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Extreme thinking in clinically depressed adolescents: Results from the Treatment for Adolescents with Depression Study (TADS)
Authors:Rachel H Jacobs  Mark A Reinecke  Neil Jordan  Susan G Silva  John S March
Institution:a Division of Psychology, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
b Duke University School of Nursing, Durham, NC, USA
c Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
d Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
e Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
f Stress and Depression Laboratory, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
g The Northwestern University, Department of Psychology, Chicago, IL, USA
h Center for Management of Complex Chronic Care, Hines VA Hospital, Hines, IL, USA
Abstract:The purpose of this report is to examine relations between extreme thinking, as measured by the Dysfunctional Attitudes Scale, and the maintenance of gains among adolescents who participated in the Treatment for Adolescents with Depression Study (TADS). We examine extreme thinking among 327 adolescents (mean age = 14.56, 57% female, 75% White) who received cognitive behavior therapy (CBT), fluoxetine (FLX), or a combination of CBT and FLX (COMB). Among those who met remission status on the Children’s Depression Rating Scale - Revised (CDRS-R ≤ 28; 56 at week 12, 79 at week 18) extreme thinking did not predict failure to maintain remission. This is in contrast to findings with depressed adults. Treatment influenced level of extreme thinking, and this appeared to be driven by greater endorsement of positively valenced beliefs as opposed to a decrease in negatively valenced beliefs. Developmental or investigation characteristics may account for the discrepancy in findings.
Keywords:Major depressive disorder  Adolescents  Recovery  Cognitive therapy
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