Effects of Familias Unidas in Preventing Adolescent Internalizing Symptoms

Introduction: Previous studies have documented the efficacy of the Familias Unidas preventive intervention in reducing adolescent substance use and sexual risk behavior, but its effects on internalizing symptoms (e.g., depressive and anxiety symptoms) have not been fully examined. While this intervention was not designed to specifically address youth internalizing symptoms, it did target parenting and family factors that may are also related to the development of youth internalizing symptoms. This study examines the efficacy of Familias Unidas in preventing internalizing symptoms in a high-risk sample of Hispanic adolescents, as well as possible moderators of intervention effects including gender, acculturation, parent-youth communication, and parental alcohol use.

Methods: 242 Hispanic youth with a history of delinquency and their primary caregivers were recruited from both the school system and juvenile justice system. Participants, 12-17 years old and 33% female, were randomized into either the Familias Unidas intervention or a Community Practice control condition. The outcome variable was parent reports of adolescent internalizing symptoms, specifically anxiety and withdrawal symptoms, assessed at baseline and then at 6 and 12 months post-baseline. A linear latent growth model was used to examine intervention effects on the trajectory of adolescent internalizing symptoms.

Results: Although the proportion of internalizing symptoms decreased in both intervention and control groups over time, there was a significant intervention effect on internalizing symptoms. That is, Familias Unidas was efficacious in reducing adolescent internalizing symptoms. Baseline family communication and parental alcohol misuse also moderated the intervention’s effects on youth internalizing symptoms. Specifically, youth with initially lower levels of communication benefited more from the intervention than those with higher levels. Youth whose parents reported recent alcohol misuse benefited less from the intervention than those whose parents had not misused alcohol.

Conclusions: Findings suggest that improving parenting and family functioning has an impact on multiple adolescent health outcomes, including youth internalizing symptoms.  Implications of these findings for preventive interventions will be addressed.