Parent-child interaction therapy emotion development: A novel treatment for depression in preschool children

Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Depression and Anxiety (Impact Factor: 4.41). 02/2011; 28(2):153-9. DOI: 10.1002/da.20770
Source: PubMed


Psychotherapies with known efficacy in adolescent depression have been adapted for prepubertal children; however, none have been empirically validated for use with depressed very young children. Due to the centrality of the parent-child relationship to the emotional well being of the young child, with caregiver support shown to mediate the risk for depression severity, we created an Emotional Development (ED) module to address emotion development impairments identified in preschool onset depression. The new module was integrated with an established intervention for preschool disruptive disorders, Parent Child Interaction Therapy (PCIT). Preliminary findings of an open trial of this novel intervention, PCIT-ED, with depressed preschool children are reported.
PCIT was adapted for the treatment of preschool depression by incorporating a novel emotional development module, focused on teaching the parent to facilitate the child's emotional development and enhance emotion regulation. Eight parent-child dyads with depressed preschoolers participated in 14 sessions of the treatment. Depression severity, internalizing and externalizing symptoms, functional impairment, and emotion recognition/discrimination were measured pre- and posttreatment.
Depression severity scores significantly decreased with a large effect size (1.28). Internalizing and externalizing symptoms as well as functional impairment were also significantly decreased pre- to posttreatment.
PCIT-ED seems to be a promising treatment for preschoolers with depression, and the large effect sizes observed in this open trial suggest early intervention may provide a window of opportunity for more effective treatment. A randomized controlled trial of PCIT-ED in preschool depression is currently underway.

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Available from: Shannon Lenze, Feb 06, 2015
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    • "Table 1 provides an overview of all studies included in the final sample and of all data elements used during the data analysis process. Study designs included two experimental studies,4,9 one quasi-experimental study,10 and 22 nonexperimental studies.7,11–31 The 25 studies were distributed into the previously determined five categories as follows: Etiology/Risk Factors (nine studies);7,9,11–7 Diagnosis (two studies);18,19 Prevention (two studies);4,20 Prognosis (ten studies);22–31 and Treatment (two studies).10,21 "
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    ABSTRACT: As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were "depression" (medical subject headings [MeSH]), "child" (MeSH), and "childhood depression" (keyword). Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children's quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs concerning childhood depression are not always taken into consideration. In this context, this review demonstrated that childhood-onset depression commonly leads to other psychiatric disorders and co-morbidities. Many of the retrieved studies also confirmed the hypothesis that human resources (eg, health care team in general) are not yet adequately trained to address childhood depression. Thus, further research on the development of programs to prepare health care professionals to deal with childhood depression is needed, as well as complementary studies, with larger and more homogeneous samples, centered on prevention and treatment of childhood depression.
    Neuropsychiatric Disease and Treatment 09/2013; 9:1417-1425. DOI:10.2147/NDT.S42402 · 1.74 Impact Factor
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    • "The original PCIT targets the parent-child relationship through behavioral and play therapy techniques to improve the relationship and teach the parent to establish appropriate limits [47]. This intervention has been recently adapted for treatment of depression in preschoolers, named Parent-Child Interaction Therapy Emotion Development (PCIT-ED), and initial findings indicate a significant decrease in depression severity scores with a large effect size [48]. While not yet tested as a depression prevention intervention for children of depressed mothers, adapting PCIT to this population may be especially beneficial given the impact of maternal depression on the mother-child relationship. "
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    ABSTRACT: Maternal depression is one of the most well-documented risk factors for child and adolescent depression, but little work has focused on how to reduce this risk. Although a few interventions have been developed and tested, implementing targeted prevention efforts with depressed mothers and their children is not common practice. The increased risk of depression for children of depressed mothers is so clear, however, professionals can no longer "sit on the sidelines" without initiating specific prevention efforts with this population. To do so requires a paradigm shift-moving from a focus on individual treatment to a prevention approach that engages the entire family as the unit of care. The purpose of this paper is to draw on existing literature to highlight potential "pathways to prevention" for children of depressed mothers. Recommendations for initiating these pathways based on family lifecycle stage, point of contact, and service setting are presented and discussed.
    Depression research and treatment 01/2012; 2012:313689. DOI:10.1155/2012/313689
  • Pediatric Annals 11/2011; 40(11):548-55. DOI:10.3928/00904481-20111007-05 · 0.61 Impact Factor
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