Poster #149 - Parent-Adolescent Communication Moderates Treatment Benefit Among Depressed and Suicidal Adolescents

• In Event: 1-169 - Poster Session 04
  In Poster Session: PS 04 Section - Parenting & Parent-Child Relationships

Integrative Statement

Although difficulties in the parent-adolescent relationship represent one common pathway to adolescent depression and suicidality, less is known about whether parent-adolescent communication moderates treatment benefit for suicidal and depressed adolescents. Prior research on this topic has been limited to self-reported measures of the more global family environment. The current study tested an observational assessment of parent-adolescent communication as a moderator of depressed and suicidal adolescents' response to Attachment-Based Family Therapy (ABFT; Diamond et al., 2010) and Family-Enhanced Non-Directive Supportive Therapy (FE-NST; Levy & Diamond, 2010), two treatments that utilize parental involvement as a central treatment element.
129 adolescents were randomly assigned to 16 weeks of treatment. Pre-treatment parent-adolescent communication was assessed using the Goal-Corrected Partnership in Adolescence Coding System (GPACS; Lyons-Ruth, Hennighausen, & Holmes, 2005), an observational method that yields a dimension assessing the parent-adolescent dyad's capacity to maintain supportive and validating communication during a conflict discussion. Parent and adolescent self-reports of family support, measured using the Self-Report of Family Functioning (SRFF; Bloom, 1985), were also included to be consistent with prior studies.
The moderating effects of baseline family support on adolescent treatment response were tested using hierarchical linear modeling. Separate models examined rates of change in depressive and suicidal ideation symptoms during treatment. Time was analyzed as a within-subjects predictor, while observed cooperative communication, treatment condition, the interaction between cooperative communication and treatment condition, adolescent- and parent-rated family support, and several demographic control variables were analyzed as between-subjects moderators of symptom trajectories. Results, presented in Table 1, indicated that cooperative communication significantly moderated the rate of change in depression, with less cooperative communication associated with greater reductions in depressive symptoms. Cooperative communication did not significantly predict pre-treatment levels of depression. There were no significant effects for adolescent- or parent-rated family support, treatment condition, or the interaction term. A reduced model was tested, excluding non-significant predictors, which again yielded cooperative communication as a significant predictor of reduction in depressive symptoms. To interpret this effect, rates of change in depressive symptoms were calculated at high and low cooperative communication (1 SD above and below the mean). Results, displayed in Figure 1, indicated that high cooperative communication corresponded to an estimated total change of 13.14 points on the BDI-II (Beck, Steer, & Brown, 1996) over the course of treatment, while low cooperative communication corresponded to an estimated total change of 20.89 points. Finally, a model was tested to examine these effects on adolescents' suicidal ideation. All indicators of family support as well as treatment condition and the interaction term yielded non-significant effects.
This study was the first, to our knowledge, to demonstrate the clinical utility of an observational assessment of parent-adolescent communication as a moderator of depressed and suicidal adolescents' treatment response. Further, these findings point to the efficacy of ABFT and FE-NST for depressed adolescents experiencing less cooperative communication with their parents at the start of treatment.

Authors

• Abigail Zisk, University of Delaware
  Presenting Author

• Caroline Abbott, University of Delaware
  Non-Presenting Author

• Nadia Bounoua, University of Delaware
  Non-Presenting Author

• Guy S. Diamond, Drexel University
  Non-Presenting Author

• Roger Kobak, University of Delaware
  Non-Presenting Author