Psychological interventions for adolescents have shown mixed efficacy, and including parents in interventions may be an important avenue to improve treatment outcomes. Evidence from meta-analyses examining the role of parents in interventions for youth is inconsistent and has typically combined findings for both children and adolescents together. No prior meta-analysis has examined the specific role of parents in adolescent interventions as compared with interventions focused solely on adolescents across several disorders. To address this gap, systematic literature reviews were conducted utilizing a combination of searches among keywords including (parent * OR family) AND (intervention OR therap * OR treatment OR prevent*) AND (adolescen*). Inclusion criteria were (1) a randomized controlled trial of an individual psychological intervention compared to the same intervention with a parental component, and (2) adolescents must have at least current symptoms or risk to be included. Literature searches identified 20 trials (N = 1251). Summary statistics suggested that interventions involving parents in treatment have a significantly greater impact on adolescent psychopathology when compared to interventions that targeted adolescents alone (g = − 0.18, p < .01, 95% CI [− 0.30, − 0.07]). Examination with symptom type (internalizing or externalizing) as a moderator found that the significant difference remained for externalizing (g = − 0.20, p = .01, 95% CI [− 0.35, − 0.05]) but not internalizing psychopathology (p = .11). Findings provide evidence of the importance of including parents in adolescent therapy, particularly for externalizing problems.
Maternal depression is associated with cognitive, emotional, and behavioral problems in offspring, but the substantial heterogeneity of depression precludes a full understanding of these associations. Variation in course of depression, characterized by severity or chronicity, may be related differentially to children’s development. The current meta-analytic review examined the relations of these characteristics of maternal depression to children’s developmental outcomes. Twenty-nine studies were identified and reviewed; the majority (93%) of studies reported a negative association between some aspect of maternal depression and children’s adjustment. Separate meta-analyses revealed significant effect sizes for severity (Fisher’s z = −.243) and chronicity (adjusted Fisher’s z = −.337) of maternal depression and children’s cognitive or behavioral functioning. Findings are synthesized across features of maternal depression; methodological limitations within the empirical literature are discussed, and recommendations for future research are suggested.
Unhealthy food advertisements (“advertisements” hereafter referred to as “ads”) are linked to poor diet and obesity, and food companies disproportionally target Black youth. Little is known about the mechanisms whereby food ads influence diet. One possibility may be racially-targeted ads that appeal to Black youth. Those with food-related attentional biases may be especially vulnerable. The objective of this project was to assess the feasibility and initial effects of a pilot study testing the influence of racially-targeted food ads and food-related attentional biases on eating behaviors among a sample of Black adolescent females. Feasibility of recruitment, retention, and procedures were examined. Participants (N = 41, 12-17y) were randomized to view a television episode clip of the Big Bang Theory embedded with either four 30-second racially-targeted food ads or neutral ads. A computer dot probe task assessed food-related attentional biases. The primary outcome was caloric consumption from a laboratory test meal. Interactions based on weight and ethnic identity were also examined. Analyses of variance and regressions were used to assess main and interaction effects. Exposure to racially-targeted food ads (versus neutral ads) did not affect energy consumption (p > .99). Although not statistically significant, adolescents with obesity consumed nearly 240 kcal more than non-overweight adolescents (p = 0.10). There were no significant preliminary effects related to food-related attentional biases or ethnic identity (ps = 0.22–0.79). Despite a non-significant interaction, these data provide preliminary support that adolescents with obesity may be particularly vulnerable to racially-targeted food ads. An adequately powered trial is necessary to further elucidate the associations among racially-targeted food ads among Black adolescent girls with obesity.
29 January 2022 in Research on Child and Adolescent Psychopathology
The present study assessed two theory-driven mediators of the effects of a family group cognitive-behavioral (FGCB) preventive intervention for youth of parents with a history of major depressive disorder (MDD) or dysthymia on long-term youth psychopathology symptoms and diagnoses. Sample included 180 parents (Mage = 41.9, 89% female, 82% White, non-Hispanic) and one of their children/adolescents ages 9-15 years (Mage = 11.4, 49% female, 74% White, non-Hispanic). Changes in the hypothesized mediators, observations of positive parenting (Iowa Family Interaction Rating Scales) and youth secondary control coping (SCC) skills (Responses to Stress Questionnaire), were assessed at 6 months. Changes in youth psychopathology symptoms were assessed on the Child Behavior Checklist and Youth Self-Report at 18- and 24-month follow-ups and MDD diagnoses with the Kiddie Schedule for Affective Disorders and Schizophrenia at 12 and 24 months. Changes in youth SCC skills (e.g., acceptance, reappraisal) after the intervention mediated the effects of the FGCB program on changes in youth internalizing and externalizing symptoms at 18- and 24-month follow-ups. Effects for changes in positive parenting behaviors as a mediator were more limited. SCC skills were further shown to mediate the effects of the FGCB intervention on MDD diagnoses from 12 to 24 months. This study provides clear and strong evidence that changes in youth SCC skills mediated the long-term effects of preventive intervention for families of depressed parents. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Exposure-based cognitive behavioral therapy (CBT) is the frontline treatment for pediatric obsessive-compulsive disorder (OCD), but not all youth fully respond to this treatment. While multiple factors may influence CBT response, homework adherence in CBT is a modifiable target that can improve treatment outcomes. This report examines the relationship between homework adherence and clinical outcomes in a large sample of youth with OCD who received exposure-based CBT. Here, 137 youth with OCD between 7 and 17 years old (M = 12.42, SD = 2.88) participated in a randomized controlled trial of exposure-based CBT. Homework adherence was monitored weekly, and OCD severity was assessed by independent evaluators masked to treatment condition using gold-standard rating scales. Mixed-effects linear and logistic regression models examined the relationship between homework adherence, reductions in OCD severity, treatment response, and clinical remission at post-treatment. Follow-up investigations explored differences in patterns between early- and late-homework adherence. Finally, baseline clinical predictors of homework adherence were explored. There was a significant predictive relationship between greater homework adherence and reduced OCD severity, greater incidence of treatment response, and greater incidence of clinical remission at post-treatment. Greater homework adherence later in treatment-as opposed to earlier in treatment-was most impactful in predicting positive clinical outcomes in exposure-based CBT. Presence of co-occurring ADHD was a significant predictor of decreased homework adherence. Taken together, findings provide insight into a modifiable therapeutic target that can improve treatment outcomes in exposure-based CBT.