Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 278, Issue -, Pages 46-53Publisher
ELSEVIER
DOI: 10.1016/j.jad.2020.09.028
Keywords
Depression; Family criticism; Adolescent; Trajectory
Categories
Funding
- Agency for Health Care Research and Quality [HS09908]
- NIMH Ruth L. Kirschstein National Research Service Award Individual Predoctoral Fellowship [F31MH111187]
- NIMH Institutional Training Grant [T32MH15144]
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This study found that high perceived parental criticism is significantly associated with more severe depression outcomes in youth over an 18-month period. The study suggests that the brief measure used in this research can be feasibly integrated into clinical assessments to help clinicians optimize treatment benefits.
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.
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