“The Future
of Longitudinal Studies:
What we know; What we don’t know; What we need to
know”
The Reciprocal
Relation Between Studies Of Health/Normality And Illness/Psychopathology
Chaired by Stephen Hinshaw, University of California, Berkeley
Friday, March 21, 2003
Carolyn
Pape Cowan
"Preventive Interventions with Non-Clinical Families:
Causality and Risk in Low-Risk Samples"
University of California, Berkeley
This research, conducted by Phil Cowan and Carolyn Pape Cowan, involved
designing, implementing, and evaluating preventive interventions
at times of early family transitions. Two studies were conducted:
in the first, couples were recruited during the transition to parenthood;
in the second, couples were recruited before their first child entered
kindergarten (when the child was four years old). Each sample was
followed for approximately six years. These studies aimed to tease
apart the role of marital and parent-child relationship quality
in children’s adaptation to school, and to learn about problematic
and successful outcomes in a sample of families not already in the
mental health system (e.g., two-parent, “low-risk” families).
Interventions were randomly offered to some couples in the second
study, and consisted of semi-structured couples groups. During an
“open-ended” part of each group, group leaders were
instructed to focus more on marital relationship issues in some
groups and more on parenting issues in other groups. For couples
who received the intervention, both partners showed positive changes
in marital interaction and parenting style (e.g., imparting warmth
and structure while parenting), and these changes were associated
with (mediated) positive effects on children’s academic achievement,
self-descriptions of how they were doing, and teacher-rated internalizing
and externalizing behavior in kindergarten, 1st and 4th grade. Overall,
children of parents in the couples groups did better than children
of parents who were not in the couples groups (with no pre-intervention
differences between the samples, according to initial self-reports).
When couples received the intervention that emphasized parenting
issues, their children reported that they were doing better in school
and with friends, according to their responses to the Berkeley Puppet
Interview, and their teachers’ reports revealed fewer internalizing
behaviors in kindergarten, grade 1, and grade 4 than for children
of parents without the intervention. When couples received the intervention
that emphasized the couple relationship, the couple demonstrated
the ability to work out problems with less conflict, according to
both self-report and staff observations, and their children performed
better on academic tests and demonstrated less aggressive, acting
out behavior.
Notably, in the Cowans’ two samples of “normal, low-risk”
families, 50% of couples endorsed significant symptoms of marital
distress; 25% endorsed depressive symptoms above the normal cut-off
scores; 20% reported a family history of alcohol problems; 20% in
the first study were separated or divorced by the time their children
were in kindergarten; and 10% of children in both studies suffered
difficulties by first grade. Taken together, these findings underscore
the importance of preventive interventions, even in families perceived
as at “low risk”.