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Ede MO, Okeke CI. Testing the Impacts of Rational-Emotive Couple Intervention in a Sample of Parents Seeking Divorce. Psychol Rep 2024; 127:1652-1677. [PMID: 38900859 DOI: 10.1177/00332941221139994] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Marital burnout has not been extensively studied despite its huge consequences on family wellbeing and quality of family life. This study, using randomised-controlled trial, tested the impact of rational-emotive couple intervention on marital burnout in a sample of parents seeking a divorce. A total of 67 parents who participated during the rational-emotive couple intervention (RECI) were assessed using the marital burnout scale, Beck depression inventory, and parent rational and irrational beliefs scale. Crosstabulation, multivariate test analysis, and bivariate analysis were used to analyse the data collected. Results show a significant reduction of marital burnout in RECI group participants, and significant improvement was maintained at the follow-up stage. The result of the group and gender interaction effect shows no significant interaction effect of group and gender on participants' marital burnout at Time two and Time 3, respectively. The results indicate that a decrease in parents' irrational beliefs accounts for marital burnout among couples seeking a divorce. Marital burnout is positively associated with depression among couples seeking a divorce. This study concludes that the RECI is an effective intervention that reduces marital burnout which is a direct consequence of irrational beliefs which later metamorphose into depressive symptoms.
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Affiliation(s)
- Moses Onyemaechi Ede
- Department of Education Foundations, University of the Free State, Bloemfontein, South Africa
| | - Chinedu Ifedi Okeke
- Department of Education Foundations, University of the Free State, Bloemfontein, South Africa
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2
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Hallford DJ, Austin DW, Takano K, Yeow JJ, Rusanov D, Fuller-Tyszkiewicz M, Raes F. Improving usual care outcomes in major depression in youth by targeting memory specificity: A randomized controlled trial of adjunct computerized memory specificity training (c-MeST). J Affect Disord 2024; 358:500-512. [PMID: 38663556 DOI: 10.1016/j.jad.2024.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/11/2024] [Accepted: 04/21/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE Extending on previous findings that computerized Memory Specificity Training (c-MeST) improves memory specificity and depressive symptoms in Major Depressive Disorder (MDD) in adults, this study aimed to assess the effects of c-MeST in youth with MDD on memory specificity and depression in addition to other treatment. METHODS Participants aged 15-25 (N = 359, 76 % female; M age = 19.2, SD = 3.1), receiving predominantly psychological therapy or counseling (85 %) and/or antidepressants (52 %) were randomized to usual care and c-MeST or usual care. Cognitive and clinical outcomes were assessed at baseline and at one, three, and six-month follow-ups. RESULTS The usual care and c-MeST group reported higher memory specificity at one-month (d = 0.42, p = .022), but not at three or six months (d's < 0.15, p's > 0.05). The rate of MDE was numerically lower in the c-MeST group at each follow-up time-point, but group was not a statistically significant predictor at one month (64 % usual care and c-MeST vs. 68 % usual care, OR = 0.81, p = .606), three months (67 % usual care and c-MeST vs. 72 % usual care, OR = 0.64, p = .327) or six months (55 % usual care and c-MeST vs. 68 % usual care, OR = 0.56, p = .266). The usual care and c-MeST group did report lower depressive symptoms at one month (d = 0.42, p = .023) and six-months (d = 0.84, p = .001), but not three-months (d = 0.13, p > .05). CONCLUSIONS c-MeST may reduce symptoms in youth with MDD when provided alongside other treatments. However, there are significant limitations to this inference, including high attrition in the study and a need for more data on the acceptability of the intervention.
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Affiliation(s)
- David John Hallford
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia.
| | - David W Austin
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Keisuke Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Leopoldstr. 13, Munich, Germany
| | - Joesph J Yeow
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Danielle Rusanov
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Box 3712, 3000 Leuven, Belgium
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Huang X, Chen Y, Luo J, Wang D, Yang C, Luo W, Zhou Y. The effect of behavioral activation play therapy in adolescents with depression: A study protocol for a randomized controlled trial. PLoS One 2024; 19:e0304084. [PMID: 38900751 PMCID: PMC11189190 DOI: 10.1371/journal.pone.0304084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/30/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Depression is a common psychological problem in adolescents worldwide. Although the World Health Organization recommends that members of this population engage in physical activity to reduce depressive symptoms, compliance with this recommendation is often low. Furthermore, although behavioral activation (BA) is recommended as a treatment for adolescents with depression, the reported effect size is small. Compared with traditional exercises, gamified physical activity (GPA) can be particularly appealing to adolescents because it is perceived as an enjoyable experience. In this study, we integrated BA and GPA to create behavioral activation play therapy (BAPT). We designed a clinical trial to investigate the feasibility, acceptability, and effectiveness of this treatment in adolescents with depression. METHODS This study is a randomized controlled trial (RCT) with a three-arm, assessor-blinded design, conducted to validate the effectiveness and applicability of BAPT for treating adolescent with depression. We will recruit 258 participants and randomly assign them to a BAPT group, BA group, or GPA group using a ratio of 1:1:1. Based on conventional strategies for treatment and care, the three groups will receive nine BAPT sessions, nine BA sessions, or nine GPA sessions, respectively. We will compare the outcomes of the BAPT with those of the BA and GPA interventions. DISCUSSION This is the first RCT to explore the effectiveness and applicability of BAPT in adolescents with depression. This study will provide evidence that may help to decrease depressive symptoms in adolescents, and will demonstrate the treatment effectiveness in terms of increasing levels of physical activity, reducing the rate of non-suicidal self-injury behaviors, and improving sleep quality. We will also assess the presence of side effects and the treatment adherence of patients receiving BAPT. TRIAL REGISTRATION Trial registration: Chinese Clinical Trial Registry, ChiCTR2300072671. Registered on 20 June 2023.
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Affiliation(s)
- Xiaolong Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Yuqi Chen
- Southern Medical University, Guangzhou, China
| | | | - Dongdong Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Chanjuan Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Wei Luo
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
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De Jaegere E, van Heeringen K, Emmery P, Mommerency G, Portzky G. Effects of a Serious Game for Adolescent Mental Health on Cognitive Vulnerability: Pilot Usability Study. JMIR Serious Games 2024; 12:e47513. [PMID: 38725223 PMCID: PMC11097755 DOI: 10.2196/47513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 03/08/2024] [Accepted: 03/24/2024] [Indexed: 05/18/2024] Open
Abstract
Background Adolescent mental health is of utmost importance. E-mental health interventions, and serious games in particular, are appealing to adolescents and can have beneficial effects on their mental health. A serious game aimed at improving cognitive vulnerability (ie, beliefs or attitudes), which can predispose an individual to mental health problems, can contribute to the prevention of these problems in adolescents. Objective This study aimed to assess the feasibility of the prototype of a serious game called "Silver." Methods The prototype of the serious game was developed using a user-centered participatory design. The prototype of Silver focused on 1 aspect of a serious game for improving cognitive vulnerability in adolescents, that is, the recognition and identification of cognitive distortions. Through the game, players were required to identify and classify the character's thoughts as helpful or unhelpful. Upon successful advancement to the next level, the task becomes more challenging, as players must also identify specific types of cognitive distortions. A pre- and posttest uncontrolled design was used to evaluate the game, with a 1-week intervention phase in which participants were asked to play the game. Participants aged 12-16 years were recruited in schools. The outcomes of interest were the recognition of cognitive distortions and presence of participants' cognitive distortions. The game was also evaluated on its effects, content, and usefulness. Results A total of 630 adolescents played Silver and completed the assessments. Adolescents were significantly better at recognizing cognitive distortions at the pretest (mean 13.09, SD 4.08) compared to the posttest (mean 13.82, SD 5.09; t629=-4.00, P<.001). Furthermore, their cognitive distortions decreased significantly at the posttest (mean 38.73, SD 12.79) compared to the pretest (mean 41.43, SD 10.90; t629=7.98, P<.001). Participants also indicated that the game helped them recognize cognitive distortions. Many participants considered the game appealing (294/610, 48.2%) but boring (317/610, 52%) and preferred a more comprehensive game (299/610, 49%). Conclusions Findings from this study suggest that a serious game may be an effective tool for improving cognitive vulnerability in adolescents. The development of such a serious game, based on the prototype, is recommended. It may be an important and innovative tool for the universal prevention of mental health problems in adolescents. Future research on the effects of the game is warranted.
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Affiliation(s)
- Eva De Jaegere
- Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Kees van Heeringen
- Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Peter Emmery
- University Psychiatric Centre KU Leuven, KU Leuven, Leuven, Belgium
| | - Gijs Mommerency
- Department of Child and Adolescent Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Gwendolyn Portzky
- Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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5
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Susman ES, Patino EO, Tiab SS, Dong L, Gumport NB, Sarfan LD, Hinshaw SP, Harvey AG. Transdiagnostic Sleep and Circadian Intervention in Youth: Long-term Follow-up of a Randomized Controlled Trial. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00240-5. [PMID: 38729603 DOI: 10.1016/j.jaac.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/25/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE This preregistered study compared the effects of the Transdiagnostic Sleep and Circadian Intervention (TranS-C) with psychoeducation (PE) about sleep, health, yoga, meditation, and outdoor appreciation activities on sleep and circadian functioning, health risk, and sleep health behaviors at long-term follow-up (LTFU), an average of 8 years following treatment. We also examined if more sleep health behaviors at LTFU were associated with better sleep and circadian functioning at LTFU and if better sleep and circadian functioning were associated with lower health risk at LTFU. METHOD At baseline, we randomly assigned adolescents with an eveningness chronotype to TranS-C (n = 89) or PE (n = 87). Of this sample, we assessed 106 young adults (mean age at follow-up = 22.5 years; n = 55 from TranS-C; n = 51 from PE) an average of 8 years following treatment. RESULTS Despite TranS-C (vs PE) sustaining improvement in circadian functioning through 12-month follow-up, at LTFU, there were no significant differences between the conditions on any outcome, including sleep and circadian functioning, risks in 5 health domains indexed by self-report and ecological momentary assessment, sleep health behaviors, and physical measurements. Across both conditions, measures indicating poorer sleep and circadian functioning were associated with higher health risk across multiple domains, and more sleep health behaviors were associated with lower levels of eveningness at LTFU. CONCLUSION These results provide an important window into the influence of development on long-term outcomes for youth and raise the possibility that interventions for youth could be enhanced with a focus on habit formation. CLINICAL TRIAL REGISTRATION INFORMATION Maintaining Behavior Change: A 6-Year Follow-up of Adolescent 'Night-owls'; https://www. CLINICALTRIALS gov/; NCT05098782. STUDY PREREGISTRATION INFORMATION Long-term Follow-up of Young Adults Who Received TranS-C to Modify Eveningness Chronotype in Adolescence; https://osf.io/; d5a4g. DIVERSITY & INCLUSION STATEMENT We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability. One or more of the authors of this paper received support from a program designed to increase minority representation in science.
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Affiliation(s)
| | | | | | - Lu Dong
- RAND, Santa Monica, California
| | | | | | - Stephen P Hinshaw
- University of California, Berkeley, California; University of California San Francisco, San Francisco, California
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Wols A, Pingel M, Lichtwarck-Aschoff A, Granic I. Effectiveness of applied and casual games for young people's mental health: A systematic review of randomised controlled studies. Clin Psychol Rev 2024; 108:102396. [PMID: 38320420 DOI: 10.1016/j.cpr.2024.102396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
Many youth experience mental health problems and digital games hold potential as mental health interventions. This systematic review provides an overview of randomised controlled studies assessing the effectiveness of digital applied and casual games for improving mental health in youth aged 6-24 years. A systematic search of PsycINFO, Web of Science and Pubmed yielded 145 eligible studies. Studies on (sub)clinical participant samples (n = 75) most often focused on attention-deficit/hyperactivity disorder (ADHD), autism and anxiety. Applied games were found most effective for improving social skills, verbal memory and anxiety, whereas casual games were found most effective for improving depression, anxiety and ADHD. Studies involving healthy youth (n = 70) were grouped into papers examining anxiety in medical settings, momentary effects on positive and negative affect, and papers employing a longitudinal design measuring mental health trait outcomes. Promising results were found for the use of games as distraction tools in medical settings, and for applied and casual games for improving momentary affect. Overall, our findings demonstrate the potential of digital games for improving mental health. Implications and recommendations for future research are discussed, such as developing evaluation guidelines, clearly defining applied games, harmonising outcome measures, including positive outcomes, and examining nonspecific factors that may influence symptom improvement as well.
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Affiliation(s)
- Aniek Wols
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands.
| | - Michelle Pingel
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | - Anna Lichtwarck-Aschoff
- Rijksuniversiteit Groningen, Department of Pedagogical & Educational Sciences, Groningen, the Netherlands
| | - Isabela Granic
- McMaster University, Health, Aging & Society, Hamilton, Ontario, Canada
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7
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Loades ME, Midgley N, Herring GT, O'Keeffe S, Reynolds S, Goodyer IM. In Context: Lessons About Adolescent Unipolar Depression From the Improving Mood With Psychoanalytic and Cognitive Therapies Trial. J Am Acad Child Adolesc Psychiatry 2024; 63:122-135. [PMID: 37121393 DOI: 10.1016/j.jaac.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 02/19/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023]
Abstract
This paper summarizes the results of the Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT) study and its implications for psychological treatment of adolescents with moderate to severe unipolar major depression. IMPACT was a pragmatic, superiority, randomized controlled trial conducted in the United Kingdom, which compared the clinical and cost-effectiveness of short-term psychoanalytic therapy (STPP), cognitive-behavioral therapy (CBT), and a brief psychosocial intervention (BPI) in reducing depression symptoms in 465 adolescents with unipolar major depression, aged 11 to 17 years. Although this was a clinically heterogeneous group of adolescents, some symptoms (eg, sleep and concentration difficulties, irritability/anger) were common and disabling. The trial reported no significant difference among the 3 treatments in reducing depression symptoms. One year after treatment, 84% of participants showed improvement in depressive symptoms (<50% of baseline symptoms) and improved psychosocial functioning, achieving this through different symptom reduction trajectories. Although participants attended fewer treatment sessions than planned, the 3 treatments were delivered with fidelity to their respective models. Ending treatment without therapist agreement occurred in 37% of cases. This was not associated with outcomes by treatment group. Adolescents emphasized the importance of the therapeutic relationship in all 3 treatments. Results suggest that although most adolescents respond to time-limited, structured psychological therapy, subgroups of depressed adolescents are likely to need additional treatment or support. These include adolescents who live in complex circumstances and/or who believe that their needs are not met in therapy, some who stop treatment early, and the 16% to 18% of adolescents who do not respond to treatment. CLINICAL TRIAL REGISTRATION INFORMATION: Improving Mood and Preventing Relapse With Psychoanalytic Psychotherapy and Cognitive Behaviour Therapy; https://www.isrctn.com; ISRCTN83033550.
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Affiliation(s)
| | - Nick Midgley
- University College London, United Kingdom and Anna Freud National Centre for Children and Families, London, United Kingdom.
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8
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Eckshtain D, Horn R, Weisz JR. Family-Based Interventions for Youth Depression: Meta-Analysis of Randomized Clinical Trials. Child Psychiatry Hum Dev 2023; 54:1737-1748. [PMID: 35616765 DOI: 10.1007/s10578-022-01375-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
Abstract
Youth depression is an impairing pediatric condition for which psychotherapy effects are modest. Can outcomes be improved by treatments that address the family context, as proposed in practice parameters of the American Academy of Child and Adolescent Psychiatry? To find out, we searched five decades of research for randomized controlled trials testing family-based interventions; 11 trials were found for ages 4-18 years. Using robust variance estimation, we obtained estimates of effect size (ES) and tested candidate moderators that might explain variation in ES. Overall pooled ES of the studies was 0.33 at posttreatment, similar to that reported for all youth depression treatments in three prior meta-analyses (i.e., 0.36, 0.30, and 0.29), but higher for adolescents (ages ≥ 13, 0.50) than children (0.04). Taken together, our findings do not show superior outcomes for family-based interventions, and raise questions about how much confidence can be placed in the evidence base to date. The small number of relevant studies in more than five decades, together with the publication bias and risk of bias concerns, highlights the need for more trials testing family-based treatment, and for pre-registered reports, publicly-available preprints, and other mechanisms for improving the dissemination of completed research.
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Affiliation(s)
- Dikla Eckshtain
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 02114, Boston, MA, United States.
| | - Rachel Horn
- Department of Psychology, Harvard University, 1030 William James Hall, 33 Kirkland Street, 02138, Cambridge, MA, United States
| | - John R Weisz
- Department of Psychology, Harvard University, 1030 William James Hall, 33 Kirkland Street, 02138, Cambridge, MA, United States
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9
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Weisz JR, Fitzpatrick OM, Venturo-Conerly KE, Sternberg A, Steinberg JS, Ng MY. Research Review: The internalizing paradox - youth anxiety and depression symptoms, psychotherapy outcomes, and implications for research and practice. J Child Psychol Psychiatry 2023; 64:1720-1734. [PMID: 37222162 PMCID: PMC10667566 DOI: 10.1111/jcpp.13820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Youth anxiety and depression have long been combined within the empirically derived internalizing syndrome. The two conditions show substantial comorbidity, symptom co-occurrence, and overlap in treatment procedures, but paradoxically diverge in psychotherapy outcomes: strong, positive effects for anxiety and weak effects for depression. METHODS Drawing on recent research, we examine candidate explanations for this paradox to help identify strategies for addressing it by improving outcomes for youth depression. RESULTS Candidate explanations include that youth depression, compared with youth anxiety, has more varied comorbidities and more heterogeneous symptom combinations, has greater uncertainty regarding mediators and mechanisms of change, is treated with more complex and potentially confusing protocols, and has characteristics that may impede client engagement. Candidate strategies for shrinking the psychotherapy effectiveness gap include personalizing through transdiagnostic modular treatment, simplifying therapy by focusing on empirically supported principles of change, developing effective strategies for engaging family members as intervention allies, using shared decision-making to inform clinical decisions and boost client engagement, capitalizing on youth-friendly technological advances, and shortening and digitizing treatments to enhance their accessibility and appeal. CONCLUSIONS Recent advances suggest explanations for the internalizing paradox, which in turn suggest strategies for shrinking the youth anxiety-depression psychotherapy outcome gap; these form an agenda for a promising new era of research.
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Affiliation(s)
- John R. Weisz
- Department of Psychology, Harvard University, Cambridge, MA 02138 USA
| | | | | | - Ariel Sternberg
- Department of Psychology, Harvard University, Cambridge, MA 02138 USA
| | | | - Mei Yi Ng
- Department of Psychology, Florida International University, Miami, FL 33199 USA
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10
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Rauf T. Differential sensitivity to adversity by income: Evidence from a study of Bereavement. SOCIAL SCIENCE RESEARCH 2023; 115:102920. [PMID: 37858363 DOI: 10.1016/j.ssresearch.2023.102920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/21/2023]
Abstract
Adverse life events are often understood as having negative consequences for mental health via objective hardships, which are worse for persons with less income. But adversity can also affect mental health via more subjective mechanisms, and here, it is possible that persons with higher income will exhibit greater psychological sensitivity to negative events, for various reasons. Drawing on multiple sociological literatures, this article theorizes potential mechanisms of increasing sensitivity with income. The proposition of differential sensitivity is tested using the strategic case of spousal and parental bereavement among older US adults. The analyses find consistent evidence of increasing sensitivity of depressive symptoms with income. A series of robustness checks indicate that findings are not due to endogenous or antecedent selection. Further, exploratory analyses of mechanisms suggest that higher sensitivity among the affluent was driven by greater expectations and better relationship quality with the deceased. These findings problematize the conceptualization and assessment of human suffering in economically stratified societies.
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Affiliation(s)
- Tamkinat Rauf
- Department of Sociology, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI, 53706, USA.
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11
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Karantzas GC, Curtis A, Knox L, Staiger PK, Head T, Toumbourou JW, Gruenert S, Romano DA, Miller PG. Do relationship education programs reduce relationship aggression? A meta-analytic study. Clin Psychol Rev 2023; 104:102285. [PMID: 37499317 DOI: 10.1016/j.cpr.2023.102285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 03/24/2023] [Accepted: 05/10/2023] [Indexed: 07/29/2023]
Abstract
There is an increasing focus on evaluating the effectiveness of Relationship Education (RE) programs on reducing relationship aggression. Nevertheless, there has been little by way of a systematic quantitative synthesis of research to date. The primary aim of this research was to conduct a meta-analysis into the effects of RE programs on relationship aggression and provide a comprehensive assessment as to the moderating effects of various methodological characteristics of studies. A secondary aim was to determine whether RE programs reduce negative aspects of relationship functioning that are known to exacerbate relationship aggression. Thirty-one studies (n = 25,527) were included comprising of pre-post comparison studies and control trials. Overall, RE programs were significantly associated with reductions in relationship aggression (d = 0.11, p = .001). Pre-post studies yielded a significantly larger effect size (d = 0.28, p < .001) than RCT studies (d = 0.05, p = .10). Subgroup analysis revealed that participants who reported moderate to severe relationship aggression upon RE program entry demonstrated large reductions in physical (d = 0.66, p = .01) and psychological (d = 0.85, p < .001) aggression compared to those who reported minimal to low relationship aggression on entry (physical aggression d = 0.07, p = .009; psychological aggression d = -0.04; p = .17). Amongst participants who reported moderate to severe relationship aggression, RE programs were also found to reduce controlling behavior (d = 0.20, p < .01) and conflict behavior (d = 0.40, p < .001). Findings demonstrate the emerging efficacy of RE programs for reducing relationship aggression and conflict behavior, particularly in those with a history of moderate to severe levels of relationship aggression.
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Affiliation(s)
- Gery C Karantzas
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia.
| | - Ashlee Curtis
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia
| | - Laura Knox
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia
| | - Petra K Staiger
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia
| | - Travis Head
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia
| | - John W Toumbourou
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia
| | - Stefan Gruenert
- Odyssey House Victoria, 660 Bridge Road, Richmond, Victoria 3121, Australia
| | - Daniel A Romano
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia
| | - Peter G Miller
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia
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12
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Sun CH, Mai JX, Shi ZM, Zheng W, Jiang WL, Li ZZ, Huang XB, Yang XH, Zheng W. Adjunctive repetitive transcranial magnetic stimulation for adolescents with first-episode major depressive disorder: a meta-analysis. Front Psychiatry 2023; 14:1200738. [PMID: 37593451 PMCID: PMC10428010 DOI: 10.3389/fpsyt.2023.1200738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/18/2023] [Indexed: 08/19/2023] Open
Abstract
Objective This meta-analysis of randomized clinical trials (RCTs) was conducted to explore the therapeutic effects, tolerability and safety of repetitive transcranial magnetic stimulation (rTMS) as an adjunct treatment in adolescents with first-episode major depressive disorder (FE-MDD). Methods RCTs examining the efficacy, tolerability and safety of adjunctive rTMS for adolescents with FE-MDD were included. Data were extracted by three independent authors and synthesized using RevMan 5.3 software with a random effects model. Results A total of six RCTs involving 562 adolescents with FE-MDD were included. Adjunctive rTMS was superior in improving depressive symptoms over the control group [standardized mean difference (SMD) = -1.50, 95% confidence interval (CI): -2.16, -0.84; I2 = 89%, p < 0.00001] in adolescents with FE-MDD. A sensitivity analysis and two subgroup analyses also confirmed the significant findings. Adolescents with FE-MDD treated with rTMS had significantly greater response [risk ratio (RR) = 1.35, 95% CI: 1.04, 1.76; I2 = 56%, p = 0.03] and remission (RR = 1.35, 95% CI: 1.03, 1.77; I2 = 0%, p = 0.03) over the control group. All-cause discontinuations were similar between the two groups (RR = 0.79, 95% CI: 0.32, 1.93; I2 = 0%, p = 0.60). No significant differences were found regarding adverse events, including headache, loss of appetite, dizziness and nausea (p = 0.14-0.82). Four out of six RCTs (66.7%), showed that adjunctive rTMS was more efficacious over the control group in improving neurocognitive function (all p < 0.05). Conclusion Adjunctive rTMS appears to be a beneficial strategy in improving depressive symptoms and neurocognitive function in adolescents with FE-MDD. Higher quality RCTs with larger sample sizes and longer follow-up periods are warranted in the future.
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Affiliation(s)
| | - Jian-Xin Mai
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhan-Ming Shi
- Chongqing Jiangbei Mental Health Center, Chongqing, China
| | - Wei Zheng
- Xiamen Xian Yue Hospital, Xiamen, China
| | | | - Ze-Zhi Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xing-Bing Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xin-Hu Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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13
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Cunningham NR, Miller A, Ely SL, Reid MR, Danguecan A, Mossad SI, Pereira LF, Abulaban K, Kessler E, Rosenwasser N, Nanda K, Rubinstein T, Reeves M, Kohut SA, Stinson J, Tal TE, Levy DM, Hiraki L, Smitherman EA, Knight AM. A multi-site pilot randomized clinical trial of the Treatment and Education Approach for Childhood-onset Lupus (TEACH) program: study design and COVID-19 adaptations. Pediatr Rheumatol Online J 2023; 21:61. [PMID: 37353795 DOI: 10.1186/s12969-023-00835-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/27/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Childhood-onset Systemic Lupus Erythematosus (cSLE) is an autoimmune disease associated with fatigue, mood symptoms, and pain. Fortunately, these symptoms are potentially modifiable with psychological intervention such as cognitive-behavioral therapy (CBT). The Treatment and Education Approach for Childhood-onset Lupus (TEACH) program is a CBT intervention developed to target these symptoms for adolescents and young adults with cSLE. This pilot randomized controlled trial (RCT) aims to determine the feasibility and effect of TEACH for youth with cSLE. Adjustments to the study protocol following the COVID-19 pandemic are also described. METHODS This two-arm multisite RCT will explore the feasibility (primary outcome) and effect (secondary outcome) of a remotely delivered TEACH protocol. Participants will be randomized to a six-week remotely delivered TEACH program plus medical treatment as usual (TAU) or TAU alone. We will include patients ages 12-22 years presenting to rheumatology clinics from six sites. Validated measures of fatigue, depressive symptoms, and pain will be obtained at baseline and approximately eight and 20 weeks later. Protocol adjustments were also made due to the COVID-19 pandemic, in collaboration with the investigative team, which included patients and caregivers. CONCLUSIONS Findings from this multi-site RCT aim to document the feasibility of TEACH and provide an estimate of effect of a remotely delivered TEACH protocol on fatigue, depression, and pain symptoms in youth with cSLE as compared to standard medical treatment alone. This findings may positively impact clinical care for patients with cSLE. CLINICAL TRIALS gov registration: NCT04335643.
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Affiliation(s)
- Natoshia R Cunningham
- Department of Family Medicine, Michigan State University, 15 Michigan St NE, Grand Rapids, MI, 49503, US.
| | - Alaina Miller
- School of Professional Psychology, Wright State University, 3640 Colonel Glenn Hwy, Dayton, OH, 45435, US
| | - Samantha L Ely
- Department of Family Medicine, Michigan State University, 15 Michigan St NE, Grand Rapids, MI, 49503, US
- Present address: Department of Psychiatry and Behavioral Neuroscience, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI, 48201, US
| | - Mallet R Reid
- Department of Psychology, Michigan State University, 316 Physics Rd, East Lansing, MI, 48824, US
| | - Ashley Danguecan
- Department of Psychology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Sarah I Mossad
- Department of Psychology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Luana Flores Pereira
- The Hospital for Sick Children, Mental Health and Neurosciences Program, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Khalid Abulaban
- Pediatric Rheumatology, Helen DeVos Children's Hospital, 35 Michigan St NE, Grand Rapids, MI, 49503, US
| | - Elizabeth Kessler
- Pediatric Rheumatology, Helen DeVos Children's Hospital, 35 Michigan St NE, Grand Rapids, MI, 49503, US
| | - Natalie Rosenwasser
- Rheumatology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, US
| | - Kabita Nanda
- Rheumatology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, US
| | - Tamar Rubinstein
- Division of Pediatric Rheumatology, Department of Pediatrics, Children's Hospital at Montefiore/Albert Einstein College of Medicine, 3415 Bainbridge Ave, NY, 10467, Bronx, US
| | - Mathew Reeves
- Michigan State University, Department of Epidemiology and Biostatistics, 909 Wilson Rd, MI, 48824, East Lansing, US
| | - Sara Ahola Kohut
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, ON, M5G 1X8, Toronto, Canada
| | - Jennifer Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, ON, M5G 1X8, Toronto, Canada
| | - Tala El Tal
- Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Deborah M Levy
- Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Linda Hiraki
- Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Emily A Smitherman
- University of Alabama at Birmingham, The Children's Hospital CPP N G10, 1600 7 Ave S Birmingham, Birmingham, AL, 35223-1711, USA
| | - Andrea M Knight
- Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
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Argiros A, Venanzi L, Dao A, Dickey L, Herman N, Pegg S, Hill K, Stewart J, Kujawa A. Social Support and Parental Conflict as Predictors of Outcomes of Group Cognitive Behavioral Therapy for Adolescent Depression. Int J Cogn Ther 2023; 16:202-221. [PMID: 37228300 PMCID: PMC10043524 DOI: 10.1007/s41811-023-00159-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2023] [Indexed: 03/30/2023]
Abstract
Group cognitive behavioral therapy (CBT) is an effective treatment for adolescent depression, but outcomes vary. Our goal was to examine interpersonal factors that predict response to group CBT for adolescent depression using a broad range of outcomes, including depressive symptoms, session attendance, treatment completion, engagement, and improvement. Seventy adolescents (age 14-18) with depression completed self-report measures of social support and parental conflict and were offered an established 16-session group CBT program. Correlation and regression analyses were conducted for interpersonal predictors and CBT outcomes. Accounting for pre-treatment depressive symptoms, fewer social supports predicted lower likelihood of finishing treatment and less clinician-rated improvement. Greater pre-treatment parental conflict predicted fewer sessions attended, lower clinician-rated engagement, and less clinician-rated improvement. Results highlight the need to consider interpersonal difficulties in CBT, as they may present a barrier to treatment attendance, engagement, and improvement.
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Affiliation(s)
- Alexandra Argiros
- Department of Psychology and Human Development, Vanderbilt University, Peabody College #552, 230 Appleton Place, Nashville, TN 37203-5721 USA
| | - Lisa Venanzi
- Department of Psychology and Human Development, Vanderbilt University, Peabody College #552, 230 Appleton Place, Nashville, TN 37203-5721 USA
| | - Anh Dao
- Department of Psychology and Human Development, Vanderbilt University, Peabody College #552, 230 Appleton Place, Nashville, TN 37203-5721 USA
| | - Lindsay Dickey
- Department of Psychology and Human Development, Vanderbilt University, Peabody College #552, 230 Appleton Place, Nashville, TN 37203-5721 USA
| | - Nicole Herman
- Department of Psychology and Human Development, Vanderbilt University, Peabody College #552, 230 Appleton Place, Nashville, TN 37203-5721 USA
| | - Samantha Pegg
- Department of Psychology and Human Development, Vanderbilt University, Peabody College #552, 230 Appleton Place, Nashville, TN 37203-5721 USA
| | - Kaylin Hill
- Department of Psychology and Human Development, Vanderbilt University, Peabody College #552, 230 Appleton Place, Nashville, TN 37203-5721 USA
| | | | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University, Peabody College #552, 230 Appleton Place, Nashville, TN 37203-5721 USA
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15
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Paauw CC, de Roos C, Koornneef MGT, Elzinga BM, Boorsma TM, Verheij MA, Dingemans AE. Eye movement desensitization and processing for adolescents with major depressive disorder: study protocol for a multi-site randomized controlled trial. Trials 2023; 24:206. [PMID: 36941688 PMCID: PMC10029217 DOI: 10.1186/s13063-023-07226-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the most common mental disorders in adolescence carrying a serious risk of adverse development later in life. Extant treatments are limited in effectiveness and have high drop-out and relapse rates. A body of literature has been published on the association between distressing/ traumatic experiences and development and maintenance of MDD, but the effectiveness of a trauma-focused treatment approach for MDD has hardly been studied. This study aims to determine the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy as stand-alone intervention in adolescents diagnosed with MDD. METHODS This study will be a randomized controlled trial with two conditions: (1) EMDR treatment (6 sessions) and (2) waiting list condition (WL: 6 weeks, followed by EMDR treatment). First, participants receive a baseline measure after which they will be randomized. Participants will be assessed post-intervention after which the WL participants will also receive six EMDR sessions. Follow-up assessments will be conducted at 3 and 6 months follow-up. STUDY POPULATION In total, 64 adolescents (aged 12-18) diagnosed with a major depressive disorder (DSM-5) and identified memories of at least one distressing or traumatic event related to the depressive symptomatology will be included. Main study parameters/endpoints: Primary outcome variables will be the percentage of patients meeting criteria for MDD classification, and level of depressive symptoms. Secondary outcome measures include symptoms of PTSD, anxiety, and general social-emotional problems. At baseline, family functioning and having experienced emotional abuse or neglect will be assessed to explore whether these factors predict post-treatment outcome. DISCUSSION With the present study, we aim to investigate whether EMDR as a trauma-focussed brief intervention may be effective for adolescents with a primary diagnosis of MDD. EMDR has been proven an effective treatment for traumatic memories in other disorders. It is hypothesized that traumatic memories play a role in the onset and maintenance of depressive disorders. Particularly in adolescence, early treatment of these traumatic memories is warranted to prevent a more chronic or recurrent course of the disorder. TRIAL REGISTRATION International Clinical Trial Registry Platform (ICTRP): NL9008 (30-10-2020).
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Affiliation(s)
- C C Paauw
- Department Youth, GGZ Rivierduinen, Sandifortdreef 19, 2333 ZZ, Leiden, the Netherlands.
| | - C de Roos
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - M G T Koornneef
- Department Youth, GGZ Rivierduinen, Sandifortdreef 19, 2333 ZZ, Leiden, the Netherlands
| | - B M Elzinga
- Institute of Psychology, Leiden University, Leiden, the Netherlands
| | | | - M A Verheij
- Department Youth, GGZ Rivierduinen, Sandifortdreef 19, 2333 ZZ, Leiden, the Netherlands
| | - A E Dingemans
- GGZ Rivierduinen Eating Disorders Ursula, Leiden, the Netherlands
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16
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De Los Reyes A, Wang M, Lerner MD, Makol BA, Fitzpatrick OM, Weisz JR. The Operations Triad Model and Youth Mental Health Assessments: Catalyzing a Paradigm Shift in Measurement Validation. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:19-54. [PMID: 36040955 DOI: 10.1080/15374416.2022.2111684] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Researchers strategically assess youth mental health by soliciting reports from multiple informants. Typically, these informants (e.g., parents, teachers, youth themselves) vary in the social contexts where they observe youth. Decades of research reveal that the most common data conditions produced with this approach consist of discrepancies across informants' reports (i.e., informant discrepancies). Researchers should arguably treat these informant discrepancies as domain-relevant information: data relevant to understanding youth mental health domains (e.g., anxiety, depression, aggression). Yet, historically, in youth mental health research as in many other research areas, one set of paradigms has guided interpretations of informant discrepancies: Converging Operations and the Multi-Trait Multi-Method Matrix (MTMM). These paradigms (a) emphasize shared or common variance observed in multivariate data, and (b) inspire research practices that treat unique variance (i.e., informant discrepancies) as measurement confounds, namely random error and/or rater biases. Several yearsw ago, the Operations Triad Model emerged to address a conceptual problem that Converging Operations does not address: Some informant discrepancies might reflect measurement confounds, whereas others reflect domain-relevant information. However, addressing this problem requires more than a conceptual paradigm shift beyond Converging Operations. This problem necessitates a paradigm shift in measurement validation. We advance a paradigm (Classifying Observations Necessitates Theory, Epistemology, and Testing [CONTEXT]) that addresses problems with using the MTMM in youth mental health research. CONTEXT optimizes measurement validity by guiding researchers to leverage (a) informants that produce domain-relevant informant discrepancies, (b) analytic procedures that retain domain-relevant informant discrepancies, and (c) study designs that facilitate detecting domain-relevant informant discrepancies.
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Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
| | - Mo Wang
- Department of Management, University of Florida
| | | | - Bridget A Makol
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
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17
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Buhl C, Sfärlea A, Loechner J, Starman-Wöhrle K, Salemink E, Schulte-Körne G, Platt B. Biased Maintenance of Attention on Sad Faces in Clinically Depressed Youth: An Eye-Tracking Study. Child Psychiatry Hum Dev 2023; 54:189-201. [PMID: 34476682 PMCID: PMC9867681 DOI: 10.1007/s10578-021-01229-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 01/26/2023]
Abstract
The role of negative attention biases (AB), central to cognitive models of adult depression, is yet unclear in youth depression. We investigated negative AB in depressed compared to healthy youth and tested whether AB are more pronounced in depressed than at-risk youth. Negative AB was assessed for sad and angry faces with an eye-tracking paradigm [Passive Viewing Task (PVT)] and a behavioural task [Visual Search Task (VST)], comparing three groups of 9-14-year-olds: youth with major depression (MD; n = 32), youth with depressed parents (high-risk; HR; n = 49) and youth with healthy parents (low-risk; LR; n = 42). The PVT revealed MD participants to maintain attention longer on sad faces compared to HR, but not LR participants. This AB correlated positively with depressive symptoms. The VST revealed no group differences. Our results provide preliminary evidence for a negative AB in maintenance of attention on disorder-specific emotional information in depressed compared to at-risk youth.
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Affiliation(s)
- Christina Buhl
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Pettenkoferstr. 8a, 80336, Munich, Germany.
| | - Anca Sfärlea
- grid.411095.80000 0004 0477 2585Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Pettenkoferstr. 8a, 80336 Munich, Germany
| | - Johanna Loechner
- grid.411095.80000 0004 0477 2585Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Pettenkoferstr. 8a, 80336 Munich, Germany ,grid.424214.50000 0001 1302 5619German Youth Institute, Munich, Germany
| | - Kornelija Starman-Wöhrle
- grid.411095.80000 0004 0477 2585Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Pettenkoferstr. 8a, 80336 Munich, Germany
| | - Elske Salemink
- grid.5477.10000000120346234Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Gerd Schulte-Körne
- grid.411095.80000 0004 0477 2585Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Pettenkoferstr. 8a, 80336 Munich, Germany
| | - Belinda Platt
- grid.411095.80000 0004 0477 2585Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Pettenkoferstr. 8a, 80336 Munich, Germany
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18
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De Los Reyes A, Epkins CC. Introduction to the Special Issue. A Dozen Years of Demonstrating That Informant Discrepancies are More Than Measurement Error: Toward Guidelines for Integrating Data from Multi-Informant Assessments of Youth Mental Health. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:1-18. [PMID: 36725326 DOI: 10.1080/15374416.2022.2158843] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Validly characterizing youth mental health phenomena requires evidence-based approaches to assessment. An evidence-based assessment cannot rely on a "gold standard" instrument but rather, batteries of instruments. These batteries include multiple modalities of instrumentation (e.g., surveys, interviews, performance-based tasks, physiological readings, structured clinical observations). Among these instruments are those that require soliciting reports from multiple informants: People who provide psychometrically sound data about youth mental health (e.g., parents, teachers, youth themselves). The January 2011 issue of the Journal of Clinical Child and Adolescent Psychology (JCCAP) included a Special Section devoted to the most common outcome of multi-informant assessments of youth mental health, namely discrepancies across informants' reports (i.e., informant discrepancies). The 2011 JCCAP Special Section revolved around a critical question: Might informant discrepancies contain data relevant to understanding youth mental health (i.e., domain-relevant information)? This Special Issue is a "sequel" to the 2011 Special Section. Since 2011, an accumulating body of work indicates that informant discrepancies often contain domain-relevant information. Ultimately, we designed this Special Issue to lay the conceptual, methodological, and empirical foundations of guidelines for integrating multi-informant data when informant discrepancies contain domain-relevant information. In this introduction to the Special Issue, we briefly review the last 12 years of research and theory on informant discrepancies. This review highlights limitations inherent to the most commonly used strategies for integrating multi-informant data in youth mental health. We also describe contributions to the Special Issue, including articles about informant discrepancies that traverse multiple content areas (e.g., autism, implementation science, measurement validation, suicide).
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Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
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19
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KOŞAN Y, SEÇER İ. Adaptation of Adolescent Behavioral Activation Program and Investigation of Its Effectiveness by Mixed Method. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1188941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
In this study, the Adolescent Behavioral Activation Program (A-BAP) based on behavioral activation (BA) therapy to reduce depressive symptoms in adolescents was adapted to Turkish culture, and its effectiveness was tested with intervention design, one of the mixed method designs. In this direction, experimental and control groups were formed with 20 students studying in three different high schools in Turkey and with highly elevated depressive symptoms. The study group was determined by nested sampling from mixed-method sampling strategies. The starting point of this study is the absence of any BA-based practice to reduce adolescent depression in Turkey. In this direction, experimental and control groups were formed with 20 students studying in three different high schools in Turkey and with highly elevated depressive symptoms. The adapted A-BAP was applied individually to the students in the experimental group for 12 weeks. Three sessions were also held with the parents of the students in the experimental group. In the quantitative phase of the study, pre-test and post-test control groups paired patterns from semi-experimental designs, and a case study was used in the qualitative stage. The qualitative data of the study were collected from adolescents and their parents through semi-structured interviews and session evaluation forms. It was determined that the adapted BA-based A-BAP was an effective intervention in reducing depressive symptoms in the Turkish adolescent sample and provided a significant decrease in the depression scores of the participants in the experimental group . The qualitative findings show that adolescents perceive the A-BAP process as a factor contributing to making them feel better. Adolescents have reported that A-BAP is effective in reducing avoidance behavior, achieving anger control, and increasing self-esteem and social interaction. Parents consider A-BAP as a developer, educator, and practice that reduces depressive symptoms in their children. In addition, it was determined that the qualitative findings obtained supported the quantitative results. Since the study is the first application of BA therapy in Turkey, it is thought that it will contribute to new studies in Turkey and intercultural studies at the international level.
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Affiliation(s)
| | - İsmail SEÇER
- ATATÜRK ÜNİVERSİTESİ, KAZIM KARABEKİR EĞİTİM FAKÜLTESİ
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20
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Grudin R, Ahlen J, Mataix-Cols D, Lenhard F, Henje E, Månsson C, Sahlin H, Beckman M, Serlachius E, Vigerland S. Therapist-guided and self-guided internet-delivered behavioural activation for adolescents with depression: a randomised feasibility trial. BMJ Open 2022; 12:e066357. [PMID: 36572500 PMCID: PMC9806095 DOI: 10.1136/bmjopen-2022-066357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Access to effective treatments for adolescents with depression needs to improve. Few studies have evaluated behavioural activation (BA) for adolescent depression, and none remotely delivered BA. This study explored the feasibility and acceptability of therapist-guided and self-guided internet-delivered BA (I-BA) in preparation for a future randomised controlled trial (RCT). DESIGN A single-blinded randomised controlled feasibility trial. SETTING A specialist outpatient clinic in Sweden. PARTICIPANTS Thirty-two adolescents with mild-to-moderate major depression, aged 13-17 years. INTERVENTIONS Ten weeks of therapist-guided I-BA or self-guided I-BA, or treatment as usual (TAU). Both versions of I-BA included parental support. TAU included referral to usual care within child and youth psychiatry or primary care. OUTCOMES Feasibility measures included study take-up, participant retention, acceptability, safety and satisfaction. The primary outcome measure was the blinded assessor-rated Children's Depression Rating Scale, Revised. The primary endpoint was the 3-month follow-up. RESULTS 154 adolescents were screened and 32 were randomised to therapist-guided I-BA (n=11), self-guided I-BA (n=10) or TAU (n=11). Participant retention was acceptable, with two drop-outs in TAU. Most participants in TAU had been offered interventions by the primary endpoint. The mean number of completed chapters (total of 8) for adolescents was 7.5 in therapist-guided I-BA and 5.4 in self-guided I-BA. No serious adverse events were recorded. Satisfaction was acceptable in both I-BA groups. Following an intent-to-treat approach, the linear mixed-effects model revealed that both therapist-guided and self-guided I-BA (Cohen's d=2.43 and 2.23, respectively), but not TAU (Cohen's d=0.95), showed statistically significant changes on the primary outcome measure with large within-group effect sizes. CONCLUSIONS Both therapist-guided and self-guided I-BA are acceptable and potentially efficacious treatments for adolescents with depression. It is feasible to conduct a large-scale RCT to establish the efficacy and cost-effectiveness of I-BA versus TAU. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT04117789).
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Affiliation(s)
- Rebecca Grudin
- Centre for Psychiatry Research,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Johan Ahlen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | - David Mataix-Cols
- Centre for Psychiatry Research,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Fabian Lenhard
- Centre for Psychiatry Research,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Eva Henje
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå Universitet, Umea, Sweden
| | - Cecilia Månsson
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Hanna Sahlin
- Centre for Psychiatry Research,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Maria Beckman
- Centre for Psychiatry Research,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Eva Serlachius
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Sarah Vigerland
- Centre for Psychiatry Research,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Parhiala P, Marttunen M, Gergov V, Torppa M, Ranta K. Predictors of outcome after a time-limited psychosocial intervention for adolescent depression. Front Psychol 2022; 13:955261. [DOI: 10.3389/fpsyg.2022.955261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022] Open
Abstract
Research on the predictors of outcome for early, community-based, and time-limited interventions targeted for clinical depression in adolescents is still scarce. We examined the role of demographic, psychosocial, and clinical variables as predictors of outcome in a trial conducted in Finnish school health and welfare services to identify factors associating to symptom reduction and remission after a brief depression treatment. A total of 55 12–16-year-olds with mild to moderate depression received six sessions of either interpersonal counseling for adolescents (IPC-A) or brief psychosocial support (BPS). Both interventions resulted in clinical improvement at end of treatment and 3- and 6-month follow-ups. Main outcome measures were self-rated BDI-21 and clinician-rated Adolescent Depression Rating Scale (ADRSc). Latent change score (LCS) models were used to identify predictors of change in depressive symptom scores and clinical remission at end of treatment and 3- and 6-month follow-ups over the combined brief intervention group. Symptom improvement was predicted by younger age and having a close relationship with parents. Both symptom improvement and clinical remission were predicted by male gender, not having comorbid anxiety disorder, and not having sleep difficulties. Our results add to knowledge on factors associating with good treatment outcome after a brief community intervention for adolescent depression. Brief depression interventions may be useful and feasible especially for treatment of mild and moderate depression among younger adolescents and boys, on the other hand clinicians may need to cautiously examine sleep problems and anxiety comorbidity as markers of the need for longer treatment.
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Cruwys T, Haslam C, Haslam SA, Rathbone JA, Donaldson JL. Acceptability and Feasibility of an Intervention to Enhance Social Group Belonging: Evidence From Three Trials of Groups 4 Health. Behav Ther 2022; 53:1233-1249. [PMID: 36229119 DOI: 10.1016/j.beth.2022.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 11/02/2022]
Abstract
Groups 4 Health (G4H) is a group psychotherapy program that targets social group disconnection. An emerging evidence base supports its efficacy in reducing loneliness, depression, and social anxiety. However, to date there has been no formal analysis of its acceptability to clients and therapists, nor an investigation of its feasibility for wider implementation. This input from end users is crucial to ensure the program's wider suitability and to contribute to its improvement. This study drew data from three clinical trials, including 266 G4H clients and 68 G4H therapists. From the Phase III trial only, additional data were available from 90 clients in a dose-controlled cognitive-behavioral therapy (CBT) comparison group, and focus groups/interviews with 6 therapists and 13 clients. Client satisfaction was high, with all average ratings >7/10, significantly exceeding the CBT comparison group. Therapist satisfaction with each module was >5/7. Retention was >80%. Homework completion was high, with <10% of clients saying that they had not attempted the homework. Therapists and clients both emphasized the benefits arising from G4H, and the contribution of the group context itself as a vehicle to achieve positive outcomes.
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Chang X, Ma M, Chen L, Song Z, Zhao Z, Shen W, Jiang H, Wu Y, Fan M, Wu H. Identification and Characterization of Elevated Expression of Transferrin and Its Receptor TfR1 in Mouse Models of Depression. Brain Sci 2022; 12:brainsci12101267. [PMID: 36291201 PMCID: PMC9599150 DOI: 10.3390/brainsci12101267] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Depression has become one of the severe mental disorders threatening global human health. In this study, we first used the proteomics approach to obtain the differentially expressed proteins in the liver between naive control and chronic social defeat stress (CSDS) induced depressed mice. We have identified the upregulation of iron binding protein transferrin (TF) in the liver, the peripheral blood, and the brain in CSDS-exposed mice. Furthermore, bioinformatics analysis of the Gene Expression Omnibus (GEO) database from various mouse models of depression revealed the significantly upregulated transcripts of TF and its receptor TfR1 in multiple brain regions in depressed mice. We also used the recombinant TF administration via the tail vein to detect its permeability through the blood-brain barrier (BBB). We demonstrated the permeability of peripheral TF into the brain through the BBB. Together, these results identified the elevated expression of TF and its receptor TfR1 in both peripheral liver and the central brain in CSDS-induced depressed mice, and peripheral administration of TF can be transported into the brain through the BBB. Therefore, our data provide a compelling information for understanding the potential role and mechanisms of the cross-talk between the liver and the brain in stress-induced depression.
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Affiliation(s)
- Xin Chang
- School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, China
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Mengxin Ma
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Liping Chen
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Zhihong Song
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Zhe Zhao
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Wei Shen
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Huihui Jiang
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Yan Wu
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
| | - Ming Fan
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
- School of Information Science & Engineering, Lanzhou University, Lanzhou 730000, China
| | - Haitao Wu
- School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, China
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, China
- Key Laboratory of Neuroregeneration, Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226019, China
- Correspondence: ; Tel.: +86-10-66931363
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Seewoo BJ, Rodger J, Demitrack MA, Heart KL, Port JD, Strawn JR, Croarkin PE. Neurostructural Differences in Adolescents With Treatment-Resistant Depression and Treatment Effects of Transcranial Magnetic Stimulation. Int J Neuropsychopharmacol 2022; 25:619-630. [PMID: 35089358 PMCID: PMC9380715 DOI: 10.1093/ijnp/pyac007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/11/2022] [Accepted: 01/26/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite its morbidity and mortality, the neurobiology of treatment-resistant depression (TRD) in adolescents and the impact of treatment on this neurobiology is poorly understood. METHODS Using automatic segmentation in FreeSurfer, we examined brain magnetic resonance imaging baseline volumetric differences among healthy adolescents (n = 30), adolescents with major depressive disorder (MDD) (n = 19), and adolescents with TRD (n = 34) based on objective antidepressant treatment rating criteria. A pooled subsample of adolescents with TRD were treated with 6 weeks of active (n = 18) or sham (n = 7) 10-Hz transcranial magnetic stimulation (TMS) applied to the left dorsolateral prefrontal cortex. Ten of the adolescents treated with active TMS were part of an open-label trial. The other adolescents treated with active (n = 8) or sham (n = 7) were participants from a randomized controlled trial. RESULTS Adolescents with TRD and adolescents with MDD had decreased total amygdala (TRD and MDD: -5%, P = .032) and caudal anterior cingulate cortex volumes (TRD: -3%, P = .030; MDD: -.03%, P = .041) compared with healthy adolescents. Six weeks of active TMS increased total amygdala volumes (+4%, P < .001) and the volume of the stimulated left dorsolateral prefrontal cortex (+.4%, P = .026) in adolescents with TRD. CONCLUSIONS Amygdala volumes were reduced in this sample of adolescents with MDD and TRD. TMS may normalize this volumetric finding, raising the possibility that TMS has neurostructural frontolimbic effects in adolescents with TRD. TMS also appears to have positive effects proximal to the site of stimulation.
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Affiliation(s)
- Bhedita J Seewoo
- Experimental and Regenerative Neurosciences, School of Biological Sciences, The University of Western Australia, WA, Australia
- Brain Plasticity Group, Perron Institute for Neurological and Translational Science, WA, Australia
- Centre for Microscopy, Characterisation and Analysis, Research Infrastructure Centre, The University of Western Australia, Perth, WA, Australia
| | - Jennifer Rodger
- Experimental and Regenerative Neurosciences, School of Biological Sciences, The University of Western Australia, WA, Australia
- Brain Plasticity Group, Perron Institute for Neurological and Translational Science, WA, Australia
| | - Mark A Demitrack
- Mayo Clinic, Rochester, Minnesota, USA; Trevena, Inc. Chesterbrook, Pennsylvania, USA
| | | | - John D Port
- Department of Radiology
Chesterbrook, Pennsylvania, USA
- Department of Psychiatry and Psychology
Chesterbrook, Pennsylvania, USA
| | - Jeffrey R Strawn
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA
| | - Paul E Croarkin
- Department of Psychiatry and Psychology
Chesterbrook, Pennsylvania, USA
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De Los Reyes A, Tyrell FA, Watts AL, Asmundson GJG. Conceptual, methodological, and measurement factors that disqualify use of measurement invariance techniques to detect informant discrepancies in youth mental health assessments. Front Psychol 2022; 13:931296. [PMID: 35983202 PMCID: PMC9378825 DOI: 10.3389/fpsyg.2022.931296] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/24/2022] [Indexed: 12/13/2022] Open
Abstract
On page 1 of his classic text, Millsap (2011) states, “Measurement invariance is built on the notion that a measuring device should function the same way across varied conditions, so long as those varied conditions are irrelevant [emphasis added] to the attribute being measured.” By construction, measurement invariance techniques require not only detecting varied conditions but also ruling out that these conditions inform our understanding of measured domains (i.e., conditions that do not contain domain-relevant information). In fact, measurement invariance techniques possess great utility when theory and research inform their application to specific, varied conditions (e.g., cultural, ethnic, or racial background of test respondents) that, if not detected, introduce measurement biases, and, thus, depress measurement validity (e.g., academic achievement and intelligence). Yet, we see emerging bodies of work where scholars have “put the cart before the horse” when it comes to measurement invariance, and they apply these techniques to varied conditions that, in fact, may reflect domain-relevant information. These bodies of work highlight a larger problem in measurement that likely cuts across many areas of scholarship. In one such area, youth mental health, researchers commonly encounter a set of conditions that nullify the use of measurement invariance, namely discrepancies between survey reports completed by multiple informants, such as parents, teachers, and youth themselves (i.e., informant discrepancies). In this paper, we provide an overview of conceptual, methodological, and measurement factors that should prevent researchers from applying measurement invariance techniques to detect informant discrepancies. Along the way, we cite evidence from the last 15 years indicating that informant discrepancies reflect domain-relevant information. We also apply this evidence to recent uses of measurement invariance techniques in youth mental health. Based on prior evidence, we highlight the implications of applying these techniques to multi-informant data, when the informant discrepancies observed within these data might reflect domain-relevant information. We close by calling for a moratorium on applying measurement invariance techniques to detect informant discrepancies in youth mental health assessments. In doing so, we describe how the state of the science would need to fundamentally “flip” to justify applying these techniques to detect informant discrepancies in this area of work.
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Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, The University of Maryland at College Park, College Park, MD, United States
- *Correspondence: Andres De Los Reyes,
| | - Fanita A. Tyrell
- Resilient Adaptation Across Culture and Context Lab, Department of Psychology, The University of Maryland at College Park, College Park, MD, United States
| | - Ashley L. Watts
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
| | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviour Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
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Conley CS, Raposa EB, Bartolotta K, Broner SE, Hareli M, Forbes N, Christensen KM, Assink M. The Impact of Mobile Technology-Delivered Interventions on Youth Well-being: Systematic Review and 3-Level Meta-analysis. JMIR Ment Health 2022; 9:e34254. [PMID: 35904845 PMCID: PMC9377434 DOI: 10.2196/34254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/04/2022] [Accepted: 03/05/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Rates of mental health problems among youth are high and rising, whereas treatment seeking in this population remains low. Technology-delivered interventions (TDIs) appear to be promising avenues for broadening the reach of evidence-based interventions for youth well-being. However, to date, meta-analytic reviews on youth samples have primarily been limited to computer and internet interventions, whereas meta-analytic evidence on mobile TDIs (mTDIs), largely comprising mobile apps for smartphones and tablets, have primarily focused on adult samples. OBJECTIVE This study aimed to evaluate the effectiveness of mTDIs for a broad range of well-being outcomes in unselected, at-risk, and clinical samples of youth. METHODS The systematic review used 5 major search strategies to identify 80 studies evaluating 83 wellness- and mental health-focused mTDIs for 19,748 youth (mean age 2.93-26.25 years). We conducted a 3-level meta-analysis on the full sample and a subsample of the 38 highest-quality studies. RESULTS Analyses demonstrated significant benefits of mTDIs for youth both at posttest (g=0.27) and follow-up (range 1.21-43.14 weeks; g=0.26) for a variety of psychosocial outcomes, including general well-being and distress, symptoms of diverse psychological disorders, psychosocial strategies and skills, and health-related symptoms and behaviors. Effects were significantly moderated by the type of comparison group (strongest for no intervention, followed by inert placebo or information-only, and only marginal for clinical comparison) but only among the higher-quality studies. With respect to youth characteristics, neither gender nor pre-existing mental health risk level (not selected for risk, at-risk, or clinical) moderated effect sizes; however, effects increased with the age of youth in the higher-quality studies. In terms of intervention features, mTDIs in these research studies were effective regardless of whether they included various technological features (eg, tailoring, social elements, or gamification) or support features (eg, orientation, reminders, or coaching), although the use of mTDIs in a research context likely differs in important ways from their use when taken up through self-motivation, parent direction, peer suggestion, or clinician referral. Only mTDIs with a clear prescription for frequent use (ie, at least once per week) showed significant effects, although this effect was evident only in the higher-quality subsample. Moderation analyses did not detect statistically significant differences in effect sizes based on the prescribed duration of mTDI use (weeks or sessions), and reporting issues in primary studies limited the analysis of completed duration, thereby calling for improved methodology, assessment, and reporting to clarify true effects. CONCLUSIONS Overall, this study's findings demonstrate that youth can experience broad and durable benefits of mTDIs, delivered in a variety of ways, and suggest directions for future research and development of mTDIs for youth, particularly in more naturalistic and ecologically valid settings.
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Affiliation(s)
- Colleen S Conley
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | | | - Kate Bartolotta
- Department of Psychology, Fordham University, Bronx, NY, United States
| | - Sarah E Broner
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Maya Hareli
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Nicola Forbes
- Department of Psychology, Fordham University, Bronx, NY, United States
| | - Kirsten M Christensen
- Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Mark Assink
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, Netherlands
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Dippel N, In-Albon T, Schneider S, Christiansen H, Brakemeier EL. Investigating the feasibility and effectiveness of a modular treatment program for children and adolescents with depression and interpersonal problems: study protocol of a quasi-experimental pilot feasibility trial (CBASP@YoungAge). Pilot Feasibility Stud 2022; 8:145. [PMID: 35821072 PMCID: PMC9275387 DOI: 10.1186/s40814-022-01091-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 06/07/2022] [Indexed: 12/12/2022] Open
Abstract
Background Depression is a serious disorder in childhood and adolescence. Affected children and adolescents show significant impairments in various aspects of life. Studies on the effectiveness or efficacy of psychotherapy in depressed children and adolescents are qualitatively very heterogeneous and reveal small effect sizes. There is thus a need to better tailor psychotherapy approaches to these age groups to improve outcomes like parent-child relationship, symptomatology, or quality of life. To address this gap, we designed a modular, individualized treatment program for children and adolescents based on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) including caregiver involvement. Method This quasi-experimental pilot feasibility trial is a phase 1 to phase 2 study investigating the feasibility and effectiveness of CBASP@YoungAge by including an intervention group (CBASP@YoungAge) and a treatment-as-usual control group. The treatment of depressive symptoms as well as interpersonal problems with primary caregivers are the main targets of CBASP@YoungAge. Personalization is ensured concerning the treatment course, caregivers’ involvement, and the patient’s age. The primary outcome relates to two areas: the feasibility of the CBASP@YoungAge treatment program in an outpatient context and a change in patients' depressive symptomatology from before to after treatment. We conduct a brief process evaluation after each session in the intervention group to closely monitor the treatment process and examine feasibility from the therapists' and patients' perspectives and mechanisms of symptom change. In addition, we consider interpersonal behavior between children and caregivers, parenting behavior, and monitor the global-health-index in children and parents as secondary outcomes. Pre-, post-, and follow-up data are evaluated. Discussion This is the first study of a modular-based intervention program for children and adolescents with depression and a clear focus on the interpersonal problems between the depressed young patient and her/his caregiver. It will provide important knowledge on the feasibility and effectiveness of the program and potential benefits of including caregivers in psychotherapy. Based on this study’s results, we plan a multicenter, randomized, controlled trial whose long-term aim is to improve the psychotherapeutic care of young patients with depression while preventing persistent courses of depressive disorders. Trial registration German Clinical Trials Register, DRKS (identifier DRKS00023281). Registered 17 November 2020–Retrospectively registered Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01091-3.
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Affiliation(s)
- N Dippel
- Philipps-University Marburg, Marburg, Germany.
| | - T In-Albon
- University of Koblenz-Landau, Landau, Germany
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Lorentzen V, Fagermo K, Handegård BH, Neumer SP, Skre I. Long-term effectiveness and trajectories of change after treatment with SMART, a transdiagnostic CBT for adolescents with emotional problems. BMC Psychol 2022; 10:167. [PMID: 35791020 PMCID: PMC9258229 DOI: 10.1186/s40359-022-00872-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 06/27/2022] [Indexed: 11/14/2022] Open
Abstract
Background There is a need for long-term effectiveness trials of transdiagnostic treatments. This study investigates the effectiveness and diagnosis-specific trajectories of change in adolescent patients attending SMART, a 6-week transdiagnostic CBT for anxiety and depression, with 6-month follow-up. Methods A randomized controlled trial with waiting list control (WLC) was performed at three child and adolescent mental health outpatient services (CAMHS) in Norway. Referred adolescents (N = 163, age = 15.72, 90.3% females) scoring 6 or more on the emotional disorders subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomly assigned to treatment or to WLC. Long-term follow-up (N = 83, baseline age = 15.57, 94% females) was performed 6 months after treatment completion (Mean = 7.1 months, SD = 2.5). Linear mixed model analysis was used to assess time by group effects in patients with no diagnosis, probable anxiety, depressive disorder, and combined anxiety and depressive disorder. Results Almost one third (31%) obtained full recovery according to the inclusion criterium (SDQ emotional). There was highly significant change in all outcome variables. Effect sizes (ES) were largest for general functioning, measured with CGAS (ES: d = 2.19), and on emotional problems measured with SDQ (ES: d = 2.10), while CORE-17, BDI-II and CGAS all obtained ES’s close to 1. There were no significant time by diagnostic group interactions for any outcomes, indicating similar trajectories of change, regardless of diagnostic group. Waiting 6 weeks for treatment had no significant impact on long-term treatment effects. Limitations Possible regression to the mean. Attrition from baseline to follow-up. Conclusions Six weeks of transdiagnostic treatment for adolescents with emotional problems showed highly significant change in emotional symptoms and functioning at 6-month follow-up. Patients with anxiety, depression, combined anxiety and depression, and emotional problems with no specific diagnoses, all had similar trajectories of change. Hence this transdiagnostic SMART treatment can be recommended for adolescent patients with symptoms within the broad spectrum of emotional problems. Trial registration: ClinicalTrials.gov Identifier: NCT02150265. First registered May 29, 2014.
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Affiliation(s)
- Veronica Lorentzen
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway. .,Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North Norway, P.O. Box 19, 9038, Tromsø, Norway.
| | - Kenneth Fagermo
- Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North Norway, P.O. Box 19, 9038, Tromsø, Norway
| | - Bjørn Helge Handegård
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Simon-Peter Neumer
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, 0484, Oslo, Norway
| | - Ingunn Skre
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Department of General Psychiatry, University Hospital of North-Norway, P.O. Box 6124, 9291, Tromsø, Norway
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Zhang R, Xie R, Ding W, Wang X, Song S, Li W. Why is my world so dark? Effects of child physical and emotional abuse on child depression: The mediating role of self-compassion and negative automatic thoughts. CHILD ABUSE & NEGLECT 2022; 129:105677. [PMID: 35640351 DOI: 10.1016/j.chiabu.2022.105677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/29/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The adverse effects of childhood maltreatment on the mental health of individuals have received increasing attention. However, it is unclear whether the effects of invisible emotional abuse and visible physical abuse differ on child depression and the mediating processes under this relationship. OBJECTIVE This study aimed to investigate whether self-compassion and negative automatic thoughts mediated the effects of physical abuse and emotional abuse on child depression and the underlying mechanistic differences. PARTICIPANTS AND SETTING Using a two-wave longitudinal design, a total of 946 elementary school students completed the self-report questionnaires at two-time points, including child abuse, self-compassion, negative automatic thoughts, and depression. METHODS This study constructed structural equation models (SEM) to examine the mediating role of self-compassion and negative automatic thoughts between emotional/physical abuse and child depression. RESULTS After controlling for demographic covariates, structural equation modeling (SEM) showed that only physical abuse significantly and positively predicted child depression directly (β = 0.16, p < 0.01). Emotional abuse was positively associated with child depression through self-compassion (β = 0.02, p < 0.05) and negative automatic thoughts (β = 0.02, p < 0.05), while physical abuse influenced child depression only via negative automatic thoughts (β = 0.07, p < 0.001). CONCLUSIONS The findings showed a strong association between emotional/physical abuse and child depression, but there were mechanistic differences under these relationships. Therefore, we also need to pay equal attention to the adverse effects of emotional abuse on children.
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Affiliation(s)
- Rui Zhang
- Parent Education Research Center in Zhejiang Normal University, Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Jinhua 321004, China
| | - Ruibo Xie
- Parent Education Research Center in Zhejiang Normal University, Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Jinhua 321004, China
| | - Wan Ding
- Parent Education Research Center in Zhejiang Normal University, Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Jinhua 321004, China.
| | - Xiaoyue Wang
- Parent Education Research Center in Zhejiang Normal University, Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Jinhua 321004, China
| | - Shengcheng Song
- Parent Education Research Center in Zhejiang Normal University, Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Jinhua 321004, China
| | - Weijian Li
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua 321004, China
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30
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Milgram L, Tonarely NA, Ehrenreich-May J. Youth Top Problems and Early Treatment Response to the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents. Child Psychiatry Hum Dev 2022; 53:582-598. [PMID: 33733398 DOI: 10.1007/s10578-021-01151-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 12/01/2022]
Abstract
The Top Problems assessment is an idiographic measure of client concerns that may allow clinicians to identify early treatment response. Few studies have examined early response to evidence-based therapies using Top Problems. We collected weekly Top Problems ratings from 95 youth with emotional disorders who received treatment using the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/UP-A). We assessed Top Problems rating change from session 1 to session 4, the role of pre-treatment variables in early Top Problems rating change, and the role of early Top Problems rating change in post-treatment symptom outcomes. Top Problems ratings decreased significantly from session 1 to session 4. Younger child age and higher parent cognitive flexibility were associated with early Top Problems improvement. Controlling for pre-treatment, early Top Problems rating change did not explain the variance in post-treatment outcomes. Future research should examine Top Problems trajectories over treatment course.
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Affiliation(s)
- Lauren Milgram
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
| | - Niza A Tonarely
- Department of Psychology, University of Miami, Coral Gables, FL, USA
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Diamond G, Kodish T, Ewing ESK, Hunt QA, Russon JM. Family processes: Risk, protective and treatment factors for youth at risk for suicide. AGGRESSION AND VIOLENT BEHAVIOR 2022; 64:101586. [PMID: 35662798 PMCID: PMC9159634 DOI: 10.1016/j.avb.2021.101586] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Family factors have continually been identified as potential risk and protective factors for youth at risk for suicide. This paper reviews family processes that not only are associated with suicide risk, but also might be malleable enough to target in treatment. We also review family intervention components have been incorporated into most youth suicide treatments. Unfortunately research on if these family processes moderator, mediator or change as a result of treatment is limited. Recommendations for future research are offered.
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32
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Yan R, Xie R, Jiang M, Li J, Lin X, Ding W. Longitudinal Relationship Between Bullying Victimization and Depression Among Left-Behind Children: Roles of Negative Thoughts and Self-Compassion. Front Psychol 2022; 13:852634. [PMID: 35418919 PMCID: PMC8996169 DOI: 10.3389/fpsyg.2022.852634] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022] Open
Abstract
Background Left-behind children (LBC) in China have aroused widespread concern in society and the academic field because they have a high risk of psychological problems. For left-behind children, depression is the most serious problem. Bullying victimization has been evidenced as one of the most common causes of children’s depression. However, less is known about its longitudinal association and the process for how bullying victimization influences depression among left-behind children. Thus, the presentation aims to explore the mechanisms underlying by considering the roles of left-behind children’s negative thoughts and self-compassion. Methods The 3-wave longitudinal data were collected from a sample of 605 aged 8–11 from central China. We used the Olweus bully and victimization questionnaire, the children’s automatic thoughts scale, the depression scale, and the self-compassion scale. Results Bullying victimization positively predicted the depression level of left-behind children. Negative thoughts and self-compassion mediate the relationship between bullying victimization and depression. In the mechanism of bullying victimization on depression exists gender differences among left-behind children. Conclusion The present study suggested the association between bullying victimization and left-behind children’s depression and revealed the internal mechanism of negative thoughts and self-compassion. These findings provide a new perspective for left-behind children’s mental health education and intervention.
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Affiliation(s)
- Ru Yan
- Parent Education Research Center in Zhejiang Normal University, Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Jinhua, China
| | - Ruibo Xie
- Parent Education Research Center in Zhejiang Normal University, Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Jinhua, China
| | - Min Jiang
- Parent Education Research Center in Zhejiang Normal University, Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Jinhua, China
| | - Jiayi Li
- Parent Education Research Center in Zhejiang Normal University, Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Jinhua, China
| | - Xiuyun Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, China
| | - Wan Ding
- Parent Education Research Center in Zhejiang Normal University, Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Jinhua, China
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Wu W, Lu Y. Is Teachers' Depression Contagious to Students? A Study Based on Classes' Hierarchical Models. Front Public Health 2022; 10:804546. [PMID: 35387183 PMCID: PMC8977487 DOI: 10.3389/fpubh.2022.804546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background According to the theory of emotional contagion, emotions in one person can trigger similar emotions in groups within social networks. In schools, the class just like a small social network, that teachers' emotion, such as depression, might be contagious to their students. However, until now there is few studies reporting this issue. This study aims to explore whether teachers' depression be contagious to students and what mechanics behind the phenomenon. Methods Using Children's depression and cognitive scales to assess 2,579 students, meanwhile using teachers' depression and emotional labor scales assess 529 teachers. The nested data from 112 classes were analyzed. Results Teachers' depression was positively correlated with emotional labor surface and deep acting, and teachers' depression cross-level predicted students' depression inversely. For teachers with higher levels of depression, the teacher's deep acting affected their students' depression significantly, the more effortful the teachers' deep acting, the lower the degree of the students' depression, however, for teachers with lower levels of depression, the deep acting was not significant. Conclusion The results maybe state that depression in teachers is not readily transmitted to students, one of reasons is that teachers' emotional labor may alleviate the influence of their depression on students. However, considered that teachers' emotional labor was positively correlated with their depression, the teachers' emotional labor may be like a double-edged sword, while alleviating the influence of teachers' depression on students, it also deteriorated their own depression, making it impossible sustainable. For students' depression interventions based in school, including teachers maybe a better selection.
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Affiliation(s)
- Wenfeng Wu
- The School of Psychology, Guizhou Normal University, Guiyang, China
| | - Yongbiao Lu
- The School of Psychology, Guizhou Normal University, Guiyang, China
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South African youth's understanding of feelings, thoughts and behaviours: Implications for the development of CBT-based mental health interventions. Behav Cogn Psychother 2022; 50:447-461. [PMID: 35388781 DOI: 10.1017/s1352465822000145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Mental health problems are common in youth in low- and middle-income countries (LMICs), including South Africa. Preventative interventions, based on cognitive behaviour therapy (CBT), delivered in schools, have been found to alleviate symptoms of depression and anxiety in high income countries (HICs). However, less is known about whether youth in LMICs are able to engage with the core concepts of CBT. AIMS To explore how young people in the Western Cape, South Africa, understand key CBT concepts, such as feelings, thoughts and behaviours. METHOD We interviewed 22 young people (10-15 years of age; mean age 11.6 years; SD = 1.0) recruited from two public primary schools in the Western Cape, South Africa. Interviews were audio-recorded, transcribed verbatim, translated from Afrikaans into English where necessary and analysed thematically using a deductive approach. RESULTS Young people described feelings as internal, private, and should only be shared with trusted others. They also described how feelings varied, depending on the situation. They found the concept of thoughts more challenging to describe. Youth were able to say what they do when they experience unpleasant feelings, and they linked their behaviours to their feelings and thoughts. CONCLUSIONS In this cultural context, our qualitative investigation found evidence that young people were able to engage with abstract concepts including feelings and to some degree, thoughts. To ensure that CBT-based interventions are developmentally appropriate and accessible, psychoeducation may help youth distinguish between thoughts, feelings and behaviours, and a focus on identifying and naming feelings may be beneficial.
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Cruwys T, Haslam C, Rathbone JA, Williams E, Haslam SA, Walter ZC. Groups 4 Health versus cognitive-behavioural therapy for depression and loneliness in young people: randomised phase 3 non-inferiority trial with 12-month follow-up. Br J Psychiatry 2022; 220:140-147. [PMID: 35049477 DOI: 10.1192/bjp.2021.128] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Depression treatments are typically less effective for young people than for adults. However, treatments rarely target loneliness, which is a key risk factor in the onset, maintenance and development of depression. AIMS This study evaluated the efficacy of a novel loneliness intervention, Groups 4 Health (G4H), relative to the best-practice treatment of cognitive-behavioural therapy (CBT) in reducing loneliness and depression over a 12-month period (Australian New Zealand Clinical Trial Registry: ACTRN12618000440224). METHOD The study was a phase 3 randomised non-inferiority trial comparing G4H with dose-controlled group CBT. Participants were 174 people aged 15-25 years experiencing loneliness and clinically significant symptoms of depression, who were not in receipt of adjunct treatment. Participants were recruited from mental health services in Southeast Queensland, Australia. Randomisation was conducted using computer software. Follow-up assessments and statistical analyses were masked to allocation. Both interventions consisted of five 75 min group-based psychotherapy sessions. The primary outcomes were depression and loneliness, with a non-inferiority margin of 2.20 for depression. RESULTS The trial enrolled 174 participants between 24 April 2018 and 25 May 2019, with 84 in the G4H condition and 90 in the CBT condition. All randomised participants were included in the intention-to-treat analyses (n = 174). The pre-post effect sizes for depression were dG4H = -0.71 and dCBT = -0.91. For loneliness, they were dG4H = -1.07 and dCBT = -0.89. At 12-month follow-up, the absolute difference between groups on depression was 1.176 (95% CI -1.94 to 4.29) and on loneliness it was -0.679 (95% CI -1.43 to 0.07). No adverse effects were observed. CONCLUSIONS G4H was non-inferior to CBT for depression and showed a slight advantage over CBT for loneliness that emerged after treatment completion.
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Affiliation(s)
- Tegan Cruwys
- Research School of Psychology, Australian National University, Canberra, Australia
| | - Catherine Haslam
- School of Psychology, University of Queensland, Brisbane, Australia
| | | | - Elyse Williams
- School of Psychology, University of Queensland, Brisbane, Australia
| | | | - Zoe C Walter
- School of Psychology, University of Queensland, Brisbane, Australia
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White K, Lubans DR, Eather N. Feasibility and preliminary efficacy of a school-based health and well-being program for adolescent girls. Pilot Feasibility Stud 2022; 8:15. [PMID: 35065669 PMCID: PMC8783480 DOI: 10.1186/s40814-021-00964-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 12/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The primary aim of this pilot study was to evaluate the feasibility and preliminary efficacy of a school-based health and well-being program (Health and Well-being for Girls: HWBG) on adolescent girls' well-being, mindfulness, screen-time, and physical activity. METHOD The HWBG program was evaluated using a group randomized controlled trial (RCT) in one secondary school. A convenience sample of female students in Grade 8 (mean age 14 ± 0.5 years) was recruited for the study (n=4 classes; 89 girls). The 20-week multi-component HWBG program, guided by Self-Determination Theory and Acceptance and Commitment Therapy, was designed and delivered by a member of the research team. Randomization occurred prior to baseline assessments at the class level (n=4 classes) into dose-matched treatment conditions (i.e., two classes received the HWBG intervention and two classes received an alternate elective course as a wait-list control group). Process evaluation measures of recruitment, retention, adherence, and satisfaction were used to determine program feasibility. This study was designed to assess feasibility (primary outcome) and preliminary efficacy (secondary outcomes), rather than effectiveness. Preliminary efficacy of HWBG for improving mental and social health, screen-time, and physical activity were measured and analyzed using linear mixed-models. RESULTS "The health and well-being program" targeting adolescent girls was found to be feasible for implementation as an elective course in a secondary school setting. Participants in the HWBG program reported high levels of satisfaction, the majority of lessons (45 out of 50), were implemented as planned and adherence to the planned HWBG program content was very high. Medium positive effects on mental health (d=0.45) and social health (d=0.50) were observed. Small effects were observed for physical activity, and no significant intervention effects were found for levels of recreational screen time. Participant ratings showed high levels of perceived benefit and enjoyment as indicated in the evaluation data (mean rating of 4.44 out of a possible 5.0) when asked whether the program was enjoyable. CONCLUSION The study provides preliminary support for HWBG as a potentially feasible and enjoyable program suitable for use with adolescent girls in the secondary school setting. Potential of the study for facilitating improvements in pro-social and psychological well-being is also supported. TRIAL REGISTRATION ACTRN12617000157370 . The trial was registered with the Australian New Zealand Clinical Trials Registry.
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Affiliation(s)
- Karen White
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
- Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, Australia
| | - David R Lubans
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
- Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, Australia
| | - Narelle Eather
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia.
- Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, Australia.
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Dickson KS, Kenworthy L, Anthony L, Brookman-Frazee L. Mental Health Therapist Perspectives on the Role of Executive Functioning in Children's Mental Health Services. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 8:39-54. [PMID: 36950479 PMCID: PMC10027378 DOI: 10.1080/23794925.2021.2013142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Executive functioning is considered a key transdiagnostic factor underlying multiple mental health conditions. Evidence-based interventions targeting executive functioning skills exist and there are ongoing efforts to implement these interventions in routine community-based care. However, there is limited research characterizing therapist perspectives regarding addressing executive functioning within community-based mental health services. The current mixed-methods study aims to characterize mental health therapist perspectives regarding the role of executive functioning in youth clinical presentation and the psychotherapy process and outcomes as well as their experience and training related to executive functioning. Forty-three therapists completed a survey about their perspectives about executive functioning and 14 participated in subsequent focus groups to expand survey results. Results indicated that therapists perceive executive functioning challenges as impacting a large portion of children on their caseload, present across multiple mental health conditions, and that executive functioning is frequently a focus of psychotherapy. Therapists also identified executive functioning challenges as a barrier to therapy engagement and effectiveness. However, therapists reported limited knowledge and training as well as significant motivation for executive functioning training, including executive functioning interventions. Findings confirm the significant role of executive functioning in youth presenting for mental health services and the psychotherapy process and outcomes. Findings also highlight the need for further translation of evidence-based interventions and tools. Challenges as well as potential solutions to inform ongoing and future work seeking to translate and implement evidence-based executive functioning interventions in community mental health services are discussed.
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Affiliation(s)
- Kelsey S. Dickson
- San Diego State University, San Diego, CA
- Child and Adolescent Services Research Center, San Diego,
CA
| | - Lauren Kenworthy
- Center for Autism Spectrum Disorders –
Children’s National Hospital, Washington, DC
| | - Laura Anthony
- University of Colorado School of Medicine, Aurora, CO
- Children’s Hospital of Colorado, Aurora, CO
| | - Lauren Brookman-Frazee
- Child and Adolescent Services Research Center, San Diego,
CA
- University of California, San Diego, CA
- Rady Children’s Hospital-San Diego, CA
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38
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Jones GM, Nock MK. Lifetime use of MDMA/ecstasy and psilocybin is associated with reduced odds of major depressive episodes. J Psychopharmacol 2022; 36:57-65. [PMID: 34983261 DOI: 10.1177/02698811211066714] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression is a major mental health issue worldwide, with high rates of chronicity and non-recovery associated with the condition. Existing treatments such as antidepressant medication and psychological treatments have modest effectiveness, suggesting the need for alternative interventions. AIM The aim of this study was to examine the relationships between MDMA (3,4-methylenedioxymethamphetamine)/ecstasy and psilocybin use and major depressive episodes (MDEs). METHODS This observational study used data from a large (N = 213,437) nationally representative sample of US adults to test the association of lifetime use of MDMA/ecstasy, psilocybin and other classic psychedelics (lysergic acid diethylamide (LSD), peyote, mescaline), other illegal substances (e.g. cocaine, phencyclidine (PCP)), and legal/medicinal substances of misuse (e.g. pain relievers, tranquilizers) with lifetime, past year, and past year severe MDEs. RESULTS Results revealed that lifetime MDMA/ecstasy use was associated with significantly lowered odds of a lifetime MDE (adjusted odds ratio (aOR) = 0.84; p < 0.001), past year MDE (aOR = 0.84; p < 0.001), and past year severe MDE (aOR = 0.82; p < 0.001). Psilocybin was associated with significantly lowered odds of a past year MDE (aOR = 0.90; p < 0.05) and past year severe MDE (aOR = 0.87; p < 0.05). All other substances either shared no relationship with a MDE or conferred increased odds of an MDE. CONCLUSIONS These results suggest that MDMA/ecstasy and psilocybin use is associated with lower risk of depression. Experimental studies are needed to test whether there is a causal association between use of these compounds and the alleviation of depressive symptoms.
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Affiliation(s)
- Grant M Jones
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
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Hervé MJ, Maurice V, Gamon L, Rusconi Serpa S, Trojan D, Guedeney N, Tereno S, Guedeney A, Myquel M, Fernandez A, Raynaud JP, Poinso F, Maury M, Purper-Ouakil D, Picot MC. Predictive factors for the outcome of emotional and/or behavioural disorders in 18- to 48-month-old children after parent-child psychotherapy: Protocol of a European prospective cohort study. Encephale 2022; 49:254-260. [DOI: 10.1016/j.encep.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/09/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
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40
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Bångstad A, Fellman J, Rosendahl C, Bellander M, Cervin M, Bjureberg J, Klintwall L. Perceived causal symptom network of adolescent mental health issues. J Child Adolesc Ment Health 2022; 34:101-114. [PMID: 38632957 DOI: 10.2989/17280583.2023.2283032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Adolescent mental health is difficult to capture in categories such as depression or specific anxiety disorders. An alternative is to approach psychiatric symptoms as causal networks, potentially revealing feedback loops that maintain a pathological state. One approach to creating such networks, implemented in the PECAN methodology, is to ask adolescents about their perceptions of the causes to their symptoms. For this purpose, a transdiagnostic item list was created, and adolescents who screened positive for depression (N = 55) completed twice in two weeks a survey quantifying perceptions of causality between their mental health problems. A network that was averaged across all participants was reliable and revealed three strong feedback loops: a first loop running through stress, insomnia, fatigue, procrastination, and back to stress; a second loop between stress and overthinking; and a third loop between stress and procrastination. Although all adolescents in the study screened positive for depression, symptoms of depression were not particularly central to the network. Instead, the most central symptoms were procrastination and overthinking. The average test-retest reliability for individual networks was low, limiting clinical application. In conclusion, PECAN was found to be reliable and useful when creating a group-level network of adolescent mental health problems. While informative at a group level, the method should be improved before it can be used to inform treatment at the individual level.
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Affiliation(s)
- Amanda Bångstad
- Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Judit Fellman
- Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Carl Rosendahl
- Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Martin Bellander
- Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Matti Cervin
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Johan Bjureberg
- Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Lars Klintwall
- Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
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Lin CH, Chen FC, Lin TC, Lin HY. A comparison of core depressive symptom improvement with anxiety symptom reduction for depressed patients treated with fluoxetine. TAIWANESE JOURNAL OF PSYCHIATRY 2022. [DOI: 10.4103/tpsy.tpsy_20_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Morgan AJ, Ross AM, Yap MBH, Reavley NJ, Parker A, Simmons MB, Scanlan F, Jorm AF. What works for mental health problems in youth? Survey of real-world experiences of treatments and side effects. Early Interv Psychiatry 2021; 15:1502-1512. [PMID: 33260268 DOI: 10.1111/eip.13087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/28/2020] [Accepted: 11/14/2020] [Indexed: 11/26/2022]
Abstract
AIM Despite youth being the most common age group for onset of mental disorders, there is less knowledge on the benefits and harms of treatments in young people. In addition, efficacy data from randomized controlled trials may not generalize to how treatment works outside of research settings. This study aimed to investigate young people's perceived effectiveness of different treatments for mental health problems, the professionals who delivered these, and the experience of negative effects. METHODS We developed a consumer report website where young people who were ever diagnosed with a mental disorder provided ratings on the helpfulness or harmfulness of different types of professionals, mental health treatments (medical, psychological complementary/alternative) and self-help strategies, and whether they had experienced particular negative effects. RESULTS Here, 557 young people aged 12-25 years, who were recruited from English-speaking, high-income countries, provided 1258 ratings of treatments. All treatments showed varied perceptions of effectiveness. Medical and psychological treatments were rated moderately helpful on average with low rates of harmfulness. Self-help strategies were rated as being as helpful as professional treatments. Side effects related to the head or mind (e.g., concentration difficulties, inability to feel emotions, depression and irritability) were the most common across all types of medicines. For psychological treatments, treatment being too expensive and feeling worse at the end of a session were the most commonly reported negative effects. CONCLUSIONS Study findings may be a useful guide to clinicians, researchers, young people and their families about what is likely to work in real-world settings.
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Affiliation(s)
- Amy J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Anna M Ross
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Marie B H Yap
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Alexandra Parker
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Magenta B Simmons
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Faye Scanlan
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,headspace, The National Youth Mental Health Foundation, Melbourne, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
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A pilot practice-based outcomes evaluation of low-intensity cognitive behavioural interventions delivered by postgraduate trainees to children and young people with mild to moderate anxiety or low mood: an efficient way forward in mental health care? COGNITIVE BEHAVIOUR THERAPIST 2021. [DOI: 10.1017/s1754470x21000301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Anxiety and depression affect a significant number of children and young people (CYP) and can have a far reaching and long-lasting impact. Cognitive behavioural (CB) interventions can be effective for treating anxiety and depression in CYP but are difficult to access. Recent government policy in England seeks to train a non-traditional graduate workforce to deliver a range of CB interventions for mild to moderate anxiety and depression to CYP, in community settings. This practice-based evaluation aimed to estimate the effectiveness of CB interventions delivered by postgraduate trainees undertaking training in a range of CB interventions for mild to moderate anxiety and depression whilst on placement in schools or community Child and Adolescent Mental Health Services (CAMHS). Self- and parent-reported routine outcome measures (ROMS) were completed pre- and post-intervention, including measures of symptom severity, symptom impact and goal achievement. Significant improvements were demonstrated across all self and parent-reported measures post-intervention, with mean scores falling firmly in the non-clinical range, a significant reduction in the proportion of CYP in the clinical range on measures, and predominantly medium to large effect sizes. Results are promising in terms of the capacity to train a graduate workforce to deliver a range of low-intensity CB interventions to CYP experiencing mild to moderate depression or anxiety-based difficulties in either CAMHS or school settings, increasing capacity across the system. The current practice-based evaluation also supports the potential effectiveness of current training models/programmes. Further research is needed in terms of long-term outcomes and to compare outcomes between settings, interventions, and demographic groups.
Key learning aims
(1)
To understand the potential prevalence rates of mental health difficulties in children and young people in England, and their wider impact.
(2)
Critical awareness of the evidence base for cognitive and behavioural interventions for depression and anxiety in children and young people.
(3)
Awareness of gaps in access to evidence-based psychological interventions for children and young people in England.
(4)
Knowledge of emerging graduate-level low-intensity psychological practitioner roles in England.
(5)
Awareness of the emerging evidence base for the estimated effectiveness of low-intensity cognitive and behavioural interventions delivered to children and young people by graduate-level practitioners in schools and community mental health settings.
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Shuper-Engelhard E, Moshe S, Kedem D, Regev D. The Parent–Child Movement Scale (PCMS): Observing emotional facets of mother–child relationships through joint dance. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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45
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van den Heuvel MWH, Bodden DHM, Smit F, Stikkelbroek Y, Weisz JR, Moerbeek M, Engels RCME. Relative Effectiveness of CBT-Components and Sequencing in Indicated Depression Prevention for Adolescents: A Cluster-Randomized Microtrial. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2021:1-16. [PMID: 34644218 DOI: 10.1080/15374416.2021.1978296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Cognitive Behavioral Therapy (CBT) was dismantled into four modules of three sessions each: cognitive restructuring (Think), behavioral activation (Act), problem solving (Solve) and relaxation (Relax). We investigated the modules' relative effectiveness in indicated depression prevention for adolescents and examined variations in sequencing of these modules. METHOD We performed a pragmatic cluster-randomized microtrial with four parallel conditions: (1) Think-Act-Relax-Solve (n = 14 clusters, n = 81 participants); (2) Act-Think-Relax-Solve (n = 13, n = 69); (3) Solve-Act-Think-Relax (n = 13, n = 77); and (4) Relax-Solve-Act-Think (n = 12, n = 55). The sample consisted of 282 Dutch adolescents with elevated depressive symptoms (Mage = 13.8; 55.7% girls, 92.9% Dutch). In total 52 treatment groups were randomized as a cluster. Assessments were conducted at baseline, after each module and at 6-month follow-up with depressive symptoms as primary outcome. RESULTS None of the modules (Think, Act, Solve, Relax) was associated with a significant decrease in depressive symptoms after three sessions and no significant differences in effectiveness were found between the modules. All sequences of modules were associated with a significant decrease in depressive symptoms at post-intervention, except the sequence Relax-Solve-Act-Think. At 6-month follow-up, all sequences showed a significant decrease in depressive symptoms. No significant differences in effectiveness were found between the sequences at post-intervention and 6-month follow-up. CONCLUSIONS Regardless of the CBT technique provided, one module of three sessions may not be sufficient to reduce depressive symptoms. The sequence in which the CBT components cognitive restructuring, behavioral activation, problem solving and relaxation are offered, does not appear to significantly influence outcomes at post- intervention or 6-month follow-up. ABBREVIATIONS CDI-2:F: Children's Depression Inventory-2 Full-length version; CDI-2:S: Children's Depression Inventory-2 Short version; STARr: Solve, Think, Act, Relax and repeat.
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Affiliation(s)
- Marieke W H van den Heuvel
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam.,Department of Mental Health and Prevention, Trimbos Institute, Netherlands Institute of Mental Health and Addiction
| | - Denise H M Bodden
- Child and Adolescent Studies, Utrecht University.,Altrecht, Child and Youth Psychiatry
| | - Filip Smit
- Department of Mental Health and Prevention, Trimbos Institute, Netherlands Institute of Mental Health and Addiction.,Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers.,Department of Clinical, Neuro and Developmental Psychology, VU University
| | - Yvonne Stikkelbroek
- Child and Adolescent Studies, Utrecht University.,GGZ Oost Brabant, Depression Expertise Center, Youth Psychiatry
| | | | - Mirjam Moerbeek
- Department of Methodology and Statistics, Utrecht University
| | - Rutger C M E Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam
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46
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Long Term Outcomes of Blended CBT Compared to Face-to-Face CBT and Treatment as Usual for Adolescents with Depressive Disorders: Analyses at 12 Months Post-Treatment. SOCIAL SCIENCES 2021. [DOI: 10.3390/socsci10100373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Depression is a major problem in youth mental health and identified as the leading cause of disability worldwide. There is ample research on the acute effects of treatment, with estimated small-to-moderate effect sizes. However, there is a lack of research on long-term outcomes. A total of 129 adolescents with clinical depression (82.2% female), aged 13–22 (M = 16.60, SD = 2.03), received blended CBT, face-to-face CBT or treatment as usual. Data were collected at 12 months after the intervention and compared between treatment conditions. Clinical diagnosis, depressive symptoms, suicide risk, internalizing symptoms and externalizing symptoms decreased significantly over time, from baseline to the 12-month follow-up, and also from post-treatment to the 12-month follow-up in all three conditions. Changes were not significantly different between conditions. At the long-term, improvements following the treatment continued. Due to the large amount of missing data and use of history control condition, our findings need to be interpreted with caution. However, we consider these findings as a clinical imperative. More evidence might contribute to convincing adolescents to start with therapy, knowing it has lasting effects. Further, especially for adolescents for whom it is not possible to receive face-to-face treatment, blended treatment might be a valuable alternative. Our findings might contribute to the implementation of blended CBT.
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47
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Behavioral Activation (BA) in the Management of Depression in an Adolescent with Down Syndrome in Dubai. Case Rep Psychiatry 2021; 2021:7112034. [PMID: 34580616 PMCID: PMC8464408 DOI: 10.1155/2021/7112034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 11/28/2022] Open
Abstract
Depression has been commonly treated with psychotherapy and/or pharmacotherapy for several decades. Ongoing research in the field has suggested promise for behavioral activation (BA), a form of psychotherapeutic intervention, as a means of increasing engagement in adaptive activities and developing skills to counter avoidance in individuals suffering from depression. In this case report, we present the treatment course of BA for an adolescent with Down syndrome (DS), presenting with depression. A multidisciplinary approach was utilized in developing a personalized management plan for the patient since the initial presentation. Sessions at the outpatient psychiatry clinic alternated between in-person visits and virtual ones, due to circumstances associated with physical distancing with the COVID-19 pandemic. Parents were included as integral parts of the management plan, and education, strategic implementation of BA, and barriers to care were discussed extensively to support the adolescent through the course of her treatment. Within 6 weeks of introducing BA, positive outcomes were noted in the patient, with the resolution of her clinical depression. In this report, we discuss BA further as a potentially effective therapeutic approach to the treatment of depressive symptoms in children and adolescents with DS and intellectual disabilities.
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48
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Zhou M, Bian B, Zhu W, Huang L. A Half Century of Research on Childhood and Adolescent Depression: Science Mapping the Literature, 1970 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9524. [PMID: 34574449 PMCID: PMC8465814 DOI: 10.3390/ijerph18189524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Abstract
In order to gain an in-depth understanding of research about childhood and adolescent depression, this article analyzes the scale, development, and geographic distribution of the literature in the field based on 8491 articles extracted from the Web of Science Core database. Using citation analysis, this article identifies influential journals, scholars, and documents in this field. The study found that in the past 15 years, the number of documents has increased significantly and geographical diversity has also increased. Most of the highly influential literature relates to depression inventories. Using keyword co-occurrence analysis, this article also identified three key research topics focusing on (a) child and adolescent depression symptoms and prevalence, (b) parental depression and child behavioral or emotional problems, and (c) childhood abuse and depression. This study uses 'science mapping' as a means to provide a better understanding of research trends about childhood and adolescent depression that have emerged over the past half century, and may serve as reference for future research.
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Affiliation(s)
| | | | | | - Li Huang
- College of Economics and Management, Shenyang Agricultural University, Shenyang 110866, Liaoning, China; (M.Z.); (B.B.); (W.Z.)
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49
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Silver J, Barch DM, Klein DN, Whalen DJ, Hennefield L, Tillman R, Luby J. A Brief Early Childhood Screening Tool for Psychopathology Risk in Primary Care: The Moderating Role of Poverty. J Pediatr 2021; 236:164-171. [PMID: 33930406 PMCID: PMC8403161 DOI: 10.1016/j.jpeds.2021.04.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To evaluate the Preschool Feeling Checklist (PFC) utility for predicting later mental disorders and functioning for children and assess whether the PFC's predictive utility differs as a function of childhood poverty. STUDY DESIGN We analyzed data from a prospective longitudinal study of preschoolers in St Louis. Preschoolers (N = 287) were recruited from primary care sites and were assessed annually for 10-15 years. The PFC screened for depressive symptoms. Later age-appropriate psychiatric diagnostic interviews were used to derive Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnoses. Regression and moderation analyses, and multilevel modeling were used to test the association between the PFC and later outcomes, and whether this relationship was moderated by income-to-needs. RESULTS The PFC predicted major depressive disorder (OR 1.13, P < .001), attention deficit hyperactivity disorder (OR 1.16, P < .001), and mania (OR 1.18, P < .05) in adolescence and early adulthood. Income-to-needs was a moderator in the predictive pathway between the PFC and later major depressive disorder (OR 1.10, P < .05) and mania (OR 1.19, P < .001) with the measure less predictive for children living in poverty. The PFC predicted worse functioning by the final assessment (b = 1.71, SE = 0.51, P = .001). CONCLUSIONS The PFC served as an indicator of risk for later attention deficit hyperactivity disorder and impairment in all children. It has predictive utility for later mood disorders only in children living above the poverty line. Predicting depression in children living below the poverty line may require consideration of risk factors not covered by the PFC.
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Affiliation(s)
- Jamilah Silver
- Department of Psychology, Stony Brook University, Stony Brook, NY.
| | - Deanna M. Barch
- Department of Psychological & Brain Science, Washington University in St Louis, St Louis, MO
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY
| | - Diana J. Whalen
- Department of Psychiatry, Washington University in St Louis, St Louis, MO
| | - Laura Hennefield
- Department of Psychiatry, Washington University in St Louis, St Louis, MO
| | - Rebecca Tillman
- Department of Psychiatry, Washington University in St Louis, St Louis, MO
| | - Joan Luby
- Department of Psychiatry, Washington University in St Louis, St Louis, MO
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50
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Walter D, Buschsieweke J, Dachs L, Goletz H, Goertz-Dorten A, Kinnen C, Perri D, Rademacher C, Schuermann S, Viefhaus P, Woitecki K, Metternich-Kaizman TW, von Wirth E, Doepfner M. Effectiveness of usual-care cognitive-behavioral therapy for adolescents with depressive disorders rated by parents and patients - an observational study. BMC Psychiatry 2021; 21:423. [PMID: 34429098 PMCID: PMC8386089 DOI: 10.1186/s12888-021-03404-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 07/31/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Depressive disorders are common in adolescence and are associated with a wide range of negative long-term outcomes. Highly controlled randomized controlled trials (RCT) provide considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) as a treatment for depression, but studies examining the effectiveness of CBT in clinical settings are very rare . METHODS In the present observational study, the changes achieved through routine CBT in adolescents with depressive disorders treated in a clinical setting in terms of a university outpatient clinic were analyzed, and compared to a historical control group of adolescents with depressive disorders who had received treatment as usual. At the start and end of treatment (pre- and post-assessment), parent and self-ratings of the German versions of the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and rating scales for depressive symptoms (FBB-DES, SBB-DES) were assessed. A total of 331 adolescents aged 11-18 years with complete data were assessed for the main analysis. RESULTS The analysis yielded small to large pre-post effect sizes (Cohen's d) for the total sample (d = 0.33 to d = 0.82) and large effect sizes for adolescents who were rated in the clinical range on each (sub) scale at the start of treatment (d = 0.85 to d = 1.30). When comparing patients in the clinical range with historical controls, medium to large net effect sizes (d = 0.53 to d = 2.09) emerged for the total scores in self- and parent rating. However, a substantial proportion of the sample remained in the clinical range at the end of treatment. CONCLUSIONS These findings suggest that CBT is effective for adolescents with depressive disorders when administered under routine care conditions, but the results must be interpreted with caution due to the lack of a direct control condition. TRIAL REGISTRATION DRKS, DRKS00021518 . Registered 27 April 2020 - Retrospectively registered, http://drks.de.
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Affiliation(s)
- Daniel Walter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany. .,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969, Cologne, Germany.
| | - Jana Buschsieweke
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Lydia Dachs
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Hildegard Goletz
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Anja Goertz-Dorten
- grid.6190.e0000 0000 8580 3777Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany ,grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Claudia Kinnen
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Daniela Perri
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Christiane Rademacher
- grid.6190.e0000 0000 8580 3777Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany ,grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Stephanie Schuermann
- grid.6190.e0000 0000 8580 3777Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany ,grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Paula Viefhaus
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Katrin Woitecki
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Tanja Wolff Metternich-Kaizman
- grid.6190.e0000 0000 8580 3777Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany ,grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Elena von Wirth
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
| | - Manfred Doepfner
- grid.6190.e0000 0000 8580 3777Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany ,grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstr. 9, 50969 Cologne, Germany
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