Parental Monitoring Predicts Depressive Symptom and Suicidal Ideation Outcomes in Adolescents Being Treated for Co-Occurring Substance Use and Psychiatric Disorders

JOURNAL OF AFFECTIVE DISORDERS

卷:284

Article

MacPherson, Heather A.^1,2  Wolff, Jennifer^1,3  Nestor, Bridget¹  Frazier, Elisabeth^1,2  Massing-Schaffer, Maya¹  Graves, Hannah¹  Esposito-Smythers, Christianne⁴  Spirito, Anthony¹ 

[1] Brown Univ, Warren Alpert Med Sch, Dept Psychiat & Human Behav, Providence, RI 02912 USA

[2] Emma Pendleton Bradley Hosp, East Providence, RI USA

[3] Rhode Isl Hosp, Providence, RI USA

[4] George Mason Univ, Fairfax, VA 22030 USA

关键词: adolescents;    parenting;    substance use disorder;    depressive symptoms;    suicidal ideation;    treatment predictors;   

DOI  :  10.1016/j.jad.2021.02.021

来源: Elsevier

【 摘 要 】

Background: Comorbidity of substance use disorders (SUDs) with mood disorders and other psychiatric conditions is common. Parenting processes and family functioning are impaired in adolescents with SUDs and mood disorders, and parent/family factors predict intervention response. However, limited research has examined the relationship between parent/family factors and mood symptom treatment response in adolescents with comorbid SUDs and psychiatric conditions. Method: This study examined the predictive effects of parenting processes and family functioning on depressive symptoms and suicidal ideation (SI) in a randomized controlled trial of integrated cognitive-behavioral therapy vs. treatment as usual for 111 adolescents with comorbid SUDs and psychiatric disorders. Measures of parenting processes, family functioning, depressive symptoms, and SI were completed at baseline and 3-, 6-, and 12-month follow-ups. Exploratory analyses involved mixed-effects regression models. Results: Across treatment conditions, depressive symptoms and SI improved over 12 months. Family functioning domains of family roles (d=0.47) and affective involvement (d=0.39) significantly improved across treatment conditions over 12 months. Higher baseline parental monitoring predicted improved trajectory of depressive symptoms (d=0.44) and SI (d=0.46). There were no significant predictive effects for baseline family functioning or other parenting processes (listening, limit setting). Limitations: Limitations include the modest sample, attrition over follow-up, and generalizability to samples with higher rates of mood disorders and/or uncomplicated mood disorders. Conclusions: Parental monitoring may be an important prognostic indicator of depressive symptoms and SI in adolescents with co-occurring SUDs and psychiatric conditions, and therefore may be useful to assess and target in treatment, in addition to family functioning.

【 授权许可】

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