(PS10-B26) Not Bad, Just Sad and Mad: The Effect of PCIT on Depression Symptoms

Although several effective evidence-based protocols exist for the treatment of internalizing disorders in children and adolescents (Ehrenreich-May and Chu, 2013), few are available to guide the treatment of early childhood emotional disorders, specifically depression (Luby, 2009; Luby, 2012). While it is known that certain parental behaviors, specifically parental rejection, are associated with childhood depression (McLeod et al., 2006), science has been slow to develop interventions targeting parenting behaviors associated with childhood depression (Webster-Stratton and Hermon, 2008; McLeod et al., 2016; Eckstein et al., 2017; Zarakoviti et al., 2021). Although Parent-Child Interaction Therapy (PCIT; Eyberg & Funderburk, 2011) was developed to treat disruptive child behaviors, due to its identification and targeting of maladaptive patterns seen among parents with a rejecting parenting style, it may also provide similar utility to parents of children with depression (Carpenter, 2014). To date, there have been no studies that have examined the effect of PCIT on early, clinically-elevated depression symptoms. 

Treatment-seeking youth (N = 853), ages 2-7 (M=4.78, SD=1.59), with elevated levels of disruptive behavior problems, and their caregiver(s) presented to a University-based research clinic for time-limited (18 weeks) Parent Child-Interaction Therapy (PCIT; Eyberg & Funderburk, 2011). Caregiver-reported child behavior problems were evaluated pre- and post-treatment using the Eyberg Child Behavior Inventory (ECBI) to assess disruptive behaviors. Caregiver-reported child externalizing and internalizing behaviors were measured using the Behavior Assessment System for Children –Third Edition (BASC-3). We used a Paired-Samples T Test to assess change in perceived and observed symptoms across treatment time points.

Among families who completed screening questionnaires (N = 1110) whose children did not screen clinically elevated on the ECBI (raw score < 131; N = 408), 70% screened at-risk or higher on the BASC-3 depression subscale, and 50% scored in the clinically elevated range. At pre-treatment, among families who completed treatment (N = 263), 40% scored in the clinically-elevated range on the BASC-3 depression subscale and 15% scored in the clinically elevated range. At post-treatment, 14% of children were rated in the at-risk range or above and 4% remained clinically elevated. Caregiver-reported youth depression symptoms significantly decreased from pre-treatment (M= 59.48, SD=.76) to post-treatment (M=49.78, SD=.64), t(262)=16.20, p < .001, Cohen’s d = 1.003. 

These results provide preliminary findings supporting the use of a behavioral parenting treatment for young children with elevated levels of depressive symptoms. Additionally, these results contribute to the current literature surrounding the phenomena that a large percentage of children who are depressed at a young age also have co-occurring conduct problems. Although findings support the extension of a behavioral parenting treatment for the treatment of early childhood depressive symptoms, future research should focus on whether these findings generalize to children who are depressed only without any conduct problems.