Family Cognitive Behavioral Therapy for Preventing Depression in Children

Family Cognitive Behavioral Prevention of Depression in Children of Parents With a History of Major Depressive Disorder

This study will determine the effectiveness of cognitive behavioral therapy (CBT) versus educational treatment in preventing depression in the children of parents with a history of depression.

Depression is a serious condition that can affect a person's work, relationships, and quality of life. Studies have shown that children of depressed parents are at a higher risk for developing depression than those whose parents have not experienced depression. Safe and effective treatments that can help prevent children of depressed parents from becoming depressed are needed. This study will compare CBT to depression education to determine which is more effective in preventing depression in the children of depressed parents. Families will be randomly assigned to receive weekly sessions of either CBT or depression education for 12 weeks. Parents in the CBT group will be taught skills to more effectively raise their children and to better manage their depressive symptoms; their children will be taught skills to cope with the stress of their parents' depression. Families in the education group will be informed about the ways that depression can affect individuals with depression and their families. Study visits will occur at study entry and at Week 12. Several follow-up visits will occur for up to 2 years after the interventional part of the study. At each visit, a clinician will make direct observations of the depressed parent's interaction with his or her children. In addition, families will be interviewed and will complete questionnaires about the parent's depressive symptoms and family interaction.

The intervention is a family group cognitive behavioral program for families of parents with a history of depression to teach parenting skills to parents and coping skills to children.

The comparison arm involves providing written information about depression and stress to parents with a history of depression and their children.

Groups of families receive training in parenting and children learn about coping in ten weekly sessions and then three monthly sessions

Families are mailed written materials that describe depression and stress in families with a depressed parent.

Child Behavior Checklist; Youth Self-Report; Internalizing and Externalizing Problems; Minimum T score = 40; Maximum T score = 80; Higher scores reflect worse outcome

Patient Health Questionnaire - 9; Total Depression Symptoms; Minimum score = 0; Maximum score = 27; Higher scores reflect worse outcomes

Responses to Stress Questionnaire; Secondary control coping scale; Minimum score = 4; Maximum score = 16; Higher scores reflect better outcomes

Inclusion Criteria for Participating Families: Families with at least one parent with a history of depression during the life of his or her child Families with at least one child between the age of 10 and 15 Parent or guardian willing to provide informed consent for participating children Exclusion Criteria for All Participants: Parent with bipolar disorder or schizophrenia Child with conduct disorder or pervasive developmental disorder