Grant: Project Grant

Approximately 40% of offspring of a parent with major depression or bipolar disorder will develop mental disorder. High risk offspring also exhibit high rates of anxious symptoms and disruptive behaviors, which often precedes the development of a full-blown mental disorder. These disturbing facts highlight the need for prevention programs that target at-risk children and precede the onset of these disorders. Based on our research on the family environment and stress hormones in the offspring of a parent with bipolar disorder, we have developed the Reducing Unwanted Stress in the Home (RUSH) program with the aim of preventing negative outcomes in at-risk children. The 12-week RUSH program is a skills-based prevention program for families that includes parent and child groups, run in parallel by trained senior graduate students in clinical psychology. The parent protocol focuses on psychoeducation, altering stressful thinking, communication enhancement training, problem-solving skills training, and effective parenting. The child program focuses on psychoeducation, identifying emotions, coping skills, altering stressful thinking, problem solving, and relaxation skills. We propose to conduct a randomized controlled trial of the RUSH program to assess its efficacy in preventing the development of mental disorders, disruptive behaviors, anxiety and depressive symptoms, and maladaptive changes in stress hormones in 160 offspring of parents having major depressive disorder or bipolar disorder, aged six to 11 years. Half of the sample will take part in the RUSH program (n=80) and half of the sample (n= 80) will be assigned to a psychoeducation control condition, which includes three sessions involving lectures on depression, parenting, and stress. Because depression in parents is highly prevalent relative to other mental health disorders, there is a substantive public health benefit of testing the efficacy of the RUSH prevention program in this population.