Skip to main content
Top
Published in: BMC Health Services Research 1/2013

Open Access 01-12-2013 | Research article

Parental depression and child conduct problems: evaluation of parental service use and associated costs after attending the Incredible Years Basic Parenting Programme

Authors: Joanna M Charles, Tracey J Bywater, Rhiannon Tudor Edwards, Judy Hutchings, Lu Zou

Published in: BMC Health Services Research | Issue 1/2013

Login to get access

Abstract

Background

There is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. Recent U.K. and Ireland trials of the effectiveness and cost-effectiveness of IY parenting programmes have assessed children’s health and social care service use, but little is known about the programme’s impact on parental service use. This paper explores whether an above clinical cut-off score on the Beck Depression Inventory II (BDI II) is associated with high or low parental health and social care service use in high-risk families receiving the IY Basic Programme.

Methods

This is a secondary analysis of a subsample (N = 119) from the first U.K. community-based randomised controlled trial of the 12-week IY Basic Programme (N = 153). Parents with children at risk of developing conduct disorder were randomised to receive the programme or to a waiting-list control group. BDI II total and BDI II clinical depression cut-off scores were compared to frequencies and costs of parents’ service use, at baseline, six, twelve and eighteen months post-baseline for the intervention group and at baseline and six months post-baseline for the control group.

Results

Intervention group parents who scored above the clinical cut-off on the BDI II at baseline used more health and social care services than those who scored below at baseline, six and eighteen months. Significant reductions in service use frequencies were found for the intervention group only.

Conclusion

Parents with higher levels or depression used more health and social care service and parenting programmes have been shown to reduce parental depression and also health and social service use. However, further exploration of depressed parents’ service use and the cost implications for publically funded health and social care services is needed.

Trial registration

Registration of the original RCT of the IY Basic Parenting Programme - Current Controlled Trials ISRCTN46984318
Appendix
Available only for authorised users
Literature
1.
go back to reference American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IVTR). 2000, Washington, DC, USA: American Psychiatric AssociationCrossRef American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IVTR). 2000, Washington, DC, USA: American Psychiatric AssociationCrossRef
4.
go back to reference Alpern L, Lyons-Ruth K: Preschool children at social risk: chronicity and timing of maternal depressive symptoms and child behaviour problems at school and at home. Dev Psychopathol. 1993, 5: 371-387. 10.1017/S0954579400004478.CrossRef Alpern L, Lyons-Ruth K: Preschool children at social risk: chronicity and timing of maternal depressive symptoms and child behaviour problems at school and at home. Dev Psychopathol. 1993, 5: 371-387. 10.1017/S0954579400004478.CrossRef
5.
go back to reference Hutchings J, Appleton P, Smith M, Lane E, Nash S: Evaluation of two treatments for children with severe behaviour problems: child behaviour and maternal mental health outcomes. Behav Cogn Psychother. 2002, 30: 279-295.CrossRef Hutchings J, Appleton P, Smith M, Lane E, Nash S: Evaluation of two treatments for children with severe behaviour problems: child behaviour and maternal mental health outcomes. Behav Cogn Psychother. 2002, 30: 279-295.CrossRef
6.
go back to reference Lahey BB, Piacentini JC, McBurnett K, Stone P, Hartdaghn S, Hynd G: Psychopathology in the parents of children with conduct disorder and hyperactivity. J Am Acad Child Adolesc Psychiatry. 1988, 27: 163-170. 10.1097/00004583-198803000-00005.CrossRefPubMed Lahey BB, Piacentini JC, McBurnett K, Stone P, Hartdaghn S, Hynd G: Psychopathology in the parents of children with conduct disorder and hyperactivity. J Am Acad Child Adolesc Psychiatry. 1988, 27: 163-170. 10.1097/00004583-198803000-00005.CrossRefPubMed
7.
go back to reference Farrington DP: The development of offending and antisocial behaviour from childhood: key findings from the Cambridge Study in Delinquent Development. J Child Psychol Psychiatry. 1995, 36: 929-964. 10.1111/j.1469-7610.1995.tb01342.x.CrossRefPubMed Farrington DP: The development of offending and antisocial behaviour from childhood: key findings from the Cambridge Study in Delinquent Development. J Child Psychol Psychiatry. 1995, 36: 929-964. 10.1111/j.1469-7610.1995.tb01342.x.CrossRefPubMed
8.
go back to reference Attride-Stirling J, Davis H, Day C, Selare I: Someone to talk to who’ll listen: addressing the psychosocial needs of children and families. J Community Appl Soc Psychol. 2001, 11: 179-191. 10.1002/casp.613.CrossRef Attride-Stirling J, Davis H, Day C, Selare I: Someone to talk to who’ll listen: addressing the psychosocial needs of children and families. J Community Appl Soc Psychol. 2001, 11: 179-191. 10.1002/casp.613.CrossRef
10.
go back to reference Hutchings J, Lane E: The role of parenting to the development and prevention of child mental health problems. Curr Opin Psychiatry. 2005, 18: 386-391. 10.1097/01.yco.0000172056.63401.e0.CrossRefPubMed Hutchings J, Lane E: The role of parenting to the development and prevention of child mental health problems. Curr Opin Psychiatry. 2005, 18: 386-391. 10.1097/01.yco.0000172056.63401.e0.CrossRefPubMed
11.
go back to reference Mihalic S: The importance of implementation fidelity. Rep Emot Behav Disord Youth. 2004, 4: 83-105. Mihalic S: The importance of implementation fidelity. Rep Emot Behav Disord Youth. 2004, 4: 83-105.
12.
go back to reference Hutchings J, Bywater T, Daley D, Gardner F, Whitaker C, Jones K, Eames C, Edwards RT: Parenting intervention in sure start services for children at risk of developing conduct disorder: pragmatic randomised controlled trial. BMJ. 2007, 334: 678-681. 10.1136/bmj.39126.620799.55.CrossRefPubMedPubMedCentral Hutchings J, Bywater T, Daley D, Gardner F, Whitaker C, Jones K, Eames C, Edwards RT: Parenting intervention in sure start services for children at risk of developing conduct disorder: pragmatic randomised controlled trial. BMJ. 2007, 334: 678-681. 10.1136/bmj.39126.620799.55.CrossRefPubMedPubMedCentral
13.
go back to reference Webster-Stratton C, Hancock L: Parent training for young children with conduct problems. Content, methods and therapeutic process. Handbook of parent training. Edited by: Schaefer CE. 1998, New York: Wiley, 98-152. Webster-Stratton C, Hancock L: Parent training for young children with conduct problems. Content, methods and therapeutic process. Handbook of parent training. Edited by: Schaefer CE. 1998, New York: Wiley, 98-152.
14.
go back to reference Barlow J, Coren E, Stewart-Brown S: Parent-training programmes for improving maternal psychosocial health. Cochrane Database Syst Rev. 2003, CD002020-DOI: 10.1002/14651858.CD002020.pub2, 4 Barlow J, Coren E, Stewart-Brown S: Parent-training programmes for improving maternal psychosocial health. Cochrane Database Syst Rev. 2003, CD002020-DOI: 10.1002/14651858.CD002020.pub2, 4
15.
go back to reference DeGarmo DS, Patterson GR, Forgatch MS: How do outcomes in a specified parent training intervention maintain or wane over time?. Prev Sci. 2004, 5: 73-89.CrossRefPubMed DeGarmo DS, Patterson GR, Forgatch MS: How do outcomes in a specified parent training intervention maintain or wane over time?. Prev Sci. 2004, 5: 73-89.CrossRefPubMed
16.
go back to reference Sheeber LB, Johnson JH: Evaluation of a temperament-focused, parent-training programme. J Clin Child Psychol. 1994, 23: 249-259. 10.1207/s15374424jccp2303_3.CrossRef Sheeber LB, Johnson JH: Evaluation of a temperament-focused, parent-training programme. J Clin Child Psychol. 1994, 23: 249-259. 10.1207/s15374424jccp2303_3.CrossRef
17.
go back to reference Scott MJ, Stradling SG: Evaluation of a group programme for parents of problem children. Behav Psychother. 1987, 15: 224-239. 10.1017/S0141347300012313.CrossRef Scott MJ, Stradling SG: Evaluation of a group programme for parents of problem children. Behav Psychother. 1987, 15: 224-239. 10.1017/S0141347300012313.CrossRef
18.
go back to reference Taylor TK, Schmidt F, Pepler D, Hodgins CA: A comparison of eclectic treatment with Webster-Stratton’s parents and children series in a children’s mental health center: a randomised controlled trial. Behav Ther. 1998, 29: 221-240. 10.1016/S0005-7894(98)80004-X.CrossRef Taylor TK, Schmidt F, Pepler D, Hodgins CA: A comparison of eclectic treatment with Webster-Stratton’s parents and children series in a children’s mental health center: a randomised controlled trial. Behav Ther. 1998, 29: 221-240. 10.1016/S0005-7894(98)80004-X.CrossRef
19.
go back to reference Bywater T, Hutchings J, Daley D, Whitaker C, Yeo ST, Jones K, Eames C, Tudor Edwards R: Long-term effectiveness of a parenting intervention in Sure Start services in Wales for children at risk of developing conduct disorder. Br J Psychiatry. 2009, 195: 318-324. 10.1192/bjp.bp.108.056531.CrossRefPubMed Bywater T, Hutchings J, Daley D, Whitaker C, Yeo ST, Jones K, Eames C, Tudor Edwards R: Long-term effectiveness of a parenting intervention in Sure Start services in Wales for children at risk of developing conduct disorder. Br J Psychiatry. 2009, 195: 318-324. 10.1192/bjp.bp.108.056531.CrossRefPubMed
20.
go back to reference Bywater T, Hutchings J, Linck P, Whitaker C, Daley D, Yeo ST, Edwards RT: Incredible Years parent training support for foster carers in Wales: a multi-center feasibility study. Child Care Health Dev. 2010, 37: 233-243.CrossRefPubMed Bywater T, Hutchings J, Linck P, Whitaker C, Daley D, Yeo ST, Edwards RT: Incredible Years parent training support for foster carers in Wales: a multi-center feasibility study. Child Care Health Dev. 2010, 37: 233-243.CrossRefPubMed
21.
go back to reference O’Neill D, McGilloway S, Donnelly M, Bywater T, Kelly P: A cost-effectiveness analysis of the Incredible Years parenting programme in reducing childhood health inequalities. Eur J Health Econ. 2013, 14: 85-94. 10.1007/s10198-011-0342-y.CrossRefPubMed O’Neill D, McGilloway S, Donnelly M, Bywater T, Kelly P: A cost-effectiveness analysis of the Incredible Years parenting programme in reducing childhood health inequalities. Eur J Health Econ. 2013, 14: 85-94. 10.1007/s10198-011-0342-y.CrossRefPubMed
22.
go back to reference Furlong M, McGilloway S, Bywater T, Hutchings J, Smith SM, Donnelly M: Behavioural and cognitive-behavioural group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years (Review). Cochrane Database Syst Rev. 2012, CD008225-DOI: 10.1002/14651858.CD008225.pub2, 2 Furlong M, McGilloway S, Bywater T, Hutchings J, Smith SM, Donnelly M: Behavioural and cognitive-behavioural group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years (Review). Cochrane Database Syst Rev. 2012, CD008225-DOI: 10.1002/14651858.CD008225.pub2, 2
23.
go back to reference Hutchings J, Bywater T, Williams ME, Lane E, Whitaker C: Improvements in parental depression as a mediator of child behaviour change. Psychology. 2012, 3: 795-801. 10.4236/psych.2012.329120.CrossRef Hutchings J, Bywater T, Williams ME, Lane E, Whitaker C: Improvements in parental depression as a mediator of child behaviour change. Psychology. 2012, 3: 795-801. 10.4236/psych.2012.329120.CrossRef
24.
go back to reference Beck AT, Steer RA, Brown GK: Manual for the Beck Depression Inventory-II. 1996, San Antonio, Texas: Psychological Corporation Beck AT, Steer RA, Brown GK: Manual for the Beck Depression Inventory-II. 1996, San Antonio, Texas: Psychological Corporation
25.
go back to reference Gardner F, Bywater JT, Hutchings T, Whitaker C: Who benefits and how does it work? Moderators and mediators of outcomes in a randomised trial of parenting interventions in multiple ‘Sure Start’ services. J Clin Child Psychol. 2010, 39: 568-580. 10.1080/15374416.2010.486315.CrossRef Gardner F, Bywater JT, Hutchings T, Whitaker C: Who benefits and how does it work? Moderators and mediators of outcomes in a randomised trial of parenting interventions in multiple ‘Sure Start’ services. J Clin Child Psychol. 2010, 39: 568-580. 10.1080/15374416.2010.486315.CrossRef
26.
go back to reference Griest DL, Forehand R, Wells KC: Follow-up assessment of parent behavioural training: an analysis of who will participate. Child Study Journal. 1981, 11: 221-229. Griest DL, Forehand R, Wells KC: Follow-up assessment of parent behavioural training: an analysis of who will participate. Child Study Journal. 1981, 11: 221-229.
27.
go back to reference Webster-Stratton C, Hammond M: Predictors of treatment outcome in parent training for families with conduct problem children. Behav Ther. 1990, 21: 319-337. 10.1016/S0005-7894(05)80334-X.CrossRef Webster-Stratton C, Hammond M: Predictors of treatment outcome in parent training for families with conduct problem children. Behav Ther. 1990, 21: 319-337. 10.1016/S0005-7894(05)80334-X.CrossRef
28.
go back to reference Knapp M, Scott S, Davies J: The cost of antisocial behaviour in younger children a pilot study of economics and family impact. J Clin Child Psychol Psychiat. 1999, 4: 457-473. 10.1177/1359104599004004003.CrossRef Knapp M, Scott S, Davies J: The cost of antisocial behaviour in younger children a pilot study of economics and family impact. J Clin Child Psychol Psychiat. 1999, 4: 457-473. 10.1177/1359104599004004003.CrossRef
29.
go back to reference Romeo R, Knapp M, Scott S: Economic cost of severe anti-social behaviour in children - and who pays it. Br J Psychiatry. 2006, 188: 547-553. 10.1192/bjp.bp.104.007625.CrossRefPubMed Romeo R, Knapp M, Scott S: Economic cost of severe anti-social behaviour in children - and who pays it. Br J Psychiatry. 2006, 188: 547-553. 10.1192/bjp.bp.104.007625.CrossRefPubMed
30.
go back to reference Edwards RT, Ó Céilleachair AJ, Bywater T, Hutchings J: A parenting programme for children at risk of developing conduct disorder: a cost-effectiveness analysis. BMJ. 2007, 10: 334-682. Edwards RT, Ó Céilleachair AJ, Bywater T, Hutchings J: A parenting programme for children at risk of developing conduct disorder: a cost-effectiveness analysis. BMJ. 2007, 10: 334-682.
32.
go back to reference Thomas CM, Morris S: Cost of depression among adults in England in 2000. Br J Psychiatry. 2003, 183: 514-519. 10.1192/bjp.183.6.514.CrossRefPubMed Thomas CM, Morris S: Cost of depression among adults in England in 2000. Br J Psychiatry. 2003, 183: 514-519. 10.1192/bjp.183.6.514.CrossRefPubMed
33.
go back to reference Herrman H, Patrick DL, Diehr P, Martin ML, Fleck M, Simon GE, Buesching DP, and The LIDO Group: Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO study. Functional status, health service use and treatment of people with depressive symptoms. Psychol Med. 2002, 32: 889-902.CrossRefPubMed Herrman H, Patrick DL, Diehr P, Martin ML, Fleck M, Simon GE, Buesching DP, and The LIDO Group: Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO study. Functional status, health service use and treatment of people with depressive symptoms. Psychol Med. 2002, 32: 889-902.CrossRefPubMed
34.
go back to reference Johnson J, Weissman MM, Klerman GL: Service utilization and social morbidity associated with depressive symptoms in the community. JAMA. 1992, 267: 1478-1483. 10.1001/jama.1992.03480110054033.CrossRefPubMed Johnson J, Weissman MM, Klerman GL: Service utilization and social morbidity associated with depressive symptoms in the community. JAMA. 1992, 267: 1478-1483. 10.1001/jama.1992.03480110054033.CrossRefPubMed
35.
go back to reference Eyberg SM: Eyberg child behaviour inventory. J Clin Child Psychol. 1980, 9: 27. Eyberg SM: Eyberg child behaviour inventory. J Clin Child Psychol. 1980, 9: 27.
36.
go back to reference Webster-Stratton C: Randomised trial of two parent-training programmes for families with conduct-disordered children. J Consult Clin Psychol. 1984, 52: 666-678.CrossRefPubMed Webster-Stratton C: Randomised trial of two parent-training programmes for families with conduct-disordered children. J Consult Clin Psychol. 1984, 52: 666-678.CrossRefPubMed
37.
go back to reference Beecham J, Knapp M: Costing psychiatric interventions. Measuring mental health needs. Edited by: Thomicroft G, Brewin C, Wing J. 1992, London: Gaskell, 163-183. 1 Beecham J, Knapp M: Costing psychiatric interventions. Measuring mental health needs. Edited by: Thomicroft G, Brewin C, Wing J. 1992, London: Gaskell, 163-183. 1
38.
go back to reference Hutchings J: The personal and parental characteristics of preschool children referred to a child and family mental health service and their relation to treatment outcome. 1996, Bangor: PhD thesis. University of Wales Hutchings J: The personal and parental characteristics of preschool children referred to a child and family mental health service and their relation to treatment outcome. 1996, Bangor: PhD thesis. University of Wales
39.
go back to reference Curtis L: Unit Costs of Health and Social Care. 2009, Canterbury: Personal Social Services Research Unit, University of Kent Curtis L: Unit Costs of Health and Social Care. 2009, Canterbury: Personal Social Services Research Unit, University of Kent
42.
go back to reference Field AP: Discovering statistics using SPSS. 2009, London: Sage Publications LTD, 3 Field AP: Discovering statistics using SPSS. 2009, London: Sage Publications LTD, 3
43.
go back to reference Weatherly H, Drummond M, Claxton K, Cookson R, Ferguson B, Godfrey C, Rice N, Sculpher M, Sowden A: Methods for assessing the cost-effectiveness of public health interventions: key challenges and recommendations. Health Policy. 2009, 93: 85-92. 10.1016/j.healthpol.2009.07.012.CrossRefPubMed Weatherly H, Drummond M, Claxton K, Cookson R, Ferguson B, Godfrey C, Rice N, Sculpher M, Sowden A: Methods for assessing the cost-effectiveness of public health interventions: key challenges and recommendations. Health Policy. 2009, 93: 85-92. 10.1016/j.healthpol.2009.07.012.CrossRefPubMed
44.
go back to reference Hutchings J, Lane E, Kelly J: Comparison of two treatments of children with severely disruptive behaviours: a four year follow up. Behav Cogn Psychother. 2004, 32: 15-30. 10.1017/S1352465804001018.CrossRef Hutchings J, Lane E, Kelly J: Comparison of two treatments of children with severely disruptive behaviours: a four year follow up. Behav Cogn Psychother. 2004, 32: 15-30. 10.1017/S1352465804001018.CrossRef
Metadata
Title
Parental depression and child conduct problems: evaluation of parental service use and associated costs after attending the Incredible Years Basic Parenting Programme
Authors
Joanna M Charles
Tracey J Bywater
Rhiannon Tudor Edwards
Judy Hutchings
Lu Zou
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2013
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-13-523

Other articles of this Issue 1/2013

BMC Health Services Research 1/2013 Go to the issue