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The Role of Maternal Depression on Treatment Outcome for Children with Externalizing Behavior Problems.

van Loon LM, Granic I, Engels RC - J Psychopathol Behav Assess (2011)

Bottom Line: Studies have shown that, on average, Parent Management Training combined with cognitive-behavioral therapy decreases children's externalizing behavior, but some children do not improve through treatment.Children with externalizing behavioral problems and their parents were recruited from combined Parent Management Training and Cognitive-Behavioral programs in "real-world" clinical settings.Results showed that treatment was less effective for children of depressed mothers compared to non-depressed mothers and that improvements in maternal depression were associated with improvements in children's externalizing behavior.

View Article: PubMed Central - PubMed

Affiliation: Behavioural Science Institute, Radboud Universiteit Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.

ABSTRACT
Studies have shown that, on average, Parent Management Training combined with cognitive-behavioral therapy decreases children's externalizing behavior, but some children do not improve through treatment. The current study aimed to examine the role of maternal depression in understanding this variability in treatment outcome. Children with externalizing behavioral problems and their parents were recruited from combined Parent Management Training and Cognitive-Behavioral programs in "real-world" clinical settings. At pre- and post treatment, maternal depression and children's externalizing behavior were assessed. Results showed that treatment was less effective for children of depressed mothers compared to non-depressed mothers and that improvements in maternal depression were associated with improvements in children's externalizing behavior. These findings suggest that treatment programs for children with externalizing problems may be able to improve outcomes if maternal depression is a target of intervention.

No MeSH data available.


Related in: MedlinePlus

Change over time in children’s externalizing behavior (CBCL) according to improvement of maternal depression over time (i.e. NDEP refers to mothers who remained non-depressed, IMP refers to mothers who improved, NIMP refers to mothers who did not improve)
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Fig2: Change over time in children’s externalizing behavior (CBCL) according to improvement of maternal depression over time (i.e. NDEP refers to mothers who remained non-depressed, IMP refers to mothers who improved, NIMP refers to mothers who did not improve)

Mentions: To address the second hypothesis that children of mothers whose depression improved with treatment would show a decrease in their externalizing behavior, mothers were classified as “Improvers” (IMPs), “Nonimprovers” (NIMPs) or “Nondepressed” (NDEPs) based on information from the BDI-II. Mothers who scored 10 or below 10 were considered non-depressed (minimal or no depression, based on BDI-II classifications); those who scored above 10 were considered depressed (mildly to severely depressed based on BDI-II classifications). Clinically significant improvement was operationalized as moving from depressed to non-depressed at post-treatment independently of the extent of the depression.1 Based on these criteria, 28 mothers were classified as improved (IMP; mothers were depressed at pre-treatment and not depressed at post-treatment), 37 as non-improved (NIMP; mothers were depressed at both pre- and post-treatment) and 36 were classified as NDEP (not depressed at pre- or post-treatment). We ran a repeated measure ANOVA to examine changes on children’s externalizing behavior from pre- to post-treatment. The results showed that the externalizing behavior of the child was not significantly affected by the depression status of the mother, F(2, 99) = 3.82 (averaged), p = .23 (averaged p-value of the imputed datasets). Of the ten imputed datasets, four showed a p-value lower than .01, one p < .05, two p < .10 and three p-values were > .10. As depicted in Fig. 2, children of NDEPs showed the largest improvement in externalizing behavior over the course of treatment, followed by children of IMPs and NIMPs. The children of the depressed improved mothers and the depressed non-improved mothers both had a mean score above the borderline clinical cutoff (> 67, Achenbach, 1991) over the course of treatment (IMPs: M = 67.98; NIMPs: M = 69.52).Fig. 2


The Role of Maternal Depression on Treatment Outcome for Children with Externalizing Behavior Problems.

van Loon LM, Granic I, Engels RC - J Psychopathol Behav Assess (2011)

Change over time in children’s externalizing behavior (CBCL) according to improvement of maternal depression over time (i.e. NDEP refers to mothers who remained non-depressed, IMP refers to mothers who improved, NIMP refers to mothers who did not improve)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3105234&req=5

Fig2: Change over time in children’s externalizing behavior (CBCL) according to improvement of maternal depression over time (i.e. NDEP refers to mothers who remained non-depressed, IMP refers to mothers who improved, NIMP refers to mothers who did not improve)
Mentions: To address the second hypothesis that children of mothers whose depression improved with treatment would show a decrease in their externalizing behavior, mothers were classified as “Improvers” (IMPs), “Nonimprovers” (NIMPs) or “Nondepressed” (NDEPs) based on information from the BDI-II. Mothers who scored 10 or below 10 were considered non-depressed (minimal or no depression, based on BDI-II classifications); those who scored above 10 were considered depressed (mildly to severely depressed based on BDI-II classifications). Clinically significant improvement was operationalized as moving from depressed to non-depressed at post-treatment independently of the extent of the depression.1 Based on these criteria, 28 mothers were classified as improved (IMP; mothers were depressed at pre-treatment and not depressed at post-treatment), 37 as non-improved (NIMP; mothers were depressed at both pre- and post-treatment) and 36 were classified as NDEP (not depressed at pre- or post-treatment). We ran a repeated measure ANOVA to examine changes on children’s externalizing behavior from pre- to post-treatment. The results showed that the externalizing behavior of the child was not significantly affected by the depression status of the mother, F(2, 99) = 3.82 (averaged), p = .23 (averaged p-value of the imputed datasets). Of the ten imputed datasets, four showed a p-value lower than .01, one p < .05, two p < .10 and three p-values were > .10. As depicted in Fig. 2, children of NDEPs showed the largest improvement in externalizing behavior over the course of treatment, followed by children of IMPs and NIMPs. The children of the depressed improved mothers and the depressed non-improved mothers both had a mean score above the borderline clinical cutoff (> 67, Achenbach, 1991) over the course of treatment (IMPs: M = 67.98; NIMPs: M = 69.52).Fig. 2

Bottom Line: Studies have shown that, on average, Parent Management Training combined with cognitive-behavioral therapy decreases children's externalizing behavior, but some children do not improve through treatment.Children with externalizing behavioral problems and their parents were recruited from combined Parent Management Training and Cognitive-Behavioral programs in "real-world" clinical settings.Results showed that treatment was less effective for children of depressed mothers compared to non-depressed mothers and that improvements in maternal depression were associated with improvements in children's externalizing behavior.

View Article: PubMed Central - PubMed

Affiliation: Behavioural Science Institute, Radboud Universiteit Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.

ABSTRACT
Studies have shown that, on average, Parent Management Training combined with cognitive-behavioral therapy decreases children's externalizing behavior, but some children do not improve through treatment. The current study aimed to examine the role of maternal depression in understanding this variability in treatment outcome. Children with externalizing behavioral problems and their parents were recruited from combined Parent Management Training and Cognitive-Behavioral programs in "real-world" clinical settings. At pre- and post treatment, maternal depression and children's externalizing behavior were assessed. Results showed that treatment was less effective for children of depressed mothers compared to non-depressed mothers and that improvements in maternal depression were associated with improvements in children's externalizing behavior. These findings suggest that treatment programs for children with externalizing problems may be able to improve outcomes if maternal depression is a target of intervention.

No MeSH data available.


Related in: MedlinePlus