Healthy emotions and relationships with teens-a guide for parents: An intervention development study of a parent-based intervention for adolescents with depression.

Problems in parent-adolescent relationships are a significant risk factor for the development of depression in adolescents. This paper describes the development of a novel and innovative intervention for parents of depressed adolescents that targets attachment-related parenting behaviors, including parent responses to adolescents' emotions (Healthy Emotions and Relationships with Teens-A Guide for Parents [HEART-P]; Reigstad, 2017) and provides results of an open pilot study that was conducted to assess the feasibility and acceptability of the intervention. 15 parents/parent dyads of adolescents (age 12-18) with a depression diagnosis (14 mothers, and one father) participated in a 10-week open trial of HEART-P. Data regarding acceptability and feasibility were collected. Self-report measures of parenting, stress, family relationships, and adolescent depression were also completed by parents at baseline, week 10, and 2 months post-intervention. Parents completed the intervention with 100% adherence to the protocol and expressed high levels of satisfaction. Parents reported reductions in parenting stress, improvement in the quality of their relationship with their adolescent, and improvement in the perception of their parenting skills, with effect sizes in the medium to large range. Adolescents reported reductions in depression, with effect sizes in the small to medium range. Outcomes appear positive and promising, and the intervention was feasible to implement and acceptable to families. Conducting a full-scale randomized control trial to evaluate the efficacy of this newly developed intervention is warranted and timely given the public health need for improved depression treatment outcomes.

Multi-modal neuroimaging of adolescents with non-suicidal self-injury: Amygdala functional connectivity.

BACKGROUND: Non-suicidal self-injury (NSSI) is a significant mental health problem among adolescents. Research is needed to clarify the neurobiology of NSSI and identify candidate neurobiological targets for interventions. Based on prior research implicating heightened negative affect and amygdala hyperactivity in NSSI, we pursued a systems approach to characterize amygdala functional connectivity networks during rest (resting-state functional connectivity [RSFC)]) and a task (task functional connectivity [TFC]) in adolescents with NSSI. METHOD: We examined amygdala networks in female adolescents with NSSI and healthy controls (n = 45) using resting-state fMRI and a negative emotion face-matching fMRI task designed to activate the amygdala. Connectivity analyses included amygdala RSFC, amygdala TFC, and psychophysiological interactions (PPI) between amygdala connectivity and task conditions. RESULTS: Compared to healthy controls, adolescents with NSSI showed atypical amygdala-frontal connectivity during rest and task; greater amygdala RSFC in supplementary motor area (SMA) and dorsal anterior cingulate; and differential amygdala-occipital connectivity between rest and task. After correcting for depression symptoms, amygdala-SMA RSFC abnormalities, among others, remained significant. LIMITATIONS: This study's limitations include its cross-sectional design and its absence of a psychiatric control group. CONCLUSIONS: Using a multi-modal approach, we identified widespread amygdala circuitry anomalies in adolescents with NSSI. While deficits in amygdala-frontal connectivity (driven by depression symptoms) replicates prior work in depression, hyperconnectivity between amygdala and SMA (independent of depression symptoms) has not been previously reported. This circuit may represent an important mechanism underlying the link between negative affect and habitual behaviors. These abnormalities may represent intervention targets for adolescents with NSSI.