Adaptive working memory training can reduce anxiety and depression vulnerability in adolescents

Adolescents can be at heightened risk for anxiety and depression, with accumulating research reporting on associations between anxiety and depression and cognitive impairments, implicating working memory and attentional control deficits. Several studies now point to the promise of adaptive working memory training to increase attentional control in depressed and anxious participants and reduce anxiety and depression symptoms, but this has not been explored in a non‐clinical adolescent population. The current study explored the effects of adaptive dual n‐back working memory training on sub‐clinical anxiety and depression symptomology in adolescents. Participants trained on either an online adaptive working memory task or non‐adaptive control task for up to 20 days. Primary outcome measures were self‐reported anxiety and depression symptomology, before and after intervention, and at 1‐month follow‐up. Self‐reported depression (p = 0.003) and anxiety (p = 0.04) decreased after training in the adaptive n‐back group relative to the non‐adaptive control group in the intention‐to‐treat sample (n = 120). These effects were sustained at follow‐up. Our findings constitute proof of principle evidence that working memory training may help reduce anxiety and depression vulnerability in a non‐clinical adolescent population. We discuss the findings’ implications for reducing risk of internalizing disorders in youth and the need for replication.     

Family Treatment Approaches for Depression in Adolescent Males

Adolescent depression is a serious and common disorder. Though adolescent males are less likely to report depression than females, they have serious risks associated with the disorder, like suicide, future substance abuse, and illegal activity. Several gender differences have been observed among depressed adolescents and should be considered in assessment and treatment. Little efficacy research exists for family treatments of depression in adolescent males, though several approaches have been proposed. These approaches include Structural Family Therapy, Interpersonal Family Therapy, and Attachment-Based Family Therapy. These treatments have been found useful in clinical settings, but much more efficacy research is necessary.     

Differentiating Adolescent Self-Injury from Adolescent Depression: Possible Implications for Borderline Personality Development

Self-inflicted injury (SII) in adolescence marks heightened risk for suicide attempts, completed suicide, and adult psychopathology. Although several studies have revealed elevated rates of depression among adolescents who self injure, no one has compared adolescent self injury with adolescent depression on biological, self-, and informant-report markers of vulnerability and risk. Such a comparison may have important implications for treatment, prevention, and developmental models of self injury and borderline personality disorder. We used a multi-method, multi-informant approach to examine how adolescent SII differs from adolescent depression. Self-injuring, depressed, and typical adolescent females (n = 25 per group) and their mothers completed measures of psychopathology and emotion regulation, among others. In addition, we assessed electrodermal responding (EDR), a peripheral biomarker of trait impulsivity. Participants in the SII group (a) scored higher than depressed adolescents on measures of both externalizing psychopathology and emotion dysregulation, and (b) exhibited attenuated EDR, similar to patterns observed among impulsive, externalizing males. Self-injuring adolescents also scored higher on measures of borderline pathology. These findings reveal a coherent pattern of differences between self-injuring and depressed adolescent girls, consistent with theories that SII differs from depression in etiology and developmental course.     

Training in child and adolescent group therapy: Two surveys and a model

Although group therapy is widely used in the treatment of children and adolescents, there has been little attention paid to establishing training standards and developing comprehensive programs for training psychiatry fellows in child and adolescent group psychotherapy. The authors conducted two surveys of child and adolescent training programs. After reviewing the literature, they present the data from their surveys, compare similarities and differences, and discuss trends. Finally, they propose a model for training in child and adolescent group therapy.     

Grandparents as family stabilizers during economic hardship in Bulgaria

T he present study of three generations' families living together during a period of marked economic dislocation investigates whether supportive grandparents can ameliorate the negative effects of economic stress on parenting and on teen outcomes. The study focuses on harsh parenting and adolescent depression, which has been shown to be especially responsive to economic stress. Three hypotheses were investigated: (1) in extended families there is a link between economic adversity and adolescent depression that is mediated by harsh parenting; (2) grandparent support diminishes the relationship between economic pressure and harsh parenting; and (3) grandparent support diminishes the relationship between harsh parenting and adolescent depression. Data were collected from a community sample of 62 extended families with an adolescent during a period of marked economic dislocation in Bulgaria. Mothers, fathers, and adolescents completed questionnaires about perceived economic pressure, parents' harsh parenting, and perceived support of grandparents. Adolescents also completed a measure of self‐reported depression. Additional interviews were conducted with every eligible family member about family relations. Results showed that even though there was significant economic stress reported by parents, adolescents reported moderate levels of depression and low levels of harsh parenting by mothers and fathers. Correlation and regression analyses revealed that whenever respondents experienced support by grandparents, it made a difference for family members. More specifically, despite economic stress, mothers who experienced the support of grandparents tended to exercise less harsh parenting practices than mothers who lacked such support. Furthermore, when grandparents were supportive, harsh parenting was not associated with adolescent depression. These findings are discussed in the light of existing studies of families under economic pressure with a special focus on extended family relations and the role of cultural context.     

Youth Depression in the Family Context: Familial Risk Factors and Models of Treatment

Research on parent risk factors, family environment, and familial involvement in the treatment of depression in children and adolescents is integrated, providing an update to prior reviews on the topic. First, the psychosocial parent and family factors associated with youth depression are examined. The literature indicates that a broad array of parent and family factors is associated with youth risk for depression, ranging from parental pathology to parental cognitive style to family emotional climate. Next, treatment approaches for youth depression that have been empirically tested are described and then summarized in terms of their level of parent inclusion, including cognitive–behavioral therapy, interpersonal therapy, and family systems approaches. Families have mostly not been incorporated into clinical treatment research with depressed adolescents, with only 32% of treatments including parents in treatment in any capacity. Nonetheless, the overall effectiveness of treatments that involve children and adolescents exclusively is very similar to that of treatments that include parents as agents or facilitators of change. The article concludes with a discussion of the implications of these findings and directions for further research.     

A Short-term Psychodynamic Supportive Psychotherapy for Adolescents with Depressive Disorders: A New Approach

Depression is one of the most common psychiatric disorders in both adolescents and adults. In this article, we introduce Short-term Psychodynamic Supportive Psychotherapy (SPSP) for adolescents, a relatively new form of psychodynamic therapy for depression that has been studied in a range of randomized controlled trials with adult patients. SPSP emphasizes the relational aetiology and significance of depression and is characterized by a supportive attitude which focuses more on working in the here-and-now relational patterns rather than interpreting transference manifestations. The supportive attitude of the therapist is advocated to engage the adolescent in the therapeutic relationship and to foster his or her innate developmental capacities by attending to previously unaddressed developmental needs. The developmental perspective’s interest in defense styles and stagnation resulting from problems in past and current relationships opens up opportunities for acquiring insight and change. The focus on relational functioning makes it a promising approach for adolescents because they can implement any positive change immediately in their actual environment, immersed as they are in many new and varied relationships.     

“民族认同，国家认同”与青少年自尊的关系

自尊被普遍认为是青少年的发展中的一个重要因素,已有研究发现它与心理幸福感呈显著的正相关,并与沮丧和绝望呈显著的负相关。就是由于自尊的心理上的重要性,所以有大量的研究来探讨它的影响因素。大多数对自尊的研究主要关注的是个体的能力和人际问的经历来作为自尊主要成分。尽管自尊的个人资源明显是很重要的,但是这样的关注忽略了自尊的群体成员方面的影响。本文就是探讨群体认同,尤其是考察民族认同和更广层面的国家认同.对少数民族青少年自尊的预测。     

Persistent Heightened Cortisol Awakening Response and Adolescent Internalizing Symptoms: A 3-year Longitudinal Community Study

An atypical Cortisol Awakening Response (CAR) has been related to adult anxiety and depression, but little is known about the association between long-term atypical CAR and adolescent anxiety and depression. This study aimed to longitudinally identify subgroups of adolescents with distinct levels of CAR (i.e., adolescents with and without persistent atypical CAR) and to examine their development of anxiety and depressive symptoms over 3 successive years. A community sample of 184 Dutch adolescents (M _age?=?14.99 at T₁, 57 % boys) completed annual salivary cortisol assessments at home at time of awakening, and 30 and 60 min post-awakening (i.e., CAR) for 3 successive years. Adolescents also reported annually on their anxiety and depressive disorder symptoms. Latent Class Growth Analysis suggested two subgroups of adolescents with respect to CAR: a “low” group with stable low levels of AUC_g (Area Under the Curve with respect to the ground) over time and a “high” group with high and increasing levels of AUC_g over time. Controlling for sex, the high and low CAR groups significantly differed in depressive symptoms only, but none of the anxiety disorder symptoms. More specifically, adolescents in the high CAR group showed significantly higher mean levels of depressive symptoms over time compared to adolescents in the low CAR group. These results suggest that persistent heightened CAR is a more consistent, yet modest, correlate of adolescent depressive symptoms than anxiety disorder symptoms.     

Forgiveness,Depression, and Suicidal Behavior in Adolescents: Gender Differences in this Relationship

With the development of positive psychology, protective factors have received increased attention as buffers against suicidal ideation and attempts and against the risk factors for suicide (e.g., depressive symptoms). Empirical evidence suggests that one of the protective factors associated with depression and suicide is forgiveness. Although previous studies have demonstrated a negative association between forgiveness and risk of suicide, studies on gender differences in adolescents are still scarce. Thus, the authors assessed the moderating role of gender in a sample of adolescents. The participants were 572 adolescents (50.9% boys; M age = 15.49 years, SD = 1.09 years) from secondary school centers. The results revealed that forgiveness moderated the relationship between depression and suicidal ideation for boys but not for girls. Specifically, for boys the relationship between depression and suicidal thoughts and behaviors weakened as levels of forgiveness increased. These findings suggest therapeutic applications to reduce the likelihood of suicide in the group of adolescent boys with higher scores on depression and lower levels of forgiveness. The study results are discussed in terms of the need to use gender perspectives in positive psychology intervention programs.     

Romantic involvement and depressive symptoms in early and late adolescence: The role of a preoccupied relational style

Two studies examined the association between depressive symptoms and romantic involvement in adolescence and tested the hypothesis that romantic involvement is associated more strongly with symptoms among adolescents who have a more preoccupied style of relating, compared to adolescents who have a less preoccupied style of relating. Study 1 (N = 96 early adolescent females) examined concurrent associations and Study 2 (N = 80 late adolescent males and females) examined longitudinal associations. In both age groups, romantic involvement was associated with greater depressive symptoms and this was most true among adolescents with a preoccupied style of relating. Implications for models of depression and adolescent romantic functioning are discussed.     

Regulation of Negative Affect During Mother–Child Problem-Solving Interactions: Adolescent Depressive Status and Family Processes

Despite recent suggestions that depression can be conceptualized as a disorder of affect regulation, relatively little research has focused on affect regulation skills in depressed individuals. This paper investigated whether depressed adolescents (N = 25) differ from nondepressed adolescents (N 25) on two indices of affect regulation (i.e., duration of negative affective states and reciprocity of maternal negative affect) as well as whether these indices are related to microsocial family interactional processes. Analyses revealed that depressed teens differed from their nondepressed peers with regard to duration of negative affective states but not in their likelihood of reciprocating negative affect. Additionally, indices of adolescent affect regulation were related to family interactional processes. Duration of depressive affect was positively associated with maternal display of facilitative behavior contingent on adolescent depressive behavior. Duration of aggressive behavior was inversely related to maternal problem-solving responses to aggressive behavior. Finally, adolescent reciprocity of maternal depressive and aggressive behaviors was strongly associated with mothers' reciprocity of adolescents' negative affective behavior.     

Coping and Positive Affect in Adolescents of Mothers With and Without a History of Depression

The adolescent children of depressed mothers are at increased risk for depression, but little is known about protective factors for these children. Maintenance of positive affect in a stressful context may be an important marker of resilience. Mothers with (n = 34) and without (n = 38) a history of depression and their adolescent children completed questionnaires regarding adolescents’ coping and depressive symptoms and engaged in a 15 min videotaped interaction about family stress. Adolescents’ observed behaviors were coded using the Iowa Family Interaction Rating Scales. No significant differences emerged in observed behavior between adolescents of mothers with and without a history of depression. Higher levels of primary and secondary control coping and lower levels of disengagement coping were related to higher levels of observed positive mood and fewer depressive symptoms in adolescents. Observed positive mood was related to fewer depressive symptoms in adolescents, even after accounting for maternal history of depression and current maternal depressive symptoms. Results suggest the importance of considering positive affect in the context of family stress as a marker of resilience in adolescents at risk for depression. The current study provides evidence for coping as a protective factor, related to higher levels of positive affect and fewer depressive symptoms, in adolescents exposed to maternal depressive symptoms.     

Adolescent triangulation into interparental conflict: Role of cognitive appraisals and birth-order

ABSTRACT

Triangulation of adolescents into interparental conflict has since long been recognized as a risk factor for adolescents’ psychological adjustment. However, there is a scarcity in research focusing on exploring the variables that make adolescents more vulnerable to get triangulated. This study used a cross-section research design to examine the relationship between interparental conflict and adolescent triangulation into that conflict in an under-researched population of Pakistani school going adolescents (N = 521), with an age range of 13-19 years (M = 15.25; SD = 1.46); while exploring the role of adolescent’s cognitive appraisals (threat and self-blame) and birth-order. The results indicated that interparental conflict, appraisal of threat and appraisal of self-blame are significant predictors of adolescent triangulation. Moreover, this study also revealed the moderating role of adolescent birth order in the relationship between interparental conflict and triangulation, as well as between appraisal of self-blame and triangulation; indicating that the ‘only’ child in the family was at the highest risk of being triangulated into their parents’ arguments, while the youngest child was least likely to get involved.     

Characteristics of Suicidality Among Adolescents

The identification of high-risk adolescent suicide attempters in a population of depressed and suicidal adolescents is of crucial importance. This retrospective study examined characteristics of suicidality (recent and lifetime, active and passive) and psychopathology (depression, aggression, impulsivity, stressful life events, SCL-90 dimensions) among four groups of depressed adolescent outpatients: (1) suicide attempters who required medical treatment (n = 84), (2) suicide attempters who did not require medical treatment (n = 57), (3) suicidal ideators who had never made a suicide attempt (n = 40), and (4) nonsuicidal patients (n = 44). Results indicate that the nonsuicidal group could be differentiated from the three suicidal groups on the basis of suicidality and psychopathology, and that the three suicidal groups could be differentiated from one another on the basis of suicidality but not psychopathology. These findings are discussed in terms of the usefulness of certain self-report measures of suicidality for identifying suicidal adolescents and for differentiating among them. Furthermore, the findings suggest that psychopathological factors do not determine which suicidal adolescents make a medically dangerous suicide attempt and which do not.     

Examining Relationships Between Ethnic Identity, Family Environment, and Psychological Outcomes for African American Adolescents

Ethnic identity has been linked to a number of healthy psychological outcomes for African American adolescents. The levels of conflict and cohesion in the family environment have also been found to be predictive of adolescent mental health. This study examined whether the ethnic identity and levels of conflict and cohesion in the family environments were related to adolescents’ psychological adjustment. Participants included 61 African American adolescents, ages 10–14 years old, and their parents. Hierarchical regression models were used to determine the cumulative effects of ethnic identity and family functioning on adolescent mental health, specifically adolescent levels of depression, self-esteem, and interpersonal functioning. Results indicated that having a positive ethnic identity and a cohesive family environment were most strongly associated with psychological adjustment. Implications of these results are discussed in terms of family interventions.     

Internalizing problems of adolescents: The role of the informant in identifying family and individual difficulties

The purpose of this study was to examine the family environment and school functioning of adolescents who differed on level of internalizing problems as reported by the adolescent and her/his mother. Thirty-six adolescents, their mothers, and their social studies teacher served as participants. Three groups were formed based on the report of level of internalizing problems: high mother and adolescent report (high concordant); low mother/high adolescent report (discordant); and low mother/low adolescent report (low concordant). The results indicated that the high concordant group, but not the discordant group, differed significantly from the low discordant group in that adolescents from the former group were from home environments with more difficulties (more interparental conflict, maternal depression, & maternal anxiety) and had more internalizing problems and lower grades in school. The results point to the importance of parent-report data when clinically assessing adolescents or conducting research on internalizing problems of adolescents.     

中国青少年抑郁的核心症状及性别、抑郁程度间的比较：基于网络分析方法

基于精神障碍网络理论,采用中文版流动调查中心抑郁量表对3634名青少年进行调查,使用网络分析方法考察了我国青少年抑郁的核心症状,比较不同性别和抑郁程度青少年的抑郁症状特征网络。结果发现：（1）我国青少年抑郁的核心症状为压抑情绪、失败感、悲伤和乏力;（2）不同性别青少年的抑郁症状网络结构、网络连接强度和核心症状不存在显著差异;（3）不同抑郁程度青少年的抑郁症状网络结构、网络连接强度、核心症状存在显著差异。     

Adapting Cognitive-Behavioral Therapy for Depressed Adolescents Exposed to Interpersonal Trauma: A Case Study With Two Teens

A substantial body of evidence indicates that interpersonal trauma increases risk for adolescent and adult depression. Findings from 4 clinical trials for adolescent depression show poorer response to standard cognitive-behavioral therapy (CBT) among depressed adolescents with a trauma history than youth without such a history. This paper reports on the development of a modified CBT (mCBT) protocol that has been adapted for treating depressed adolescents who have been exposed to traumatic interpersonal events (physical/sexual abuse or witnessing domestic violence). First, we provide an empirical rationale for targeting executive function deficits and trauma-related cognitions in the mCBT protocol. Second, we present promising results from 2 community clinic cases.