbidity, case complexity, and effects of evidence-based treatment for children referred for disruptive behavior. Journal of Consulting and Clinical Psychology, 74(3), 455–467. doi: 10.1037/0022-006X.74.3.455.CrossRefPubMedGoogle Scholar
  16. Mintz, J., Mintz, L. I., Arruda, M. J., & Hwang, S. (1992). Treatments of depression and the functional capacity to work. Archives of General Psychiatry, 49(10), 761–768.CrossRefPubMedGoogle Scholar
  17. Nieter, L., Thornberry, T, Jr., & Brestan-Knight, E. (2013). The effectiveness of group parent–child interaction therapy with community families. Journal of Child and Family Studies, 22(4), 490–501. doi: 10.1007/s10826-012-9601-5.CrossRefGoogle Scholar
  18. Reyno, S. M., & McGrath, P. J. (2006). Predictors of parent training efficacy for child externalizing behavior problem–a meta-analytic review. Journal of Child Psychology and Psychiatry, 47(1), 99–111. doi: 10.1111/j.1469-7610.2005.01544.x.CrossRefPubMedGoogle Scholar
  19. Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior assessment system for children (2nd ed.). Circle Pines, MN: American Guidance Service Inc.Google Scholar
  20. Sanders, M. R., & McFarland, M. (2001). Treatment of depressed mothers with disruptive children: A controlled evaluation of cognitive behavioral family intervention. Behavior Therapy, 31, 89–112.CrossRefGoogle Scholar
  21. Selig, J. P., & Little, T. D. (2011). Autoregressive and cross-lagged panel analysis. In B. Laursen, T. D. Little, & N. A. Card (Eds.), Handbook of developmental research methods (pp. 265–278). New York: Guildford Press.Google Scholar
  22. Wang, P. S., Beck, A. L., Berglund, P., McKenas, D. K., Pronk, N. P., Simon, G. E., & Kessler, R. C. (2004). Effects of major depression on moment-in-time work performance. The American Journal of Psychiatry, 161(10), 1885–1891. doi: 10.1176/appi.ajp.161.10.1885.CrossRefPubMedGoogle Scholar
  23. Webster-Stratton, C. (1990). Long-term follow-up of families with young conduct problem children: From preschool to grade school. Journal of Clinical Child Psychology, 19(2), 144.CrossRefGoogle Scholar
  24. Webster-Stratton, C. (1992). Individually administered videotape parent training: Who benefits? Cognitive Therapy and Research, 16, 31–52.CrossRefGoogle Scholar
  25. Webster-Stratton, C. (1994). Advancing videotape parent training: A comparison study. Journal of Consulting and Clinical Psychology, 62(3), 583–593.CrossRefPubMedGoogle Scholar
  26. Webster-Stratton, C., & Hammond, M. (1990). Predictors of treatment outcome in parent training for families with conduct problem children. Behavior Therapy, 21, 319–337.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Jack Dempsey
    • 1
  • Samuel McQuillin
    • 2
  • Ashley M. Butler
    • 1
  • Marni E. Axelrad
    • 1
  1. 1.Section of Psychology, Baylor College of Medicine, Psychology ServiceTexas Children’s HospitalHoustonUSA
  2. 2.Department of PsychologyUniversity of South CarolinaColumbiaUSA

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