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1.
Cogn Affect Behav Neurosci ; 24(1): 42-59, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-38093157

RESUMEN

Exposure to stressful events is associated with a range of negative physical and mental health outcomes, including depression. It is critical to understand the mechanisms through which stress impacts mental health to identify promising targets for prevention and intervention efforts. Low-reward responsiveness is thought to be a mechanism of effects of stress on negative health outcomes and can be reliably measured at the neurophysiological level by using event-related potentials (ERPs), such as the reward positivity (RewP) component. The goal of this systematic review and preliminary meta-analysis was to examine evidence of associations between stress and alterations in reward responsiveness measured using ERPs. Through a systematic review of the literature, 23 studies examining the effects of laboratory-induced stressors and naturalistic stressors or perceived stress on reward responsiveness met study criteria, 13 of which were included in the meta-analysis. Most studies were conducted in undergraduate and community samples, with three selected for specific conditions, and primarily in adults. The systematic review supported evidence of associations between laboratory-induced stressors and blunted reward responsiveness as measured by the RewP but there were more mixed results when considering direct associations between naturalistic stressors/perceived stress and reward-related ERPs. Given that all studies examined the RewP, the meta-analysis focused on this component and indicated that there was a weak, nonsignificant negative association between stress and RewP. Results emphasize the complex nature of relations between stress and reward-related ERPs and the need to consider alternative models in future research. We also provide reporting recommendations for ERP researchers to facilitate future meta-analyses.


Asunto(s)
Electroencefalografía , Potenciales Evocados , Adulto , Humanos , Potenciales Evocados/fisiología , Motivación , Recompensa , Salud Mental , Depresión
2.
Psychophysiology ; 61(3): e14497, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38044748

RESUMEN

Electroencephalography (EEG) data processing to derive event-related potentials (ERPs) follows a standard set of procedures to maximize signal-to-noise ratio. This often includes ocular correction, which corrects for artifacts introduced by eye movements, typically measured by electrooculogram (EOG) using facial electrodes near the eyes. Yet, attaching electrodes to the face may be uncomfortable for some populations, best to avoid in some situations, and contribute to data loss. Eye movements can also be measured using electrodes in a standard 10-20 EEG cap. An examination of the impact of electrode selection on ERPs is needed to inform best practices. The present study examined data quality when using different electrodes to measure eye movements for ocular correction (i.e., facial electrodes, cap electrodes, and no ocular correction) for two well-established and widely studied ERP components (i.e., reward positivity, RewP; and late positive potential, LPP) elicited in adolescents (N = 34). Results revealed comparable split-half reliability and standardized measurement error (SME) between facial and cap electrode approaches, with lower SME for the RewP with facial or cap electrodes compared to no ocular correction. Few significant differences in mean amplitude of ERPs were observed, but the LPP to positive images differed when using facial compared to cap electrodes. Findings provide preliminary evidence of the ability to collect high-quality ERP data without facial electrodes. However, when using cap electrodes for EOG measurement and ocular correction, it is recommended to use consistent procedures across the sample or statistically examine the impact of ocular correction procedures on results.


Asunto(s)
Electroencefalografía , Potenciales Evocados , Humanos , Adolescente , Reproducibilidad de los Resultados , Electroencefalografía/métodos , Electrodos , Recompensa
3.
Psychophysiology ; 61(1): e14413, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37612834

RESUMEN

Maladaptive responses to peer acceptance and rejection arise in numerous psychiatric disorders in adolescence; yet, homogeneity and heterogeneity across disorders suggest common and unique mechanisms of impaired social function. We tested the hypothesis that social feedback is processed similarly to other forms of feedback (e.g., monetary) by examining the correspondence between the brain's response to social acceptance and rejection and behavioral performance on a separate reward and loss task. We also examined the relationship between these brain responses and depression and social anxiety severity. The sample consisted of one hundred and thirteen 16-21-year olds who received virtual peer acceptance/rejection feedback in an event-related potential (ERP) task. We used temporospatial principal component analysis and identified a component consistent with the reward positivity (RewP) or feedback negativity (FN). RewP to social acceptance was not significantly related to reward bias or the FN to social rejection related to loss avoidance. The relationship between RewP and depression severity, while nonsignificant, was of a similar magnitude to prior studies. Exploratory analyses yielded a significant relationship between lower socioeconomic status (SES) and blunted RewP and between lower SES and heightened loss avoidance and blunted reward bias. These findings build on prior work to improve our understanding of the function of the brain's response to social feedback, while also suggesting a pathway for further study, whereby poverty leads to depression via social and reward learning mechanisms.


Asunto(s)
Electroencefalografía , Potenciales Evocados , Adolescente , Humanos , Retroalimentación , Potenciales Evocados/fisiología , Encéfalo , Depresión , Recompensa
4.
Curr Psychiatry Rep ; 24(12): 853-859, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36370264

RESUMEN

PURPOSE OF REVIEW: This review integrates recent systematic reviews and meta-analyses on the efficacy of cognitive behavioral therapy (CBT) for the treatment of anxiety disorders in children and adolescents. To inform personalized approaches to intervention, we also review recent research on moderators and predictors of outcomes. RECENT FINDINGS: Meta-analyses provide strong support for the efficacy of CBT for youth anxiety disorders, including with preschool-aged children using appropriate modifications. Furthermore, there is evidence that CBT is an effective adjunct treatment to psychopharmacological interventions, and the combination of treatments may be most effective for some youth. There is limited evidence of consistent demographic and clinical moderators of outcomes. Recent work in neuroscience has highlighted novel predictors of treatment outcomes that, with replication, may aid in more personalized approaches to youth anxiety treatment. CBT is efficacious for treating anxiety disorders in youth and lowering recurrence rates. CBT can also be an efficacious adjunct treatment for psychopharmacological interventions. Neuroimaging and psychophysiological measures of threat and motivational processing have shown initial promise in predicting symptom change with CBT, with potential implications for precision medicine.


Asunto(s)
Trastornos de Ansiedad , Terapia Cognitivo-Conductual , Niño , Preescolar , Humanos , Adolescente , Trastornos de Ansiedad/terapia , Trastornos de Ansiedad/psicología , Ansiedad , Resultado del Tratamiento , Terapia Cognitivo-Conductual/métodos , Medicina de Precisión
5.
J Soc Clin Psychol ; 41(1): 30-53, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35785150

RESUMEN

Introduction: The COVID-19 pandemic has led to major stressors, increases in internalizing symptomatology, and greater reliance on online interactions. We examined associations between social media use, online social support, pandemic-related stress, and internalizing symptoms, and tested the moderating role of social media use on the relation between stress and symptom change across time. Methods: Emerging adults aged 18-25 (N=200) self-reported pandemic-related stress, internalizing symptoms, social media use, and online social support in May 2020, then repeated measures of internalizing symptoms in August 2020. Results: Greater social media use was cross-sectionally associated with greater stress and anxiety symptoms. High social media use in conjunction with high interpersonal stress was predictive of increases in depression, whereas low online social support and high total stress was predictive of increases in anxiety. Discussion: Findings suggest that general social media usage and online social support are differentially related to internalizing symptom change among emerging adults.

6.
Cogn Affect Behav Neurosci ; 21(6): 1306-1318, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34272679

RESUMEN

Affective neuroscience research using electrocortical event-related potentials has provided valuable insights on alterations in emotion processing in internalizing disorders. However, internalizing disorders are accompanied by additional impairments in social cognition and functioning, and most extant research examines neural responses to broad categories of emotional scenes or faces presented irrespective of context. Examining neural reactivity specifically to interpersonal emotional scenes may more precisely capture and disentangle processes involved in depression and social anxiety, two highly comorbid forms of psychopathology. The current study validated a novel set of positive and threatening interpersonal emotional stimuli in a sample of emerging adults (N = 114) who completed a modified emotional interrupt paradigm while electroencephalogram and behavioral data were recorded. Participant ratings of valence and arousal supported the validity of the emotional images. Consistent with prior research, sustained neurophysiological processing indexed by the late positive potential (LPP) was observed for interpersonal emotional images, especially positive, compared with neutral images. Elevated LPP reactivity to both positive and threatening interpersonal images moderated the effects of chronic interpersonal stress on social anxiety symptoms, such that enhanced LPP reactivity in conjunction with higher levels of chronic interpersonal stress was associated with elevated social anxiety symptoms. These results were unique to social anxiety symptoms and not symptoms of depression, suggesting sustained neural processing of interpersonal stimuli may differentiate social anxiety from depression. Future research on emotional reactivity specifically within the interpersonal domain is needed to inform our understanding of developmental pathways to internalizing psychopathology.


Asunto(s)
Depresión , Emociones , Adulto , Ansiedad , Electroencefalografía , Potenciales Evocados , Miedo , Humanos
7.
J Soc Clin Psychol ; 40(2): 97-120, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34334930

RESUMEN

INTRODUCTION: Depression is associated with increased negative affect (NA) and low positive affect (PA), as well as interpersonal difficulties. Although most studies examine symptoms and affect at only one time point, ecological momentary assessment (EMA) captures data on affect and activity in real time and across contexts. The present study used EMA to explore the links between in-person and virtual social interactions, depressive symptoms, and momentary affect. METHODS: Emerging adults (N=86) completed a self-report measure of both general depression and dysphoria symptoms, followed by EMA surveys 8 times daily for one week, reporting momentary affect (PA and NA) and social context (in-person and virtual interactions with friends). RESULTS: In-person, but not virtual, presence of friends was associated with increased PA overall. Depressive symptoms were linked to less time with in-person friends and elevated NA. There was also a significant interaction between in-person presence of friends and dysphoria in predicting NA, such that presence of in-person friends was associated with lower NA only for those low in dysphoria. DISCUSSION: Findings suggest that time with in-person friends is associated with increased PA overall and decreased NA only for those lower in depressive symptoms, but these effects do not generalize to virtual interactions. Those with greater depressive symptoms may be less responsive to positive stimuli and experience less of an effect of friends' presence on affect. Alternatively, maladaptive social behaviors characteristic of depression may influence the effect of social interactions on affect.

8.
Depress Anxiety ; 37(12): 1280-1288, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33169481

RESUMEN

BACKGROUND: Stressful events due to the coronavirus disease-2019 (COVID-19) pandemic are likely to have profound effects on mental health, and validated methods for assessing these experiences and associations with psychopathology are needed. We developed the Pandemic Stress Questionnaire (PSQ) and tested its psychometric properties, characterized experiences in emerging adults, and examined associations with internalizing symptoms. METHODS: Emerging adults (N = 450) completed the PSQ and measures of internalizing symptoms and perceived stress through an online platform in May 2020. One month later, 288 participants completed a follow-up questionnaire to assess reliability of the PSQ and longitudinal associations between stress and internalizing symptoms. RESULTS: Results supported the validity/reliability of PSQ total scores and indicated that stressful events were highly prevalent in May, particularly among younger, female, and Black emerging adults. Symptoms of depression and anxiety were high overall, but decreased at the follow-up assessment. Pandemic-related stress was moderately associated with both depression and anxiety at each assessment, but baseline stress did not predict change in symptoms when controlling for baseline symptoms. CONCLUSIONS: Results provide empirical evidence that emerging adults are at high risk for depression and anxiety related to the psychosocial effects of the COVID-19 pandemic, and highlight specific types of experiences associated with greatest risk. Further, this study provides support for a questionnaire measure of experiences related to the COVID-19 pandemic that can be applied in future work to advance understanding of risk and resilience in response to stressful events.


Asunto(s)
COVID-19 , Pandemias , Adulto , Ansiedad/epidemiología , Depresión/epidemiología , Femenino , Humanos , Reproducibilidad de los Resultados , SARS-CoV-2 , Estrés Psicológico/epidemiología , Estados Unidos/epidemiología
9.
Depress Anxiety ; 37(9): 876-884, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32248653

RESUMEN

BACKGROUND: Suicidality in youth is a major public health problem and objective methods for identifying those at greatest risk are critically needed. Suicidality has been associated with alterations in reward-related decision-making, but the extent to which measures of reward responsiveness (RR) can differentiate youth with and without suicidality in clinical samples remains unclear. METHODS: We examined reliable and accessible neurophysiological (i.e., reward positivity [RewP] event-related potential) and self-report (Behavioral Activation System subscales) measures of RR in relation to active suicidality in 58 clinically depressed adolescents (14- to 18-year-olds). RESULTS: Logistic regression analysis indicated that active suicidality in depressed adolescents was associated with heightened RR at both the self-report and neurophysiological levels. A relatively more positive RewP to win and a more negative RewP to loss uniquely predicted active suicidality beyond demographic, clinical, and self-report measures. CONCLUSIONS: Results support the utility of neurophysiological measures in differentiating clinically depressed adolescents with and without suicidality. Although depression is commonly characterized by reduced RR, depressed adolescents with active suicidality exhibited relatively enhanced neural responses to reward and loss feedback. Results highlight the need for consideration of heterogeneity in RR in depression and research on personalized depression treatment.


Asunto(s)
Suicidio , Adolescente , Depresión , Potenciales Evocados , Humanos , Recompensa , Autoinforme
10.
Artículo en Inglés | MEDLINE | ID: mdl-38500633

RESUMEN

Depressed individuals tend to use maladaptive emotion regulation strategies more frequently than non-depressed individuals while using adaptive strategies (e.g., reappraisal) less frequently. Objective neural markers of emotion regulation ability could aid in identifying youth at greatest risk for depression and functional impairment more broadly. We used electroencephalography to examine emotion regulation in adolescents (aged 14-17; N = 201) with current depression (n = 94) and without any history of depression (n = 107) at high (n = 54) and low (n = 53) risk for depression based on a maternal history of depression. Results revealed group differences in event-related potential markers of emotion regulation using multiple scoring approaches. Never-depressed adolescents had significant reductions in mean-activity and principal component analysis-identified late positive potential responses to dysphoric stimuli under reappraisal instructions compared to passive viewing. There was no significant difference in neural responses between conditions among depressed adolescents. The magnitude of the reappraisal effects appeared slightly stronger for low-risk adolescents relative to high-risk. Exploratory analyses further demonstrated that the association between neural markers of emotion regulation and overall functioning was moderated by age, such that impaired emotion regulation abilities predicted poorer functioning among older adolescents. Findings support the sensitivity of the late positive potential to emotion regulation impairments in depression and psychopathology more broadly.

11.
J Am Coll Health ; : 1-10, 2024 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-38810263

RESUMEN

Objective: The first year of college is a time of major changes in social dynamics, raising questions about ways to promote students' mental health. We examined longitudinal associations between students' sense of belonging, imposter syndrome, depressive symptoms, and well-being. Participants: Fifty-eight first-year college students at a university in the United States participated in the study. Methods: Students completed questionnaires during the first 6 months of college (T1) and at the end of the academic year (T2). Results: Greater sense of social and academic belonging was correlated with lower imposter syndrome, depression, and greater well-being at T1. Accounting for T1 measures, lower imposter syndrome predicted greater well-being but not depression at T2. Accounting for T1 mental health, belonging was not a significant predictor of depression or well-being at T2. Conclusion: Increasing sense of belonging and addressing imposter syndrome early in the transition to college may be critical in promoting mental health.

12.
Res Child Adolesc Psychopathol ; 52(2): 195-206, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37707698

RESUMEN

Trauma exposure is associated with a heightened risk for depression and such risk is thought to vary based on the type of traumatic events (e.g., interpersonal, including abuse and domestic violence, or non-interpersonal, including accidents or natural disasters). Depression is often accompanied by altered emotional reactivity, and the late positive potential (LPP) serves as a reliable neurophysiological measure of sustained attention towards emotional stimuli, raising questions regarding the role of the LPP in moderating trauma effects on depression. We conducted a cross-sectional study of 201 adolescents aged 14-17 years (61.2% female) who were oversampled for current depression and elevated risk of depression based on maternal history. Clinical interviews were conducted to assess diagnoses and lifetime trauma exposure, and participants reported on current depressive symptoms. Electroencephalogram (EEG) was continuously recorded while participants completed a previously validated interpersonal emotional images task. Cumulative trauma (CT) and interpersonal trauma (IPT) were both associated with greater depressive symptoms, but non-interpersonal trauma (NIPT) was not significantly related to depressive symptoms. The association between IPT and depressive symptoms was moderated by the LPP to positive interpersonal images, such that IPT-exposed adolescents with blunted neural responses to such images showed the greatest symptoms. This result was specific to IPT, and the LPP to threatening interpersonal images did not significantly moderate the effects of IPT on depressive symptoms. These findings highlight the unique effects of interpersonal trauma on depressive symptoms and elucidate a potential vulnerability linking trauma exposure to depression risk among adolescents.


Asunto(s)
Depresión , Violencia Doméstica , Humanos , Femenino , Adolescente , Masculino , Estudios Transversales , Emociones/fisiología , Electroencefalografía
13.
Res Child Adolesc Psychopathol ; 52(4): 567-578, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38008786

RESUMEN

Very little is known about the mechanisms underlying the development of personality disorders, hindering efforts to address early risk for these costly and stigmatized disorders. In this study, we examined associations between social and monetary reward processing, measured at the neurophysiological level, and personality pathology, operationalized through the Level of Personality Functioning (LPF), in a sample of early adolescent females (Mage = 12.21 years old, SD = 1.21). Female youth with (n = 80) and without (n = 30) a mental health history completed laboratory tasks assessing social and monetary reward responsiveness using electroencephalogram (EEG) and completed ratings of personality pathology. Commonly co-occurring psychopathology, including depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) were also assessed. At the bivariate level, significant associations did not emerge between psychopathology and reward processing variables. When covarying symptoms of depression, anxiety, ADHD, ODD, and CD, an enhanced reward positivity (RewP) component to social reward feedback (accounting for response to social rejection) was associated with higher levels of personality impairment. Results were specific to social rather than monetary reward processing. Depression, anxiety, and ODD also explained unique variance in LPF. These findings suggest that alterations in social reward processing may be a key marker for early emerging personality pathology. Future work examining the role of social reward processing on the development of LPF across adolescence may guide efforts to prevent the profound social dysfunction associated with personality pathology.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Electroencefalografía , Humanos , Femenino , Adolescente , Niño , Recompensa , Personalidad , Trastornos de la Personalidad/epidemiología
14.
Res Child Adolesc Psychopathol ; 52(5): 743-755, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38376716

RESUMEN

Social media use is common in adolescents, with implications for psychosocial development and the emergence of depression. Yet, little is known about the time-linked connections between social media use and adolescents' affective experiences and how they may differ between depressed and non-depressed youth. We leveraged ecological momentary assessment in adolescents oversampled for current depression to examine (1) associations between social media use and concurrent and later positive and negative affect and (2) sex and presence of a depressive disorder as moderators of these associations. Adolescents aged 14-17 with (n = 48) and without (n = 97) clinical depression, as indicated via clinical interview, reported momentary social media use and positive and negative affect seven times per day for one week. Multilevel modeling indicated that social media use was associated with reduced positive affect both concurrently and at the next assessment. Further, among clinically depressed youth only, social media use was associated with reduced negative affect at the next assessment. Results suggest that social media use may reduce both positive and negative affect, highlighting the nuanced relation between adolescent social media use and emotional health and laying the groundwork for future research to address several open questions.


Asunto(s)
Afecto , Evaluación Ecológica Momentánea , Medios de Comunicación Sociales , Humanos , Medios de Comunicación Sociales/estadística & datos numéricos , Adolescente , Femenino , Masculino , Depresión/psicología , Trastorno Depresivo/psicología , Trastorno Depresivo/epidemiología , Conducta del Adolescente/psicología
15.
Artículo en Inglés | MEDLINE | ID: mdl-36183967

RESUMEN

The goal of this study was to examine social feedback processing among emerging adults with borderline personality features (BPF). Participants (N = 118; 66.9% female) completed ratings of BPF and a computerized peer interaction task designed to measure processing of rejection and acceptance cues at the neurophysiological (i.e., electroencephalogram [EEG]), behavioral, and self-report levels. When covarying symptoms of depression and social anxiety, greater BPF were associated with heightened neural processing of social acceptance cues, accounting for reactivity to neutral and rejection cues, as demonstrated by an enhanced reward positivity (RewP) component. Additionally, BPF were associated with less adaptive voting in response to peer acceptance, such that emerging adults with higher BPF made fewer votes to keep peers in the game who had provided acceptance feedback to participants. These neural and behavioral patterns associated with BPF highlight the potential role of social reward processing in borderline personality. Specifically, emerging adults high in BPF show a hyper-responsiveness to social acceptance at the neural level but difficulty modulating behavioral responses in an adaptive way to obtain more social rewards. Future research replicating these effects across development may guide efforts to address and prevent the profound social dysfunction associated with BPF.


Asunto(s)
Trastorno de Personalidad Limítrofe , Electroencefalografía , Adulto , Humanos , Femenino , Masculino , Retroalimentación , Recompensa , Motivación
16.
Res Child Adolesc Psychopathol ; 51(1): 119-131, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-35852700

RESUMEN

Increased rates of depression beginning in adolescence are thought to be attributed in part to marked developmental changes in reward systems and interpersonal relationships. Blunted reward response has been observed in depression and this may be shaped in part by social experiences, raising questions about the combined associations of parental conflict, depression, and reward response in both social and monetary domains. The present study used the reward positivity (RewP), an event-related potential that indexes both monetary and social reward processing, to examine the unique and combined associations of parental conflict and depressive symptoms on reward responsiveness in adolescents with clinical depression (N = 70) 14-18 years of age (M = 15.81, SD = 1.46; 65.7% female). Results indicated that depressive symptoms interacted with maternal conflict in characterizing the RewP to social, but not monetary, rewards. Specifically, higher levels of current depressive symptoms and potentiated maternal conflict together were associated with an attenuated RewP to social rewards in this clinical sample. We found no significant effects of paternal conflict. This investigation highlights maternal conflict as an important environmental factor for reward responsiveness and also emphasizes the utility of examining social reward responsiveness in depression in order to better understand the impacts of contextual factors.


Asunto(s)
Depresión , Trastorno Depresivo Mayor , Masculino , Femenino , Humanos , Adolescente , Potenciales Evocados/fisiología , Padre , Recompensa
17.
Behav Res Ther ; 168: 104384, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37591042

RESUMEN

Reduced activation of the Research Domain Criteria (RDoC) positive valence systems (PVS) is observed in high-risk (HR) children of depressed mothers and predictive of future psychopathologies. We developed a dyadic, neuroscience-informed preventive intervention, Family Promoting Positive Emotions (FPPE), designed to prevent psychopathology in HR children by targeting PVS processes. We evaluated the initial efficacy of FPPE compared to written information (WI) psychoeducation in engaging PVS-related targets and reducing perceived stress and emotional distress symptoms in HR youth. Participants included 74 children ages 8-12 years and their biological mothers reporting elevated depressive symptoms. Following random assignment, 55 dyads completed FPPE (n = 29) or WI (n = 26) and pre-post assessments of child clinical symptoms. Youth completed a reinforcement learning task and 10 days of positive affect ratings to assess PVS-related targets. Results revealed a small within-subjects increase in child daily positive affect in FPPE, but not WI. Further, FPPE resulted in reductions in mother-reported child perceived stress and symptoms of anger, anxiety, and depression with medium-to-large within-subjects effects. Intervention effects on reinforcement learning and child-rated clinical symptoms were not observed. This study suggests FPPE shows promise in enhancing positive affect and reducing the emergence of clinical symptoms in HR children. CLINICALTRIALS.GOV IDENTIFIER: NCT05223842.


Asunto(s)
Depresión , Madres , Adolescente , Femenino , Humanos , Proyectos Piloto , Emociones , Ansiedad
18.
Int J Cogn Ther ; 16(2): 202-221, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37228300

RESUMEN

Group cognitive behavioral therapy (CBT) is an effective treatment for adolescent depression, but outcomes vary. Our goal was to examine interpersonal factors that predict response to group CBT for adolescent depression using a broad range of outcomes, including depressive symptoms, session attendance, treatment completion, engagement, and improvement. Seventy adolescents (age 14-18) with depression completed self-report measures of social support and parental conflict and were offered an established 16-session group CBT program. Correlation and regression analyses were conducted for interpersonal predictors and CBT outcomes. Accounting for pre-treatment depressive symptoms, fewer social supports predicted lower likelihood of finishing treatment and less clinician-rated improvement. Greater pre-treatment parental conflict predicted fewer sessions attended, lower clinician-rated engagement, and less clinician-rated improvement. Results highlight the need to consider interpersonal difficulties in CBT, as they may present a barrier to treatment attendance, engagement, and improvement.

19.
Res Child Adolesc Psychopathol ; 51(8): 1069-1082, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37084164

RESUMEN

Earlier depression onsets are associated with more debilitating courses and poorer life quality, highlighting the importance of effective early intervention. Many youths fail to improve with evidence-based treatments for depression, likely due in part to heterogeneity within the disorder. Multi-method assessment of individual differences in positive and negative emotion processing could improve predictions of treatment outcomes. The current study examined self-report and neurophysiological measures of reward responsiveness and emotion regulation as predictors of response to cognitive-behavioral therapy (CBT). Adolescents (14-18 years) with depression (N = 70) completed monetary reward and emotion regulation tasks while electroencephalogram (EEG) was recorded, and self-report measures of reward responsiveness, emotion regulation, and depressive symptoms at intake. Adolescents then completed a 16-session group CBT program, with depressive symptoms and clinician-rated improvement assessed across treatment. Lower reward positivity amplitudes, reflecting reduced neural reward responsiveness, predicted lower depressive symptoms with treatment. Larger late positive potential residuals during reappraisal, potentially reflecting difficulty with emotion regulation, predicted greater clinician-rated improvement. Self-report measures were not significant predictors. Results support the clinical utility of EEG measures, with impairments in positive and negative emotion processing predicting greater change with interventions that target these processes.


Asunto(s)
Terapia Cognitivo-Conductual , Regulación Emocional , Humanos , Adolescente , Depresión , Emociones/fisiología , Terapia Cognitivo-Conductual/métodos , Recompensa
20.
Artículo en Inglés | MEDLINE | ID: mdl-37982056

RESUMEN

Depression is a prevalent, debilitating, and costly disorder that often manifests in adolescence. There is an urgent need to understand core pathophysiological processes for depression to inform more targeted intervention efforts. The Research Domain Criteria (RDoC) Positive Valence Systems (PVS) and Negative Valence Systems (NVS) have both been implicated in depression symptomatology and vulnerability; however, the nature of NVS alterations is unclear across studies, and associations between single neural measures and symptoms are often small in magnitude and inconsistent. The present study advances characterization of depression in adolescence via an innovative data-driven approach to identifying subgroups of PVS and NVS function by integrating multiple neural measures (assessed by electroencephalogram [EEG]) relevant to depression in adolescents oversampled for clinical depression and depression risk based on maternal history (N = 129; 14-17 years old). Results of the k-means cluster analysis supported a two-cluster solution wherein one cluster was characterized by relatively attenuated reward and emotion responsiveness across valences and the other by relatively intact responsiveness. Youth in the attenuated responsiveness cluster reported significantly greater depressive symptoms and were more likely to have major depressive disorder diagnoses than youth in the intact responsiveness cluster. In contrast, associations of individual neural measures with depressive symptoms were non-significant. The present study highlights the importance of innovative neuroscience approaches to characterize emotional processing in depression across domains, which is imperative to advancing the clinical utility of RDoC-informed research.

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