Developing Cognitive Behavioral Therapy to Prevent Depressive Relapse in Youth

Relapse rates for children and adolescents with major depressive disorder (MDD) range from 30% to 40% within 1 to 2 years after acute treatment. Although relapse rates are high, there have been relatively few studies on the prevention of relapse in youth. While acute phase pharmacotherapy has been shown to reduce symptoms rapidly in depressed youth, children and adolescents frequently report ongoing residual symptoms and often relapse following acute treatment. Recent adult trials have begun examining augmentation with psychosocial treatment after successful medication treatment to enhance medication response and prevent future relapse. This strategy has not yet been examined in youth with depression. Here we present initial efforts to develop a sequential, combination treatment strategy to promote rapid remission and to prevent relapse in depressed youth. We describe efforts to adapt CBT to prevent relapse (RP-CBT) in youth who respond to pharmacotherapy. The goals of RP-CBT include: preventing relapse, increasing wellness, and developing skills to promote and sustain well-being. We describe the rationale for, components of, and methods used to develop RP-CBT. The results from a small open series sample demonstrate feasibility and indicate that youth appear to tolerate RP-CBT well. A future test of the treatment in a randomized controlled trial is described.     

Why Odd Pricing?1

The practice of setting prices a few pennies or a few dollars below an even (whole) number is referred to as odd pricing. Most attempts to explain odd pricing use an argument that, in part, draws on varying degrees of consumer irrationality. In this note, a justification for odd pricing is provided that assumes rational and informed consumers and businesses. Empirical evidence is offered in support of this view.     

Taxometric and factor analytic models of anxiety sensitivity among youth: exploring the latent structure of anxiety psychopathology vulnerability

This study represents an effort to better understand the latent structure of anxiety sensitivity (AS), a well-established affect-sensitivity individual difference factor, among youth by employing taxometric and factor analytic approaches in an integrative manner. Taxometric analyses indicated that AS, as indexed by the Child Anxiety Sensitivity Index (CASI; Silverman, Flesig, Rabian, & Peterson, 1991), demonstrates taxonic latent class structure in a large sample of youth from North America (N=4,462; M(age)=15.6 years; SD=1.3). Subsequent confirmatory factor analyses indicated that the latent continuous, multidimensional, 4-factor model of AS among youth (Silverman, Goedhart, Barrett, & Turner, 2003) provided good fit for the CASI data among the complement class ("normative form" of AS), but not among the taxon class ("high-risk form" of AS). EFAs supported the prediction that the AS taxon demonstrates a unique, heretofore unexplored latent continuous, unidimensional factor structure among youth. Findings are discussed in relation to refining our understanding of the latent structure of AS and the clinical implications that arise from it.     

An evaluation of the conservative dual-criterion method for teaching university students to visually inspect AB-design graphs

The present study evaluated the effects of both a traditional lecture and the conservative dual-criterion (CDC) judgment aid on the ability of 6 university students to visually inspect AB-design line graphs. The traditional lecture reliably failed to improve visual inspection accuracy, whereas the CDC method substantially improved the performance of each participant.     

Dark Side of the Mothering Role: Abuse of Mothers by Adolescent and Adult Children

Mothering is generally considered women’s major source of identity and satisfaction. But mothering can also bring misery when children develop anti-social behaviors. The rather limited literature on this topic refers to by the term “parent abuse,” with mothers reportedly the usual victims. The present study analyzed the types of abuse by adolescent and adult children reported by women in a community sample. The data come from in-depth life review interviews with 60 women aged between 40 and 65 when initially interviewed, and re-interviewed 5 years later. All women lived in the lower-income western suburbs of Sydney, Australia. Two major categories of abuse were identified: acting-out (including physical attacks and threats) and psychological. Seventy percent of perpetrators were male. Mothers’ explanations for the behavior included family dysfunction, child’s personality, child’s mental illness, social and cultural influences, and gender power imbalance. Strategies used to handle the behaviors were related to these explanations. Compared to older mothers, those aged in their 40s were likely to see the problem as belonging to the child rather than themselves, and were more proficient in accessing community services.     

Diabetes, depression, and metabolic control in Latinas

Diabetes is steadily becoming an epidemic among Latinos, and depression has been found to complicate diabetes management. This study examined depressive symptoms and metabolic control in Latinas with diabetes in a community clinic setting. The association of depressive symptoms with metabolic control was supported in this study. Social support (but not acculturation) was found to be associated with depressive symptoms. Finally, age and metabolic control were related. These findings are explained in a culture-specific framework. The authors speculate that the role of the woman in Latino families makes it difficult for a Latina to attend to her own care needs until she ages.     

Comparing Cognitive Behavior Therapy,Problem Solving Therapy,and Treatment as Usual in a High Risk Population

Cognitive behavior therapy (CBT), problem‐solving therapy (PST), or treatment as usual (TAU) were compared in the management of suicide attempters. Participants completed the Beck Hopelessness Scale, Beck Scale for Suicidal Ideation, Social Problem‐Solving Inventory, and Client Satisfaction Questionnaire at pre‐ and posttreatment. Both CBT and PST indicated significant improvements over time within the majority of measured variables; when compared to TAU, both groups showed significant differences on satisfaction. When PST was compared to TAU, results indicated significant differences on suicidal ideation, indicating overall efficacy of brief therapies with suicide attempters.