Preschoolers who display symptoms of depression are better able to function and regulate their emotions when taught through a new psychosocial approach, according to a study funded by the National Institute of Mental Health.
Recently, studies have shown that symptoms of clinical depression can be present in children as young as 3 years old and that these symptoms may be early signs of a childhood mood disorder.
No studies, however, have investigated how best to treat the disorder in such young children. Furthermore, many conventional psychosocial treatments for depression in adults and older youth, such as cognitive behavioral therapy or interpersonal therapy, might not work well with the developmental needs of very young children.
It is an established fact, however, that very early behavioral interventions can have a positive impact in lessening conduct problems and neuro-developmental disorders like autism and other developmental problems. These findings suggest that very early intervention for a mood disorder could possibly minimize depression later in life.
Based on these previous findings, Joan Luby, M.D., of Washington University and a team conducted a preliminary pilot study which compared a new form of psychotherapy called Parent Child Interaction Therapy-Emotion Development (PCIT-ED) with a psychoeducational program.
PCIT includes a hands-on approach designed to strengthen the parent-child relationship through positive play techniques. Parents are coached through the process and given techniques for handling noncompliance and disruptive behavior. PCIT has already been shown to be effective for treating disruptive disorders among preschoolers. The Emotion Development portion was added to assist the parent in helping the child recognize emotions in self and others and better handle intense emotions.
The psycho-education program—the control course—educated parents in small groups about child development. It included emotional and social development but did not incorporate the individual coaching or practice sessions with the parents and their children.
For the study, 54 preschoolers (aged 3-7) and their parents were randomly assigned to either PCIT-ED or to the psycho-education program. Each program was carried out during a 12-week period.
In both groups, depression symptoms in the preschoolers significantly declined after 12 weeks. The group receiving PCIT-ED also improved in levels of anxiety, hyperactivity, conduct problems, hostility and inattention, whereas the psycho-education group showed improvements in separation anxiety.
Furthermore, children in the PCIT-ED group showed improvements in executive functioning and his or her ability to recognize and regulate emotions, compared to the control group. The PCIT-ED group also experienced lower parenting stress and decreases in maternal depression, whereas the psycho-education group did not.
The results suggest that PCIT-ED is suitable for families and may be beneficial. The research team concludes that a full-scale randomized controlled trial is needed.
The study is published online in the Journal of Child Psychology and Psychiatry.