William Beardslee

Harvard Medical School | HMS · Department of Psychiatry

Little is known about the effects of parental depression on offspring as they transition to adulthood—a challenging time developmentally, when late adolescents must separate from home, achieve intimate relationships, and develop a sense of identity. We present long-term quantitative and qualitative data from early adolescents with a depressed paren...

Transnational migration of refugees is associated with poor mental health, particularly among children. We conducted a pilot trial of the Family Strengthening Intervention for Refugees (FSI-R), using a community-based participatory research (CBPR) approach to deliver a home-based intervention “for refugees by refugees” to improve family functioning...

Military-connected families face many challenges associated with military life transitions, including deployment separations. We report on a randomized controlled trial to evaluate the efficacy of Families OverComing Under Stress-Early Childhood (FOCUS-EC) delivered through an in-home, virtual telehealth platform. FOCUS-EC is a trauma-informed, fam...

Objective To determine whether there are racial/ethnic differences in depression treatment for caregivers investigated by the U.S. child welfare system. Methods This cross-sectional study used baseline data from the Second National Survey of Child and Adolescent Well-being, a nationally representative sample of children and caregivers investigated...

Maltreatment of children continues to be a major public health concern, with high social, economic and health burdens. Rates vary by a number of factors that can be categorized into different levels of the social ecology. Research and theory in this field point to the importance of community-level factors that can contribute to either risk or preve...

The Biden/Harris Administration faces many challenges, from systems and policies that do not work for or benefit all Americans to stark social and political divisions. Multiple courses of action will be necessary, and there must be commitment and investment for the "long haul." When considering the nation's challenges, overarching themes emerge tha...

Purpose: There are disparities in mental health of refugee youth compared with the general U.S. Population: We conducted a pilot feasibility and acceptability trial of the home-visiting Family Strengthening Intervention for refugees (FSI-R) using a community-based participatory research approach. The FSI-R aims to promote youth mental health and...

Recent studies suggest that parental depressive symptoms may affect a child's ability to benefit from interventions for anxiety and depression. This article reviews the current literature, suggesting that, when parents experience current depressive symptoms, children are less likely to benefit from psychosocial interventions for anxiety and depress...

The study of parental depression in families with children who are depressed and the development of appropriate family prevention strategies to assist families with parents who are depressed have expanded and improved significantly over the past 30 years. This article highlights an evidence-informed approach for clinicians dealing with parents who...

Objective:: Youth depression can be prevented, yet few programs are offered. Decision makers lack cost information. This study evaluated the cost-effectiveness of a cognitive-behavioral prevention program (CBP) versus usual care. Methods:: A cost-effectiveness analysis was conducted with data from a randomized controlled trial of 316 youths, age...

Objective:: The authors sought to determine whether a multicomponent, community-based program for preventing maternal depression also promotes engagement with mental health services for individuals with persistent symptoms. Methods:: Mothers of children enrolled in Head Start were randomly assigned between February 2011 and May 2016 to Problem-S...

Importance Although problem solving has been an important component of successful depression prevention and treatment interventions, evidence to support problem solving’s mechanism of action is sparse. Objective To understand the mechanism of an efficacious depression prevention intervention, problem-solving education (PSE). Design, Setting, and...

Although child welfare caseworkers are responsible for facilitating mental health services access for maltreated children, little is known about caseworkers' decisions to refer children to services. We aimed to identify factors associated with caseworker referral of children to mental health services after a maltreatment investigation. We analyzed...

Objective: This study examined relationships between attention-deficit/hyperactivity disorder (ADHD), stimulant use, and BMI change in a nationally representative cohort of children as well as differences in diet and physical activity that may mediate associations between stimulant use and BMI change. Methods: By using the Early Childhood Longit...

Importance Low-income and minority mothers experience a disproportionate incidence of depression and lack access to treatment services. Development of prevention strategies in accessible community-based venues is a potentially important public health strategy. Objective To determine the efficacy of a depression prevention strategy embedded in Head...

Objectives: 18F-sodium fluoride (NaF) is a PET tracer that elucidates metabolic activities and bone turnover in osseous structures. While NaF-PET is used clinically to image metastatic legions in bones, there is potential for other applications using novel quantitative techniques. In particular, bone degeneration is easily definable and quantifiabl...

Background: Children affected by HIV are at risk for poor mental health. We conducted a pilot randomized controlled trial (RCT) of the Family Strengthening Intervention (FSI-HIV), a family home-visiting intervention to promote mental health and improve parent-child relationships in families with caregivers living with HIV, hypothesizing that child...

Aerobic exercise may positively affect behavior in children but little research has been conducted among those with behavioral health disorders (BHD). This study is a secondary exploration of data originally collected from an RCT that tested effects of a cybercycling intervention on behavior in children with BHD. We examine dose-response relationsh...

Background and objectives: Exercise is linked with improved cognition and behavior in children in clinical and experimental settings. This translational study examined if an aerobic cybercycling intervention integrated into physical education (PE) resulted in improvements in behavioral self-regulation and classroom functioning among children with...

This paper presents the first findings of an integrative data analysis of individual-level data from 19 adolescent depression prevention trials (n = 5210) involving nine distinct interventions across 2 years post-randomization. In separate papers, several interventions have been found to decrease the risk of depressive disorders or elevated depress...

Often the focus of the field of child maltreatment has concentrated on identifying and intervening on risk and protective factors at the individual and family levels; however, since the 1970s, the important roles that communities play in both exacerbating and preventing child maltreatment have received attention as well. This article outlines the d...

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This study evaluated the acceptability, feasibility, and satisfaction associated with a newly developed online clinician training program for the Family Talk preventive intervention, both alone and together with a redesigned, shortened, face-to-face component. Fifty-eight predominately in-home therapy clinicians participated in the study. Results i...

Family-focused prevention programs have been shown to effectively reduce a range of negative behavioral health outcomes but have had limited reach. Three key barriers must be overcome to expand the reach of family-focused prevention programs and thereby achieve a significant public health impact. These barriers are (1) current social norms and perc...

Children and families affected by HIV merit special attention by policymakers, health workers, and researchers. HIV-related stressors, family functioning, and child mental health are inextricably linked and can be addressed via family-based preventive interventions. The FSI-HIV is a promising intervention to promote resilience and prevent mental he...

A "risk of harm" protocol to identify youth in need of immediate emergency assistance in a study on mental health and HIV in Rwanda among 680 youth ages 10-17 is described. Cases are presented that describe the experience in using this protocol to ensure safety of participants, with ethical and logistical challenges considered. Among the population...

Background: One of the most important risk factors for childhood depression is being the child of a depressed parent. These at-risk children have two to four times the probability of having an affective episode compared with their peers. Preventive interventions such as Beardslee's Preventive Intervention Program (PIP) that are targeted at childre...

In a randomized controlled trial, we found that a cognitive behavioral program (CBP) was significantly more effective than usual care (UC) in preventing the onset of depressive episodes, although not everyone benefitted from the CBP intervention. The present paper explored this heterogeneity of response. Participants were 316 adolescents (M age = 1...

Objective: To assess predictors and moderators of a cognitive-behavioral prevention (CBP) program for adolescent offspring of parents with depression. Method: This 4-site randomized trial evaluated CBP compared to usual community care (UC) in 310 adolescents with familial (parental depression) and individual (youth history of depression or curre...

Child maltreatment is a preventable public health problem. Research has demonstrated that neighborhood structural factors (e.g. poverty, crime) can influence the proportion of a neighborhood's children who are victims of maltreatment. A newer strategy is the identification of potentially modifiable social processes at the neighborhood level that ca...

Objective: This study evaluates the longitudinal outcomes of Families OverComing Under Stress (FOCUS), a family-centered preventive intervention implemented to enhance resilience and to reduce psychological health risk in military families and children who have high levels of stress related to parental wartime military service. Method: We perfor...

The importance of preventative medicine has been firmly established for decades, most notably in addressing risk factors for cardiovascular disease. However, in the field of mental healthcare, the prevention agenda has received insufficient attention.

Importance Adolescents whose parents have a history of depression are at risk for developing depression and functional impairment. The long-term effects of prevention programs on adolescent depression and functioning are not known.Objective To determine whether a cognitive-behavioral prevention (CBP) program reduced the incidence of depressive ep...

We evaluated predictors and moderators of differential response to two family-based depression prevention programs for families with a depressed parent: a clinician-facilitated intervention and a lecture group intervention. Individual and family level variables were examined using regression analyses with generalized estimating equations. For the o...

Parental Psychiatric Disorder presents an innovative approach to thinking about and working with families where a parent has a mental illness. With 30 new chapters from an internationally renowned author team, this new edition presents the current state of knowledge in this critically important field. Issues around prevalence, stigma and systems th...

Parental Psychiatric Disorder presents an innovative approach to thinking about and working with families where a parent has a mental illness. With 30 new chapters from an internationally renowned author team, this new edition presents the current state of knowledge in this critically important field. Issues around prevalence, stigma and systems th...

Efforts to prevent depression have become a key health system priority. Currently, there is a high prevalence of depression among adolescents, and treatment has become costly due to the recurrence patterns of the illness, impairment among patients, and the complex factors needed for a treatment to be effective. Primary care may be the optimal locat...

The high prevalence of major depressive disorder in adolescents and the low rate of successful treatment highlight a pressing need for accessible, affordable adolescent depression prevention programs. The Internet offers opportunities to provide adolescents with high quality, evidence-based programs without burdening or creating new care delivery s...

Depression, which is characterized by low positive affect (PA) and high negative affect (NA), is relatively common during late adolescence and young adulthood. During this period, interaction with an increasing social sphere gains importance, and interest in romantic companions assumes a central role. However, little is known about how PA and NA ma...

Evidence-based interventions to prevent child maltreatment among individuals and families are being implemented across wide areas of the U.S. Often focused on high-risk families such as teenage parents, single parents, or families living in poverty, these approaches are typically focused on giving parents skills, knowledge, and sometimes assistance...

There has been a remarkable growth of high quality empirical studies in the prevention of mental illness and the promotion of mental health over the past three decades. A series of reports (Institute of Medicine (IOM), Reducing risks for mental disorders: Frontiers for preventive intervention research, 1994; National Advisory Mental Health Council...

Certain subgroups of youth are at high risk for depression and elevated depressive symptoms, and experience limited access to quality mental health care. Examples are socioeconomically disadvantaged, racial/ ethnic minority, and sexual minority youth. Research shows that there are efficacious interventions to prevent youth depression and depressive...

Objective: Insurance coverage for young adults has increased since 2010, when the Affordable Care Act (ACA) required insurers to permit children to remain on parental policies until age 26 as dependents. This study estimated the association between the dependent coverage provision and changes in young adults' use of hospital-based services for sub...

Background: The global HIV/AIDS response has advanced in addressing the health and well-being of HIV-positive children. Although attention has been paid to children orphaned by parental AIDS, children who live with HIV-positive caregivers have received less attention. This study compares mental health problems and risk and protective factors in HI...

Objective: The objective of this study is to assess the feasibility and acceptability of an intervention to reduce mental health problems and bolster resilience among children living in households affected by caregiver HIV in Rwanda. Design: Pre-post design, including 6-month follow-up. Methods: The Family Strengthening Intervention (FSI) aims...

Homeless mothers experience disproportionately high rates of major depressive disorder compared with the general population. Stressed by their circumstances, these women struggle to protect their families. Children living with a depressed parent have poorer medical, mental health, and educational outcomes. Despite the adverse impact on children, de...

Background The Family Strengthening Intervention (FSI) is a 6-module intervention designed to build resilience and prevent mental health problems in youth affected by multiple forms of adversity in Rwanda. The dual vectors of the 1994 Rwandan Genocide and the subsequent increase in HIV/AIDS have had devastating consequences for youth and families i...

Importance: Young adults have high levels of behavioral health needs but often lack health insurance. Recent health reforms have increased coverage, but it is unclear how use of hospital-based care changed after expanding insurance. OBJECTIVE To evaluate the association between health insurance coverage expansions and use of hospital-based care am...

Studies document that there are efficacious interventions to prevent adolescent depression and internalizing symptoms, including several family-focused interventions. Questions remain about for whom interventions work (moderation) and by what mechanisms they work (mediation) to prevent internalizing symptoms. Unfortunately, single trials are often...

Certain subgroups of youth are at high risk for depression and elevated depressive symptoms, and experience limited access to quality mental health care. Examples are socioeconomically disadvantaged, racial/ ethnic minority, and sexual minority youth. Research shows that there are efficacious interventions to prevent youth depression and depressive...

Background: HIV-affected children are at increased risk for a range of mental health problems including depression, anxiety, and social withdrawal. Prevention-focused, family-based interventions have important public health applications in preventing mental health problems, including behavioral problems that may increase risk of HIV infection. Meth...

Background: Children infected with and affected by HIV are at increased risk of mental health problems, which has implications for risk behavior, educational attainment and provision of healthcare services. Methods: A case-control design was used to assess the prevalence of mental health problems among N= 680 children aged 10-17 who are (a) HIV-inf...

In response to the needs of military families confronting the challenges of prolonged war, we developed Families OverComing Under Stress (FOCUS), a multi-session intervention for families facing multiple deployments and combat stress injuries adapted from existing evidence-based family prevention interventions (Lester et al. in Mil Med 176(1): 19-2...

Pediatricians are in the unique position of being on the front line of care for children and having access to their families. This article presents both a rationale and the evidence base for identifying the family characteristics and processes that affect child health and suggests approaches that pediatricians can implement to improve the care of c...

Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on th...

This commentary discusses key themes in four conceptually related papers in this special issue on military families. Individually, the papers highlight the importance of the experiences of young children, the vital role of family narratives, the need for effective communication in families with a combat-injured member, and the need to understand th...

The demand for researchers to share their data has increased dramatically in recent years. There is a need to replicate and confirm scientific findings to bolster confidence in many research areas. Data sharing also serves the critical function of allowing synthesis of findings across trials. As innovative statistical methods have helped resolve ba...

We draw upon family resilience and narrative theory to describe an evidence-based method for intervening with military families who are impacted by multiple wartime deployments and psychological, stress-related, or physical parental injuries. Conceptual models of familial resilience provide a guide for understanding the mechanics of how families re...

http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/family/docs/depression-pfce-rtp.pdf

Although current research recognizes robust interdependence among family members, it is not yet evident that such principles have fully integrated into existing systems of care for military and veteran families. Such gaps can create disadvantages in delivering effective support, prevention, and treatment, while including families may yield signific...

We assessed the validity of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) as a screen for depression in Rwandan children and adolescents. Although the CES-DC is widely used for depression screening in high-income countries, its validity in low-income and culturally diverse settings, including sub-Saharan Africa, is u...

These are commentaries on a Cochrane review, published in this issue of EBCH, first published as: Merry SN, Hetrick SE, Cox GR, Brudevold-Iversen T, Bir JJ, McDowell H. Psychological and educational interventions for preventing depression in children and adolescents. Cochrane Database of Systematic Reviews 2011, Issue 12. Art. No.: CD003380. DOI: 1...

Background/Aims Adolescent depression is common and leads to many negative personal, social, and economic consequences for youth and their families; unfortunately, most youth who experience major depression do not receive any treatment. Depression prevention programs can reduce these negative consequences, but they must be affordable to be widely d...