Parenting Enhancement, Interpersonal Psychotherapy to Reduce Depression in Low-Income Mothers of Infants and Toddlers: A Randomized Trial
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BACKGROUND: Depressive symptoms and clinical depression are highly prevalent in low-income mothers and negatively affect their infants and toddlers. OBJECTIVES: The aim of this study was to test interpersonal psychotherapy combined with parenting enhancement on depressive symptoms and parenting behavior, compared with an equal attention-control condition. METHODS: Mothers (n = 226) of Early Head Start infants and toddlers from the southeastern and northeastern United States were randomized to the intervention delivered in-home by psychiatric mental health advanced practice nurses or an equal attention-control condition delivered by generalist nurses. Rigorous clinical depressive symptom and depression assessments and videotaped, coded mother-child interactions were used as baseline and 14-, 22-, and 26-week postintervention measures. RESULTS: Both the intervention and control groups had significantly reduced Hamilton Rating Scale for Depression scores at each subsequent time point compared with baseline (p < .0001). However, only mothers receiving the intervention showed a significant increase in positive involvement with their child, as measured by closeness, positive effect, affection, and warm touch at T4 (t = 2.22, df = 156, p < .03). DISCUSSION: Both intervention and control conditions resulted in symptom reduction, but only the intervention mothers showed significant interaction changes with their child, an essential step in reducing the negative child outcomes associated with maternal depressive symptoms. Results suggest that a combination of generalist and specialist nurses could be used to treat depressive symptoms in these mothers. Further study with longer postintervention observation is needed to see if, over time, the intervention led to longer-lasting symptom reduction.
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Several other well-designed randomized controlled trials of psychologically-based postpartum depression prevention and treatment interventions have similarly reported lack of a significant difference between intervention and control groups on depression and related outcomes.
“It is interesting to note that several other well-designed randomized controlled trials of psychologically-based PPD prevention and treatment interventions have similarly reported lack of a significant difference between intervention and control groups on depression and related outcomes (Austin et al. 2008; Beeber et al. 2013; Cooper et al. 2003; Dugravier et al. 2013; Horowitz et al. 2013; Murray”
From Perinatal Dyadic Psychotherapy for postpartum depression: a randomized controlled pilot trial (2015) · cites this paper as Beeber et al. 2013
The Results (page unavailable) explicitly report no statistically significant between-group difference in depressive-symptom reduction at 14, 22, or 26 weeks. The claim is too broad about related outcomes: the Results also report a significant improvement in maternal positive involvement with the child for the intervention group. The study included mothers of infants and toddlers, with depression extending beyond the postpartum period (Discussion; page unavailable). (LLM, conf=0.88)
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- Authors
- Beeber, L. S., Schwartz, T. A., Holditch-Davis, D., Canuso, R., Lewis, V., & Hall, H. W.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Nursing Research
- Published
- 2013-03
- Volume
- 62
- Issue
- 2
- Pages
- 82-90
- ISSN
- 0029-6562 (ISSN-L)
- PMC
- PMC4235749
- OpenAlex
- W2069904385
- Cited by
- 62
- References
- 31
- Citations by year
- 2025: 6 · 2024: 6 · 2023: 5 · 2022: 3 · 2021: 7 · 2020: 6 · 2019: 3 · 2018: 5 · 2017: 9 · 2016: 1 · 2015: 6 · 2014: 4 · 2013: 1
- FWCI
- 4.08
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Nursing Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH065524)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- maternal depression, interpersonal psychotherapy, low-income mothers, Early Head Start, mother-infant interaction, nurse-led intervention, depressive symptoms, toddlers
- MeSH terms
- Adult, Child, Preschool, Depression, Female, Humans, Infant, Interpersonal Relations, Male, Mothers, New England, Poverty, Psychotherapy, Southeastern United States, Parenting, Treatment Outcome, Young Adult
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