Disorders - Depressive Disorders
Tandon, S. D., Latimore, A. D., Clay, E., Mitchell, L., Tucker, M., Sonenstein, F. L.
Importance: Recent estimates indicate that 6.5 million adolescents and young adults in the United States are neither in school nor working. These youth have significant mental health concerns that require intervention.; Objective: To determine whether a mental health intervention, integrated into an employment training program that serves adolescents and young adults disconnected from school and work, can reduce depressive symptoms and improve engaged coping strategies.; Design, Setting, and Participants: A quasi-experimental study was conducted; 512 adolescents and young adults newly enrolling in one employment training program site were intervention participants, while 270 youth from a second program site were enrolled as controls. Participants were aged 16 to 23 years and not in foster care. Study recruitment took place from September 1, 2008, to May 31, 2011, with follow-up data collection occurring for 12 months after recruitment. Propensity score matching adjusted for observed baseline differences between the intervention and control groups.; Main Outcomes and Measures: Depressive symptoms measured on a Center for Epidemiologic Studies Depression Scale (CES-D) and engaged coping strategies.; Results: The mean age of participants was 19 years, 93.7% were African American, and 49.4% were male. Six- and 12-month follow-up rates were 61.0% (n = 477) and 56.8% (n = 444), respectively. Males in the intervention group with high baseline depressive symptoms exhibited a statistically significant decrease in depressive symptoms at 12 months (5.64-point reduction in CES-D score; 95% CI, -10.30 to -0.96; P = .02) compared with similar males in the control group. A dosage effect was observed at 12 months after the intervention, whereby males with greater intervention exposure showed greater improvement in depressive symptoms compared with similar males with lower intervention doses (effect on mean change in CES-D score, -3.37; 95% CI, -6.72 to -0.09; P = .049). Males and females in the intervention group were more likely than participants in the control group to increase their engaged coping skills, with statistically significant differences found for males (effect on mean change in CES-D score, 0.32; 95% CI, 0.14-0.50; P = .001) and females (effect on mean change in CES-D score, 0.19; 95% CI, 0.01-0.37; P = .047) at 12 months.; Conclusions and Relevance: Given the growing number of adolescents and young adults using employment training programs and the mental health needs of this population, increased efforts should be made to deliver mental health interventions in these settings that usually focus primarily on academic and job skills. Ways to extend the effect of intervention for females and those with lower levels of depressive symptoms should be explored.;
JAMA Psychiatry, 72(1) : 31-39
- Year: 2015
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Individual placement and support (IPS), vocational interventions
, Other service delivery and improvement interventions
Papakostas, G. I., Ostergaard, S. D., Iovieno, N.
Objective: To review factors influencing placebo response and clinical trial outcome in depression, and suggest ways to optimize trial success in mood disorders.; Data Sources: PubMed searches were conducted by cross-referencing the terms depression, depressive with placebo, clinical trial, and clinical trials for studies published in English between 1970 and September 2013.; Study Selection: Relevant abstracts were identified in PubMed, including clinical trials, quantitative studies, and qualitative research. We obtained and reviewed relevant articles and utilized their information to synthesize the present review.; Data Extraction: Included articles were grouped in the following areas of relevance: (1) biological validity of illness, (2) baseline severity of illness, (3) chronicity of the index episode of depression, (4) age of participants, (5) medical and psychiatric comorbidity, (6) probability of receiving placebo, (7) use of prospective treatment phases (lead-in) (8) dosing schedule, (9) trial duration, (10) frequency of follow-up assessments, and (11) study outcome measure.; Results: Several key elements emerge as critical to the ultimate success of a clinical trial, including the probability of receiving placebo, study duration, dosing schedule, visit frequency, the use of blinded lead-in phases, the use of centralized raters, illness severity and duration, and comorbid anxiety.; Conclusions: Our increasing understanding of the placebo response in clinical trials of major depressive disorder lends to a, gradually, more predictable phenomenon and, hopefully, to one that becomes lesser in magnitude and variability. Several elements have emerged that seem to play a critical role in trial success, gradually reshaping the design of clinical, translational, as well as mechanistic studies in depression.; © Copyright 2015 Physicians Postgraduate Press, Inc.
Journal of Clinical Psychiatry, 76(4) : 456-466
- Year: 2015
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Pennant, M. E., Loucas, C. E., Whittington, C., Creswell, C., Fonagy, P., Fuggle, P., Kelvin, R., Naqvi, S., Stockton, S., Kendall, T., Bevington, D., Fairburn, C., Keen, D., Lamb, S., Larsson, L., Murphy, M., Pilling, S., Pugh, K., Ringwood, S., Sealey, C., Williams, P.
One quarter of children and young people (CYP) experience anxiety and/or depression before adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmentingtreatment and this work aimed to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5-25 years old. Databases were searched for randomised controlled trials and 27 studies were identified. For young people (12-25 years) with risk of diagnosed anxiety disorders or depression, computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD-0.77, 95% CI-1.45 to-0.09, k=6, N=220) and depression (SMD-0.62, 95% CI-1.13 to-0.11, k=7, N=279). In a general population study of young people, there were small positive effects for anxiety (SMD-0.15, 95% CI-0.26 to-0.03; N=1273) and depression (SMD-0.15, 95% CI-0.26 to-0.03; N=1280). There was uncertainty around the effectiveness of cCBT in children (5-11 years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety and depression in clinical and general populations of young people. Further program development and research is required to extend its use and establish its benefit in children.
Behaviour Research & Therapy, 67 : 1-18
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
, Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Technology, interventions delivered using technology (e.g. online, SMS)
Rickhi, B., Kania-Richmond, A., Moritz, S., Cohen, J., Paccagnan, P., Dennis, C., Liu, M., Malhotra, S., Steele, P., Toews, J.
Background: Depression in adolescents and young adults is a major mental health condition that requires attention. Research suggests that approaches that include spiritual concepts and are delivered through an online platform are a potentially beneficial approach to treating/managing depression in this population. The purpose of this study was to evaluate the effectiveness of an 8-week online spirituality informed e-mental health intervention (the LEAP Project) on depression severity, and secondary outcomes of spiritual well-being and self-concept, in adolescents and young adults with major depressive disorder of mild to moderate severity. Methods: A parallel group, randomized, waitlist controlled, assessor-blinded clinical pilot trial was conducted in Calgary, Alberta, Canada. The sample of 62 participants with major depressive disorder (DSM-IV-TR) was defined by two age subgroups: adolescents (ages 13 to 18 years; n = 31) and young adults (ages 19 to 24 years; n = 31). Participants in each age subgroup were randomized into the study arm (intervention initiated upon enrolment) or the waitlist control arm (intervention initiated after an 8-week wait period). Comparisons were made between the study and waitlist control arms at week 8 (the point where study arm had completed the intervention and the waitlist control arm had not) and within each arm at four time points over 24-week follow-up period. Results: At baseline, there was no statistical difference between study and waitlist participants for both age subgroups for all three outcomes of interest. After the intervention, depression severity was significantly reduced; comparison across arms at week 8 and over time within each arm and both age subgroups. Spiritual well-being changes were not significant, with the exception of an improvement over time for the younger participants in the study arm (p = 0.01 at week 16 and p = 0.0305 at week 24). Self-concept improved significantly for younger participants immediately after the intervention (p = 0.045 comparison across arms at week 8; p = 0.0175 in the waitlist control arm) and over time in the study arm ( p = 0.0025 at week 16). In the older participants, change was minimal, with the exception of a significant improvement in one of six factors (vulnerability) in study arm over time (p = 0.025 at week 24). Conclusions: The results of the LEAP Project pilot trial suggest that it is an effective, online intervention for youth ages 13 to 24 with mild to moderate major depressive disorder with various life situations and in a limited way on spiritual well-being and self-concept. Trial registration: ClinicalTrials.gov NCT00985686. Registered 24 September 2009.
BMC Complementary & Alternative Medicine, 15(1) :
- Year: 2015
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Porter, L. S., Porter, B. O., McCoy, V., Bango-Sanchez, V., Kissel, B., Williams, M., Nunnewar, S.
Purpose This study aimed to determine whether a blended Infant Massage-Parenting Enhancement Program (IMPEP) improved maternal psychosocial health outcomes (parenting stress, depressive symptoms, self-esteem, maternal attachment) and maternal-infant interaction among substance-addicted mothers (SAMs) actively engaged in outpatient rehabilitation. Methods Designed as a randomized, three-group controlled trial testing two levels of psychoeducational intervention (IMPEP vs. PEP) and a control group (standard care parenting resources), the study was conducted in two substance abuse centers in southeast Florida on a convenience sample of 138 recovering SAM-infant pairs. IMPEP or PEP classes were held weekly on Weeks 2-5, with data collected at baseline (Week 1), Week 6, and Week 12 via structured interviews, observation (Observation Checklist on Maternal-Infant Interaction), and self-administered questionnaires (Abidin Parenting Stress Index, Beck Depression Inventory, Rosenberg Self-Esteem Scale, Muller's Maternal Attachment Inventory), analyzed descriptively and inferentially using Kruskall-Wallis analysis of variance and post hoc Wilcoxon rank sum and Mann-Whitney U tests. Results Both IMPEP and PEP groups had significantly increased Parenting Stress Index scores (decreased parenting stress) and decreased Beck Depression Inventory scores (decreased depressive symptoms) compared to controls at Week 12, whereas there were no clinically meaningful differences among study groups in Rosenberg Self-Esteem Scale, Muller's Maternal Attachment Inventory, or Observation Checklist on Maternal-Infant Interaction scores. Only the IMPEP group showed significant improvements in both psychological and physical (waist-hip ratio) measures of parenting stress over time. Conclusions The findings suggest that infant massage blended into a structured parenting program has value-added effects in decreasing parenting stress and maternal depressive symptoms, but not on SAM's self-esteem, attachment, or maternal-infant interaction.
Asian Nursing Research, 9(4) : 318-327
- Year: 2015
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Psychoeducation, Massage
Pedrelli, P., Borsari, B.
Almost half of college students in the US report engaging in heavy episodic drinking (HED), a behavior associated with increased risk for physical injury, sexual and/or physical assault, driving while intoxicated, suicidal behavior and death. Many students report drinking heavily in order to cope with aversive mood states and HED is more frequent among students with depressive symptoms. This combination of depressive symptoms and the use of alcohol to cope with them increases risk for negative consequences and worsening long-term impairment. However, no empirically supported treatments are available for students with depressive symptoms who report concurrent HED. To address this gap, we developed a treatment program integrating a Brief Motivational Intervention (BMI) with an empirically supported treatment for depressive symptoms, Cognitive Behavioral Therapy (CBT). This presentation will discuss the development and current evidence of its effectiveness in an ongoing randomized controlled trial. Participants are undergraduate students reporting mild to severe depressive symptoms and HED who are randomized to eight therapy sessions of (i) CBT Depression or (ii) CBT-Depression + BMI. To date, 19 undergraduate college students (84% females, Age = 19.6 + 1.3) have completed the trial and an additional 10 students are undergoing treatment. Preliminary results indicate that CBT + BMI is feasible, is associated with better alcohol outcome than CBT alone (Cohen's d = 0.71 vs. 0.51) and with less reduction of depressive symptoms (Cohen's d = 1.30 vs. 1.51). Additionally, BMI + CBT is associated with greater improvement in problem solving skills (Cohen's d = 0.86 vs. d = 0.18) and readiness to change (Cohen's d = 0.42 vs. d = 0.35). Increase during the course of treatment in seeking social support as a coping strategy is associated with decrease in HED (r = 0.49, p = 0.03). Decrease in drinking to cope is directly associated with a decrease in weekly drinks (r = 0.49; p = 0.04) and inversely related with coping with an aggressive style (r = -0.71, p < 0.01). Changes in depressive symptoms and alcohol consumption were not associated with each other. Preliminary findings suggest that an integrated intervention may be more beneficial to reduce hazardous drinking among college students with co-occurring symptoms. Moreover, focusing on enhancing social support as well as problem solving skills and lowering aggressive coping may be mechanisms of the observed effects.
Alcoholism: Clinical & Experimental Research, 39 : 269A
- Year: 2015
- Problem: Depressive Disorders, Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy
O'Shea, G., Spence, S. H., Donovan, C. L.
Background: This study adds to the limited evidence concerning the benefits of Interpersonal Psychotherapy (IPT) with depressed adolescents. It evaluates the long-term effects of group versus individual delivery of this treatment approach. Aims: To conduct a smallscale examination of the long-term efficacy of group versus individual delivery of IPT for depressed adolescents. Method: Thirty-nine adolescents, aged 13-19 years, with a primary diagnosis of Major Depressive Disorder, were randomly assigned in blocks to either group or individual delivery of IPT. Standardized clinical interview and questionnaire assessments were conducted at pre- and posttreatment, and 12-month follow-up. Results: Intent-to-treat (ITT) analyses indicated significant improvements in depression, anxiety, youth-reported internalizing problems, and global functioning from pre- to posttreatment for those receiving IPT, with no significant differences in outcome between group and individual formats of delivery. Improvements were maintained at 12-month follow-up. Completer analyses also revealed significant and sustained improvements on these measures for those receiving IPT, with no differences in outcome between therapy formats for most measures. Individual IPT showed significantly greater improvements than group IPT in parent-reported internalizing problems for the completer but not the ITT analyses. Conclusions: Both individual and group formats of IPT offer promise in producing long-term benefits in the treatment of depression among adolescents. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Behavioural & Cognitive Psychotherapy, 43(1) : 19
- Year: 2015
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Interpersonal therapy (IPT)
, Other service delivery and improvement interventions
Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., Parsons, J. T.
Objectives: We tested the preliminary efficacy of a transdiagnostic cognitive-behavioral treatment adapted to improve depression, anxiety, and co-occurring health risks (i.e., alcohol use, sexual compulsivity, condomless sex) among young adult gay and bisexual men. Treatment adaptations focused on reducing minority stress processes that underlie sexual orientation-related mental health disparities. Method: Young gay and bisexual men (n = 63; M age = 25.94) were randomized to immediate treatment or a 3-month waitlist. At baseline, 3-month, and 6-month assessments, participants completed self-reports of mental health and minority stress and an interview of past-90-day risk behavior. Results: Compared to waitlist, treatment significantly reduced depressive symptoms (b =-2.43, 95% CI:-4.90, 0.35, p <.001), alcohol use problems (b =-3.79, 95% CI:-5.94,-1.64, p <.001), sexual compulsivity (b =-5.09, 95% CI:-8.78,-1.40, p <.001), and past-90-day condomless sex with casual partners (b =-1.09, 95% CI:-1.80,-0.37, p <.001), and improved condom use self-efficacy (b = 10.08, 95% CI: 3.86, 16.30, p <.001). The treatment yielded moderate and marginally significant greater improvements than waitlist in anxiety symptoms (b =-2.14, 95% CI:-4.61, 0.34, p =.09) and past-90-day heavy drinking (b =-0.32, 95% CI:-0.71, 0.07, p =.09). Effects were generally maintained at follow-up. Minority stress processes showed small improvements in the expected direction. Conclusion: This study demonstrated preliminary support for the first intervention adapted to address gay and bisexual men's co-occurring health problems at their source in minority stress. If found to be efficacious compared to standard evidence-based treatments, the treatment will possess substantial potential for helping clinicians translate LGB-affirmative treatment guidelines into evidence-based practice.
Journal of Consulting & Clinical Psychology, 83(5) : 875-886
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Morris, R. R., Schueller, S. M., Picard, R. W.
Background: Self-guided, Web-based interventions for depression show promising results but suffer from high attrition and low user engagement. Online peer support networks can be highly engaging, but they show mixed results and lack evidence-based content.; Objective: Our aim was to introduce and evaluate a novel Web-based, peer-to-peer cognitive reappraisal platform designed to promote evidence-based techniques, with the hypotheses that (1) repeated use of the platform increases reappraisal and reduces depression and (2) that the social, crowdsourced interactions enhance engagement.; Methods: Participants aged 18-35 were recruited online and were randomly assigned to the treatment group, "Panoply" (n=84), or an active control group, online expressive writing (n=82). Both are fully automated Web-based platforms. Participants were asked to use their assigned platform for a minimum of 25 minutes per week for 3 weeks. Both platforms involved posting descriptions of stressful thoughts and situations. Participants on the Panoply platform additionally received crowdsourced reappraisal support immediately after submitting a post (median response time=9 minutes). Panoply participants could also practice reappraising stressful situations submitted by other users. Online questionnaires administered at baseline and 3 weeks assessed depression symptoms, reappraisal, and perseverative thinking. Engagement was assessed through self-report measures, session data, and activity levels.; Results: The Panoply platform produced significant improvements from pre to post for depression (P=.001), reappraisal (P<.001), and perseverative thinking (P<.001). The expressive writing platform yielded significant pre to post improvements for depression (P=.02) and perseverative thinking (P<.001), but not reappraisal (P=.45). The two groups did not diverge significantly at post-test on measures of depression or perseverative thinking, though Panoply users had significantly higher reappraisal scores (P=.02) than expressive writing. We also found significant group by treatment interactions. Individuals with elevated depression symptoms showed greater comparative benefit from Panoply for depression (P=.02) and perseverative thinking (P=.008). Individuals with baseline reappraisal deficits showed greater comparative benefit from Panoply for depression (P=.002) and perseverative thinking (P=.002). Changes in reappraisal mediated the effects of Panoply, but not the expressive writing platform, for both outcomes of depression (ab=-1.04, SE 0.58, 95% CI -2.67 to -.12) and perseverative thinking (ab=-1.02, SE 0.61, 95% CI -2.88 to -.20). Dropout rates were similar for the two platforms; however, Panoply yielded significantly more usage activity (P<.001) and significantly greater user experience scores (P<.001).; Conclusions: Panoply engaged its users and was especially helpful for depressed individuals and for those who might ordinarily underutilize reappraisal techniques. Further investigation is needed to examine the long-term effects of such a platform and whether the benefits generalize to a more diverse population of users.; Trial Registration: ClinicalTrials.gov NCT02302248; https://clinicaltrials.gov/ct2/show/NCT02302248 (Archived by WebCite at http://www.webcitation.org/6Wtkj6CXU).;
Journal of Medical Internet Research, 17(3) : e72-e72
- Year: 2015
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Muller, S., Rohde, P., Gau, J.M., Stice, E.
We investigated factors hypothesized to moderate the effects of cognitive behavioral group-based (CB group) and bibliotherapy depression prevention programs. Using data from two trials (N = 631) wherein adolescents (M age = 15.5, 62% female, 61% Caucasian) with depressive symptoms were randomized into CB group, CB bibliotherapy, or an educational brochure control condition, we evaluated the moderating effects of individual, demographic, and environmental factors on depressive symptom reductions and major depressive disorder (MDD) onset over 2-year follow-up. CB group and bibliotherapy participants had lower depressive symptoms than controls at posttest but these effects did not persist. No MDD prevention effects were present in the merged data. Relative to controls, elevated depressive symptoms and motivation to reduce depression amplified posttest depressive symptom reduction for CB group, and elevated baseline symptoms amplified posttest symptom reduction effects of CB bibliotherapy. Conversely, elevated substance use mitigated the effectiveness of CB group relative to controls on MDD onset over follow-up. Findings suggest that both CB prevention programs are more beneficial for youth with at least moderate depressive symptoms, and that CB group is more effective for youth motivated to reduce their symptoms. Results also imply that substance use reduces the effectiveness of CB group-based depression prevention. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Behaviour Research & Therapy, 75 : 1-10
- Year: 2015
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Self-help
Nehmy, T. J., Wade, T. D.
Objective: The aim of the current study was to evaluate a prevention program targeting unhelpful perfectionism and self-compassion, designed to prevent growth of negative affect (NA). Method: Four schools participated in the research, where grade levels were allocated to either the intervention (". Healthy Minds") or the control condition (N=688 individuals; mean age 14.90 years), and assessments occurred at baseline, post-intervention, and 6- and 12-month follow-up. Results: There were no significant between group differences at post-intervention but at 6-month follow-up the intervention group had significantly lower unhelpful perfectionism, self-criticism and NA than the controls. Only significant between-group differences in unhelpful perfectionism were retained at 12-month follow-up (Cohen's d=.24). Examination of the sub-group lower in NA at baseline showed the intervention group was significantly less likely to have elevated NA at 6-month follow-up than controls, indicating a prevention effect. Discussion: The effects obtained in the current study provide support for the utility of a perfectionism intervention for reducing transdiagnostic outcomes, including unhelpful perfectionism, self-judgment, and NA, and preventing the growth of NA. Ways of producing longer terms effects for NA need to be further investigated, as does the impact of the intervention on different types of psychopathology. Trial registration: ACTRN12614000650695.
Behaviour Research & Therapy, 67 : 55-63
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions
Rice, F., Rawal, A., Riglin, L., Lewis, G., Dunsmuir, S.
Background: Effective methods to prevent adolescent depressive symptoms could reduce suffering and burden across the lifespan. However, psychological interventions delivered to adolescents show efficacy only in symptomatic or high-risk youth. Targeting causal risk factors and assessing mechanistic change can help devise efficacious universal or classroom based prevention programs.; Methods: A non-randomized longitudinal design was used to compare three classroom-based prevention programs for adolescent depression (Behavioral Activation with Reward Processing, "Thinking about Reward in Young People" (TRY); Cognitive Behavioral Therapy (CBT) and Mindfulness Based Cognitive Therapy (MBCT)), and determine cognitive mechanisms of change in these programs. Cognitive mechanisms examined were reward-seeking, negative self-beliefs (assessed with behavioral tasks) and over-general autobiographical memory. 256 healthy adolescents aged 13-14 participated with 236 (92%) and 227 (89%) completing the pre- and post-assessments.; Results: TRY was the only intervention associated with a reduction in depressive symptoms at follow-up. Reward-seeking increased following TRY. In the other programs there were non-significant changes in cognitive mechanisms, with more reflective negative self-beliefs in CBT and fewer over-general autobiographical memories in MBCT In the TRY program, which focused on increasing sensitivity to rewarding activities, reward seeking increased and this was associated with decreased depressive symptoms.; Limitations: Due to the infeasibility of a cluster randomized controlled trial, a non-randomized design was used.; Conclusions: Increased reward-seeking was associated with decreased depressive symptoms and may be a mechanism of depressive symptom change in the intervention with a focus on enhancing sensitivity and awareness of reward. This study provides preliminary evidence to suggest that incorporating activities to enhance reward sensitivity may be fruitful in randomized controlled trials of universal prevention programs for depression.; Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.
Journal of Affective Disorders, 186 : 320-327
- Year: 2015
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions