Jaiswal Satish, Nan Jason, Dizon Seth, Young Jessica O, Purpura Suzanna R, Manchanda James K, Ramanathan Dhakshin, Kuo Dennis J, Mishra Jyoti
Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Guava Building, Room 130, La Jolla, CA, 92093, United States, 1 6086092291.
VA San Diego Medical Center, San Diego, CA, United States.
JMIR Form Res. 2025 Jul 17;9:e69607. doi: 10.2196/69607.
Depression in children is a concerning societal issue and can be associated with poor academic performance, school dropout, and poor overall quality of life. Additionally, child depression is often associated with parallel stress and depression in parents.
This scenario highlights the urgent need for the development and implementation of accessible and scalable solutions that may cobenefit child and parent mental well-being.
This pilot study introduced "Cooperative Compassion" (CoCo), a parent-child cotraining digital application aimed at promoting mindfulness and compassion through brief, performance-adaptive sessions. A community sample of 24 parent-child dyads (children's mean age 9.5, SD 3.27 years; female: n=14, male: n=10; Asian: n=5, White: n=11, mixed race: n=7, other race: n=1; and parents' mean age 44.5, SD 6.5 years; 20 female: n=20, male: n=4; Asian: n=8, White: n=14, mixed race: n=2) of high average affluence socioeconomic scores participated in the study. These parent-child dyads completed 30 sessions of CoCo training over 3 months with baseline and postintervention assessments occurring within 2 weeks of training initiation or completion, respectively.
The program was feasible, with 80% (n=19) of families completing over 90% (n=22) of sessions and providing positive feedback. Mental health assessments showed a nonsignificant effect in the expected direction in children's depression scores (Cohen d=-0.19; 95% CI -8.89 to 1.74; P=.07) and significant reductions in parental stress (d=-0.41; 95% CI -2.63 to -0.16; P=.02), anxiety (d=-0.47; 95% CI -2.67 to -0.20; P=.02), and depression (d=-0.50; 95% CI -3.25 to -0.08; P=.03), with sustained benefits at the 3-month follow-up. Parental mindfulness improvements were correlated with stress reduction (ρ=-0.45; P=.03). On an emotion bias task used as an objective assessment of cognition, children demonstrated improved processing speed after the intervention (d=0.54; 95% CI 0.012-0.083; P=.005), and a marginal improvement was also observed in parents (d=0.19; 95% CI -0.004 to 0.030; P=.05). Cortical source imaging of electroencephalographic recordings was acquired simultaneous to an attention-to-breathing assessment that showed significant reduction in task-related default mode network activity (d=-0.62; 95% CI -0.0096 to -0.0002; P=.01).
Post-CoCo intervention decrease in default mode network activity on the attention-to-breath task in parent-child dyads may be indicative of cortical plasticity reflecting reduced mind-wandering and thereby, enhanced focus after training. The current promising behavioral and cognitive results suggest the need for a larger sample size and a randomized controlled study design. Overall, these findings highlight the potential for brief, digital mindfulness and compassion cotraining to improve family mental health and well-being.
儿童抑郁症是一个令人担忧的社会问题，可能与学业成绩不佳、辍学以及整体生活质量差有关。此外，儿童抑郁症往往与父母同时存在的压力和抑郁情绪相关。
本案例强调迫切需要开发和实施可及且可扩展的解决方案，以共同促进儿童和父母的心理健康。
这项试点研究引入了“合作式关怀”（CoCo），这是一款亲子共同训练的数字应用程序，旨在通过简短的、根据表现调整的课程来促进正念和同情心。一个由24对亲子组成的社区样本（儿童平均年龄9.5岁，标准差3.27岁；女性：n = 14，男性：n = 10；亚洲人：n = 5，白人：n = 11，混血：n = 7，其他种族：n = 1；父母平均年龄44.5岁，标准差6.5岁；女性：n = 20，男性：n = 4；亚洲人：n = 8，白人：n = 14，混血：n = 2）参与了该研究，这些亲子的社会经济得分处于较高平均富裕水平。这些亲子在3个月内完成了30节CoCo训练课程，分别在训练开始或完成后的2周内进行基线和干预后评估。
该项目是可行的，80%（n = 19）的家庭完成了超过90%（n = 22）的课程，并提供了积极反馈。心理健康评估显示，儿童抑郁得分在预期方向上有不显著的影响（科恩d值 = -0.19；95%置信区间 -8.89至1.74；P = 0.07），而父母的压力（d = -0.41；95%置信区间 -2.63至 -0.16；P =
