Interpersonal Psychotherapy for Adolescent Depression

Interpersonal psychotherapy for adolescents (IPT-A) is a short-term treatment for adolescents with major depression. Unlike most supportive, expressive forms of psychotherapy that are often used to treat depressed adolescents and are not standardised, IPT-A has a treatment manual available (Mufson et al., 1993) and specific training is required for the therapist. Unfortunately, there is no training centre yet in the U.K., although several groups, including ours, are developing expertise in IPT-A. This paper discusses the role of IPT-A, outlines the structure of sessions, and offers an analysis of the differences between this and other therapies.     

Early Adolescent Relationship Predictors of Emerging Adult Outcomes: Youth With and Without Type 1 Diabetes

Background

Emerging adulthood is a high-risk period for mental health problems and risk behaviors for youth generally and for physical health problems among those with type 1 diabetes.

Purpose

The purpose of this study was to examine whether adolescents’ relationships with parents and friends predict health and risk behaviors during emerging adulthood.

Method

Youth with and without diabetes were enrolled at average age 12 and followed for 7 years. Parent and friend relationship variables, measured during adolescence, were used to predict emerging adulthood outcomes: depression, risk behavior, and, for those with diabetes, diabetes outcomes.

Results

Parent relationship quality predicted decreased depressive symptoms and, for those with diabetes, decreased alcohol use. Parent control predicted increased smoking, reduced college attendance, and, for control participants, increased depressive symptoms. For those with diabetes, parent control predicted decreased depressive symptoms and better self-care. Friend relationship variables predicted few outcomes.

Conclusions

Adolescent parent relationships remain an important influence on emerging adults’ lives.     

Ten Recommendations for Effective School-Based,Adolescent, Suicide Prevention Programs

School-based suicide prevention programs are one of the key strategies to address suicide in adolescence. The number of programs increased rapidly during the 1980s and was largely designed for high school- or middle school-aged students (11–18 years old), due to the vulnerable time and predictive risk of future suicidal ideation or health problems in later life. However, key recommendations from these studies are often obscured by the volume of such programs, resulting in significant challenges for program designers. This study aimed to undertake a review of the numerous suicide prevention programs implemented globally in recent years to provide informed recommendations for the development of effective school-based programs for adolescents. The study employed a scoping review process to enable the deconstruction of large or complex issues to promote comprehension and ease of interpretation. A search of online international databases using combinations of key words (variations in ‘suicide,’ ‘school,’ ‘program,’ and ‘prevention’) within a specified time frame (January 2010 to June 2015) identified 397 articles. Preferred reporting items for systematic reviews and meta-analyses were used to identify relevant articles at each stage of the review process, resulting in a total of 20 studies addressing 13 different school programs. Results were presented using established program categories (as education/awareness, gatekeeper, peer leadership, skills, screening/assessment) and informed ten recommendations that address the design, content, delivery, and review of school-based suicide prevention programs for adolescents.     

The Dexamethasone Suppression Test in Adolescent Depression

The data on the dexamethasone suppression test (DST) in a consecutive series of 101 adolescent inpatients are presented. In those with a diagnosis of major depression according to DSM-III criteira, 64% showed nonsuppression. In contrast, only 15% of conduct disorder patients showed nonsuppression. The authors conclude that the DST was useful in confirming a diagnosis of major depression in adolescents.     

Achieving Depression Literacy: The Adolescent Depression Knowledge Questionnaire (ADKQ)

Mental health literacy appears to be an important target for prevention and intervention efforts. However, limitations exist in this literature base, including the lack of a validated measure to assess this construct. The Adolescent Depression Knowledge Questionnaire (ADKQ) was created to assess knowledge of depression and attitudes about seeking help (i.e., depression literacy) for mental health issues before and after introduction of a universal, school-based intervention, the Adolescent Depression Awareness Program (ADAP). The ADKQ measured depression knowledge and attitudes in 8,216 high school students immediately before ADAP was implemented and 6 weeks after. The latent structure of the Knowledge section was examined with attention to measurement invariance between males and females and type of instructor, as well as pre- to post-test. Categories were developed for the open-ended questions of the Attitudes section. A one-factor (General Knowledge) latent structure was the best fit to the data. The latent structure of the ADKQ did not differ by student’s gender or type of instructor, nor did it differ based on pre- or post-test. Categories for the Attitudes portion of the ADKQ were developed. Psychometric evidence supports the ADKQ as a measure to evaluate adolescent depression literacy pre- to post-test and within several groups of interest (e.g., gender, facilitator). Categories for the Attitudes section of the ADKQ will allow for easier evaluation of this measure with quantitative data.     

Eye Movement Desensitization and Reprocessing for Adolescent Depression

While cognitive behavior therapy is considered to be the first-line therapy for adolescent depression, there are limited data on whether other psychotherapeutic techniques are also effective in treating adolescents with depression. This report suggests the potential application of eye movement desensitization and reprocessing (EMDR) for treatment of depressive disorder related, not to trauma, but to stressful life events. At present, EMDR has only been empirically validated for only trauma-related disorders such as posttraumatic stress disorder. Two teenagers with major depressive disorder (MDD) underwent three and seven sessions of EMDR aimed at memories of stressful life events. After treatment, their depressive symptoms decreased to the level of full remission, and the therapeutic gains were maintained after two and three months of follow up. The effectiveness of EMDR for depression is explained by the model of adaptive information processing. Given the powerful effects observed within a brief period of time, the authors suggest that further investigation of EMDR for depressive disorders is warranted.     

Depression with Mixed Features in Adolescent Psychiatric Patients

Depression with mixed features is poorly understood, especially in pediatric samples. This study compares symptoms and correlates of depressed adolescent inpatients with mixed features to inpatients with bipolar disorder and major depression. 407 adolescents were administered diagnostic interviews and self-reports, and 262 were categorized as Depression with Mixed Features (MXD; n = 38), Consensus Bipolar (CB; n = 79), or Depression Only (DO; n = 145). Demographic and morbidity information were collected via chart reviews. MXD adolescents evidenced elevated mania-related symptoms compared to DO adolescents. MXD adolescents had elevated Unusually Energetic symptoms and increases for six additional category B mania-related symptoms compared to CB adolescents. MXD adolescents met criteria for more comorbid disorders and reported elevated suicidality, anger, and trauma symptoms compared to CB and DO adolescents. Overall, MXD adolescents evidenced elevated symptomatology compared to other groups, suggesting mixed depression may represent a unique constellation of symptoms meriting further investigation.     

Adolescent Gambling: A Narrative Review of Behavior and Its Predictors

This narrative review summarizes current knowledge on adolescent gambling for the period 1990–2010, assesses adolescent gambling behavior and person and environment predictors, and suggests directions for future research. The review includes 99 studies that identified their subjects as adolescents, children, youth, and students, and discusses adolescent gambling behavior, male and female adolescent gambling, and person and environment variables relating to adolescent gambling. Results reveal that most past research was conducted in Australia, North America, and Europe under the hypothesis of behavior as a function of person and environment variables. Future research should examine the mediated effects of person and environment variables, gambling cessation, gambling in other countries, and internet gambling. Intervention and prevention of adolescent gambling need parental involvement with parents not gambling themselves.