Increasing Understanding in Children of Depressed Parents: Predictors and Moderators of Intervention Response

Abstract

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 outcome of child understanding of depression, parental changes in child-related behaviors and attitudes predicted greater child understanding (p<0.001). For the parent outcome of behavior and attitude change, across intervention conditions, younger parent age (p<0.05), female parent gender (p<0.01), more chronic and severe parental depression history (p<0.05), lower SES (p<0.05), and single-parent status (p<0.05) were associated with better outcomes across conditions. Effect sizes were moderate, ranging from 0.4 to 0.7 SD. Family and marital functioning were not found to be predictors of any outcomes. When both parents were depressed at baseline, there was no difference in the clinician- versus lecture-based approach, and when only the father was depressed, families reported more changes with the clinician condition than with the lecture condition (p<0.05). Findings from this study can help identify intervention strategies that are appropriate for different types of at-risk individuals and families.