The ultimate goal of this program of research is to decrease the incidence of clinical depression in high risk individuals through prevention intervention. Low-income, single mothers are at high risk for depression which may have negative effects on their children.
The specific aim of this randomized controlled prevention trial is to test the effects of a cognitive-behavioral intervention designed to reduce negative thoughts, chronic stress, and depressive symptoms and increase self-esteem of low income single mothers experiencing subclinical depressive symptoms. In addition, the effects of the intervention on mothers' reports of behavioral problems of their 2- to 6-year old children will be tested. While cognitive-behavioral interventions with depressed individuals have been used extensively, the effects of affirmations and thought stopping techniques in reducing the risk of depression have not been tested empirically. A sample of 550 single mothers at least 18 years of age will be recruited for the cross-sectional phase of this study. Inclusion and exclusion criteria are: (1) no prior treatment for psychiatric care; (2) not now or ever on antidepressants; (3) never diagnosed with clinical depression; (4) not suicidal; (5) never married, separated at least 6 months, or divorced; (6) at least one child 2 to 6 years of age living with the mother; (7) no child under the age of 2; (8) not pregnant by self-report; (9) not currently in counseling; (10) at or below 185% of Federal poverty level guidelines by family size. Baseline data on depressive symptoms, negative thoughts, self-esteem, chronic stressors, and mothers' report of child behavior will be collected from all women. Recruitment will continue until 160 women with a Beck Depression Inventory score between 9 and 35 and/or a Center for Epidemiologic Studies--Depression Scale score between 16 and 40 are identified and agree to participate in the clinical trial. As women are recruited for the intervention phase, each will be randomly assigned to the control or experimental condition. The intervention consists of six one-hour per week group sessions that target identification and management of negative thinking as it effects depressive symptoms. Though stopping and the use of affirmations (positive self-talk) are the primary techniques that are taught. Experimental and control subjects will be re-interviewed at one-month, six-months and twelve-month post-intervention to assess their negative thinking, depressive symptoms, self-esteem, and chronic stressors and to obtain reports of their children's behavior.
