Heather A MacPherson1, Jennifer Wolff2, Bridget Nestor3, Elisabeth Frazier4, Maya Massing-Schaffer3, Hannah Graves3, Christianne Esposito-Smythers5, Anthony Spirito3. 1. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Emma Pendleton Bradley Hospital, East Providence, RI, USA. Electronic address: heather_macpherson@brown.edu. 2. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Rhode Island Hospital, Providence, RI, USA. 3. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA. 4. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Emma Pendleton Bradley Hospital, East Providence, RI, USA. 5. George Mason University, Fairfax, VA, USA.
Abstract
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.
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.
Authors: Anna Figueras Masip; Juan Antonio Amador-Campos; Juana Gómez-Benito; Victoria del Barrio Gándara Journal: Span J Psychol Date: 2010-11 Impact factor: 1.264
Authors: J Kaufman; B Birmaher; D Brent; U Rao; C Flynn; P Moreci; D Williamson; N Ryan Journal: J Am Acad Child Adolesc Psychiatry Date: 1997-07 Impact factor: 8.829
Authors: Guillermo Perez Algorta; Heather A MacPherson; Eric A Youngstrom; Caroline C Belt; L Eugene Arnold; Thomas W Frazier; H Gerry Taylor; Boris Birmaher; Sarah McCue Horwitz; Robert L Findling; Mary A Fristad Journal: J Clin Child Adolesc Psychol Date: 2017-02-26
Authors: Sally M Weinstein; David B Henry; Andrea C Katz; Amy T Peters; Amy E West Journal: J Am Acad Child Adolesc Psychiatry Date: 2014-11-22 Impact factor: 8.829
Authors: Maria Anna Donati; Cristiana Alessia Guido; Giuliano De Meo; Alberto Spalice; Francesco Sanson; Carola Beccari; Caterina Primi Journal: Int J Environ Res Public Health Date: 2021-06-21 Impact factor: 3.390