Examining reward-seeking, negative self-beliefs and over-general autobiographical memory as mechanisms of change in classroom prevention programs for adolescent depression

The relationship between mental health and risky decision-making in children and adolescents: a scoping review

BACKGROUND

Evidence from studies on adult participants and clinical samples of children suggest an association between risky decision-making and mental health problems. However, the extent and nature of this association in the general youth population remains unknown. Therefore, this scoping review explores the current evidence on the relationship between mental health (internalising and externalising symptoms) and risky decision-making in the general youth population.

METHODS

A three-step search strategy was followed and applied to four databases. Selection criteria included participants < 18 years representative of the general population, and information on both risky decision-making (assessed using gambling tasks) and internalising /externalising symptoms. Data were extracted and synthesised for study and participant characteristics, aspects and measures for the main variables, and key findings.

RESULTS

Following screening, twenty-one studies were retrieved. Non-significant associations were more frequent than significant associations for both internalising and externalising symptoms, particularly for social difficulties and broad externalising symptoms. Among the significant associations, hyperactivity/inattention and conduct problems appeared to be positively associated with risk-taking and negatively associated with quality of decision-making. However, patterns were less clear for links between risky decision-making and internalising symptoms, especially between risk-taking and anxiety symptoms.

CONCLUSIONS

The present review suggests predominantly a lack of relationship between risky decision-making and mental health problems, and outlines several possible reasons for it. However, when specificity is considered carefully there seems to be a link between risk-taking and specific externalising problems. Future research should employ study designs aimed at disentangling the direction of this relationship and identifying specific aspects of mental health and risky decision-making that could be eventually addressed by tailored interventions.

Moderating Effects of Mindfulness in the Relation between Bullying Victimization and Sleep Disturbance in Chinese Children: Sex Differences

Bullying victimization is associated with sleep disturbance. The present study aimed to investigate the impact of bullying victimization on sleep disturbance, and the moderating effect of mindfulness on this association, also exploring differences across sex. A sample of 420 Chinese children (Mage = 9.60, SD age = 1.11, 48.10% girls) in grade 3 to grade 6 were recruited to complete the revised Bully/Victim Questionnaire, the Chinese version of Pittsburg Sleep Quality Index, the Child and Adolescent Mindfulness Measure, as well as the Family Affluence Scale. Results showed that bullying victimization was positively associated with sleep disturbance (β = 0.20, p < 0.001). And the effect of bullying victimization on sleep disturbance was moderated by mindfulness (β = -0.16, p < 0.001), and the effect was invalid for children with high mindfulness (β = 0.04, p > 0.05). Subgroup analyses indicated the buffering effect of mindfulness only existed among boys (β = -0.19, p < 0.01) but not girls (β = -0.11, p > 0.05), suggesting that mindfulness may buffer this association, mainly for boys.

Universal Mindfulness Training in Schools for Adolescents: a Scoping Review and Conceptual Model of Moderators, Mediators, and Implementation Factors

There is evidence that universal school-based mindfulness training (SBMT) can have positive effects for young people. However, it is unknown who benefits most from such training, how training exerts effects, and how implementation impacts effects. This study aimed to provide an overview of the evidence on the mediators, moderators, and implementation factors of SBMT, and propose a conceptual model that can be used both to summarize the evidence and provide a framework for future research. A scoping review was performed, and six databases and grey literature were searched. Inclusion and exclusion criteria were applied to select relevant material. Quantitative and qualitative information was extracted from eligible articles and reported in accordance with PRISMA-ScR guidelines. The search produced 5479 articles, of which 31 were eligible and included in the review. Eleven studies assessed moderators of SBMT on pupil outcomes, with mixed findings for all variables tested. Five studies examined the mediating effect of specific variables on pupil outcomes, with evidence that increases in mindfulness skills and decreases in cognitive reactivity and self-criticism post-intervention are related to better pupil outcomes at follow-up. Twenty-five studies assessed implementation factors. We discuss key methodological shortcomings of included studies and integrate our findings with existing implementation frameworks to propose a conceptual model. Widespread interest in universal SBMT has led to increased research over recent years, exploring who SBMT works for and how it might work, but the current evidence is limited. We make recommendations for future research and provide a conceptual model to guide theory-led developments.

Targeting image-based autobiographical memory in childhood to prevent emotional disorders: Intervention development and a feasibility randomised controlled trial

Maladaptive cognitive styles confer vulnerability for emotional disorders and may emerge in childhood. In three phases, we developed and evaluated a novel parent-led intervention (My Memory Forest) to target overgeneral memory and avoidance of negative memories. In phase 1, the intervention was co-designed using two focus groups (n = 30 children) and consultation with teachers and parents. The acceptability, feasibility, and clinical potential of My Memory Forest was initially evaluated in phase two (n = 12 children aged 6 to 9) and then in a feasibility randomised controlled trial in phase three, against an active control (n = 56 aged 6 to 9). Acceptability and engagement were good, and no harm was reported by parents or participants. Phase 2 identified decreases in self-reported anxiety (d = 1.08), depression (d = 0.51) and vividness of negative events (d = 0.53). There was little change in parent-reported symptoms. In phase 3, recruitment was highly feasible and participant retention excellent (100%) but parent retention poor (55%). Descriptive statistics indicated similar changes in anxiety and depression for both groups. Changes between Phases 2 and 3 (e.g. methods of recruitment) could explain the discrepancy between results. Further development is necessary before proceeding to another trial. TRIAL REGISTRATION: ISRCTN13142918.

Parent-Adolescent Dyads' Efficacy, Coping, Depression, and Adolescent Health Risks

BACKGROUND

Efficacy beliefs have been suggested to protect children from many risky health behaviors. However, the relationships between parent-child dyads' coping and efficacy beliefs are not clear. Therefore, this study examined the relationships between parent-child dyads' coping patterns and their association with collective family efficacy, adolescent filial efficacy, parenting efficacy, family satisfaction, depressive symptoms, and parents' perceived adolescent health risks.

METHODS

Guided by the Bandura's efficacy framework, we surveyed 158 parent-adolescent dyads from the midwestern U.S. on coping, collective family efficacy, adolescent filial efficacy, family satisfaction, parenting efficacy, depressive symptoms, and parent perceived adolescent health risks. Descriptive statistics, bivariate correlations, multiple regression, and path modeling were performed.

FINDINGS

Parent-adolescent dyads spiritual coping was positively correlated, but other coping subscales were not. The path models revealed that adolescents collective family and filial efficacy were positively related to their overall coping. Adolescent family satisfaction both directly and indirectly protected adolescents from depressive symptoms. Parents' parenting efficacy and family satisfaction were directly and indirectly associated with lower parents' perceived adolescent health risks.

DISCUSSION

It seems that parents' constructive coping mechanisms were more collective-focused, while adolescents' coping strategies were more individual-focused (venting and humor). Promoting parent-adolescent dyads' efficacy beliefs could enhance their coping strategies and minimize depressive symptoms and adolescent health risks. APPLICATION TO PRACTICE: adolescents' collective coping mechanisms (self-reliance and family problem solving) can be promoted within the family context. In fact, when helping adolescents develop family problem solving skills, it is important to consider parents' ability/efficacy and their emotional status.

Towards an Individual Differences Perspective in Mindfulness Training Research: Theoretical and Empirical Considerations

A growing body of research indicates that mindfulness training can have beneficial effects on critical aspects of psychological well-being, cognitive function, and brain health. Although these benefits have been generalized to the population level, individual variability in observed effects of mindfulness training has not been systematically investigated. Research on other similar forms of psychological intervention demonstrates that individual differences are prominent in terms of intervention responsiveness and outcomes. Furthermore, individual characteristics such as personality traits have been shown to play a crucial role in influencing the effects of intervention. In light of these lines of evidence, we review representative work on individual differences in mindfulness training and advocate for an individual difference perspective in mindfulness training research. We discuss relevant empirical evidence of individual differences potentially influencing behavioral outcomes of mindfulness training, focusing on both cognitive function and psychological well-being. Finally, theoretical considerations and potentially fruitful research strategies and directions for studying individual differences in mindfulness training are discussed, including those involving cognitive neuroscience methods.

Modulation of anterior cingulate cortex reward and penalty signalling in medication-naive young-adult subjects with depressive symptoms following acute dose lurasidone

BACKGROUND

Aberrations in reward and penalty processing are implicated in depression and putatively reflect altered dopamine signalling. This study exploits the advantages of a placebo-controlled design to examine how a novel D2 antagonist with adjunctive antidepressant properties modifies activity in the brain's reward network in depression.

METHODS

We recruited 43 medication-naïve subjects across the range of depression severity (Beck's Depression Inventory-II score range: 0-43), including healthy volunteers, as well as people meeting full-criteria for major depressive disorder. In a double-blind placebo-controlled cross-over design, all subjects received either placebo or lurasidone (20 mg) across two visits separated by 1 week. Functional magnetic resonance imaging with the Monetary Incentive Delay (MID) task assessed reward functions via neural responses during anticipation and receipt of gains and losses. Arterial spin labelling measured cerebral blood flow (CBF) at rest.

RESULTS

Lurasidone altered fronto-striatal activity during anticipation and outcome phases of the MID task. A significant three-way Medication-by-Depression severity-by-Outcome interaction emerged in the anterior cingulate cortex (ACC) after correction for multiple comparisons. Follow-up analyses revealed significantly higher ACC activation to losses in high- v. low depression participants in the placebo condition, with a normalisation by lurasidone. This effect could not be accounted for by shifts in resting CBF.

CONCLUSIONS

Lurasidone acutely normalises reward processing signals in individuals with depressive symptoms. Lurasidone's antidepressant effects may arise from reducing responses to penalty outcomes in individuals with depressive symptoms.

Reward Processing in Depression: A Conceptual and Meta-Analytic Review Across fMRI and EEG Studies

OBJECTIVE

A role for aberrant reward processing in the pathogenesis of depression has long been proposed. However, no review has yet examined its role in depression by integrating conceptual and quantitative findings across functional MRI (fMRI) and EEG methodologies. The authors quantified these effects, with an emphasis on development.

METHOD

A total of 38 fMRI and 12 EEG studies were entered into fMRI and EEG meta-analyses. fMRI studies primarily examined reward anticipation and reward feedback. These were analyzed using the activation likelihood estimation method. EEG studies involved mainly the feedback-related negativity (FRN) event-related potential, and these studies were analyzed using random-effects meta-analysis of the association between FRN and depression.

RESULTS

Analysis of fMRI studies revealed significantly reduced striatal activation in depressed compared with healthy individuals during reward feedback. When region-of-interest analyses were included, reduced activation was also observed in reward anticipation, an effect that was stronger in individuals under age 18. FRN was also significantly reduced in depression, with pronounced effects in individuals under age 18. In longitudinal studies, reduced striatal activation in fMRI and blunted FRN in EEG were found to precede the onset of depression in adolescents.

CONCLUSIONS

Taken together, the findings show consistent neural aberrations during reward processing in depression, namely, reduced striatal signal during feedback and blunted FRN. These aberrations may underlie the pathogenesis of depression and have important implications for development of new treatments.

Universal, school-based interventions to promote mental and emotional well-being: what is being done in the UK and does it work? A systematic review

OBJECTIVES

The present review aimed to assess the quality, content and evidence of efficacy of universally delivered (to all pupils aged 5-16 years), school-based, mental health interventions designed to promote mental health/well-being and resilience, using a validated outcome measure and provided within the UK in order to inform UK schools-based well-being implementation.

DESIGN

A systematic review of published literature set within UK mainstream school settings.

DATA SOURCES

Embase, CINAHL, MEDLINE, PsycINFO, PsychArticles, ASSIA and Psychological and Behavioural Sciences published between 2000 and April 2016.

ELIGIBILITY CRITERIA

Published in English; universal interventions that aimed to improve mental health/emotional well-being in a mainstream school environment; school pupils were the direct recipients of the intervention; pre-post design utilised allowing comparison using a validated outcome measure.

DATA EXTRACTION AND SYNTHESIS

12 studies were identified including RCTs and non-controlled pre-post designs (5 primary school based, 7 secondary school based). A narrative synthesis was applied with study quality check. 1 RESULTS: Effectiveness of school-based universal interventions was found to be neutral or small with more positive effects found for poorer quality studies and those based in primary schools (pupils aged 9-12 years). Studies varied widely in their use of measures and study design. Only four studies were rated 'excellent' quality. Methodological issues such as small sample size, varying course fidelity and lack of randomisation reduced overall study quality. Where there were several positive outcomes, effect sizes were small, and methodological issues rendered many results to be interpreted with caution. Overall, results suggested a trend whereby higher quality studies reported less positive effects. The only study that conducted a health economic analysis suggested the intervention was not cost-effective.

CONCLUSIONS

The current evidence suggests there are neutral to small effects of universal, school-based interventions in the UK that aim to promote emotional or mental well-being or the prevention of mental health difficulties. Robust, long-term methodologies need to be pursued ensuring adequate recording of fidelity, the use of validated measures sensitive to mechanisms of change, reporting of those lost to follow-up and any adverse effects. Further high-quality and large-scale research is required across the UK in order to robustly test any long-term benefits for pupils or on the wider educational or health system.

Effectiveness of Mindfulness Intervention on Psychological Behaviors Among Adolescents With Parental HIV Infection: A Group-Randomized Controlled Trial

This study aims to identify the effectiveness of mindfulness intervention on the psychological behaviors of adolescents with parental HIV infection and its associated factors in Myanmar. A total of 80 adolescents from 2 intervention townships and 80 adolescents from 2 control townships were enrolled in a group randomized controlled trial with assessments at baseline and 6 months follow-up. The mindfulness intervention involved monthly group sessions for 3 consecutive months led by an experienced mindfulness trainer. Three domains of psychological behaviors-namely, emotional, conduct, and social behaviors-were assessed at baseline and compared after 6 months. Multilevel regression analysis was used to determine the effectiveness of the intervention and associated factors for psychological behaviors. The intervention significantly improved emotional and conduct behaviors at 6 months (P < .001) but had no effect on social behavior. The significant effect of the intervention existed after adjusting for gender, family type, child age, and orphan status.

Women Benefit More Than Men in Response to College-based Meditation Training

Objectives: While recent literature has shown that mindfulness training has positive effects on treating anxiety and depression, there has been virtually no research investigating whether effects differ across genders-despite the fact that men and women differ in clinically significant ways. The current study investigated whether college-based meditation training had different effects on negative affect for men and women. Methods: Seventy-seven university students (36 women, age = 20.7 ± 3.0 years) participated in 12-week courses with meditation training components. They completed self-report questionnaires of affect, mindfulness, and self-compassion before and after the course. Results: Compared to men, women showed greater decreases in negative affect and greater increases on scales measuring mindfulness and self-compassion. Women's improvements in negative affect were correlated to improvements in measures of both mindfulness skills and self-compassion. In contrast, men showed non-significant increases in negative affect, and changes in affect were only correlated with ability to describe emotions, not any measures of experiential or self-acceptance. Conclusion: These findings suggest that women may have more favorable responses than men to school-based mindfulness training, and that the effectiveness of mindfulness-based interventions may be maximized by gender-specific modifications.

The neuroscience and context of adolescent depression

Adolescent depression is a growing public health concern with an increased risk of negative health outcomes, including suicide. The use of antidepressants and psychotherapy has not halted its increasing prevalence, and there is a critical need for effective prevention and treatment. We reviewed the neuroscience of adolescent depression, with a focus on the neurocircuitry of sustained threat and summarised contextual factors that have an impact on brain development and the pathophysiology of depression. We also reviewed novel treatment models.

CONCLUSION

Attention to the relevant neurocircuitry and contextual factors implicated in adolescent depression is necessary to advance prevention and treatment development.