title: Parent-child interaction therapy emotion development: a novel treatment for depression in preschool children.
abstract: BACKGROUND
  Psychotherapies with known efficacy in adolescent depression have been adapted for prepubertal children; however, none have been empirically validated for use with depressed very young children. Due to the centrality of the parent-child relationship to the emotional well being of the young child, with caregiver support shown to mediate the risk for depression severity, we created an Emotional Development (ED) module to address emotion development impairments identified in preschool onset depression. The new module was integrated with an established intervention for preschool disruptive disorders, Parent Child Interaction Therapy (PCIT). Preliminary findings of an open trial of this novel intervention, PCIT-ED, with depressed preschool children are reported.
  
  
  METHODS
  PCIT was adapted for the treatment of preschool depression by incorporating a novel emotional development module, focused on teaching the parent to facilitate the child's emotional development and enhance emotion regulation. Eight parent-child dyads with depressed preschoolers participated in 14 sessions of the treatment. Depression severity, internalizing and externalizing symptoms, functional impairment, and emotion recognition/discrimination were measured pre- and posttreatment.
  
  
  RESULTS
  Depression severity scores significantly decreased with a large effect size (1.28). Internalizing and externalizing symptoms as well as functional impairment were also significantly decreased pre- to posttreatment.
  
  
  CONCLUSIONS
  PCIT-ED seems to be a promising treatment for preschoolers with depression, and the large effect sizes observed in this open trial suggest early intervention may provide a window of opportunity for more effective treatment. A randomized controlled trial of PCIT-ED in preschool depression is currently underway.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
authors.forename: Shannon N
authors.initials: SN
authors.lastname: Lenze
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pautsch
authors.forename: Joan
authors.initials: J
authors.lastname: Luby
mesh_terms: D057189:Checklist; D002675:Child, Preschool; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D004493:Education / Q000379:methods*; D056348:Emotional Intelligence; D004644:Emotions; D005196:Family Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D010287:Parent-Child Relations; D010552:Personality Assessment; D010553:Personality Development; D010865:Pilot Projects; D016896:Treatment Outcome