Disorders - Depressive Disorders
Townshend, K., Jordan, Z., Stephenson, M., Tsey, K.
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 A three-step search strategy was utilized to retrieve both published and unpublished studies written in English from PubMed, PsycINFO, EMBASE, Scopus, Psychological and Behavioral Sciences Collection, CINAHL, Cochrane Library and ProQuest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
- Year: 2016
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions, Mindfulness based therapy
Vitiello, B., Ordonez, A. E.
INTRODUCTION: Despite an increasing number of studies, there is debate whether antidepressants have a favorable benefit/risk balance in depressed youth. Areas covered: A systematic search identified 23 systematic reviews and meta-analyses published between 2010-2016. More than 30 controlled clinical trials were conducted in adolescents, but only a few in pre-pubertal patients. About one-third of the trials were severely statistically underpowered. Most studies failed to detect differences from placebo, but a few found fluoxetine effective. Although no suicide occurred in these studies, antidepressants increased suicidality risk (including suicidal ideation and behavior) versus placebo (OR = 2.39). Only two placebo-controlled trials with acceptable statistical power were publicly funded: both showed efficacy of fluoxetine, and one found a higher incidence of suicidality (OR = 3.7, 95% C.I. 1.00-13.7). Expert opinion: In youth, antidepressants have, on average, a small therapeutic effect. The high placebo response is exacerbated by the large number of sites in many industry-funded studies. There is evidence that fluoxetine leads to greater and faster improvement than placebo or psychotherapy in adolescents. Considering both the high response to non-specific interventions and safety concerns, antidepressants should be used cautiously in youth, and limited to patients with moderate-to-severe depression for whom psychosocial interventions are either ineffective or not feasible.
Expert Opinion on Pharmacotherapy, 17(17) : 2273-2279
- Year: 2016
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Antidepressants (any)
, Medications used to treat substance abuse
Yap, M. B. H., Morgan, A. J., Cairns, K., Jorm, A. F., Hetrick, S. E., Merry, S.
Purpose of the research Burgeoning evidence that modifiable parental factors can influence children's and adolescents' risk for depression and anxiety indicates that parents can play a crucial role in prevention of these disorders in their children. However, it remains unclear whether preventive interventions that are directed primarily at the parent (i.e. where the parent receives more than half of the intervention) are effective in reducing child internalizing (including both depression and anxiety) problems in the longer term. Principal results Compared to a range of comparison conditions, parenting interventions reduced child internalizing problems, at a minimum of 6 months after the intervention was delivered. Mean effects were very small for measures of internalizing and depressive symptoms, and small for measures of anxiety symptoms. Pooled effects for anxiety diagnoses were significant and indicated a number needed to treat (NNT) of 10. Pooled effects for depression diagnoses approached significance but suggested a NNT of 11. These results were based on effects reported at the longest follow-up interval for each included study, which ranged from 6 months up to 15 years for internalizing measures, 5.5 years for depressive measures, and 11 years for anxiety measures. Major conclusions Our findings underscore the likely benefits of increasing parental involvement in preventing internalizing problems, particularly anxiety problems, in young people. Copyright © 2016 Elsevier Ltd
Clinical Psychology Review, 50 : 138-158
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Rohde, P., Stice, E., Shaw, H., Gau, J. M.
Objective: Conduct a pilot trial testing whether a new cognitive-behavioral (CB) group prevention program that incorporated cognitive-dissonance change principles was feasible and appeared effective in reducing depressive symptoms and major depressive disorder onset relative to a brochure control condition in college students with elevated depressive symptoms. Method: 59 college students (M age = 21.8, SD = 2.3; 68% female, 70% White) were randomized to the 6-session Change Ahead group or educational brochure control condition, completing assessments at pretest, posttest, and 3-month follow-up. Results: Recruitment and screening methods were effective and intervention attendance was high (86% attended all 6 sessions). Change Ahead participants showed medium-large reductions in depressive symptoms at posttest (M d = 0.64), though the effect attenuated by 3-month follow-up. Incidence of major depression onset at 3-month follow-up was 4% for Change Ahead participants versus 13% (difference ns). Conclusions: Change Ahead appears highly feasible and showed positive indications of reduced acute phase depressive symptoms and MDD onset relative to a minimal intervention control in this initial pilot. Given the brevity of the intervention, its apparent feasibility, and the lack of evidence-based depression prevention programs for college students, continued evaluation of Change Ahead appears warranted.
Behaviour Research & Therapy, 82 : 21-27
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Cognitive dissonance therapy
Sadeghi, K., Ahmadi, S. M., Rezaei, M., Miri, J., Abdi, A., Khamoushi, F., Salehi, M., Jamshidi, K.
Global Journal of Health Science, 8(10) : 1
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Physical activity, exercise
Sanchez, O., Carrillo, F. X., Garber, J.
A pilot study was conducted with the primary objective to study the effectiveness of a cognitive-behavioral intervention inspired by the Penn Resiliency Program (PRP; Gillham, Jaycox, Reivich, Seligman, & Silver, 1990; Seligman, Reivich, Jaycox, & Gillham, 2005), for the prevention of depression in students from primary education. The main components of the program include modifying explanatory style and resolving interpersonal problems. Results indicated that there was significant improvement from pre-test to post-test in the experimental group for children with "high depressive symptoms" compared with controls. Qualitative analysis were consistent with this trend. Conclusions in light of these results are discussed and potential directions for future research are recommended. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Anales de Psicologia, 32(3) : 741-748
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Schleider, J. L., Weisz, J. R.
Efforts to reduce youth mental health problems have advanced greatly but have not lowered overall rates of youth mental illness. Thus, a need exists for disseminable, mechanism-targeted approaches to reducing risk of youth psychopathology. Accordingly, we conducted a randomized-controlled trial testing whether a single-session intervention teaching growth personality mindsets (the belief that personality is malleable) reduced known risk factors for anxiety and depression in adolescents experiencing or at risk for internalizing problems (N = 96, ages 12-15). Compared to a supportive-therapy control, a 30-min computer-guided mindset intervention strengthened adolescents' perceived control; this improvement was associated with increases in growth mindsets. Further, electrodermal activity recovery slopes showed that youths receiving the mindset intervention recovered from a lab-based social stressor over three times as fast as control group youths. Improvements in growth mindsets and perceived control were linked with faster stress recovery. Results suggest a disseminable strategy for reducing internalizing problem risk among adolescents. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Behaviour Research and Therapy, 87 : 170-181
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Supportive therapy, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Sibinga, E. M. S., Webb, L., Ghazarian, S. R., Ellen, J. M.
Background and Objective: Many urban youth experiencesignificant and unremitting negative stressors, including those associated with community violence, multigenerational poverty, failing educational systems, substance use, limited avenues for success, health risks, and trauma. Mindfulness instruction improves psychological functioning in a variety of adult populations; research on mindfulness for youth is promising, but has been conducted in limited populations. Informed by implementation science, we evaluated an adapted mindfulness-based stress reduction (MBSR) program to ameliorate the negative effects of stress and trauma among low-income, minority, middle school public school students. Methods: Participants were students at two Baltimore City Public Schools who were randomly assigned by grade to receive adapted MBSR or health education (Healthy Topics [HT]) programs. Self-report survey data were collected at baseline and postprogram. Deidentified data were analyzed in the aggregate, comparing MBSR and HT classes, by using regression modeling. Results: Three hundred fifth-to eighth-grade students (mean 12.0 years) were in MBSR and HT classes and provided survey data. Participants were 50.7% female, 99.7% African American, and 99% eligible for free lunch. The groups were comparable at baseline. Postprogram, MBSR students had significantly lower levels of somatization, depression, negative affect, negative coping, rumination, self-hostility, and posttraumatic symptom severity (all Ps <.05) than HT. Conclusions: These findings support the hypothesis that mindfulness instruction improves psychological functioning and may ameliorate the negative effects of stress and reduce trauma-associated symptoms among vulnerable urban middle school students. Additional research is needed to explore psychological, social, and behavioral outcomes, and mechanisms of mindfulness instruction.
Pediatrics, 137(1) :
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
Zemestani, M., Davoodi, I., Honarmand, M. M., Zargar, Y., Ottaviani, C.
Background: The high incidence and prevalence rates of depression among students identify them as a vulnerable population and make the case for the development of cost-effective treatments. Aims: We aimed to examine the comparative effects of brief group metacognitive therapy (MCT) versus behavioural activation (BA) treatments for depression, anxiety, and emotion regulation in university students. Method: All participants (25 women, 16 men; age range: 18-30 years) fulfilled criteria for major depression and were randomly assigned to MCT (n = 15), BA (n = 15), or a wait-list control group (n = 15). The treatment groups received 8 weekly MCT or BA sessions. Scores on the Beck Depression Inventory, Beck Anxiety Inventory, and Cognitive Emotion Regulation Questionnaire were used as outcome measures. Results: This pilot study showed that both treatments were equally effective for depressive and anxiety symptoms. However, therapeutic techniques differed with regards to their effects on specific facets of emotion regulation, such as Positive Reappraisal and Catastrophizing, with MCT being more effective compared to BA. BA also showed a stronger relapse at follow-up with regards to Acceptance and Refocus on Planning. Conclusions: Results suggest that groups MCT and BA may be implemented as cost-effective treatments for students with moderate depression. Copyright © 2015 Taylor & Francis Group, LLC.
Journal of Mental Health, 25(6) : 479-485
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Burckhardt, R., Manicavasagar, V., Batterham, P. J., Hadzi-Pavlovic, D.
To date, most early intervention programs have been based on emotion regulation strategies that address dysfunctional cognitive appraisals, problem-solving skills, and rumination. Another emotion regulation strategy, 'acceptance' training, has largely been overlooked. To examine the efficacy of this strategy, a school-based mental health program combining positive psychology with acceptance and commitment therapy (Strong Minds) was evaluated in a randomized controlled trial with a sample of 267 Year 10 and 11 high-school students in Sydney, Australia. Mixed models for repeated measures examined whether the program led to reductions in symptoms amongst students who commenced the program with high depression, anxiety, and stress scores, and increased wellbeing scores amongst all students. Results demonstrated that compared to controls, participants in the Strong Minds condition with elevated symptom scores (n=63) reported significant reductions in depression (p=.047), stress (p=.01), and composite depression/anxiety symptoms (p=.02) with medium to strong effect sizes (Cohen's d=0.53, 0.74, and 0.57, respectively). Increased wellbeing (p=.03) in the total sample and decreased anxiety scores (p=.048) for students with elevated symptoms were significant for Year 10 students with medium effect sizes (Cohen's d=0.43 and 0.54, respectively). This study tentatively suggests that including the emotion regulation strategy of acceptance in early intervention programs may be effective in reducing symptoms and improving wellbeing in high school students. Further research to investigate the generalizability of these findings is warranted. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
Journal of School Psychology, 57 : 41-52
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Acceptance & commitment therapy (ACT)
, Positive psychology
Guo, T., Guo, Z., Zhang, W., Ma, W., Yang, X., Hwang, J., He, X., Chen, X., Ya, T.
BACKGROUND: Individuals with sub-syndromal depression (SSD) are at increased risk of incident depressive disorders; however, the ideal therapeutic approach to SSD remains unknown. OBJECTIVE: To evaluate the effects of electroacupuncture (EA) and cognitive behavioural therapy (CBT), alone or in combination, on depressive symptoms. METHODS: Undergraduate students with SSD were recruited and allocated to one of four groups based on their preferences: EA (n=6), CBT (n=10), EA+CBT (n=6), and untreated control (n=11) groups. Six weeks of treatment were provided in the first three groups. Clinical outcomes were measured using the 17-item Hamilton Depression (HAMD-17) rating scale, Center for Epidemiologic Depression (CES-D) scale, WHO Quality of Life-Brief version (WHOQOL-BREF) questionnaire, and clinical remission rate. RESULTS: All 33 subjects were included in an intent-to-treat analysis. Statistically significant improvements in HAMD-17, CES-D, and WHOQOL-BREF scores and a higher remission rate were found in the EA, CBT, and EA+CBT intervention groups compared with the control group (all p<0.05). No significant differences were found between the three intervention groups. HAMD-17 factor score analysis revealed that EA reduced sleep disturbance scores more than CBT or EA+CBT (p<0.05), and CBT reduced retardation scores more than EA (p<0.01). EA+CBT reduced anxiety/somatisation scores more than EA or CBT (p<0.05) and retardation scores more than EA (p<0.05). CONCLUSIONS: Early intervention may alleviate depressive symptoms in SSD. EA and CBT may have differential effects on certain symptoms. Combination therapy targeting both physical and psychological symptoms may represent an ideal strategy for SSD intervention. However, randomised trials with larger sample sizes are needed. TRIAL REGISTRATION NUMBER: ChiCTR-TRC-10000889; Results. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Acupuncture in medicine : journal of the British Medical Acupuncture Society, 34(5) : 356-363
- Year: 2016
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Acupuncture, acupressure
Tolnai, N., Szabó, Z., Koteles, F., Szabo, A.
Physiology & behavior, 163 : 211-218
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Physical activity, exercise