Dyadic Therapy for Mothers and Children

NCT ID: NCT02123160

Last Updated: 2017-08-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Clinical Phase

PHASE1

Total Enrollment

2 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-11-30

Study Completion Date

2014-10-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This study compares the effectiveness of Child Parent Psychotherapy to that of usual care (defined as: referral to therapists in the community or Columbia University Medical Center) in improving maternal depressive symptoms and child emotional and behavioral disturbances. The investigators will recruit mothers who report being mildly to moderately depressed and their preschoolers (ages 3-5 years) who they are concerned are exhibiting emotional and/or behavioral problems.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Child Parent Psychotherapy (CPP) has been demonstrated to be effective in improving mother-child attachment relationship, maternal (depression, posttraumatic stress symptoms, global symptoms of distress) and child (behavior problems, posttraumatic stress symptoms and diagnosis, cognitive and representational models) outcomes, in the context of risk factors such as maternal depression and exposure to traumatic events. It is the only treatment for preschool aged children and caregivers that seeks to affect changes at both behavioral and schematic/ cognitive levels. The investigators aim to assess the feasibility and acceptability of providing CPP as a dyadic preventive intervention for children who are displaying signs of emotional and behavioral difficulties in the context of maternal depression.

Investigators will compare the effectiveness of CPP to that of usual care (usual care defined as: referral to therapists in the community and within Columbia University Medical Center for psychoeducation, counseling/ therapy for maternal depressive symptoms, and child behavioral/ emotional difficulties) in improving maternal depressive symptoms and child emotional and behavioral problems. The investigators will recruit mothers who report being mildly to moderately depressed and their preschoolers (aged 3-5 years) who they are concerned are exhibiting emotional and/or behavioral problems.

Mother-child patient dyads will be screened via telephone to assess study eligibility. If eligible mothers and their children will complete an in-person pre-treatment assessment. After the Time 1 (pre-treatment) assessment, mother-child patient dyads will be randomly assigned to one of two treatment conditions - 1. six months of weekly CPP intervention sessions OR 2. control condition in which mothers and their children will be referred for usual treatment in the community. Random assignment will be done based on a pre-determined schedule (a random number generator will be used to create a schedule for patient treatment assignment). Following randomization mother-child patient dyads will complete the following assessments: Time 2 (after 12 sessions or an average of three months), Time 3 (after 24 sessions or an average of six months), and Time 4 (six months after 24 treatment sessions or an average of one year after Time 1). All assessments will be conducted by a licensed clinician in conjunction with a research assistant.

Mothers (30 in each group) will be recruited through the Women's Program and pediatric practices affiliated with Columbia University Medical Center, including the Columbia Center of the New York Presbyterian Hospital, as well as its satellite center, the Allen Pavilion, and the Children's Hospital of New York. Approximately 90 women will need to screened to recruit 60 women for the study.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Depression Behavioral Problems

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Psychotherapy-behavioral intervention
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Child Parent Psychotherapy (CPP)

Following Time 1 (pre-treatment) assessment, mother-child patient dyads will be randomly assigned to either Child Parent Psychotherapy (CPP) treatment or control (usual treatment) group. CPP treatment will be conducted by a CPP study clinician over approximately six months (24 weekly sessions). CPP includes developmental guidance and fostering affect regulation , continuity in daily living, reciprocity between mother and child, and helping the mother and child understand themselves and each other in the context of the maternal psychiatric functioning and/or familial exposure to trauma.

Group Type EXPERIMENTAL

Child Parent Psychotherapy (CPP)

Intervention Type BEHAVIORAL

Child Parent Psychotherapy (CPP) is a multi-theoretical approach to enhance the caregiver-child relationship in the context of the caregiver's psychiatric history (e.g., depression) and/or caregiver/child exposure to traumatic events. Mother and child's in-session interactions are used to provide developmental guidance, and reinforce reciprocity between parent and child, affect regulation , continuity in daily living, and helping mother and child understand themselves and each other in the context of the maternal psychiatric functioning and/or familial exposure to trauma. When there is a history of trauma exposure for mother and/or child, mother and child create a joint narrative of the trauma, identify and address traumatic triggers, and focus on safety issues.

Usual Treatment

Following Time 1 (pre-treatment) assessment, mother-child patient dyads randomized to the control group will be referred for usual treatment via referral to therapists in the community and at Columbia University Medical Center, for psychoeducation, counseling/ therapy for maternal depressive symptoms, and child behavioral/ emotional difficulties. Additionally, control patient dyads will be monitored through regular contact with the study research assistant. If the research assistant detects worsening of depressive symptoms or the presentation of new symptoms, a licensed study clinician will follow up to assess mother/ child's psychiatric functioning and make necessary referrals to alternative treatments or arrange an emergency evaluation, if needed.

Group Type ACTIVE_COMPARATOR

Control (usual treatment)

Intervention Type BEHAVIORAL

Following Time 1 (pre-treatment) assessment, mother-child patient dyads randomized to the control group will be referred to usual treatment in the community for psychoeducation, counseling/ therapy for maternal depressive symptoms, and child behavioral/ emotional difficulties. Control patient dyads will be closely monitored through regular contact with the study research assistant and follow up by a licensed study clinician to assess mother/ child's psychiatric functioning and make necessary referrals to alternative treatments or arrange an emergency evaluation, if needed.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Child Parent Psychotherapy (CPP)

Child Parent Psychotherapy (CPP) is a multi-theoretical approach to enhance the caregiver-child relationship in the context of the caregiver's psychiatric history (e.g., depression) and/or caregiver/child exposure to traumatic events. Mother and child's in-session interactions are used to provide developmental guidance, and reinforce reciprocity between parent and child, affect regulation , continuity in daily living, and helping mother and child understand themselves and each other in the context of the maternal psychiatric functioning and/or familial exposure to trauma. When there is a history of trauma exposure for mother and/or child, mother and child create a joint narrative of the trauma, identify and address traumatic triggers, and focus on safety issues.

Intervention Type BEHAVIORAL

Control (usual treatment)

Following Time 1 (pre-treatment) assessment, mother-child patient dyads randomized to the control group will be referred to usual treatment in the community for psychoeducation, counseling/ therapy for maternal depressive symptoms, and child behavioral/ emotional difficulties. Control patient dyads will be closely monitored through regular contact with the study research assistant and follow up by a licensed study clinician to assess mother/ child's psychiatric functioning and make necessary referrals to alternative treatments or arrange an emergency evaluation, if needed.

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Maternal age 18-40 years
* Child age 3-5 years
* Maternal Beck Depression Inventory-II score 14-30
* Maternal report of at least two of ten child emotional/behavioral problems (excessive shyness, fussiness, sleep pattern problems, irritability, frequent inappropriate behavior) during phone screen administration of an adapted version of the Child Behavior Checklist.

Exclusion Criteria

* Maternal lack of fluency in English as assessed through phone screening
* Maternal self-report of suicidality as assessed through Beck Depression Inventory-II
* Maternal self-report of Psychotic/Bipolar/Thought disorder
* Maternal self-report of substance abuse problems in the past 6 months
* Maternal report of child's lack of fluency in English
* Maternal report of child's developmental disorders / mental retardations / significant speech and language delays
Minimum Eligible Age

3 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Sackler Foundation

OTHER

Sponsor Role collaborator

New York State Psychiatric Institute

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Catherine Monk, PhD

Role: PRINCIPAL_INVESTIGATOR

New York State Psychiatric Institute, Columbia University Medical Center

Andrew Gerber, MD

Role: STUDY_DIRECTOR

New York State Psychiatric Institute

Archana Basu, PhD

Role: STUDY_DIRECTOR

Columbia University

Elizabeth Werner, PhD

Role: STUDY_DIRECTOR

Columbia University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

New York State Psychiatric Institute

New York, New York, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Carpenter LL, Gawuga CE, Tyrka AR, Lee JK, Anderson GM, Price LH. Association between plasma IL-6 response to acute stress and early-life adversity in healthy adults. Neuropsychopharmacology. 2010 Dec;35(13):2617-23. doi: 10.1038/npp.2010.159. Epub 2010 Sep 29.

Reference Type BACKGROUND
PMID: 20881945 (View on PubMed)

Chandra RK. Nutrition and the immune system from birth to old age. Eur J Clin Nutr. 2002 Aug;56 Suppl 3:S73-6. doi: 10.1038/sj.ejcn.1601492.

Reference Type BACKGROUND
PMID: 12142969 (View on PubMed)

Chen E, Miller GE, Kobor MS, Cole SW. Maternal warmth buffers the effects of low early-life socioeconomic status on pro-inflammatory signaling in adulthood. Mol Psychiatry. 2011 Jul;16(7):729-37. doi: 10.1038/mp.2010.53. Epub 2010 May 18.

Reference Type BACKGROUND
PMID: 20479762 (View on PubMed)

Coe CL, Laudenslager ML. Psychosocial influences on immunity, including effects on immune maturation and senescence. Brain Behav Immun. 2007 Nov;21(8):1000-8. doi: 10.1016/j.bbi.2007.06.015. Epub 2007 Aug 15.

Reference Type BACKGROUND
PMID: 17706917 (View on PubMed)

Coe CL, Lubach GR. Critical periods of special health relevance for psychoneuroimmunology. Brain Behav Immun. 2003 Feb;17(1):3-12. doi: 10.1016/s0889-1591(02)00099-5.

Reference Type BACKGROUND
PMID: 12615044 (View on PubMed)

Cole SW. Social regulation of leukocyte homeostasis: the role of glucocorticoid sensitivity. Brain Behav Immun. 2008 Oct;22(7):1049-1055. doi: 10.1016/j.bbi.2008.02.006. Epub 2008 Apr 3.

Reference Type BACKGROUND
PMID: 18394861 (View on PubMed)

Danese A, Pariante CM, Caspi A, Taylor A, Poulton R. Childhood maltreatment predicts adult inflammation in a life-course study. Proc Natl Acad Sci U S A. 2007 Jan 23;104(4):1319-24. doi: 10.1073/pnas.0610362104. Epub 2007 Jan 17.

Reference Type BACKGROUND
PMID: 17229839 (View on PubMed)

de Heredia FP, Gomez-Martinez S, Marcos A. Obesity, inflammation and the immune system. Proc Nutr Soc. 2012 May;71(2):332-8. doi: 10.1017/S0029665112000092. Epub 2012 Mar 20.

Reference Type BACKGROUND
PMID: 22429824 (View on PubMed)

DeVries AC, Craft TK, Glasper ER, Neigh GN, Alexander JK. 2006 Curt P. Richter award winner: Social influences on stress responses and health. Psychoneuroendocrinology. 2007 Jul;32(6):587-603. doi: 10.1016/j.psyneuen.2007.04.007. Epub 2007 Jun 21.

Reference Type BACKGROUND
PMID: 17590276 (View on PubMed)

Feder A, Alonso A, Tang M, Liriano W, Warner V, Pilowsky D, Barranco E, Wang Y, Verdeli H, Wickramaratne P, Weissman MM. Children of low-income depressed mothers: psychiatric disorders and social adjustment. Depress Anxiety. 2009;26(6):513-20. doi: 10.1002/da.20522.

Reference Type BACKGROUND
PMID: 19016460 (View on PubMed)

Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005 Nov;106(5 Pt 1):1071-83. doi: 10.1097/01.AOG.0000183597.31630.db.

Reference Type BACKGROUND
PMID: 16260528 (View on PubMed)

Gouin JP, Glaser R, Malarkey WB, Beversdorf D, Kiecolt-Glaser JK. Childhood abuse and inflammatory responses to daily stressors. Ann Behav Med. 2012 Oct;44(2):287-92. doi: 10.1007/s12160-012-9386-1.

Reference Type BACKGROUND
PMID: 22714139 (View on PubMed)

Irwin MR. Human psychoneuroimmunology: 20 years of discovery. Brain Behav Immun. 2008 Feb;22(2):129-39. doi: 10.1016/j.bbi.2007.07.013. Epub 2007 Oct 29.

Reference Type BACKGROUND
PMID: 17911004 (View on PubMed)

Kurstjens S, Wolke D. Effects of maternal depression on cognitive development of children over the first 7 years of life. J Child Psychol Psychiatry. 2001 Jul;42(5):623-36.

Reference Type BACKGROUND
PMID: 11464967 (View on PubMed)

Lieberman AF, Van Horn P, Ippen CG. Toward evidence-based treatment: child-parent psychotherapy with preschoolers exposed to marital violence. J Am Acad Child Adolesc Psychiatry. 2005 Dec;44(12):1241-8. doi: 10.1097/01.chi.0000181047.59702.58.

Reference Type BACKGROUND
PMID: 16292115 (View on PubMed)

Lieberman AF, Ghosh Ippen C, VAN Horn P. Child-parent psychotherapy: 6-month follow-up of a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2006 Aug;45(8):913-918. doi: 10.1097/01.chi.0000222784.03735.92.

Reference Type BACKGROUND
PMID: 16865033 (View on PubMed)

Murray L. The impact of postnatal depression on infant development. J Child Psychol Psychiatry. 1992 Mar;33(3):543-61. doi: 10.1111/j.1469-7610.1992.tb00890.x.

Reference Type BACKGROUND
PMID: 1577898 (View on PubMed)

McDade TW. Early environments and the ecology of inflammation. Proc Natl Acad Sci U S A. 2012 Oct 16;109 Suppl 2(Suppl 2):17281-8. doi: 10.1073/pnas.1202244109. Epub 2012 Oct 8.

Reference Type BACKGROUND
PMID: 23045646 (View on PubMed)

Pace TW, Wingenfeld K, Schmidt I, Meinlschmidt G, Hellhammer DH, Heim CM. Increased peripheral NF-kappaB pathway activity in women with childhood abuse-related posttraumatic stress disorder. Brain Behav Immun. 2012 Jan;26(1):13-7. doi: 10.1016/j.bbi.2011.07.232. Epub 2011 Jul 27.

Reference Type BACKGROUND
PMID: 21801830 (View on PubMed)

Schechter DS, Coots T, Zeanah CH, Davies M, Coates SW, Trabka KA, Marshall RD, Liebowitz MR, Myers MM. Maternal mental representations of the child in an inner-city clinical sample: violence-related posttraumatic stress and reflective functioning. Attach Hum Dev. 2005 Sep;7(3):313-31. doi: 10.1080/14616730500246011.

Reference Type BACKGROUND
PMID: 16210242 (View on PubMed)

Schechter DS, Coates SW, Kaminer T, Coots T, Zeanah CH Jr, Davies M, Schonfeld IS, Marshall RD, Liebowitz MR, Trabka KA, McCaw JE, Myers MM. Distorted maternal mental representations and atypical behavior in a clinical sample of violence-exposed mothers and their toddlers. J Trauma Dissociation. 2008;9(2):123-47. doi: 10.1080/15299730802045666.

Reference Type BACKGROUND
PMID: 18985165 (View on PubMed)

Scheeringa MS, Haslett N. The reliability and criterion validity of the Diagnostic Infant and Preschool Assessment: a new diagnostic instrument for young children. Child Psychiatry Hum Dev. 2010 Jun;41(3):299-312. doi: 10.1007/s10578-009-0169-2.

Reference Type BACKGROUND
PMID: 20052532 (View on PubMed)

Shanahan L, Copeland WE, Worthman CM, Angold A, Costello EJ. Children with both asthma and depression are at risk for heightened inflammation. J Pediatr. 2013 Nov;163(5):1443-7. doi: 10.1016/j.jpeds.2013.06.046. Epub 2013 Aug 3.

Reference Type BACKGROUND
PMID: 23919906 (View on PubMed)

Shonkoff JP. From neurons to neighborhoods: old and new challenges for developmental and behavioral pediatrics. J Dev Behav Pediatr. 2003 Feb;24(1):70-6. doi: 10.1097/00004703-200302000-00014.

Reference Type BACKGROUND
PMID: 12584488 (View on PubMed)

Sohr-Preston SL, Scaramella LV. Implications of timing of maternal depressive symptoms for early cognitive and language development. Clin Child Fam Psychol Rev. 2006 Mar;9(1):65-83. doi: 10.1007/s10567-006-0004-2.

Reference Type BACKGROUND
PMID: 16817009 (View on PubMed)

Toth SL, Rogosch FA, Manly JT, Cicchetti D. The efficacy of toddler-parent psychotherapy to reorganize attachment in the young offspring of mothers with major depressive disorder: a randomized preventive trial. J Consult Clin Psychol. 2006 Dec;74(6):1006-16. doi: 10.1037/0022-006X.74.6.1006.

Reference Type BACKGROUND
PMID: 17154731 (View on PubMed)

Weissman MM, Pilowsky DJ, Wickramaratne PJ, Talati A, Wisniewski SR, Fava M, Hughes CW, Garber J, Malloy E, King CA, Cerda G, Sood AB, Alpert JE, Trivedi MH, Rush AJ; STAR*D-Child Team. Remissions in maternal depression and child psychopathology: a STAR*D-child report. JAMA. 2006 Mar 22;295(12):1389-98. doi: 10.1001/jama.295.12.1389.

Reference Type BACKGROUND
PMID: 16551710 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

#6687

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.