Incorporating family factors into treatment planning for adolescent depression: Perceived parental criticism predicts longitudinal symptom trajectory in the Youth Partners in Care trial

JOURNAL OF AFFECTIVE DISORDERS

卷:278

Article

Rapp, Amy M.^1,2,3  Chavira, Denise A.¹  Sugar, Catherine A.^4,5  Asarnow, Joan R.⁴ 

[1] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA USA

[2] Columbia Univ, Dept Psychiat, New York, NY 10027 USA

[3] New York State Psychiat Inst & Hosp, New York, NY 10032 USA

[4] Univ Calif Los Angeles, Jane & Terry Semel Inst Neurosci & Human Behav, Dept Psychiat & Biobehav Sci, 300 Med Pl, Los Angeles, CA 90095 USA

[5] Univ Calif Los Angeles, Dept Biostat, Los Angeles, CA USA

关键词: Depression;    Family criticism;    Adolescent;    Trajectory;   

DOI  :  10.1016/j.jad.2020.09.028

来源: Elsevier

【 摘 要 】

Background: This study aimed to clarify the predictive significance of youth perceptions of parental criticism assessed using a brief measure designed to enhance clinical utility. We hypothesized that high perceived parental criticism would be associated with more severe depression over 18-months of follow-up. Methods: The study involved secondary analyses from the Youth Partners in Care trial, which demonstrated that a quality improvement intervention aimed at increasing access to evidence-based depression treatment in primary care led to improved depression outcomes at post-treatment compared to usual care enhanced by provider education regarding depression evaluation/management. Patients (N = 418; ages 13-21) were assessed at four time points: baseline; post-treatment (six-month follow-up); 12and 18-month follow-ups. The primary analysis estimated the effect of perceived parental criticism on likelihood of severe depression (i.e., Center for Epidemiological Studies-Depression Scale >= 24) over post-intervention follow-ups using a repeated-measures logistic regression model. Secondarily, a linear mixed-effects growth model examined symptom trajectories from baseline through 18-months using the Mental Health Index-5, a measure of emotional distress available at all time-points. Results: High perceived parental criticism emerged as a robust predictor of clinically-elevated depression (OR=1.66, p=.02) and a more pernicious symptom trajectory over 18-months (beta=-1.89, p<.0001). Limitations: The association between the self-report perceived criticism and traditional expressed emotion measures derived from verbal and nonverbal parental behaviors was not evaluated. Conclusions: Results support perceived parental criticism as a predictor of youth depression outcomes over 18 months. This brief measure can be feasibly integrated within clinical assessment to assist clinicians in optimizing treatment benefits.

【 授权许可】

Free