Effectiveness of Preventive Family Intervention in Improving Cognitive Attributions Among Children of Depressed Parents: a Randomized Study

Our randomized trial examined the effectiveness of preventive interventions in increasing positive cognitive attributions and reducing negative cognitive attributions in children of depressed parents. In addition, it tested the role of attribution changes in mediating the intervention effects on children's depressive and emotional symptoms. The participants were 109 Finnish families with at least one parent in treatment for affective disorder, for a total of 145 children, 8-16 years of age. Families were randomized into two groups: the "family talk intervention" (FTI, a whole-family approach enhancing communication and child resilience, Beardslee et al., 1997) group, and an active control, the "let's talk about the children" (LTC, a parent-only psycho-educational approach, Solantaus, Paavonen, Toikka, & Punamäki, 2010) group. Children reported their cognitive attributions (CASQ-R, Children's Attributional Style Questionnaire-Revised (Thompson, Kaslow, Weiss, & Nolen-Hoeksema, 1998)), depressive (CDI/BDI, Child Depression Inventory (Kovacs, 1981)/Beck Depression Inventory (Beck, Steer, & Garbin, 1988)) and emotional (SDQ, Strengths and Difficulties Questionnaire (Goodman, 1997)) symptoms, and mothers reported their children's emotional symptoms (SDQ at baseline (T1) and 10-month (T2) and 18-month (T3)) follow-ups. Contrary to our hypothesis, no beneficial attribution changes were found in the FTI group across the follow-ups. Instead, positive cognitive appraisals increased in the LTC group, especially from T2 to T3. The increase of positive attribution further served as a mediator for changes in children's emotional and depressive symptoms. The findings suggest that a short preventive intervention can enhance beneficial cognitive processes in high-risk families in routine adult psychiatric care.