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Children of Mentally III Parents at Risk Evaluation (COMPARE): Design and Methods of a Randomized Controlled
Hanna Christiansen1, Corinna Reck2, Anna-Lena Zietlow3
1Department of Clinical Child and Adolescent Psychology, Faculty of Psychology, Philipps University Marburg, Marburg, Germany.
Insights
This study evaluates interventions to prevent mental illness transmission from parents to children. It aims to reduce intergenerational mental health risks in children of mentally ill parents (COPMI) through a randomized controlled trial.
Area of Science:
- Psychiatry and Mental Health
- Developmental Psychology
- Public Health
Background:
- Mental disorders impose significant disability and economic burdens.
- Children of parents with mental illness (COPMI) face elevated risks for developing disorders.
- Transgenerational transmission models consider parental, social, and interactional factors.
Purpose of the Study:
- To establish the efficacy and cost-effectiveness of interventions for COPMI.
- To interrupt the intergenerational transmission of mental disorders.
- To test components of the transgenerational transmission model.
Main Methods:
- A randomized controlled trial comparing parental cognitive behavioral therapy (CBT) with CBT plus the Positive Parenting Program.
- Four add-on projects (COMPARE-emotion, -interaction, -work, -school) using behavioral, psychophysiological, and neuro-imaging methods.
- Examination of emotion processing, maternal comorbid diagnoses, work-family strain transmission, and school adjustment in COPMI.
Main Results:
- The study protocol outlines an interdisciplinary approach to test the transgenerational transmission model.
- Specific risk transmission mechanisms are being examined through applied basic and clinical research.
Conclusions:
- The research facilitates understanding and addressing risk transmission in a neglected area.
- Findings aim for promotion, dissemination, and implementation into clinical practice.
Abstract:
Objectives: Mental disorders are frequent, associated with disability-adjusted life years, societal, and economic costs. Children of parents with a mental illness (COPMI) are at an increased risk to develop disorders themselves. The transgenerational transmission of mental disorders has been conceptualized in a model that takes parental and family factors, the social environment (i.e., school, work, and social support), parent-child-interaction and possible child outcomes into account. The goal of the "Children of Mentally Ill Parents At Risk Evaluation" (COMPARE) study will thus be twofold: (1) to establish the efficacy and cost-effectiveness of a high-quality randomized controlled trial (RCT) with the aim of interrupting the intergenerational transmission of mental disorders in COPMI, (2) to test the components of the trans-generational transmission model of mental disorders. Methods: To implement a randomized controlled trial (RCT: comparison of parental cognitive behavioral therapy/CBT with CBT + Positive Parenting Program) that is flanked by four add-on projects that apply behavioral, psychophysiological, and neuro-imaging methods to examine potential moderators and mediators of risk transmission (projects COMPARE-emotion/-interaction/-work/-school). COMPARE-emotion targets emotion processing and regulation and its impact on the transgenerational disorder transmission; COMPARE-interaction focuses especially on the impact of maternal comorbid diagnoses of depression and anxiety disorders and will concentrate on different pathways of the impact of maternal disorders on socio-emotional and cognitive infant development, such as parent-infant interaction and the infant's stress regulation skills. COMPARE-work analyzes the transmission of strains a person experiences in one area of life to another (i.e., from family to work; spill-over), and how stress and strain are transmitted between individuals (i.e., from parent to child; cross-over). COMPARE-school focuses on the psychosocial adjustment, school performance, and subjective well-being in COPMI compared to an adequate control group of healthy children. Results: This study protocol reports on the interdisciplinary approach of COMPARE testing the model of the transgenerational transmission of mental disorders. Conclusion: The combination of applied basic with clinical research will facilitate the examination of specific risk transmission mechanisms, promotion, dissemination and implementation of results into a highly important but largely neglected field. Clinical Trial Registration: DRKS-ID: DRKS00013516 (German Clinical Trials Register, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00013516).
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