Interventions for Depressed Low Income Mothers and Their Infants

• Maternal depression [ Time Frame: Measured when the child is 12, 16, 24, 36, and 48 months of age ] [ Designated as safety issue: No ]
• Child development [ Time Frame: Measured when the child is 12, 16, 24, 36, and 48 months of age ] [ Designated as safety issue: No ]
• Infant-parent attachment [ Time Frame: Measured when the child is 12, 16, 24, 36, and 48 months of age ] [ Designated as safety issue: No ]

• Maternal depression
• Child development
• Infant-parent attachment

This study will compare three interventions for depressed, low income mothers and determine which is most effective in treating maternal depression and in fostering development in infants.

Poorly educated, low income mothers are at high risk for becoming depressed. The effects of living in poverty and being reared by a depressed parent can be detrimental to an infant's development. Effective interventions to reduce maternal depression and strengthen the mother-infant relationships are needed.

Participants will be randomly assigned to one of three groups. Group 1 mothers will receive 16 weekly sessions of interpersonal psychotherapy (IP) designed to directly treat maternal depression. Group 1 participants will have monthly follow-up visits for 1 year. Participants in Group 2 will receive 16 weekly sessions of IP followed by 1 year of in-home, infant-parent psychotherapy, an intervention addressing relationship difficulties between depressed mothers and their infants. Group 3 mothers will be invited to attend informational meetings as well as be referred to local services available to people with depression.

All mother-child pairs will be evaluated when the child is 12, 16, 24, 36, and 48 months of age. Evaluations will involve questionnaires, diagnostic interviews, developmental assessments, and video- and audio-taped measures.

• Behavioral: Maternal interpersonal psychotherapy (IP)
  Participants will receive 16 weekly sessions of maternal IP designed to directly treat maternal depression.
• Behavioral: Infant-parent psychotherapy
  Participants will receive 1 year of in-home, infant-parent psychotherapy, an intervention addressing relationship difficulties between depressed mothers and their infants.
• Behavioral: Informational meetings plus treatment as usual
  Participants will be invited to attend informational meetings as well as be referred to local services available to people with depression.

• Experimental: 1
  Participants will receive interpersonal psychotherapy for depression.
  Intervention: Behavioral: Maternal interpersonal psychotherapy (IP)
• Experimental: 2
  Participants will receive interpersonal psychotherapy for depression plus 1 year of in-home, infant-parent psychotherapy.
  Interventions:

  • Behavioral: Maternal interpersonal psychotherapy (IP)
  • Behavioral: Infant-parent psychotherapy
• Active Comparator: 3
  Participants will be invited to attend informational meetings as well as be referred to local services available to people with depression.
  Intervention: Behavioral: Informational meetings plus treatment as usual

Inclusion Criteria for Mothers:

• Current diagnosis of depression
• Mother of an infant 9 to 11 months of age
• Low income, defined as less than $25,000 for a family of two or less than $31,400 for a family of three (add approximately $7,960 for each additional family member)

Exclusion Criteria for Mothers:

• Current substance abuse
• Severe mental or physical limitations that would interfere with the study