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Joan L Luby - One of the best experts on this subject based on the ideXlab platform.
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the differential contribution of the components of parent child interaction therapy emotion development for treatment of preschool Depression
Journal of the American Academy of Child and Adolescent Psychiatry, 2020Co-Authors: Joan L Luby, Kirsten Gilbert, Rebecca Tillman, Diana J Whalen, M DeannaAbstract:Objective An adaptation of Parent-Child Interaction Therapy (PCIT) with a novel Emotion Development (ED) module has shown efficacy for the treatment of early Childhood Depression. Children who received PCIT-ED also showed healthy alterations in neural response to reward. We investigated whether the novel ED module made a unique contribution to the treatment of Depression and neural response to reward, and whether child-directed intervention (CDI) and parent-directed intervention (PDI) modules (standard elements of PCIT) were also effective. Method Dyads who participated in a randomized controlled trial of PCIT that compared the active PCIT-ED to a wait list (WL) condition were assessed at the completion of each module of PCIT-ED (CDI, PDI, ED) or WL time equivalent for child Depression and other symptoms, parenting styles, stress, and Depression. Event-related potentials during a reward task were obtained at the end of standard PCIT and after the novel ED module. Results Study findings showed that the ED module as well as some elements of standard PCIT were effective in reducing child Depression and other forms of psychopathology. Changes in the child’s neural response to reward and parental response to child emotional expression were specific to the ED module. Conclusion Study findings suggest that the novel ED module has added efficacy for the treatment of early Childhood Depression, as well as unique efficacy in changing neural responses to reward and parenting response to child emotional expression. These findings can inform clinical uses of this treatment in a modular fashion. Future studies are needed that control for session number and order of PCIT-ED modules. Clinical trial registration information A Randomized Controlled Trial of PCIT-ED for Preschool Depression; https://clinicaltrials.gov/ ; NCT02076425 .
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neural indicators of anhedonia predictors and mechanisms of treatment change in a randomized clinical trial in early Childhood Depression
Biological Psychiatry, 2019Co-Authors: M Deanna, Kirsten Gilbert, Diana J Whalen, Danielle Kelly, Emily S Kappenman, Greg Hajcak, Joan L LubyAbstract:Abstract Background Early Childhood Depression is associated with anhedonia and reduced event-related potential (ERP) responses to rewarding or pleasant stimuli. Whether these neural measures are indicators of target engagement or treatment outcome is not yet known. Methods We measured ERP responses to win and loss feedback in a guessing task and to pleasant versus neutral pictures in young (4.0–6.9 years of age) depressed children before and after randomization to either 18 weeks of Parent-Child Interaction Therapy–Emotion Development (PCIT-ED) treatment or waitlist (WL) control condition. Results Analyses included reward positivity (RewP) data from 118 children randomized to PCIT-ED treatment (n = 60) or WL control condition (n = 58) at baseline and late positive potential (LPP) data from 99 children (44 PCIT-ED treatment vs. 55 WL control condition) at baseline. Children in the PCIT-ED group showed a greater reduction in anhedonia (F1,103 = 10.32, p = .002, partial η2 = .09). RewP reward responses increased more (F1,87 = 5.45, p = .02, partial η2 = .06) for PCIT-ED and a greater change in RewP was associated with a greater reduction in major depressive disorder symptoms (r = −.24, p = .05). Baseline RewP did not predict treatment change. LPPs to positive pictures did not change across treatment, but greater baseline LPPs to positive pictures predicted a higher likelihood of remission from major depressive disorder in the PCIT-ED group (B = 0.14; SE = 0.07; odds ratio = 1.15; p = .03). Conclusions The ERP reward response improved in young children with Depression during a treatment designed to enhance emotion development, providing evidence of target engagement of the neural systems associated with reward. Further, greater baseline LPP responses to positive pictures were associated with a greater reduction in Depression, suggesting that this ERP measure can predict which children are most likely to respond to treatment.
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brain behavior relationships in the experience and regulation of negative emotion in healthy children implications for risk for Childhood Depression
Development and Psychopathology, 2014Co-Authors: David Pagliaccio, Joan L Luby, Katherine R Luking, Andy C Belden, M DeannaAbstract:Structural and functional alterations in a variety of brain regions have been associated with Depression and risk for Depression across the life span. A majority of these regions are associated with emotion reactivity and/or regulation. However, it is generally unclear what mechanistic role these alterations play in the etiology of Depression. A first step toward understanding this is to characterize the relationships between variation in brain structure/function and individual differences in Depression severity and related processes, particularly emotion regulation. To this end, the current study examines how brain structure and function predict concurrent and longitudinal measures of Depression symptomology and emotion regulation skills in psychiatrically healthy school-age children (N ¼ 60). Specifically, we found that smaller hippocampus volumes and greater responses to sad faces in emotion reactivity regions predict increased depressive symptoms at the time of scan, whereas larger amygdala volumes, smaller insula volumes, and greater responses in emotion reactivity regions predict decreased emotion regulation skills. In addition, larger insula volumes predict improvements in emotion regulation skills even after accounting for emotion regulation at the time of scan. Understanding brain–behavior relationships in psychiatrically healthy samples, especially early in development, will help inform normative developmental trajectories and neural alterations in Depression and other affective pathology.
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the 2 week duration criterion and severity and course of early Childhood Depression implications for nosology
Journal of Affective Disorders, 2011Co-Authors: Michael S Gaffrey, Andy C Belden, Joan L LubyAbstract:Background Although validity for DSM-IV MDD symptom criteria in preschoolers has been demonstrated, whether the 2-week duration criterion is an appropriate threshold of clinical significance at this age remains unclear. The current study aimed to begin addressing this question.
M Deanna - One of the best experts on this subject based on the ideXlab platform.
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the differential contribution of the components of parent child interaction therapy emotion development for treatment of preschool Depression
Journal of the American Academy of Child and Adolescent Psychiatry, 2020Co-Authors: Joan L Luby, Kirsten Gilbert, Rebecca Tillman, Diana J Whalen, M DeannaAbstract:Objective An adaptation of Parent-Child Interaction Therapy (PCIT) with a novel Emotion Development (ED) module has shown efficacy for the treatment of early Childhood Depression. Children who received PCIT-ED also showed healthy alterations in neural response to reward. We investigated whether the novel ED module made a unique contribution to the treatment of Depression and neural response to reward, and whether child-directed intervention (CDI) and parent-directed intervention (PDI) modules (standard elements of PCIT) were also effective. Method Dyads who participated in a randomized controlled trial of PCIT that compared the active PCIT-ED to a wait list (WL) condition were assessed at the completion of each module of PCIT-ED (CDI, PDI, ED) or WL time equivalent for child Depression and other symptoms, parenting styles, stress, and Depression. Event-related potentials during a reward task were obtained at the end of standard PCIT and after the novel ED module. Results Study findings showed that the ED module as well as some elements of standard PCIT were effective in reducing child Depression and other forms of psychopathology. Changes in the child’s neural response to reward and parental response to child emotional expression were specific to the ED module. Conclusion Study findings suggest that the novel ED module has added efficacy for the treatment of early Childhood Depression, as well as unique efficacy in changing neural responses to reward and parenting response to child emotional expression. These findings can inform clinical uses of this treatment in a modular fashion. Future studies are needed that control for session number and order of PCIT-ED modules. Clinical trial registration information A Randomized Controlled Trial of PCIT-ED for Preschool Depression; https://clinicaltrials.gov/ ; NCT02076425 .
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neural indicators of anhedonia predictors and mechanisms of treatment change in a randomized clinical trial in early Childhood Depression
Biological Psychiatry, 2019Co-Authors: M Deanna, Kirsten Gilbert, Diana J Whalen, Danielle Kelly, Emily S Kappenman, Greg Hajcak, Joan L LubyAbstract:Abstract Background Early Childhood Depression is associated with anhedonia and reduced event-related potential (ERP) responses to rewarding or pleasant stimuli. Whether these neural measures are indicators of target engagement or treatment outcome is not yet known. Methods We measured ERP responses to win and loss feedback in a guessing task and to pleasant versus neutral pictures in young (4.0–6.9 years of age) depressed children before and after randomization to either 18 weeks of Parent-Child Interaction Therapy–Emotion Development (PCIT-ED) treatment or waitlist (WL) control condition. Results Analyses included reward positivity (RewP) data from 118 children randomized to PCIT-ED treatment (n = 60) or WL control condition (n = 58) at baseline and late positive potential (LPP) data from 99 children (44 PCIT-ED treatment vs. 55 WL control condition) at baseline. Children in the PCIT-ED group showed a greater reduction in anhedonia (F1,103 = 10.32, p = .002, partial η2 = .09). RewP reward responses increased more (F1,87 = 5.45, p = .02, partial η2 = .06) for PCIT-ED and a greater change in RewP was associated with a greater reduction in major depressive disorder symptoms (r = −.24, p = .05). Baseline RewP did not predict treatment change. LPPs to positive pictures did not change across treatment, but greater baseline LPPs to positive pictures predicted a higher likelihood of remission from major depressive disorder in the PCIT-ED group (B = 0.14; SE = 0.07; odds ratio = 1.15; p = .03). Conclusions The ERP reward response improved in young children with Depression during a treatment designed to enhance emotion development, providing evidence of target engagement of the neural systems associated with reward. Further, greater baseline LPP responses to positive pictures were associated with a greater reduction in Depression, suggesting that this ERP measure can predict which children are most likely to respond to treatment.
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brain behavior relationships in the experience and regulation of negative emotion in healthy children implications for risk for Childhood Depression
Development and Psychopathology, 2014Co-Authors: David Pagliaccio, Joan L Luby, Katherine R Luking, Andy C Belden, M DeannaAbstract:Structural and functional alterations in a variety of brain regions have been associated with Depression and risk for Depression across the life span. A majority of these regions are associated with emotion reactivity and/or regulation. However, it is generally unclear what mechanistic role these alterations play in the etiology of Depression. A first step toward understanding this is to characterize the relationships between variation in brain structure/function and individual differences in Depression severity and related processes, particularly emotion regulation. To this end, the current study examines how brain structure and function predict concurrent and longitudinal measures of Depression symptomology and emotion regulation skills in psychiatrically healthy school-age children (N ¼ 60). Specifically, we found that smaller hippocampus volumes and greater responses to sad faces in emotion reactivity regions predict increased depressive symptoms at the time of scan, whereas larger amygdala volumes, smaller insula volumes, and greater responses in emotion reactivity regions predict decreased emotion regulation skills. In addition, larger insula volumes predict improvements in emotion regulation skills even after accounting for emotion regulation at the time of scan. Understanding brain–behavior relationships in psychiatrically healthy samples, especially early in development, will help inform normative developmental trajectories and neural alterations in Depression and other affective pathology.
Kirsten Gilbert - One of the best experts on this subject based on the ideXlab platform.
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the differential contribution of the components of parent child interaction therapy emotion development for treatment of preschool Depression
Journal of the American Academy of Child and Adolescent Psychiatry, 2020Co-Authors: Joan L Luby, Kirsten Gilbert, Rebecca Tillman, Diana J Whalen, M DeannaAbstract:Objective An adaptation of Parent-Child Interaction Therapy (PCIT) with a novel Emotion Development (ED) module has shown efficacy for the treatment of early Childhood Depression. Children who received PCIT-ED also showed healthy alterations in neural response to reward. We investigated whether the novel ED module made a unique contribution to the treatment of Depression and neural response to reward, and whether child-directed intervention (CDI) and parent-directed intervention (PDI) modules (standard elements of PCIT) were also effective. Method Dyads who participated in a randomized controlled trial of PCIT that compared the active PCIT-ED to a wait list (WL) condition were assessed at the completion of each module of PCIT-ED (CDI, PDI, ED) or WL time equivalent for child Depression and other symptoms, parenting styles, stress, and Depression. Event-related potentials during a reward task were obtained at the end of standard PCIT and after the novel ED module. Results Study findings showed that the ED module as well as some elements of standard PCIT were effective in reducing child Depression and other forms of psychopathology. Changes in the child’s neural response to reward and parental response to child emotional expression were specific to the ED module. Conclusion Study findings suggest that the novel ED module has added efficacy for the treatment of early Childhood Depression, as well as unique efficacy in changing neural responses to reward and parenting response to child emotional expression. These findings can inform clinical uses of this treatment in a modular fashion. Future studies are needed that control for session number and order of PCIT-ED modules. Clinical trial registration information A Randomized Controlled Trial of PCIT-ED for Preschool Depression; https://clinicaltrials.gov/ ; NCT02076425 .
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Sustained remission of child Depression despite drift in parent emotion management skills 18 weeks following Parent Child Interaction Therapy: emotion development
European Child & Adolescent Psychiatry, 2020Co-Authors: Joan Luby, Meghan Rose Donohue, Kirsten Gilbert, Rebecca Tillman, Deanna M. BarchAbstract:Whether effects of psychotherapies for Depression are sustained after treatment is an important clinical issue. In older depressed children and adolescents such treatments have been shown to be sustained for several months. Rates of remission ranged from 62–69% at 3 months–1 year in one large scale study. To date there has been no data to inform whether the effects of earlier interventions for Depression in the preschool period are sustained. To address this, we used data from a randomized controlled trial of a novel early intervention for Depression called “Parent Child Interaction Therapy Emotion Development” (PCIT-ED) that has shown efficacy for Depression, parenting stress and parenting practices. Participants and their caregivers were re-assessed 18 weeks after treatment completion. All study procedures were approved by the Washington University School of Medicine Internal Review Board prior to data collection. Study findings demonstrated a high rate of sustained gains in remission from Depression, decreased parenting stress and parental Depression 18 weeks after completion of a trial of PCIT-ED in a population of young children. Parental response to the child expression of emotion, a key treatment target drifted back towards baseline after 3 months. Relapse rates were 17% and predictors of relapse were the presence of an externalizing disorder, a higher number of co-morbid disorders and poorer guilt reparation and emotion regulation measured at treatment completion. This extends the body of literature demonstrating parent–child interaction therapy (PCIT) to have sustained effects on targeted disruptive symptom profiles to early Childhood Depression. This relatively low relapse rate after 18 weeks is comparable or better than many empirically proven treatments for Depression in older children.
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neural indicators of anhedonia predictors and mechanisms of treatment change in a randomized clinical trial in early Childhood Depression
Biological Psychiatry, 2019Co-Authors: M Deanna, Kirsten Gilbert, Diana J Whalen, Danielle Kelly, Emily S Kappenman, Greg Hajcak, Joan L LubyAbstract:Abstract Background Early Childhood Depression is associated with anhedonia and reduced event-related potential (ERP) responses to rewarding or pleasant stimuli. Whether these neural measures are indicators of target engagement or treatment outcome is not yet known. Methods We measured ERP responses to win and loss feedback in a guessing task and to pleasant versus neutral pictures in young (4.0–6.9 years of age) depressed children before and after randomization to either 18 weeks of Parent-Child Interaction Therapy–Emotion Development (PCIT-ED) treatment or waitlist (WL) control condition. Results Analyses included reward positivity (RewP) data from 118 children randomized to PCIT-ED treatment (n = 60) or WL control condition (n = 58) at baseline and late positive potential (LPP) data from 99 children (44 PCIT-ED treatment vs. 55 WL control condition) at baseline. Children in the PCIT-ED group showed a greater reduction in anhedonia (F1,103 = 10.32, p = .002, partial η2 = .09). RewP reward responses increased more (F1,87 = 5.45, p = .02, partial η2 = .06) for PCIT-ED and a greater change in RewP was associated with a greater reduction in major depressive disorder symptoms (r = −.24, p = .05). Baseline RewP did not predict treatment change. LPPs to positive pictures did not change across treatment, but greater baseline LPPs to positive pictures predicted a higher likelihood of remission from major depressive disorder in the PCIT-ED group (B = 0.14; SE = 0.07; odds ratio = 1.15; p = .03). Conclusions The ERP reward response improved in young children with Depression during a treatment designed to enhance emotion development, providing evidence of target engagement of the neural systems associated with reward. Further, greater baseline LPP responses to positive pictures were associated with a greater reduction in Depression, suggesting that this ERP measure can predict which children are most likely to respond to treatment.
Deanna M. Barch - One of the best experts on this subject based on the ideXlab platform.
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Sustained remission of child Depression despite drift in parent emotion management skills 18 weeks following Parent Child Interaction Therapy: emotion development
European Child & Adolescent Psychiatry, 2020Co-Authors: Joan Luby, Meghan Rose Donohue, Kirsten Gilbert, Rebecca Tillman, Deanna M. BarchAbstract:Whether effects of psychotherapies for Depression are sustained after treatment is an important clinical issue. In older depressed children and adolescents such treatments have been shown to be sustained for several months. Rates of remission ranged from 62–69% at 3 months–1 year in one large scale study. To date there has been no data to inform whether the effects of earlier interventions for Depression in the preschool period are sustained. To address this, we used data from a randomized controlled trial of a novel early intervention for Depression called “Parent Child Interaction Therapy Emotion Development” (PCIT-ED) that has shown efficacy for Depression, parenting stress and parenting practices. Participants and their caregivers were re-assessed 18 weeks after treatment completion. All study procedures were approved by the Washington University School of Medicine Internal Review Board prior to data collection. Study findings demonstrated a high rate of sustained gains in remission from Depression, decreased parenting stress and parental Depression 18 weeks after completion of a trial of PCIT-ED in a population of young children. Parental response to the child expression of emotion, a key treatment target drifted back towards baseline after 3 months. Relapse rates were 17% and predictors of relapse were the presence of an externalizing disorder, a higher number of co-morbid disorders and poorer guilt reparation and emotion regulation measured at treatment completion. This extends the body of literature demonstrating parent–child interaction therapy (PCIT) to have sustained effects on targeted disruptive symptom profiles to early Childhood Depression. This relatively low relapse rate after 18 weeks is comparable or better than many empirically proven treatments for Depression in older children.
Rebecca Tillman - One of the best experts on this subject based on the ideXlab platform.
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the differential contribution of the components of parent child interaction therapy emotion development for treatment of preschool Depression
Journal of the American Academy of Child and Adolescent Psychiatry, 2020Co-Authors: Joan L Luby, Kirsten Gilbert, Rebecca Tillman, Diana J Whalen, M DeannaAbstract:Objective An adaptation of Parent-Child Interaction Therapy (PCIT) with a novel Emotion Development (ED) module has shown efficacy for the treatment of early Childhood Depression. Children who received PCIT-ED also showed healthy alterations in neural response to reward. We investigated whether the novel ED module made a unique contribution to the treatment of Depression and neural response to reward, and whether child-directed intervention (CDI) and parent-directed intervention (PDI) modules (standard elements of PCIT) were also effective. Method Dyads who participated in a randomized controlled trial of PCIT that compared the active PCIT-ED to a wait list (WL) condition were assessed at the completion of each module of PCIT-ED (CDI, PDI, ED) or WL time equivalent for child Depression and other symptoms, parenting styles, stress, and Depression. Event-related potentials during a reward task were obtained at the end of standard PCIT and after the novel ED module. Results Study findings showed that the ED module as well as some elements of standard PCIT were effective in reducing child Depression and other forms of psychopathology. Changes in the child’s neural response to reward and parental response to child emotional expression were specific to the ED module. Conclusion Study findings suggest that the novel ED module has added efficacy for the treatment of early Childhood Depression, as well as unique efficacy in changing neural responses to reward and parenting response to child emotional expression. These findings can inform clinical uses of this treatment in a modular fashion. Future studies are needed that control for session number and order of PCIT-ED modules. Clinical trial registration information A Randomized Controlled Trial of PCIT-ED for Preschool Depression; https://clinicaltrials.gov/ ; NCT02076425 .
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Sustained remission of child Depression despite drift in parent emotion management skills 18 weeks following Parent Child Interaction Therapy: emotion development
European Child & Adolescent Psychiatry, 2020Co-Authors: Joan Luby, Meghan Rose Donohue, Kirsten Gilbert, Rebecca Tillman, Deanna M. BarchAbstract:Whether effects of psychotherapies for Depression are sustained after treatment is an important clinical issue. In older depressed children and adolescents such treatments have been shown to be sustained for several months. Rates of remission ranged from 62–69% at 3 months–1 year in one large scale study. To date there has been no data to inform whether the effects of earlier interventions for Depression in the preschool period are sustained. To address this, we used data from a randomized controlled trial of a novel early intervention for Depression called “Parent Child Interaction Therapy Emotion Development” (PCIT-ED) that has shown efficacy for Depression, parenting stress and parenting practices. Participants and their caregivers were re-assessed 18 weeks after treatment completion. All study procedures were approved by the Washington University School of Medicine Internal Review Board prior to data collection. Study findings demonstrated a high rate of sustained gains in remission from Depression, decreased parenting stress and parental Depression 18 weeks after completion of a trial of PCIT-ED in a population of young children. Parental response to the child expression of emotion, a key treatment target drifted back towards baseline after 3 months. Relapse rates were 17% and predictors of relapse were the presence of an externalizing disorder, a higher number of co-morbid disorders and poorer guilt reparation and emotion regulation measured at treatment completion. This extends the body of literature demonstrating parent–child interaction therapy (PCIT) to have sustained effects on targeted disruptive symptom profiles to early Childhood Depression. This relatively low relapse rate after 18 weeks is comparable or better than many empirically proven treatments for Depression in older children.