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Children’s Maternal Representations Moderate the Efficacy of Parent–Child Interaction Therapy—Emotion Development (PCIT-ED) Treatment For Preschool Depression

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Abstract

A randomized controlled trial (RCT) demonstrated that a novel psychotherapy, Parent–Child Interaction Therapy—Emotion Development (PCIT-ED), effectively treats preschool-onset depression. However, little is known about which children benefit most from PCIT-ED. As positive parent-level factors are associated with lesser depressive symptoms, this study explored the potential moderating role of positive parenting relationships on PCIT-ED efficacy. This study examined mothers and their children aged 3–6 (N = 185) who participated in the PCIT-ED RCT. Children were randomized to immediate PCIT-ED treatment (n = 94) or a waitlist control condition (n = 91) that received treatment after 18 weeks. Prior to treatment, children completed a narrative story completion task that was videotaped and coded for children’s positive and negative representations of their mothers. Parent–child interaction tasks were also completed pre-treatment and videotaped and coded to measure observed parenting. Odds of MDD diagnosis post-treatment were predicted by the interaction of children’s negative maternal representations and treatment group (Estimate = -.68; SE = .27; \({\chi }^{2}\) = 6.45; p = .01) and the interaction of children’s relatively more positive than negative maternal representations and treatment group (Estimate = .30; SE = .13; \({\chi }^{2}\) = 5.27; p = .02). Observed parenting measures did not significantly predict odds of MDD diagnosis. Thus, PCIT-ED predicted loss of MDD diagnosis for children who displayed maternal representations that were less negative, and relatively more positive than negative. Results suggest that children with relatively more positive maternal representations may be more likely to benefit from PCIT-ED, whereas children with more negative maternal representations may need targeted work to decrease negative maternal perceptions before initiating PCIT-ED in order for treatment to be most effective.

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Funding

All phases of this study were supported by an NIH grant (R01MH064769-06A1). Work by Dr. Donohue was supported by NIH grant K23MH125023 (PI: Donohue). Work by Dr. Quiñones-Camacho was supported by NIH grant T32MH100019 (PIs: Barch and Luby). Work by Dr. Hennefield was supported by NIH grant F32HD093273 (PI: Hennefield). Work by Dr. Gilbert’s was supported by NIH grant K23MH115074 (PI: Gilbert). Work by Dr. Whalen was supported by NIH grant K23MH118426 (PI: Whalen).

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Authors and Affiliations

  1. Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA

    Meghan Rose Donohue, Jenny Yin, Laura Quiñones-Camacho, Laura Hennefield, Rebecca Tillman, Kirsten Gilbert, Diana Whalen, Deanna M. Barch & Joan Luby

  2. Department of Educational Psychology, The University of Texas at Austin, Austin, TX, USA

    Laura Quiñones-Camacho

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  1. Meghan Rose Donohue
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  2. Jenny Yin
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  3. Laura Quiñones-Camacho
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Correspondence to Meghan Rose Donohue.

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Study procedures were pre-approved by the Washington University School of Medicine IRB. Informed consent and assent was obtained from parents and children, respectively.

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Donohue, M.R., Yin, J., Quiñones-Camacho, L. et al. Children’s Maternal Representations Moderate the Efficacy of Parent–Child Interaction Therapy—Emotion Development (PCIT-ED) Treatment For Preschool Depression. Res Child Adolesc Psychopathol 50, 1233–1246 (2022). https://doi.org/10.1007/s10802-022-00897-2

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