Parent Child Interaction Therapy and Young Children Clinically Depressed
We've probably all come across them at some point. The little boy or girl who doesn't seem to interact well or enjoy the games others are playing. Maybe their appetite isn't all it might be and perhaps they're a bit quieter than the kids around them. According to Joan Luby, a Professor of Psychiatry in the Early Emotional Development Program at the Washington University School of Medicine, these may be symptoms of preschool depression.
Depression in children is a well established if still somewhat controversial concept. However, is the notion of a 3-year-old suffering with clinical depression convincing? If it is, what are we meant to do about it?
According to Luby the fact that depression is a brain disorder means it isn't restricted to older children and adults. Her view is that while preschool depression isn't common it exists in up to 2 percent of the population in that age range. Luby says a lack of disruptive behavior may also be a sign and that "good" children may actually be depressed.
If you feel your pre-school child exhibits a general "lack of joy" and even if the symptoms are not consistent, it may be time to visit the pediatrician Luby argues. The reason for this, she states, is that early depression may indicate a higher risk for depression in later life. But what is the pediatrician supposed to do? Put your 3-year-old on antidepressant medication? Will they even recognize the concept of clinical depression in a child so young?
It's fortunate, I believe, that Luby supports the principle of never giving medication to preschoolers. Her current view is that psychotherapy in the form of Parent Child Interaction Therapy (PCIT) is the best option, although as a new therapy it is still being evaluated. Luby hopes that the tender young brain and its capacity to adapt to new and novel situations would embrace early changes in emotion skills necessary for a more adaptive way of coping.
I'm truly not sure what to think about this. When I searched for reactions and responses to the claim I did find myself nodding with John Grohol's assessment on his PsychCentral blog. Grohol isn't convinced. As he says, "we only have a handful of studies that have examined this issue in any significant manner. There are simply too few studies to justify dropping major clinical depression into the laps of a 3-year-old."
However, it's only fair to point out that Professor Luby has support. For example Professor of Nursing Bernadette Melnk at Arizona State University, Phoenix, says more parents should be aware of early onset mood disorders in children. Typically, the behavior of a depressed child is restlessness, hyperactivity and irritability. Such behavior can easily lead to a misdiagnosis of ADHD.
The can of worms is open. Share your thoughts with us.
Luby et al. Preschool Depression: The Importance and Identification of Depression Early in Development. Current Directions in Psychological Science, 2010; 19 (2): 91.
Grohol. J.M (2010) Preschool Depression: Real or Imagined? PsychCentral.com. http://psychcentral.com/blog/archives/2010/05/22/preschool-depression-real-or-imagined/