Caregiver Depression and Youth Disruptive Behavior Difficulties

Journal of Emotional and Behavioral Disorders, 2017

Disproportionately high rates of caregiver stress and depression are found among poverty-impacted communities, with high levels of caregiver stress and depression putting youth at heightened risk for the onset and perpetuation of disruptive behavior disorders. The purpose of this study was to examine the effects of a behavioral parent training program called the 4Rs and 2Ss for Strengthening Families Program (4R2S) on caregiver stress and depressive symptoms among 320 youth aged 7 to 11 and their families assigned to either the 4R2S or services as usual (SAU) condition. Among caregivers with clinically significant (CS) scores at baseline, 4R2S participants manifested significantly reduced scores on the stress and depressive symptom scores to SAU participants at 6-month follow-up. Findings suggest that 4R2S may reduce caregiver stress and depressive symptoms among those caregivers initially manifesting CS levels of stress or depressive symptoms.

Child Abuse & Neglect, 2018

Child welfare involvement has been linked to child behavioral health issues, including increased likelihood of internalizing mental health problems such as depression and anxiety, and externalizing behavioral problems such as oppositional behaviors and substance use problems. One predictor of child behavioral health is caregiver mental health. Although, there remains a specific gap associated with identification of factors among caregivers that are associated with longitudinal child behavioral health trajectories. Using LONGSCAN, we explore the effects of caregiver depression on the behavioral health of children over time. Multilevel mixed-effects linear regression models showed that children with a caregiver who reported depression showed significantly higher internalizing behavioral problems over time, and significantly larger decreases in externalizing behavioral problems over time, compared to children with a caregiver who reported no depression. These findings emphasize that early interventions geared towards jointly assessing and treating parent and child mental health issues in the child welfare system may be successful at improving future behavioral health outcomes.

Social Work in Mental Health, 2015

Introduction-The purpose of this study was to investigate the prevalence of depression, use of mental health services, and correlates of service use among caregivers who are dually involved in the child welfare and child mental health systems. Methods-This study analyzed baseline data from 129 caregivers who reported child welfare system involvement and were participating in a Multiple Family Group service delivery model to reduce childhood disruptive behavior disorders. Results-Seventy-eight (60.5%) of caregivers met or exceed the clinical-cut off for depression; of them 50 (64.1%) reported utilizing mental health services for their emotional health. Race, employment status, and CES-D score were significantly associated with lifetime mental heath services use. Discussion-Depression rates exceeded those found among caregiver involved in either the child welfare or child mental health systems. Rates of service use were higher than found in existing research. As expected, racial differences and depression were associated with service use; contrary to expectations, full time employment was not associated with service use. Discrepancies between this study and existing research are discussed, as are practice, policy, and research implications.

The purpose of this study was to investigate the prevalence of depression, use of mental health services, and correlates of service use among caregivers who are dually involved in the child welfare and child mental health systems. Methods: This study analyzed baseline data from 129 caregivers who reported child welfare system involvement and were participating in a Multiple Family Group service delivery model to reduce childhood disruptive behavior disorders. Results: Seventy-eight (60.5%) of caregivers met or exceed the clinical-cut off for depression; of them 50 (64.1%) reported utilizing mental health services for their emotional health. Race, employment status, and CES-D score were significantly associated with lifetime mental heath services use. Discussion: Depression rates exceeded those found among caregiver involved in either the child welfare or child mental health systems. Rates of service use were higher than found in existing research. As expected, racial differences and depression were associated with service use; contrary to expectations, full time employment was not associated with service use. Discrepancies between this study and existing research are discussed, as are practice, policy, and research implications.

Archives of Psychiatric Nursing

This article describes the development of a 6-week multiple caregiver group intervention for primary caregivers of adolescents diagnosed with Oppositional Defiant Disorder or Conduct Disorder in low-income African American families. The intervention is aimed at increasing the primary caregivers' self-efficacy in managing interactions within the family and especially with child serving educational, mental health, juvenile justice, and child welfare systems. Development of the intervention involved seven iterative activities performed in a collaborative effort between an interdisciplinary academic team, community engagement specialists, members of the targeted population, and clinical partners from a large public mental health system. The intervention development process described in this article can provide guidance for teams that aim to develop new mental health interventions that target specific outcomes in populations with unique needs.

Adolescents with disruptive behavior disorders (DBD), including oppositional defiant disorder and conduct disorder, present unique challenges for their families. Although, most empirically supported treatments for DBD are family-based, the emphasis is typically on the behavior of the child rather than on the life challenges and resultant distress experienced by the family members. Fifteen families of adolescents with DBD were recruited from a large publicly funded Community Mental Health Center. For this report, data from in-depth interviews with the adolescents' primary caregivers were analyzed by standard content analytic procedures to describe the challenges they experienced living with and caring for the adolescents. The primary caregivers reported that the challenges were overwhelming, demanding, and unrelenting. The two most salient challenges were (a) managing the

Child & Youth Care Forum

Early Childhood Research Quarterly, 2004

The current study describes the prevalence of self-reported depressive symptoms in a sample of 1217 nonfamilial caregivers and examines the relation between depression and the quality of interactions between caregivers and young children. One hundred and fourteen of these caregivers (9.4%) reported clinically significant levels of depressive symptoms. Analyses provided evidence of small, but consistent and unique associations between caregivers' self-reported depression and the quality of their interactions with children. Caregivers reporting more depression were less sensitive and more withdrawn than caregivers reporting fewer depressive symptoms. Depression was more closely associated with negative behavior for caregivers working in family child-care settings, as well as among caregivers with less education and among those that spend more time without other adults present. The current study provides preliminary evidence that expanding knowledge of caregivers' characteristics may be an important component of understanding the nonfamilial caregiving environment.

Child and Adolescent Mental Health, 2016

Background-Parental perceptions about treatment influence their child's engagement in and ongoing utilization of mental health services, but less is known about the association between caregiver expectancies and family outcomes. The literature is particularly lacking with families of color, who are at high risk for the onset and perpetuation of disruptive behaviors. Methods-The purpose of this study was to examine caregiver treatment satisfaction amongst 320 youth of color aged 7 to 11 and their families who were assigned to either a Multiple Family Group intervention or services as usual condition. Caregiver stress was measured by the Parenting Stress Index Short-Form full scale and child oppositional defiant behaviors were measured using the Iowa Connors Rating Scale-Oppositional/Defiant subscale both at baseline and post-test. Satisfaction with treatment was measured using the Metropolitan Area Child Study process measures program satisfaction subscale at post-test. Results-The two main effects models that focused on satisfaction with treatment was predictive of parental stress and child oppositional defiant behaviors independently. Satisfaction with treatment accounted for 31% of the variance in child oppositional behavior and 24% of parental stress improvements across time holding all covariates constant. Conclusions-Our findings support previous research that shows parental expectancies, including treatment satisfaction, are powerful mechanisms of treatment outcomes for children with DBDs as well as parental emotional health. Further, parental expectancies may be enhanced by the involvement of families in the development of treatment approaches for children and a greater focus on caregiver emotional health for the benefit of the family as a whole.

Journal of Affective Disorders, 2023

Background Caregiver distress is the strain experienced by individuals providing care for people with chronic conditions which limit their self-sufficiency for tasks of daily living. Over 1 in 5 Americans are caregivers–a number expected to increase with an aging population. Methods We performed a cross-sectional analysis using the 2021 Behavioral Risk Factor Surveillance System (BRFSS) conducted by the Centers for Disease Control and Prevention (CDC) to determine rates of depressive disorders among caregivers and associations between demographic and relational aspects of the care recipient. Results The included sample size for analysis was 32,676, representing 17,274,935 US caregivers. We found that caregivers who were female, American Indian/Alaskan Native, race-not-listed, earning less than $15,000 a year, or did not complete high school, had higher rates of depression diagnosis. The rates of depression were higher among caregivers if the recipient had a mental or chronic respiratory condition, or if the recipient was their live-in partner. Rates of depression were lower for caregivers of their mother-in-law or spouse. Limitations Results were based on self-reported survey data, which are susceptible to social desirability bias. Diagnoses of depression may also be over or under reported across several demographic variables, which may confound results. Conclusion Our findings add to previous research showing that specific groups of caregivers are at higher risk for caregiver stress. Future qualitative research may elucidate underlying causes of depression among caregivers. Analysis into the risk factors for depression among caregivers is vital in providing effective therapeutic options for the caregiver.