Tuesday, February 13, 2024

Preventive Intervention for Youth Shows Intergenerational Effects

At-risk youth whose parents were enrolled in a behavioral intervention as children use fewer inpatient and outpatient mental health services than their peers, according to a report in AJP in Advance. The intervention, known as Fast Track, combines cognitive and social skills training for children and child behavior management training for parents.

“Preventive interventions like Fast Track delivered in one generation may reduce use of some of the highest-demand and most expensive health services for children in the next generation,” wrote W. Andrew Rothenberg, Ph.D., of Duke University and colleagues. “Potential mechanisms that might explain these reductions include a decreased risk for internalizing psychopathology and decreased use of corporal punishment to create a more optimal family environment for the next generation.”

The initial Fast Track cohort included 891 children in grades 1 through 5 and families recruited from elementary schools in areas of high crime and poverty in the early 1990s. Half of the children were provided the Fast Track intervention, and the other half were in the control group. Participants in both groups were subsequently interviewed at age 25, which included assessments of internalizing and externalizing problems and whether the participants, if parents, spanked their children. The participants with children were contacted again at age 34 and asked to complete a survey about their children’s mental health and health service use.

In total, 398 parents filled out these surveys at age 34; 209 of the parents were in the Fast Track group and filled out measures for a combined 581 children. The remaining 189 parents were in the control group and filled out these measures for a combined 476 children.

Rothenberg and colleagues found that compared with the children whose parents were in the control group, those whose parents were in Fast Track were 3.29 times less likely to have used inpatient mental health services, 1.85 times less likely to have used outpatient mental health services, and 1.38 times less likely to have used general inpatient health services. However, there were no differences between the groups in the use of general outpatient services, school-based services, and overall mental health symptoms.

“[A]lthough there were no significant differences between the intervention and control groups on … mental health scores, both groups appear to be functioning as well as or better than children from a ‘normative’ population whose parents were not at high risk for conduct problems,” the authors wrote.

For related information, see the Psychiatric News article “Group School Intervention Helps Girls Cope With Internalized Trauma.”

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