Washington University School of Medicine, St. Louis, Missouri.
Washington University School of Medicine, St. Louis, Missouri.
J Am Acad Child Adolesc Psychiatry. 2020 Jul;59(7):868-879. doi: 10.1016/j.jaac.2019.07.937. Epub 2019 Jul 31.
An adaptation of Parent-Child Interaction Therapy (PCIT) with a novel Emotion Development (ED) module has shown efficacy for the treatment of early childhood depression. Children who received PCIT-ED also showed healthy alterations in neural response to reward. We investigated whether the novel ED module made a unique contribution to the treatment of depression and neural response to reward, and whether child-directed intervention (CDI) and parent-directed intervention (PDI) modules (standard elements of PCIT) were also effective.
Dyads who participated in a randomized controlled trial of PCIT that compared the active PCIT-ED to a wait list (WL) condition were assessed at the completion of each module of PCIT-ED (CDI, PDI, ED) or WL time equivalent for child depression and other symptoms, parenting styles, stress, and depression. Event-related potentials during a reward task were obtained at the end of standard PCIT and after the novel ED module.
Study findings showed that the ED module as well as some elements of standard PCIT were effective in reducing child depression and other forms of psychopathology. Changes in the child's neural response to reward and parental response to child emotional expression were specific to the ED module.
Study findings suggest that the novel ED module has added efficacy for the treatment of early childhood depression, as well as unique efficacy in changing neural responses to reward and parenting response to child emotional expression. These findings can inform clinical uses of this treatment in a modular fashion. Future studies are needed that control for session number and order of PCIT-ED modules.
A Randomized Controlled Trial of PCIT-ED for Preschool Depression; https://clinicaltrials.gov/; NCT02076425.
亲子互动治疗（PCIT）的改编版结合了新颖的情绪发展（ED）模块，已显示出对儿童期抑郁症治疗的有效性。接受 PCIT-ED 的儿童在对奖励的神经反应中也表现出健康的变化。我们研究了新颖的 ED 模块是否对治疗抑郁症和奖励的神经反应做出了独特的贡献，以及儿童导向干预（CDI）和父母导向干预（PDI）模块（PCIT 的标准要素）是否也有效。
参加 PCIT 随机对照试验的对子将 PCIT-ED 的主动治疗与候补名单（WL）条件进行了比较，在完成 PCIT-ED 的每个模块（CDI、PDI、ED）或 WL 时间等效的情况下，对儿童抑郁和其他症状、育儿风格、压力和抑郁进行了评估。在标准 PCIT 结束时和新颖的 ED 模块之后，获得了奖励任务期间的事件相关电位。
研究结果表明，ED 模块以及 PCIT 的一些标准要素在降低儿童抑郁和其他形式的精神病理学方面是有效的。儿童对奖励的神经反应和父母对儿童情绪表达的反应的变化特定于 ED 模块。
研究结果表明，新颖的 ED 模块对儿童期抑郁症的治疗具有额外的疗效，并且在改变奖励的神经反应和父母对儿童情绪表达的反应方面具有独特的疗效。这些发现可以为以模块化方式使用这种治疗提供临床依据。未来的研究需要控制 PCIT-ED 模块的次数和顺序。
亲子互动治疗（PCIT-ED）治疗学龄前抑郁症的随机对照试验；https://clinicaltrials.gov/；NCT02076425。
