Category: Child / Adolescent - Depression
Keywords: Depression | Cognitive Processes | Adolescents
Presentation Type: Symposium
Background: There is little evidence that effects of youth depression prevention programs are attributable to improvements in targeted mechanisms. We evaluated a model in which improvements in cognitive style mediated effects of a cognitive behavioral prevention (CBP) program on adolescent depression and early-adulthood well-being.
Method: Adolescents (N=316) with elevated baseline depressive symptoms or prior depressive episodes and a parent with a history of depressive episodes were randomized to CBP (14 sessions) or usual care, and completed 5 assessments across 33 months of follow-up. Cognitive style was measured with the Children’s Attributional Style Questionnaire, the Beck Hopelessness Scale for Children, the Dysfunctional Attitudes Scale, and the Rosenberg Self-Esteem Scale. Depression-free-days (DFDs) were calculated based on weekly clinician ratings of depressive symptoms across the 33-month follow-up using the Longitudinal Interval Follow-up Evaluation. In early adulthood (6 years post-intervention), participants completed the Adolescent Quality of Life scale and a brief measure of life satisfaction.
Data Analysis: A unidimensional latent factor model of cognitive vulnerability (CV) based on composite scores from the 4 cognitive style measures yielded a close fit (RMSEA=.03) and showed no evidence of temporal factor structure instability. Two second-order latent growth curve models were specified, modeling the association between growth in CV across the 33-month follow-up and early adulthood quality of life (model 1) and life satisfaction (model 2). An intermediate outcome was adolescents’ DFDs.
Results: CBP reduced levels of CV at the 3-month evaluation (b= -0.13, 95% CI [-0.21, -0.04]). There were significant indirect effects of CBP on adolescent DFDs (b= 0.14, 95% CI [0.01, 0.26]) and both early adulthood quality of life (b= 0.02, 95% CI [0.01, 0.04]) and life satisfaction (b= 0.20, 95% CI [0.06, 0.35]) through improvements in 3-month levels of CV.
Conclusion: Findings were consistent with CBP’s hypothesized model of change. Early improvements in cognitive style predicted long-term benefits in emotional well-being in early adulthood.
Friday, November 17
3:45 PM – 5:15 PM
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