Marital and Parent-Child Relationships during Treatment for Adolescent Depression: Child-Driven and Bidirectional Effects.

Adolescent depression can be a stressor for parents and families. This study evaluated how treating adolescent depression affects marital and parent-child relationships. We examined whether marital adjustment and parent-child conflict improved over the course of active treatment of depressed adolescents (36-week visit) and long-term follow-up (one year after discontinuation of treatment) in a sample of 322 clinically depressed youth participating in the Treatment for Adolescents with Depression Study (TADS).

The long-term effect of trauma history on adolescent depression treatment.

Background: Childhood trauma is associated with the development of depression during adolescence. Prior research suggests that traumatic experiences may result in differential acute treatment outcomes for depressed adolescents. However, the long-term effects of trauma on treatment response remain unclear.

Trajectories of Functioning Into Emerging Adulthood Following Treatment for Adolescent Depression.

Purpose: It is well established that empirically supported treatments reduce depressive symptoms for most adolescents; however, it is not yet known whether these interventions lead to sustained improvements in global functioning. The goal of this study is to assess the clinical characteristics and trajectories of long-term psychosocial functioning among emerging adults who have experienced adolescent-onset major depressive disorder.

Methods: Global functioning was assessed using the Clinical Global Assessment Scale for children (participants ≤18 years), the Global Assessment of Functioning (participants ≥ 19 years) and the Health of the Nation Outcome Scales for Adolescents among 196 adolescents who elected to complete 3.

Increasing Positive Outlook Partially Mediates the Effect of Empirically Supported Treatments on Depression Symptoms Among Adolescents.

Among adolescents there is evidence that cognitive change partially mediates the effect of cognitive behavioral therapy (CBT) on depression outcome. However, prior studies have been limited by small samples, narrow measures of cognition, and failure to compare cognitive change following CBT to cognitive change following antidepressant medication. This study examined whether change in four cognitive constructs (cognitive distortions, cognitive avoidance, positive outlook, and solution-focused thinking) mediated change in depression severity in a sample of 291 adolescents who participated in the Treatment for Adolescents with Depression Study (TADS).

Randomized Clinical Trial of a Primary Care Internet-based Intervention to Prevent Adolescent Depression: One-year Outcomes.

Objective: We developed a primary care/Internet-based intervention for adolescents at risk for depression (CATCH-IT, Competent Adulthood Transition with Cognitive-behavioral, Humanistic and Interpersonal Training). This phase II clinical trial compares two forms of primary care provider (PCP) engagement (motivational interview [MI] and brief advice [BA]) for adolescents using the Internet program.

Method: ADOLESCENTS SCREENING POSITIVE FOR DEPRESSION WERE RECRUITED FROM PRIMARY CARE PRACTICES AND RANDOMLY ASSIGNED TO A VERSION OF THE INTERVENTION: PCP MI + Internet program or PCP BA + Internet program.

Onset of alcohol or substance use disorders following treatment for adolescent depression.

Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD).

Method: For 5 years, we followed 192 adolescents (56.2% female; 20.

Randomized controlled trial of primary care physician motivational interviewing versus brief advice to engage adolescents with an Internet-based depression prevention intervention: 6-month outcomes and predictors of improvement.

We believe that primary care physicians could play a key role in engaging youth with a depression prevention intervention. We developed CATCH-IT (Competent Adulthood Transition with Cognitive Behavioral and Interpersonal Training), which is an adolescent Internet-based behavior change model. We conducted a randomized comparison of two approaches in engaging adolescents with the Internet intervention: primary care physician (PCP) motivational interview + CATCH-IT Internet program (MI) vs PCP brief advice + CATCH-IT Internet program (BA).

Recovery and recurrence following treatment for adolescent major depression.

Context: Major depressive disorder in adolescents is common and impairing. Efficacious treatments have been developed, but little is known about longer-term outcomes, including recurrence.

Objectives: To determine whether adolescents who responded to short-term treatments or who received the most efficacious short-term treatment would have lower recurrence rates, and to identify predictors of recovery and recurrence.

Parental marital discord and treatment response in depressed adolescents.

Evidence suggests that parental marital discord contributes to the development of internalizing and externalizing symptoms in children and adolescents. Few studies, however, have examined the association between parental marital discord and youth's response to treatment. The present study examined the impact of interparental discord on treatment response in a randomized control trial of adolescents with major depression enrolled in the Treatment for Adolescents with Depression Study (TADS).

Extreme thinking in clinically depressed adolescents: Results from the Treatment for Adolescents with Depression Study (TADS).

The purpose of this report is to examine relations between extreme thinking, as measured by the Dysfunctional Attitudes Scale, and the maintenance of gains among adolescents who participated in the Treatment for Adolescents with Depression Study (TADS). We examine extreme thinking among 327 adolescents (mean age=14.56, 57% female, 75% White) who received cognitive behavior therapy (CBT), fluoxetine (FLX), or a combination of CBT and FLX (COMB).

Treating depression and oppositional behavior in adolescents.

Adolescents with depression and high levels of oppositionality often are particularly difficult to treat. Few studies, however, have examined treatment outcomes among youth with both externalizing and internalizing problems. This study examines the effect of fluoxetine, cognitive behavior therapy (CBT), the combination of fluoxetine and CBT, and placebo on co-occurring oppositionality within a sample of depressed adolescents.

Ethnic differences among adolescents beginning treatment for depression.

This study examines ethnic/racial differences at the start of treatment among participants in the Treatment for Adolescents with Depression Study (TADS). African American and Latino youth were compared to Caucasian youth on symptom presentation and cognitive variables associated with depression. Contrary to hypothesis, there were no significant differences in symptom presentation as measured by the interview-based items of the Children's Depression Rating Scale--Revised (CDRS-R).

Service use and costs of care for depressed adolescents: who uses and who pays?

Major depressive disorder is common in adolescence and is associated with significant morbidity and family burden. Little is known about service use by depressed adolescents. The purpose of this article is to report the patterns of services use and costs for participants in the Treatment for Adolescents with Depression Study sample during the 3 months before randomization.

An exploratory analysis of the impact of family functioning on treatment for depression in adolescents.

This article explores aspects of family environment and parent-child conflict that may predict or moderate response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive behavioral therapy, their combination, or placebo. Outcomes were Week 12 scores on measures of depression and global impairment. Of 20 candidate variables, one predictor emerged: Across treatments, adolescents with mothers who reported less parent-child conflict were more likely to benefit than their counterparts.

Cognitive measures of adolescent depression: unique or unitary constructs?

The factor structure of several self-report questionnaires assessing depression-relevant cognitions frequently employed in clinical research was examined in a sample of 390 adolescents (M age = 14.54; 216 girls; 74% Caucasian) with current major depressive disorder enrolled in the Treatment of Adolescents with Depression Study. A four-factor solution resulted, accounting for 65% of the total variance.

The dysfunctional attitudes scale: psychometric properties in depressed adolescents.

The psychometric properties and factor structure of the Dysfunctional Attitudes Scale were examined in a sample of 422 male and female adolescents (ages 12-17) with current major depressive disorder. The scale demonstrated high internal consistency (alpha = .93) and correlated significantly with self-report and interview-based measures of depression.

Factor structure and psychometric properties of the Children's Negative Cognitive Error Questionnaire with a clinically depressed adolescent sample.

The factor structure and psychometric properties of the Children's Negative Cognitive Error Questionnaire (CNCEQ) were examined with 427 adolescents ages 12 to 18 (193 boys) with current major depressive disorder. Results of confirmatory factor analysis supported a four-factor model comprised of three content area factors (i.e.

From prototype to product: development of a primary care/internet based depression prevention intervention for adolescents (CATCH-IT).

We describe the prototype to product development process of a low cost, socio-culturally relevant, easily implemented Internet-based depression prevention intervention for adolescents in primary care. The intervention named "Project CATCH-IT" (Competent Adulthood Transition with Cognitive-behavioral, Humanistic and Interpersonal Training) includes an initial motivational interview in primary care to engage the adolescent, fourteen Web-based modules based on behavioral activation, cognitive behavioral and interpersonal psychotherapy which target known risk factors, and a follow-up motivational interview in primary care. This was successfully fielded in a pilot study with 25 adolescents.

Relative cost-effectiveness of treatments for adolescent depression: 36-week results from the TADS randomized trial.

Objective: The cost-effectiveness of three active interventions for major depression in adolescents was compared after 36 weeks of treatment in the Treatment of Adolescents with Depression Study.

Method: Outpatients aged 12 to 18 years with a primary diagnosis of major depression participated in a randomized controlled trial conducted at 13 U.S.

Predictors of hopelessness among clinically depressed youth.

Background: Factors that distinguish depressed individuals who become hopeless from those who do not are poorly understood.

Method: In this study, predictors of hopelessness were examined in a sample of 439 clinically depressed adolescents participating in the Treatment for Adolescents with Depression Study (TADS). The total score of the Beck Hopelessness Scale (BHS) was used to assess hopelessness at baseline.