Effectiveness of a Family-Centered Emotion-Regulation Intervention on Major Depressive Disorder Symptoms, Non-Suicidal Self-Injury, and Parent–Adolescent Conflict in Adolescents With MDD

Objective: This study evaluated the effectiveness of a family-centered emotion-regulation intervention on depressive symptoms, NSSI, and parent–adolescent conflict among adolescents with MDD.

Methods and Materials: In this randomized controlled trial, 80 adolescents aged 13–17 years with MDD and recent NSSI were recruited from the Child and Adolescent Psychiatry Outpatient Clinic of Roozbeh Hospital, Tehran, Iran, in 2026. Participants were randomly assigned to family-centered emotion-regulation intervention plus treatment as usual (n = 40) or treatment as usual alone (n = 40). The intervention consisted of 10 weekly 120-minute sessions involving adolescents and caregivers. Outcomes were assessed at baseline, post-treatment, and 3-month follow-up using the Children’s Depression Inventory, 30-day NSSI frequency, Revised Parent–Adolescent Conflict Issues Checklist, and Difficulties in Emotion Regulation Scale-16. Mixed-effects models and negative binomial regression were applied.

Findings: Significant group × time effects favored the intervention for depressive symptoms, parent–adolescent conflict, and emotion-regulation difficulties (all adjusted p < .001). At post-treatment, large between-group effects were observed for depression (d = −1.03) and parent–adolescent conflict (d = −0.95). NSSI frequency was 54% lower in the intervention group than in controls (IRR = 0.46, 95% CI [0.31, 0.68]). Improvements remained significant at 3-month follow-up. Emotion-regulation difficulties also showed a large reduction (d = −1.19).

Conclusion: Family-centered emotion-regulation intervention may provide substantial and sustained benefits for adolescents with MDD and NSSI by reducing depressive symptoms, self-injury, and family conflict while improving emotion regulation.