Taylor, C., Kass, A. E., Trockel, M., Cunning, D., Weisman, H., Bailey, J., Sinton, M., Aspen, V., Schecthman, K., Jacobi, C., Wilfley, D. E.

Reducing eating disorder onset in a very high risk sample with significant comorbid depression: A randomized controlled trial

Objective: Eating disorders (EDs) are serious problems among college-age women and may be preventable. An indicated online eating disorder (ED) intervention, designed to reduce ED and comorbid pathology, was evaluated. Method: 206 women (M age = 20 +/- 1.8 years; 51% White/Caucasian, 11% African American, 10% Hispanic, 21% Asian/Asian American, 7% other) at very high risk for ED onset (i.e., with high weight/shape concerns plus a history of being teased, current or lifetime depression, and/or nonclinical levels of compensatory behaviors) were randomized to a 10-week, Internet-based, cognitive-behavioral intervention or waitlist control. Assessments included the Eating Disorder Examination (EDE, to assess ED onset), EDE-Questionnaire, Structured Clinical Interview for DSM Disorders, and Beck Depression Inventory-II. Results: ED attitudes and behaviors improved more in the intervention than control group (p = .02, d = 0.31); although ED onset rate was 27% lower, this difference was not significant (p = .28, NNT = 15). In the subgroup with highest shape concerns, ED onset rate was significantly lower in the intervention than control group (20% vs. 42%, p = .025, NNT = 5). For the 27 individuals with depression at baseline, depressive symptomatology improved more in the intervention than control group (p = .016, d = 0.96); although ED onset rate was lower in the intervention than control group, this difference was not significant (25% vs. 57%, NNT = 4). Conclusions: An inexpensive, easily disseminated intervention might reduce ED onset among those at highest risk. Low adoption rates need to be addressed in future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).

Journal of Consulting & Clinical Psychology, 84(5) : 402-414

Thomas, J., Raynor, M., Bahussain, E.

Stress reactivity, depressive symptoms, and mindfulness: A Gulf Arab perspective

Explorations of the relationship between stress reactivity and depression are relatively scarce outside of Europe and North America. This research examined the relationship between emotional reactivity to daily life stressors (stress reactivity) and depressive symptoms among citizens of the United Arab Emirates (UAE). Emirati college students (N = 286, 76% females) completed a culturally grounded measure of daily life stress, along with measures of depression and anxiety symptoms. Stress reactivity was associated with elevated depression and anxiety symptoms. In a second study, we examined the efficacy of a Mindfulness-Based Stress Reduction (MBSR) program within the same population. Emirati College women (N = 24) were randomly assigned to either an 8-week MBSR program or a waiting list control group (WLC). MBSR participants demonstrated significantly greater reductions in stress reactivity and depressive symptoms compared with the WLC group. These findings extend the stress reactivity literature to an Arabian Gulf nation. Interventions that help young adults better manage responses to daily life stress may play an important role in reducing the prevalence of depressive illness in the region. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

International Perspectives in Psychology: Research, Practice, Consultation, 5(3) : 156-166

Tompson, M. C., Sugar, C. A., Asarnow, J. R.

Family-focused treatment for childhood depressive disorders versus individual supportive treatment: Results of a randomized clinical trial [conference abstract]

Objectives: Psychosocial treatments seem efficacious in the treatment of depressive disorders during adolescence; however, few studies have examined the efficacy of treatments for depressive disorders during childhood. Family-Focused Treatment for Child Depression (FFT-CD) incorporates an interpersonal model of depression, psychoeducation, and enhancement of skills to reduce stress and improve family support. In this randomized clinical trial, we compare FFT-CD with individual supportive psychotherapy, modeled after standard community care (interprofessional, IP), on depression outcomes. Methods: A sample group of 134 children (ages 7-14 years) with diagnoses of major depressive disorder, dysthymic disorder, or depressive disorder NOS participated. After baseline assessment, children were randomized to 15 sessions of either FFT-CD or IP and reassessed after treatment. The primary outcome was adequate clinical depression response, defined as a decrease in the Children's Depression Rating Scale-Revised (CDRS-R) of > 50 percent; furthermore, we examined clinical depression remission, defined as a posttreatment CDRS-R score of <28. We report results of both completer and intent-to-treat (ITT) analysis. Results: Most participants (74 percent) completed 10 or more treatment sessions with no group differences in dropout or number of sessions. Children assigned to FFT-CD showed higher rates of adequate clinical depression response in completer (OR = 2.64, p = 0.02, 79.6 vs. 59.7 percent) and ITT analyses (OR = 2.29, p = 0.05, estimated rates 77.7 vs. 59.9 percent); higher rates of clinical depression remission in completer analysis (OR = 2.11, p = 0.05, 53.7 vs. 35.5 percent); and a trend toward higher rates in ITT analyses (OR = 1.84, p = 0.10, estimated rates 52.3 vs. 37.3 percent). Conclusions: The high rate of depression clinical response across treatment arms supports the utility of psychosocial intervention for children with depressive disorders. Family treatment resulted in a higher rate of depression response than individual supportive psychotherapy, which confirmed the efficacy of family-based intervention for children with depressive disorders. There was a suggestion of greater clinical remission, although results were attenuated in ITT analyses. Current findings underscore the importance of incorporating the family in interventions for depression in childhood.

Journal of the American Academy of Child and Adolescent Psychiatry, 55 (10 Supplement 1) : S335

Trudeau, L., Spoth, R., Mason, W., Randall, G., Redmond, C., Schainker, L.

Effects of adolescent universal substance misuse preventive interventions on young adult depression symptoms: Mediational modeling

Depression symptoms are associated with impairments in functioning and have substantial health and economic consequences. Universal substance misuse prevention programs have shown effects on non-targeted mental health-related symptoms, but long-term effects are understudied. This cluster randomized controlled trial examined effects of both the LifeSkills Training (LST) and Strengthening Families Program: For Parents and Youth10-14 (SFP 10-14) interventions, delivered during seventh grade, on age 22 young adult depression symptoms. The study was conducted in US rural Midwestern communities with a randomly-selected sample from a larger study (N = 670). Experimental conditions were LST + SFP 10-14, LST-only, and a control condition. Effects on age 22 depression symptoms were hypothesized as mediated through effects on age 21 relationship problems and illicit use of substances. Structural equation modeling with manifest and latent variables was conducted to test hypotheses; the intervention conditions were combined and compared with the control condition because analyses indicated a comparable pattern of effects between intervention conditions. Significant indirect intervention effects were found on age 22 depression symptoms via effects on the mediating variables (indirect effect: beta = -0.06, 95 % CI [-0.10, -0.01], p = 0.011). Effect sizes for the young adult variables were between d = 0.17 and 0.29, which can be considered small, but nontrivial, especially in the context of public health benefits. Results support scaled-up implementation of school-based and family-focused universal substance misuse preventive interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).

Journal of Abnormal Child Psychology, 44(2) : 257- 268

Uliaszek, A. A., Rashid, T., Williams, G. E., Gulamani, T.,

Group therapy for university students: A randomized control trial of dialectical behavior therapy and positive psychotherapy

The present study examined the efficacy of two evidence- based group treatments for significant psychopathology in university students. Fifty-four treatment-seeking participants were randomized to a semester-long dialectical behavior therapy (DBT) or positive psychotherapy (PPT) group treatment. Mixed modeling was used to assess improvement over time and group differences on variables related to symptomatology, adapative/maladaptive skill usage, and well-being/acceptability factors. All symptom and skill variables improved over the course of treatment. There were no statistically significant differences in rate of change between groups. The DBT group evidenced nearly all medium to large effect sizes for all measures from pre-to post-treatment, with mostly small to medium effect sizes for the PPT group. There was a significant difference in acceptability between treatments, with the DBT group demonstrating significantly lower attrition rates, higher attendance, and higher overall therapeutic alliance. While both groups demonstrated efficacy in this population, the DBT group appeared to be a more acceptable and efficacious treatment for implementation. Results may specifically apply to group therapy as an adjunctive treatment because a majority of participants had concurrent individual therapy.

Behaviour Research & Therapy, 77 : 78-85

Walsh, E., Eisenlohr-Moul, T., Baer, R.

Brief mindfulness training reduces salivary IL-6 and TNF-alpha in young women with depressive symptomatology

Objective: Pro-inflammatory cytokines have been implicated in the pathophysiology and maintenance of depression. This study investigated the effects of a brief mindfulness intervention on salivary proinflammatory correlates of depression (IL-6, TNF-alpha) and self- reported symptoms of depression in college women. Methods: Sixty-four females with a cut score of <16 on the Center for Epidemiological Studies for Depression Scale (CES-D) were assigned to a 4-week mindfulness-based intervention (MBI; N = 31) or a contact-control group (N = 33). For both groups, salivary cytokines and depressive symptoms were assessed at baseline and posttreatment. For the mindfulness group only, salivary cytokines were also assessed at a 3-month follow-up. Results: Both groups showed similar reductions in depression. However, MBI (vs. control) predicted greater reductions in IL-6 and TNF-alpha; changes in IL-6 were sustained at 3-month follow-up. Higher baseline depressive symptoms predicted greater reductions in inflammation in the mindfulness group. Conclusion: MBIs may reduce inflammatory immune markers commonly implicated in depression. Individuals with greater depressive symptoms may benefit more from mindfulness training. Although reductions in salivary cytokines in the mindfulness condition were not attributable to changes in depressive symptoms, future work should examine the possibility that such reductions are protective against the development of future depressive episodes. Copyright © 2016 American Psychological Association.

Journal of Consulting and Clinical Psychology, 84(10) : 887-897

Wang, Y., Li, S., Liu, H., Liu, D., Ma, Q., Cui, H., Zhu, B.

The roles of family environment, personality and coping styles in adolescent depression

Objective: Family environment, coping styles, personality characteristics played critical roles in the development of adolescent depression, their correlations with adolescent depression were explored in depth. Methods: The participants were divided into 3 groups. The samples in groups A and B were the ones who have been diagnosed as major depression. Group A was treated with sertraline, group B was treated with a combination of sertraline and cognitive behavioral therapy. Group C was a control group and consisted by mentally healthy teenagers. They were asked to fulfill the questionnaires/scales of family environment scale (FES), Eysenck personality questionnaire (EPQ) and simplified coping style questionnaire (SCSQ). Their general socio-demographic characteristics and scores of the questionnaires/scales for each group were evaluated. Results: There were significant differences in scores between groups A/B and group C after treatment (P < 0. 01 or P < 0. 05). The further analysis revealed that all the scores of subscales, except positive coping in group A and expressiveness, conflict, achievement orientation, control, positive coping, negative coping in group B were significant different with group C (P < 0. 01 or P < 0. 05). Conclusion: A harmonious family environment, healthy personality characteristic and mature coping style were essential factors in preventing and reducing adolescent depression.

International Journal of Clinical & Experimental Medicine, 9(2) : 4989-4994

Yang, W., Zhang, J. X., Ding, Z., Xiao, L.

Attention bias modification treatment for adolescents with major depression: A randomized controlled trial

Objective: Attention bias modification (ABM) is a promising treatment for depression, but trial data remain restricted to adults. The present trial examined effects of ABM on adolescent depression. Method: A total of 45 adolescents with major depressive disorder (MDD), selected from a school population (n = 2,731) using a 2-stage case-finding procedure, were randomized to an active ABM intervention (n = 23) or placebo ABM training (n = 22). In the active condition, participants completed a neutral ABM over 2 weeks for 8 sessions (320 trials each) to shift attention away from sad words to neutral words. At a 9-week follow-up, they received a positive ABM for 2 weeks with 4 more sessions (480 trials each), shifting attention to positive words. The placebo training used the same tasks but shifted attention toward neutral and sad words equally often. Attentional biases and clinical status determined by semi-structured interviews and questionnaires were obtained before and after each training. Depressive symptoms were reassessed at 8- and 12-month follow-ups. Results: Greater reductions in attentional bias score and clinician-rated depressive symptoms were found for active ABM compared with placebo after initial neutral ABM. More participants no longer met diagnostic criteria for MDD in active ABM than in placebo. Greater reductions in self-reported depressive and anxious symptoms at the 12-month follow-up were also found in active ABM compared with placebo. Conclusion: ABM may be a potential treatment tool for mild to moderate adolescent major depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).

Journal of the American Academy of Child & Adolescent Psychiatry, 55(3) : 208-218

Young, J. F., Benas, J. S., Schueler, C. M., Gallop, R., Gillham, J. E., Mufson, L.

A randomized depression prevention trial comparing interpersonal psychotherapy-Adolescent skills training to group counseling in schools

Given the rise in depression disorders in adolescence, it is important to develop and study depression prevention programs for this age group. The current study examined the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a group prevention program for adolescent depression, in comparison to group programs that are typically delivered in school settings. In this indicated prevention trial, 186 adolescents with elevated depression symptoms were randomized to receive IPT-AST delivered by research staff or group counseling (GC) delivered by school counselors. Hierarchical linear modeling examined differences in rates of change in depressive symptoms and overall functioning from baseline to the 6-month follow-up assessment. Cox regression compared rates of depression diagnoses. Adolescents in IPT-AST showed significantly greater improvements in self-reported depressive symptoms and evaluator-rated overall functioning than GC adolescents from baseline to the 6-month follow-up. However, there were no significant differences between the two conditions in onset of depression diagnoses. Although both intervention conditions demonstrated significant improvements in depressive symptoms and overall functioning, results indicate that IPT-AST has modest benefits over groups run by school counselors which were matched on frequency and duration of sessions. In particular, IPT-AST outperformed GC in reduction of depressive symptoms and improvements in overall functioning. These findings point to the clinical utility of this depression prevention program, at least in the short-term. Additional follow-up is needed to determine the long-term effects of IPT-AST, relative to GC, particularly in preventing depression onset. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Prevention Science, 17(3) : 314-324

Stockings, E. A., Degenhardt, L., Dobbins, T., Lee, Y. Y., Erskine, H. E., Whiteford, H. A., Patton, G.

Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention

Depression and anxiety (internalizing disorders) are the largest contributors to the non-fatal health burden among young people. This is the first meta-analysis to examine the joint efficacy of universal, selective, and indicated preventive interventions upon both depression and anxiety among children and adolescents (5-18 years) while accounting for their co-morbidity. We conducted a systematic review of reviews in Medline, PsycINFO and the Cochrane Library of Systematic Reviews, from 1980 to August 2014. Multivariate meta-analysis examined the efficacy of preventive interventions on depression and anxiety outcomes separately, and the joint efficacy on both disorders combined. Meta-regressions examined heterogeneity of effect according to a range of study variables. Outcomes were relative risks (RR) for disorder, and standardized mean differences (Cohen's d) for symptoms. One hundred and forty-six randomized controlled trials (46 072 participants) evaluated universal (children with no identified risk, n = 54) selective (population subgroups of children who have an increased risk of developing internalizing disorders due to shared risk factors, n = 45) and indicated prevention (children with minimal but detectable symptoms of an internalizing disorder, n = 47), mostly using psychological-only strategies (n = 105). Reductions in internalizing disorder onset occurred up to 9 months post-intervention, whether universal [RR 0.47, 95% confidence interval (CI) 0.37- 0.60], selective (RR 0.61, 95% CI 0.43-0.85) or indicated (RR 0.48, 95% CI 0.29-0.78). Reductions in internalizing symptoms occurred up to 12 months post-intervention for universal prevention; however, reductions only occurred in the shorter term for selective and indicated prevention. Universal, selective and indicated prevention interventions are efficacious in reducing internalizing disorders and symptoms in the short term. They might be considered as repeated exposures in school settings across childhood and adolescence. (PROSPERO registration: CRD42014013990.).

Psychological Medicine, 46(1) : 11- 26

Tan, L. B.

A critical review of adolescent mindfulness-based programmes.

Clinical child psychology and psychiatry, 21(2) : 193- 207

Townshend, K., Jordan, Z., Stephenson, M., Tsey, K.

The effectiveness of mindful parenting programs in promoting parents' and children's wellbeing: A systematic review

Background The rationale for undertaking this review was to investigate a potential strategy to address the rising prevalence of child and adolescent mental health disorders. The central tenants of mindful parenting appear to be emotional awareness, emotional regulation, attention regulation, intentionality and non-judgmental acceptance. Objectives The primary objective of this review was to systematically evaluate the effectiveness of mindful parenting programs in promoting children's, adolescents' and parents' wellbeing, particularly in relation to the intensity of symptoms associated with internalizing (depression, anxiety, stress) and externalizing (conduct) disorders. The secondary objective was to evaluate how effective mindful parenting programs are in improving emotional regulation, attention regulation, quality of the parent-child relationship, resilience and mindfulness of the children, adolescents and parents. Inclusion criteria Types of participants Children aged between 0 and 18 years and their parents who have completed a mindful parenting program were the focus of this review. Types of intervention(s)/phenomena of interest Mindful parenting programs included in this review had a minimum duration of one to two hours per week for 6 to 8 weeks, delivered in a group format, by a facilitator with appropriate training. It included parenting programs that drew upon mindfulness-based stress reduction, mindfulness-based cognitive therapy, mindfulness-based cognitive behavior therapy, dialectical behavior therapy or acceptance commitment therapy. The comparator was the control or waitlist conditions. Types of studies This review focused on randomized controlled trials evaluating the effectiveness of mindful parenting programs. Types of outcomes Primary outcomes were wellbeing or intensity of symptoms associated with internalizing disorders (depression, anxiety, stress) and externalizing disorders (conduct disorders) in children, adolescents and parents. Secondary outcomes were emotional regulation, quality of the parent-child relationship, resilience and mindfulness of the children, adolescents and parents. Search strategy Eight databases were searched for studies evaluating mindful parenting programs from 1997 to November 2014. A three-step search strategy was utilized to retrieve both published and unpublished studies written in English from PubMed, PsycINFO, EMBASE, Scopus, Psychological and Behavioral Sciences Collection, CINAHL, Cochrane Library and ProQuest Dissertations and Theses databases. A logic grid was developed for each of the eight databases to identify the indexing terms and synonyms for the keywords ''mindful'' and ''parenting''. Methodological quality Methodological limitations included small sample sizes leading to lack of statistical power, multiple testing leading to increased alpha errors in addition to information bias caused by a lack of blinding in the implementation and assessment phase. Data extraction The data extraction process entailed using the standardized data extraction form from Joanna Briggs Institute Meta-analysis of Statistics Assessment and Review Instrument to extract data from the selected studies. Data synthesis The heterogeneity of the samples, the measurement tools and outcomes measured precluded data synthesis through meta-analysis. Conclusions on intervention effects were based on comparisons of the overall statistical significance of the outcomes data. Results The search yielded 1232 articles, from which seven randomized controlled trials met the inclusion criteria. The findings indicate mindful parenting programs may reduce parental stress, increase parents' emotional awareness of their 10 to 14-year-old children and reduce preschool children's symptoms associated with externalizing disorders. A recurring finding was that the mindful parenting programs reduced parents' emotional dismissal of their adolescents and preschoolers. Conclusions At present, there is insufficient evidence to conclude that mindful parenting programs can improve parents' and children's wel being because of the methodological quality of the few studies that met the inclusion criteria. Implications for practice Although there is currently insufficient evidence, mindful parenting programs are increasingly used in a variety of contexts. It may not be appropriate for psychotic or severely traumatized individuals. Implications for research Future studies could make a significant contribution to the field by designing studies with sufficient sample sizes, adequate statistical power as well as blinding participants, facilitators and assessors. Copyright © 2016 Joanna Briggs Institute.

JBI Database of Systematic Reviews and Implementation Reports, 14(3) : 139- 178