Lupien, S. J., Ouellet-Morin, I., Trepanier, L., Juster, R. P., Marin, M. F., Francois, N., Sindi, S., Wan, N., Findlay, H., Durand, N., Cooper, L., Schramek, T., Andrews, J., Corbo, V., Dedovic, K., Lai, B., Plusquellec, P.

The Destress for Success Program: Effects of a stress education program on cortisol levels and depressive symptomatology in adolescents making the transition to high school

Various studies have shown that increased activity of the hypothalamic-pituitary-adrenal (HPA) axis can predict the onset of adolescent depressive symptomatology. We have previously shown that adolescents making the transition to high school present a significant increase in cortisol levels, the main product of HPA axis activation. In the present study, we evaluated whether a school-based education program developed according to the current state of knowledge on stress in psychoneuroendocrinology decreases cortisol levels and/or depressive symptoms in adolescents making the transition to high school. Participants were 504 Year 7 high school students from two private schools in the Montreal area. Adolescents of one school were exposed to the DeStress for Success Program while adolescents from the other school served as controls. Salivary cortisol levels and depressive symptomatology were measured before, immediately after as well as 3. months after exposure to the program. Measures of negative mood were obtained at baseline in order to determine whether adolescents starting high school with specific negative moods were differentially responsive to the program. The results show that only adolescents starting high school with high levels of anger responded to the intervention with a significant decrease in cortisol levels. Moreover, we found that adolescents who took part in the intervention and showed decreasing cortisol levels following the intervention (responders) were 2.45 times less at risk to suffer from clinical and subclinical depressive states three months post-intervention in comparison to adolescents who showed increasing cortisol levels following the intervention (nonresponders). This study provides the first evidence that a school-based program on stress is effective at decreasing cortisol levels and depressive symptomatology in adolescents making the transition to high school and it helps explain which adolescents are sensitive to the program and what are some of the characteristics of these individuals. (copyright) 2013 IBRO.

Neuroscience, 249 : 74- 87

Julious, S. A.

Efficacy and suicidal risk for antidepressants in paediatric and adolescent patients

A number of meta-analyses have been undertaken to assess both the safety and efficacy of antidepressants in paediatric and adolescent patients. This article updates the analyses with additionally reported trials. The aim of this analysis was to investigate whether antidepressant treatments are associated with an increased risk of suicide-related outcomes in paediatric and adolescent patients. Also, in the same population, to assess whether antidepressant treatments are beneficial in terms of efficacy. A meta-analysis of randomised controlled trials of antidepressant treatments compared with placebo in paediatric and adolescent patients was undertaken of 6039 individuals participating in 35 randomised controlled trials. For suicide-related outcomes suicidal behaviour, suicidal ideation and suicidal behaviour or ideation were examined. These data presented the additional problem of the events of interest being rare. An analysis was described in this article to account for the rare events that also included studies which had no events on either treatment arm. There were trends to indicate that active treatments increased the risk of these events in absolute terms. For efficacy, the results indicated that antidepressant treatments did have a statistically significant effects compared to placebo but the effect was less for the trials in depression. The results are in the main consistent with previous meta-analyses on a smaller number of trials. There was evidence of an increased risk in suicide-related outcomes on antidepressant treatments, while antidepressant treatments were also shown to be efficacious. (copyright) The Author(s) 2011 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Statistical Methods in Medical Research, 22(2) : 190-218

Johnson, E. A., O’Brien, K. A.

Self-compassion soothes the savage ego-threat system: Effects on negative affect, shame, rumination, and depressive symptoms

Self-compassion, involving self-kindness, common humanity, and mindfulness, appears well-suited to soothing feelings of threat following negative events and thereby reducing depressive sequellae. Study 1 found a strong negative association between self-compassion and depressive symptoms in 335 university students and evaluated four markers of threat that potentially mediate this relation. A test of multiple mediation revealed shame as a significant mediator, along with rumination and self-esteem. In Study 2, shame-prone students recalled an experience of shame and then were randomly assigned to (1) write about it self- compassionately, (2) express their feelings about it in writing, or (3) do neither. Participants completed their assigned task three times in one week. Immediately after writing, participants in the self-compassion condition reported less state shame and negative affect than those in the expressive writing condition. At two-week follow-up, participants in the self-compassion condition alone showed reductions in shame-proneness (d = .53), and depressive symptoms (d = .49). It appears that self-compassion promotes soothing, \"hypo-egoic\" (Leary, 2012) responses to negative outcomes that reduce threat system activation and depressive symptoms. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)

Journal of Social & Clinical Psychology, 32(9) : 939- 963

Israel, P., Diamond, G. S.

Feasibility of Attachment Based Family Therapy for depressed clinic-referred Norwegian adolescents

Several studies have earned Attachment Based Family Therapy (ABFT) the designation of a promising empirically supported treatment for adolescents with depression. This study evaluated the feasibility of importing ABFT into a hospital- based outpatient clinic in Norway. This article documents the challenges of initiating and conducting research in a real world clinical setting and training staff therapists. It also reports on outcomes of a pilot randomized clinical trial. Implementation barriers rapidly emerged in relation to hospital administration, infrastructure development, and therapists. Despite these barriers, 20 clinic-referred adolescents were randomly assigned to ABFT (n= 11) or to Treatment as Usual (TAU) (n= 9). Adolescents in ABFT showed significantly better symptom reduction compared to adolescents in TAU with an effect size of 1.08. While preliminary, this study suggests that Norwegian clinical staff therapists could be engaged in learning and delivering ABFT, and in producing promising treatment results. The importance of institutional support for dissemination research is highlighted.

Clinical Child Psychology & Psychiatry, 18(3) : 334-350

Huffziger, S., Ebner-Priemer, U., Eisenbach, C., Koudela, S., Reinhard, I., Zamoscik, V., Kirsch, P., Kuehner, C.

Induced ruminative and mindful attention in everyday life: An experimental ambulatory assessment study

Background and objectives: Rumination has been proposed as a risk factor for depression, while mindful attention might be protective. Differential effects of these attention foci have so far only been examined in the laboratory. Therefore, we conducted an experimental ambulatory assessment study using ruminative and mindful attention inductions in everyday life to examine their effects in a natural context. Methods: Fifty young adults carried palmtops over three weekdays (rumination induction day, mindful attention induction day, noninduction day; randomized cross-over design). Ten times a day, participants rated ruminative self-focus and mood. On the induction days, they were additionally subjected to 3-min inductions of ruminative or mindful attention at each assessment. Results: The two induction modes exhibited differential immediate effects on ruminative self-focus and mood. While induced rumination immediately deteriorated valence and calmness, induced mindful attention specifically enhanced calmness. Depressive symptoms did not moderate these effects. While overall longer term effects of the inductions were missing, the mindful attention day was associated with slightly increasing positive valence over the day. Limitations: The results need to be replicated in high-risk and patient samples to demonstrate the clinical significance of identified effects. Conclusions: Results confirm the emotional relevance of rumination and mindful attention in real world settings. Future work may test whether adaptive attention-focusing instructions delivered in daily life can support clinical interventions. (copyright) 2013 Elsevier Ltd. All rights reserved.

Journal of Behavior Therapy & Experimental Psychiatry, 44(3) : 322-328

Hughes, C. W., Barnes, S., Barnes, C., Defina, L. F., Nakonezny, P., Emslie, G. J.

Depressed Adolescents Treated with Exercise (DATE): A pilot randomized controlled trial to test feasibility and establish preliminary effect sizes

The Depressed Adolescents Treated with Exercise (DATE) study evaluated a standardized aerobic exercise protocol to treat nonmedicated adolescents that met DSM-IV-TR criteria for major depressive disorder. From an initial screen of 90 individuals, 30 adolescents aged 12-18 years were randomized to either vigorous exercise (EXER) (>12 kg/kcal/week [KKW]) or a control stretching (STRETCH) activity (<4 KKW) for 12 weeks. The primary outcome measure was the blinded clinician rating of the Children's Depression Rating Scale - Revised (CDRS-R) to assess depression severity and Actical (KKW) accelerometry 24hr/7days a week to assess energy expenditure and adherence. Follow-up evaluations occurred at weeks 26 and 52. The EXER group averaged 77% adherence and the STRETCH group 81% for meeting weekly target goals for the 12 week intervention based on weekly sessions completed and meeting KKW requirements. There was a significant increase in overall weekly KKW expenditures (p <.001) for both groups with the EXER group doubling the STRETCH group in weekly energy expenditure. Depressive symptoms were significantly reduced from baseline for both groups with the EXER group improving more rapidly than STRETCH after six weeks (p <.016) and nine weeks (p <.001). Both groups continued to improve such that there were no group differences after 12 weeks (p =.07). By week 12, the exercise group had a 100% response rate (86% remission), whereas the stretch group response rate was 67% (50% remission) (p =.02). Both groups had improvements in multiple areas of psychosocial functioning related to school and relationships with parents and peers. Anthropometry reflected decreased waist, hip and thigh measurements (p =.02), more so for females than males (p =.05), but there were no weight changes for either gender. The EXER group sustained 100% remission at week 26 and 52. The STRETCH group had 80% response and 70% remission rates at week 26 and by week 52 only one had not fully responded. The study provides support for the use of exercise as a non-medication intervention for adolescents with major depressive disorders when good adherence and energy expenditure (KKW) are achieved. (copyright) 2013 Elsevier Ltd. All rights reserved.

Mental Health & Physical Activity, 6(2) : 119- 131

Kanojia, S., Kumar-Sharma, V., Gandhi, A., Kapoor, R., Kukreja, A., Kumar-Subramanian, S.

Effect of yoga on autonomic functions and psychological status during both phases of menstrual cycle in young healthy females

Context: Premenstrual stress affects 75% of women of childbearing age and yoga has been found to be beneficial in many psycho-somatic disorders. Aims: To investigate the effect of integrated yoga on autonomic parameters and psychological well-being during both pre and post phases of menstrual cycle in healthy young female subjects. Settings and Design: Present study is a randomized control trial and was conducted in the Department of Physiology, Lady Hardinge Medical College, New Delhi, India. Material and Methods: Fifty apparently healthy females in the age group of 18-20 years were randomized into two groups: Group I (n=25) consisted of subjects who practiced yoga 35-40 minutes per day, six times per week for the duration of three menstrual cycles. Training was given by qualified yoga instructor. Group II (n=25) subjects acted as controls. Following parameters were recorded at the beginning and after completion of three menstrual cycles in all the subjects: Height, weight (BW), Resting Heart Rate (HR), Resting Systolic (SBP) and Diastolic Blood Pressure (DBP), parasympathetic reactivity tests including Expiration-Inspiration Ratio (E: I ratio) and 30:15 ratio, sympathetic reactivity tests including BP changes due to Isometric Hand Grip (IHG) exercise, and Cold Pressor Test (CPT). Assessment of psychological status was done by administering DIPAS (Defense Institute of Physiology and Allied Sciences) inventories of Anger self report scale, Trait Anxiety, Sense of well-being and Depression scale. Statistical Analysis: Intra-group comparison of physiological parameters was done by using paired 't' test, whereas intra-group comparison of non-parameteric data such as scores of anxiety, depression, anger and sense of well-being was done by Wilcoxon signed-rank test. Inter-group comparison of parameters was done by Students 't' test for parametric tests and Mann-Whitney 'U' test for non-parameteric tests. Results: There was significantly higher BW, resting SBP, DBP, sympathetic activity and blunting of parasympathetic reactivity and also, significantly higher scores of anger, depression, anxiety and decreased score of well-being in premenstrual phase as compared to postmenstrual phase in both the groups in initial cycle. There was significantly higher percentage decrease in BW, HR, SBP & DBP in yoga group as compared to control group in both the phases from initial to second and onwards between second and third menstrual cycle. Also, decrease in anger, depression and anxiety and increase in well-being score was significant in yoga group as compared to control group from initial to second and third cycle in premenstrual phase while the change was significant only in depression score in postmenstrual phase. Conclusion: Our study shows that there was significant alteration of autonomic functions and psychological status in premenstrual phase when compared with postmenstrual phase in young healthy females. Also, regular practice of yoga has beneficial effects on both phases of menstrual cycle by bringing parasympathodominance and psychological well-being probably by balancing neuro-endocrinal axis.

Journal of Clinical & Diagnostic Research, 7(10) : 2133- 2139

Gearing, Robin E., Schwalbe, Craig S. J., Lee, RaeHyuck, Hoagwood, Kimberly E.

The effectiveness of booster sessions in CBT treatment for child and adolescent mood and anxiety disorders

Background: To investigate the effects of booster sessions in cognitive behavioral therapy (CBT) for children and adolescents with mood or anxiety disorders, whereas controlling for youth demographics (e.g., gender, age), primary diagnosis, and intervention characteristics (e.g., treatment modality, number of sessions).; Methods: Electronic databases were searched for CBT interventions for youth with mood and anxiety disorders. Fifty-three (k = 53) studies investigating 1,937 youth met criteria for inclusion. Booster sessions were examined using two case-controlled effect sizes: pre-post and pre-follow-up (6 months) effect sizes and employing weighted least squares (WLSs) regressions.; Results: Meta-analyses found pre-post studies with booster sessions had a larger effect size r = .58 (k = 15; 95% CI = 0.52-0.65; P < .01) than those without booster sessions r = .45 (k = 38; 95% CI = 0.41-0.49; P < .001). In the WLS regression analyses, controlling for demographic factors, primary diagnosis, and intervention characteristics, studies with booster sessions showed larger pre-post effect sizes than those without booster sessions (B = 0.13, P < .10). Similarly, pre-follow-up studies with booster sessions showed a larger effect size r = .64 (k = 10; 95% CI = 0.57-0.70; P < .10) than those without booster sessions r = .48 (k = 20; 95% CI = 0.42-0.53; P < .01). Also, in the WLS regression analyses, pre-follow-up studies showed larger effect sizes than those without booster sessions (B = 0.08, P < .01) after accounting for all control variables.; Conclusions: Result suggests that CBT interventions with booster sessions are more effective and the effect is more sustainable for youth managing mood or anxiety disorders than CBT interventions without booster sessions.; © 2013 Wiley Periodicals, Inc.

Depression & Anxiety, 30(9) : 800-808

Grandner, M. A., Kripke, D. F., Elliott, J., Cole, R.

Short wavelength light administered just prior to waking: A pilot study

Bright light in the blue-green range, administered in the early morning hours (prior to waking) may be particularly effective in shifting circadian rhythms and may increase gonadotropin production. Accordingly, we tested the feasibility and utility of a mask that emits bright blue/green light (compared to a similar mask that emitted a dim red light) towards the end of sleep in a randomized, placebocontrolled pilot study. The study included a three-day baseline period, immediately followed by a 12-day intervention period. Subjects were 30 healthy young men with minimal-mild depression. The bright light masks were welltolerated and demonstrated adequate safety and feasibility. Following the intervention, those who wore the bright light mask demonstrated altered sleep timing suggestive of an earlier sleep period, and excreted a slight increase in follicle-stimulating hormone (FSH). Overall, light masks may prove useful in future studies of bright light therapy. Copyright (copyright) 2013 Taylor & Francis.

Biological Rhythm Research, 44(1) : 13-32

Hides, L., Carroll, S., Scott, R., Cotton, S., Baker, A., Lubman, D. I.

Quik fix: A randomized controlled trial of an enhanced brief motivational interviewing intervention for alcohol/cannabis and psychological distress in young people

Psychotherapy & Psychosomatics, 82(2) : 122- 124

Harold, G. T., Kerr, D. C. R., van-Ryzin, M., DeGarmo, D. S., Rhoades, K. A., Leve, L. D.

Depressive Symptom Trajectories Among Girls in the Juvenile Justice System: 24-month Outcomes of an RCT of Multidimensional Treatment Foster Care

Youth depression is a significant and growing international public health problem. Youth who engage in high levels of delinquency are at particularly high risk for developing problems with depression. The present study examined the impact of a behavioral intervention designed to reduce delinquency (Multidimensional Treatment Foster Care; MTFC) compared to a group care intervention (GC; i.e., services as usual) on trajectories of depressive symptoms among adolescent girls in the juvenile justice system. MTFC has documented effects on preventing girls' recidivism, but its effects on preventing the normative rise in girls' depressive symptoms across adolescence have not been examined. This indicated prevention sample included 166 girls (13-17 years at T1) who had at least one criminal referral in the past 12 months and who were mandated to out-of-home care; girls were randomized to MTFC or GC. Intent-to-treat analyses examined the main effects of MTFC on depression symptoms and clinical cut-offs, and whether benefits were greatest for girls most at risk. Depressive symptom trajectories were specified in hierarchical linear growth models over a 2 year period using five waves of data at 6 month intervals. Depression clinical cut-off scores were specified as nonlinear probability growth models. Results showed significantly greater rates of deceleration for girls in MTFC versus GC for depressive symptoms and for clinical cut-off scores. The MTFC intervention also showed greater benefits for girls with higher levels of initial depressive symptoms. Possible mechanisms of effect are discussed, given MTFC's effectiveness on targeted and nontargeted outcomes. (copyright) 2013 Society for Prevention Research.

Prevention Science, 14(5) : 437- 446

Horigian, Viviana E., Weems, Carl F., Robbins, Michael S., Feaster, Daniel J., Ucha, Jessica, Miller, Michael, Werstlein, Robert

Reductions in anxiety and depression symptoms in youth receiving substance use treatment

Background and Objectives: Research shows that interventions for substance use disorders may be helpful in reducing internalizing disorders in adolescents. This paper examines the prevalence and reductions of anxiety and depression symptoms among youth receiving substance use treatment.; Methods: Four hundred eighty adolescents ages 12-17 who received treatment for substance abuse as part of the Brief Strategic Family Therapy effectiveness trial were screened for anxiety and depression using the Diagnostic Interview Schedule for Children-Predictive Scales (DISC-PS). Twelve-month post-randomization assessments were completed by 327 parents and 315 youth. Sixty-five percent of the sample was found to have probability of at least one anxiety disorder or depression diagnosis.; Results: Significant reduction of anxiety and depressive symptoms and significant reductions in probable anxiety and depression diagnoses were observed at follow-up. Few differences by treatment type and by ethnic group were noticed.; Conclusions and Scientific Significance: Findings indicate that substance use interventions might help reduce the prevalence of anxiety and depressive symptoms and the probability of these disorders.; Copyright © American Academy of Addiction Psychiatry.

American Journal on Addictions, 22(4) : 329-337