Abstract

Since children with a parent suffering from depression are at heightened risk of developing psychiatric disorders themselves, they are a target group for preventive interventions and as such a major public health priority. The cognitive-behavioural, family-, and group-based prevention program “Raising Healthy Children” (RHC) has shown promising findings in reducing the prevalence of depression and general psychopathology in a sample of children of depressed parents in the United States of America. The overarching aim of the current thesis is the evaluation of a German adaption of RHC prevention program. The current study is in this form unique, because the program was not evaluated yet outside the research group on an international level. In the first step I investigated whether the psychopathology of children of depressed parents is associated with parental depression (number of symptoms, number of depressive episodes), number of stressful experiences the child experienced and the parental socio-economic status (SES). For baseline differences, data of 77 families (who took part in an intervention study) were available, which were included in the analyses. There was no evidence that children of depressed parents differ at baseline in depressive symptoms in relation to parent depression severity, number of depressive episodes, the number of stressful experiences or the SES. But evidence emerged that offspring’s externalising problem behaviour is related to the number of parental depressive episodes, and offspring’s general psychopathology is related to the number of stressful life events. No relation between SES and offspring’s mental health could be demonstrated. In a second step, I examined whether the prevention program is effective in reducing child’s depression in the short-term (six months after baseline). By investigating preliminary data on incidence of depression at 15 months after baseline, I also investigated the extent to which the intervention prevented depression in the long-term. Further key aims were to see whether the program is effective in reducing child’s general psychopathology, and whether the program is effective in enhancing child’s knowledge of depression as well as whether it is effective in changing the parenting style in a positive direction in the short- and medium-term (six and nine months after baseline). The study was conducted as randomised controlled trial. The 77 families were randomised to receive the twelve session intervention vs. waiting list. Intervention outcomes suggested that the program has positive effects from child’s perspective on child’s internalising and mixed psychopathological symptoms. However, the parental view did not confirm these findings. Parent reports indicate that independent of group (intervention vs. waiting list) both symptom scales improved over a period of nine months. No evidence was found that the program shows benefits on child’s depression, knowledge of depression or child’s perception of parenting style. The knowledge of depression rather enhanced in short-term independent of participation. A feedback evaluation suggested that the general acceptability of the prevention program is high. The baseline findings indicate that the psychopathology of children of depressed parents is influenced by some, but not all, parental factors. Although I could not demonstrate the prevention effect of the program for depression prevention, I could show that some general psychopathological symptoms of children can be reduced by the program. The study provides an important step in the development of more effective prevention, which is exigently required.