Donohue Meghan Rose, Yin Jenny, Quiñones-Camacho Laura, Hennefield Laura, Tillman Rebecca, Gilbert Kirsten, Whalen Diana, Barch Deanna M, Luby Joan
Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA.
Department of Educational Psychology, The University of Texas at Austin, Austin, TX, USA.
Res Child Adolesc Psychopathol. 2022 Sep;50(9):1233-1246. doi: 10.1007/s10802-022-00897-2. Epub 2022 Feb 8.
A randomized controlled trial (RCT) demonstrated that a novel psychotherapy, Parent-Child Interaction Therapy-Emotion Development (PCIT-ED), effectively treats preschool-onset depression. However, little is known about which children benefit most from PCIT-ED. As positive parent-level factors are associated with lesser depressive symptoms, this study explored the potential moderating role of positive parenting relationships on PCIT-ED efficacy. This study examined mothers and their children aged 3-6 (N = 185) who participated in the PCIT-ED RCT. Children were randomized to immediate PCIT-ED treatment (n = 94) or a waitlist control condition (n = 91) that received treatment after 18 weeks. Prior to treatment, children completed a narrative story completion task that was videotaped and coded for children's positive and negative representations of their mothers. Parent-child interaction tasks were also completed pre-treatment and videotaped and coded to measure observed parenting. Odds of MDD diagnosis post-treatment were predicted by the interaction of children's negative maternal representations and treatment group (Estimate = -.68; SE = .27; [Formula: see text] = 6.45; p = .01) and the interaction of children's relatively more positive than negative maternal representations and treatment group (Estimate = .30; SE = .13; [Formula: see text] = 5.27; p = .02). Observed parenting measures did not significantly predict odds of MDD diagnosis. Thus, PCIT-ED predicted loss of MDD diagnosis for children who displayed maternal representations that were less negative, and relatively more positive than negative. Results suggest that children with relatively more positive maternal representations may be more likely to benefit from PCIT-ED, whereas children with more negative maternal representations may need targeted work to decrease negative maternal perceptions before initiating PCIT-ED in order for treatment to be most effective.
一项随机对照试验（RCT）表明，一种新型心理疗法——亲子互动疗法-情绪发展（PCIT-ED）能有效治疗学龄前儿童抑郁症。然而，对于哪些儿童能从PCIT-ED中获益最多，人们知之甚少。由于积极的父母层面因素与较少的抑郁症状相关，本研究探讨了积极的亲子关系对PCIT-ED疗效的潜在调节作用。本研究考察了参与PCIT-ED随机对照试验的母亲及其3至6岁的孩子（N = 185）。孩子们被随机分为立即接受PCIT-ED治疗组（n = 94）或等待名单对照组（n = 91），后者在18周后接受治疗。在治疗前，孩子们完成了一项叙事故事完成任务，该任务被录像，并对孩子们对母亲的积极和消极表征进行编码。亲子互动任务也在治疗前完成，进行录像并编码以测量观察到的养育方式。治疗后重度抑郁障碍（MDD）诊断的几率通过孩子对母亲的消极表征与治疗组的相互作用来预测（估计值 = -0.68；标准误 = 0.27；[公式：见原文] = 6.45；p = 0.01），以及孩子对母亲相对更积极而非消极的表征与治疗组的相互作用来预测（估计值 = 0.30；标准误 = 0.13；[公式：见原文] = 5.27；p = 0.02）。观察到的养育方式测量指标并未显著预测MDD诊断的几率。因此，PCIT-ED预测，对于那些对母亲的表征不那么消极且相对更积极而非消极的孩子，MDD诊断会消失。结果表明，对母亲的表征相对更积极的孩子可能更有可能从PCIT-ED中获益，而对母亲的表征更消极的孩子可能需要在开始PCIT-ED之前进行有针对性的工作，以减少对母亲的负面认知，从而使治疗最有效。
