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A Randomized Controlled Trial of the Impact of a Family-Based Adolescent Depression Intervention on both Youth and Parent Mental Health Outcomes

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Abstract

This paper presents findings from a multi-centre, double-blind, randomized controlled trial that tested the hypothesis that parent and youth mental health improvements would be superior in a family-based intervention for adolescent depression (BEST MOOD) compared to a treatment-as-usual supportive parenting program (PAST). Eligible participants were families with a young person aged between 12 and 18 years who met diagnostic criteria for a depressive disorder (major, minor or dysthymic). Participating families (N = 64; 73.4% of youth were female) were recruited in Victoria, Australia and allocated to treatment condition using a block randomization procedure (parallel design) with two levels of blinding. This paper reports on the trial’s secondary outcomes on youth and parent mental health. General linear mixed models were used to examine the longitudinal effect of treatment group on outcome. Data were analyzed according to intention-to-treat; 31 families were analyzed in BEST MOOD, and 33 families in PAST. Parents in the BEST MOOD group experienced significantly greater reductions in stress and depressive symptoms than parents in the PAST group at 3-month follow-up. A greater reduction in parental anxiety was observed in the BEST MOOD group (d = 0.35) compared with PAST (d = 0.02), although the between-group difference was not significant. Both groups of youth showed similar levels of improvement in depressive symptoms at post-treatment (d = 0.83 and 0.80 respectively), which were largely sustained at a 3-month follow-up. The family-based BEST MOOD intervention appeared superior to treatment-as-usual (PAST) in demonstrating greater reductions in parental stress and depression. Both interventions produced large reductions in youth depressive symptoms.

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References

  • Allen, J. P., Litten, R. Z., Fertig, J. B., & Babor, T. (1997). A review of research on the alcohol use disorders identification test (AUDIT). Alcoholism: Clinical and Experimental Research, 21, 613–619.

    Article  Google Scholar 

  • Altman, D. G., & Bland, J. M. (1999). How to randomise. BMJ, 319, 703–704.

    Article  PubMed  PubMed Central  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5, 5edn. Arlington: American Psychiatric Association.

    Book  Google Scholar 

  • Angold, A., & Costello, E. J. (1987). Mood and Feelings questionnaire (MFQ). Durham: Developmental Epidemiology Program, Duke University.

    Google Scholar 

  • Angold, A., Costello, E. J., & Messer, S. C. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5, 237–249.

    Google Scholar 

  • Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress Scales in clinical groups and a community sample. Psychological Assessment, 10, 176–181.

    Article  Google Scholar 

  • Australian Bureau of Statistics. (2008). National Survey of mental health and wellbeing: Summary of results, 2007. Canberra: Australian Bureau of Statistics.

    Google Scholar 

  • Australian Bureau of Statistics. (2011). Census of population and housing: Socio-economic indexes for areas (SEIFA), Australia. Canberra: Australian Bureau of Statistics.

    Google Scholar 

  • Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). The alcohol use disorders identification test. Guidelines for use in primary care, 2, 1–41.

    Google Scholar 

  • Bamberg, J. H., Toumbourou, J. W., & Marks, R. (2008). Including the siblings of youth substance abusers in a parent-focused intervention: A pilot pest of the BEST Plus program. Journal of Psychoactive Drugs, 40, 281–291.

    Article  PubMed  Google Scholar 

  • Baskin, T. W., Tierney, S. C., Minami, T., & Wampold, B. E. (2003). Establishing specificity in psychotherapy: A meta-analysis of structural equivalence of placebo controls. Journal of Consulting and Clinical Psychology, 71, 973–979. doi:10.1037/0022-006X.71.6.973.

    Article  PubMed  Google Scholar 

  • Bertino, M. D., Lewis, A. J., Knight, T., & Toumborou, J. W. (2012). Parenting Adolescents Support Training (PAST): Treatment manual (pp. 1-36). Melbourne: Deakin University.

  • Bertino, M. D., Richens, K., Knight, T., Toumbourou, J. W., Ricciardelli, L., & Lewis, A. J. (2013). Reducing parental anxiety using a family based intervention for youth mental health: A randomized controlled trial. Open Journal of Psychiatry, 3, 173–185. doi:10.4236/ojpsych.2013.31A013.

    Article  Google Scholar 

  • Birmaher, B., Brent, D., Bernet, W., Bukstein, O., Walter, H., Benson, R. S., et al. (2007). Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 46, 1503–1526. doi:10.1097/chi.0b013e318145ae1c.

    Article  Google Scholar 

  • Blatt, S. J., Quinlan, D. M., Chevron, E. S., McDonald, C., & Zuroff, D. (1982). Dependency and self-criticism: Psychological dimensions of depression. Journal of Consulting and Clinical Psychology, 50, 113–124.

    Article  PubMed  Google Scholar 

  • Blatt, S. J., Schaffer, C. E., Bers, S. A., & Quinlan, D. M. (1992). Psychometric properties of the depressive experiences questionnaire for adolescents. Journal of Personality Assessment, 59, 82–98.

    Article  PubMed  Google Scholar 

  • Bronte-Tinkew, J., Moore, K. A., Matthews, G., & Carrano, J. (2007). Symptoms of major depression in a sample of fathers of infants: Sociodemographic correlates and links to father involvement. Journal of Family Issues, 28, 61–99.

    Article  Google Scholar 

  • Carr, A. (2014). The evidence base for family therapy and systemic interventions for child-focused problems. Journal of Family Therapy, 36, 107–157. doi:10.1111/1467-6427.12032.

    Article  Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155.

    Article  PubMed  Google Scholar 

  • Corp, I. B. M. (2013). IBM SPSS statistics for Macintosh, 22.0 edn. Armonk: IBM Corp.

    Google Scholar 

  • Costa, N., Weems, C., Pellerin, K., & Dalton, R. (2006). Parenting stress and childhood psychopathology: An examination of specificity to internalizing and externalizing symptoms. Journal of Psychopathology & Behavioral Assessment, 28, 113–122. doi:10.1007/s10862-006-7489-3.

    Article  Google Scholar 

  • Diamond, G. S., & Josephson, A. (2005). Family-based treatment research: A 10-year update. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 872–887.

    Article  Google Scholar 

  • Diamond, G. S., Reis, B. F., Diamond, G. M., Siqueland, L., & Isaacs, L. (2002). Attachment-based family therapy for depressed adolescents: A treatment development study. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1190–1196.

    Article  PubMed  Google Scholar 

  • Diamond, G. S., Siqueland, L., & Diamond, G. M. (2003). Attachment-based family therapy for depressed adolescents: Programmatic treatment development. Clinical Child & Family Psychology Review, 6, 107–127.

    Article  Google Scholar 

  • Diamond, G. S., Wintersteen, M. B., Brown, G. K., Diamond, G. M., Gallop, R., Shelef, K., et al. (2010). Attachment-based family therapy for adolescents with suicidal ideation: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 122–131.

    PubMed  Google Scholar 

  • Fichman, L., Koestner, R., & Zuroff, D. C. (1994). Depressive styles in adolescence: Assessment, relation to social functioning, and developmental trends. Journal of Youth and Adolescence, 23, 315–330.

    Article  Google Scholar 

  • Forsberg, S., Darcy, A., Bryson, S. W., Arnow, K. D., Datta, N., Le Grange, D., et al. (2015). Psychological symptoms among parents of adolescents with anorexia nervosa: A descriptive examination of their presence and role in treatment outcome. Journal of Family Therapy. doi:10.1111/1467-6427.12088.

    Google Scholar 

  • Garber, J. (2006). Depression in children and adolescents: Linking risk research and prevention. American Journal of Preventive Medicine, 31, 104–125. doi:10.1016/j.amepre.2006.07.007.

    Article  Google Scholar 

  • Gibbons, R. D., Hedeker, D., & DuToit, S. (2010). Advances in analysis of longitudinal data. Annual Review of Clinical Psychology, 6, 79–107. doi:10.1146/annurev.clinpsy.032408.153550.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gillham, J. E., Reivich, K., Freres, D. R., Lascher, M., Litzinger, S., Shatte, A. J., et al. (2006). School-based prevention of depression and anxiety symptoms in early adolescence: A pilot of a parent intervention component. School Psychology Quarterly, 21, 323–348.

    Article  Google Scholar 

  • Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586.

    Article  PubMed  Google Scholar 

  • Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 1337–1345.

    Article  Google Scholar 

  • Goodman, S. H., & Gotlib, I. H. (1999). Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission. Psychological Review, 106, 458–490.

    Article  PubMed  Google Scholar 

  • Hankin, B. L. (2008). Cognitive vulnerability-stress model of depression during adolescence: Investigating depressive symptom specificity in a multi-wave prospective study. Journal of Abnormal Child Psychology, 36, 999–1014.

    Article  PubMed  PubMed Central  Google Scholar 

  • Henry, J. D., & Crawford, J. R. (2005). The short-form version of the depression anxiety stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44, 227–239.

    Article  PubMed  Google Scholar 

  • Hien, D., Matzner, F. J., First, M. B., Spitzer, R. L., Williams, J., & Gibbon, M. (1994). Structured clinical interview for DSM-IV childhood diagnoses (KID-SCID). New York: Biometrics Research presentation.

    Google Scholar 

  • Hollon, S. D., Muñoz, R. F., Barlow, D. H., Beardslee, W. R., Bell, C. C., Bernal, G., et al. (2002). Psychosocial intervention development for the prevention and treatment of depression: Promoting innovation and increasing access. Biological Psychiatry, 52, 610–630.

    Article  PubMed  Google Scholar 

  • Jacka, F. N., Reavley, N. J., Jorm, A. F., Toumbourou, J. W., Lewis, A. J., & Berk, M. (2013). Prevention of common mental disorders: What can we learn from those who have gone before and where do we go next? Australian & New Zealand journal of psychiatry, 47, 920–929. doi:10.1177/0004867413493523.

    Article  Google Scholar 

  • Jacobson, C., & Mufson, L. (2010). Treating adolescent depression using interpersonal therapy. In J. Weisz, & a. Kazdin (Eds.), evidence-based psychotherapies for children and adolescents (pp. 126–139) (2nd ed.). New York: Guilford.

    Google Scholar 

  • Kaslow, N. J., Broth, M. R., Smith, C. O., & Collins, M. H. (2012). Family-based interventions for child and adolescent disorders. Journal of Marital and Family Therapy, 38, 82–100. doi:10.1111/j.1752-0606.2011.00257.x.

    Article  PubMed  Google Scholar 

  • Kendler, K. S., Gatz, M., Gardner, C. O., & Pedersen, N. L. (2006). A Swedish national twin study of lifetime major depression. The American Journal of Psychiatry, 163, 109–114. doi:10.1176/appi.ajp.163.1.109.

    Article  PubMed  Google Scholar 

  • Lerner, R. M. (2007). Developmental science, developmental systems, and contemporary theories of human development. In handbook of child psychology. Hoboken, NJ: John Wiley & Sons.

  • Lewinsohn, P. M., Clarke, G. N., Hops, H., & Andrews, J. A. (1990). Cognitive-behavioral treatment for depressed adolescents. Behavior Therapy, 21, 385–401.

    Article  Google Scholar 

  • Lewis, A. J., Pryor, R., Bertino, M. D., Toumbourou, J., & Knight, T. (2012). Behaviour exchange and systems therapy - MOOD: Treatment manual (pp. 1–82). Geelong: Deakin University.

    Google Scholar 

  • Lewis, A. J., Bertino, M. D., Skewes, J., Shand, L., Borojevic, N., Knight, T., et al. (2013). Adolescent depressive disorders and family based interventions in the family options multicenter evaluation: Study protocol for a randomized controlled trial. Trials, 14, 1–22. doi:10.1186/1745-6215-14-384.

    Article  Google Scholar 

  • Lewis, A. J., Bertino, M. D., Bailey, C. M., Skewes, J., Lubman, D. I., & Toumbourou, J. W. (2014). Depression and suicidal behavior in adolescents: A multi-informant and multi-methods approach to diagnostic classification. Frontiers in Psychology, 5, 1–9. doi:10.3389/fpsyg.2014.00766.

    Article  Google Scholar 

  • Lewis, A. J., Knight, T., Germanov, G., Benstead, L. M., Joseph, C. I., & Poole, L. A. (2015a). The impact on family functioning of social media use by depressed adolescents: a qualitative analysis of the Family Options Study. Frontiers in Psychiatry, 6. doi:10.3389/fpsyt.2015.00131/full.

  • Lewis, A. J., Kremer, P., Douglas, K., Toumborou, J. W., Hameed, M. A., Patton, G. C., et al. (2015b). Gender differences in adolescent depression: Differential female susceptibility to stressors affecting family functioning. Australian Journal of Psychology, 67, 131–139.

    Article  Google Scholar 

  • Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress Scales (DASS) with the Beck depression and anxiety inventories. Behaviour Research and Therapy, 33, 335–343.

    Article  PubMed  Google Scholar 

  • Malhi, G. S., Bassett, D., Boyce, P., Bryant, R., Fitzgerald, P. B., Fritz, K., et al. (2015). Royal Australian and new Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Australian and New Zealand Journal of Psychiatry, 49, 1–185.

    Article  Google Scholar 

  • Mattejat, F., & Remschmidt, H. (2008). The children of mentally ill parents. Deutsches Ärzteblatt International, 105, 413–418.

    PubMed  PubMed Central  Google Scholar 

  • McDermott, B., Baigent, M., Chanen, A., Fraser, L., Graetz, B., Hayman, N., et al. (2010). Clinical practice guidelines: Depression in adolescents and young adults. The national depression initiative. Melbourne: Beyondblue.

    Google Scholar 

  • Mordoch, E., & Hall, W. A. (2002). Children living with a parent who has a mental illness: A critical analysis of the literature and research implications. Archives of Psychiatric Nursing, 16, 208–216.

    Article  PubMed  Google Scholar 

  • Morris, S. B., & DeShon, R. P. (2002). Combining effect size estimates in meta-analysis with repeated measures and independent-group designs. Psychological Methods, 7, 105–125.

    Article  PubMed  Google Scholar 

  • Mowbray, C. T., Lewandowski, L., Bybee, D., & Oyserman, D. (2004). Children of mothers diagnosed with serious mental illness: Patterns and predictors of service use. Mental Health Services Research, 6, 167–183.

    Article  PubMed  Google Scholar 

  • National Institute for Health and Care Excellence [NICE] (2005). Depression in Children and Young People: Identification and Management in Primary, Community and Secondary Care. Retrieved from http://guidance.nice.org.uk/CG28.

  • Pape, S. E., & Collins, M. P. (2011). A systematic literature review of parenting behaviours exhibited by anxious people. European Psychiatry, 26, 170.

    Article  Google Scholar 

  • Pardini, D. A. (2008). Novel insights into longstanding theories of bidirectional parent–child influences: Introduction to the special section. Journal of Abnormal Child Psychology, 36, 627–631.

    Article  PubMed  Google Scholar 

  • Parra, G., Buckholdt, K., Olsen, J., Jobe-Shields, L., Davis, G., & Gamble, H. (2011). Targeting family risk factors in the context of treating youth depression: A survey of psychologists. The Family Journal, 19, 381–388. doi:10.1177/1066480711419801.

    Article  Google Scholar 

  • Poole, L. A., Lewis, A. J., Toumbourou, J. W., Knight, T., Bertino, M. D., & Pryor, R. (2016). A multi-family group intervention for adolescent depression: The BEST MOOD program. Family Process, advance online publication doi:10.1111/famp.12218.

  • Rohde, P., Clarke, G. N., Mace, D. E., Jorgensen, J. S., & Seeley, J. R. (2004). An efficacy/effectiveness study of cognitive-behavioral treatment for adolescents with comorbid major depression and conduct disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 660–668.

    Article  Google Scholar 

  • Sander, J., & McCarty, C. (2005). Youth depression in the family context: Familial risk factors and models of treatment. Clinical Child & Family Psychology Review, 8, 203–219. doi:10.1007/s10567-005-6666-3.

    Article  Google Scholar 

  • Saunders, J. B., Aasland, O. G., Babor, T. F., De la Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88, 791–804.

    Article  PubMed  Google Scholar 

  • Sexton, T. L., & Datchi, C. (2014). The development and evolution of family therapy research: Its impact on practice, current status, and future directions. Family Process, 53, 415–433.

    Article  PubMed  Google Scholar 

  • Sheeber, L., Hops, H., Alpert, A., Davis, B., & Andrews, J. (1997). Family support and conflict: Prospective relations to adolescent depression. Journal of Abnormal Child Psychology, 25, 333–344.

    Article  PubMed  Google Scholar 

  • Sim, L. J., & England, M. J. (2009). Associations between depression in parents and parenting, child health, and child psychological functioning. In depression in parents, parenting, and children : Opportunities to improve identification, treatment, and prevention (pp. 119–181). Washington, D.C.: National Academies Press.

    Google Scholar 

  • Stark, K. D., Banneyer, K. N., Wang, L. A., & Arora, P. (2012). Child and adolescent depression in the family. Couple and Family Psychology: Research and Practice, 1, 161–184. doi:10.1037/a0029916.

    Article  Google Scholar 

  • Tan, S., & Rey, J. (2005). Depression in the young, parental depression and parenting stress. Australasian Psychiatry, 13, 76–79.

    Article  PubMed  Google Scholar 

  • Toumbourou, J. W., & Bamberg, J. H. (2008). Family recovery from youth substance use related problems: A pilot study of the BEST Plus program. Substance Use & Misuse, 43, 1829–1843. doi:10.1080/10826080802297385.

    Article  Google Scholar 

  • Toumbourou, J. W., Blyth, A., Bamberg, J., & Forer, D. (2001). Early impact of the BEST intervention for parents stressed by adolescent substance abuse. Journal of Community and Applied Social Psychology, 11, 291–304. doi:10.1002/casp.632.

    Article  Google Scholar 

  • Vostanis, P., Graves, A., Meltzer, H., Goodman, R., Jenkins, R., & Brugha, T. (2006). Relationship between parental psychopathology, parenting strategies and child mental health. Social Psychiatry and Psychiatric Epidemiology, 41, 509–514. doi:10.1007/s00127-006-0061-3.

    Article  PubMed  Google Scholar 

  • Weissman, M. M., Warner, V., Wickramaratne, P., Moreau, D., & Olfson, M. (1997). Offspring of depressed parents: 10 years later. Archives of General Psychiatry, 54, 932–940.

    Article  PubMed  Google Scholar 

  • Weissman, M. M., Wickramaratne, P., Nomura, Y., Warner, V., Pilowsky, D., & Verdeli, H. (2006). Offspring of depressed parents: 20 years later. American Journal of Psychiatry, 163, 1001–1008. doi:10.1176/ajp.2006.163.6.1001.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., McCarty, C. A., & Valeri, S. M. (2006). Effects of psychotherapy for depression in children and adolescents: A meta-analysis. Psychological Bulletin, 132, 132–149.

    Article  PubMed  PubMed Central  Google Scholar 

  • World Health Organisation. (2014). Health for the world’s adolescents: A second chance in the second decade. Geneva: World Health Organisation.

    Google Scholar 

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Acknowledgments

This study was funded by the Australian Research Council (grant number LP110200167). The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia

    Lucinda A. Poole, Tess Knight, John W. Toumbourou & Andrew J. Lewis

  2. Turning Point, Eastern Health, Melbourne, VIC, Australia

    Dan I. Lubman

  3. Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia

    Dan I. Lubman

  4. The Victorian Rehabilitation Centre, Melbourne, VIC, Australia

    Melanie D. Bertino

  5. School of Psychology & Exercise Science, Murdoch University, Perth, WA, Australia

    Andrew J. Lewis

  6. Harry Perkins Medical Research Institute, Fiona Stanley Hospital, Perth, WA, Australia

    Andrew J. Lewis

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  1. Lucinda A. Poole
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  2. Tess Knight
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  3. John W. Toumbourou
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  4. Dan I. Lubman
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  5. Melanie D. Bertino
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Correspondence to Andrew J. Lewis.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

Additional information

Clinical trial registration information—Engaging youth with high prevalence mental health problems using family based interventions; http://www.anzctr.org.au; ACTRN12612000398808.

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Poole, L.A., Knight, T., Toumbourou, J.W. et al. A Randomized Controlled Trial of the Impact of a Family-Based Adolescent Depression Intervention on both Youth and Parent Mental Health Outcomes. J Abnorm Child Psychol 46, 169–181 (2018). https://doi.org/10.1007/s10802-017-0292-7

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