School-based prevention of depressive symptoms in adolescents: a 6-month follow-up

OBJECTIVE: Depressive disorders in adolescents are a widespread problem with extensive psychosocial consequences. The authors designed a school-based program to prevent the increase in depressive symptoms. The authors expect the program to reduce dysfunctional automatic thoughts and improve social skills and thus prevent the increase in depressive symptoms. METHOD: The design includes a training group and a nontreatment control group with pre- and post-measurement and 3- and 6-month follow-up. The authors followed up 324 eighth graders in both groups. School classes were randomly assigned to one of the two groups. The prevention program, LISA-T, is based on cognitive-behavioral therapy concepts and targets of cognitive and social aspects. It comprises 10 meetings of 1.5 hours in a regular school setting. RESULTS: Increases in depressive symptoms in nondepressed adolescents in the training group were prevented over a 6-month period. Furthermore, adolescents with subsyndromal depression in the training group reported fewer symptoms, whereas depressive symptoms within the control group did not change. However, the groups did not differ with regard to social skills, frequency of negative automatic thoughts, and depressive symptoms before the prevention program. CONCLUSIONS: LISA-T is an effective school-based prevention program for eighth graders with minimal to mild depressive symptoms, but further research is needed.     

Brief report: A randomized controlled trial examining peer support and behavioral weight loss treatment

Peer support among adolescents has been positively associated with heath behaviors; however, enhancing peer support for weight loss has rarely been studied among adolescents. This study examined whether a peer support training component delivered to enhance a standard weight loss program led to improved outcomes. Forty-one overweight adolescent females were randomly assigned to a Standard or Enhanced Peer Support intervention. The Enhanced group received in person peer support skills training and practiced skills using social networking. At 16 weeks, participants in the Enhanced condition reported significantly increased perceptions of friend support. Both groups demonstrated significant weight loss (6.4 lbs, ± 8.3). Attendance and self-monitoring were associated with weight loss. Perceptions of peer support can be increased with a peer training component, but did not increase weight loss during the short term.     

Self-concept,Social Skills,and Resilience as Moderators of the Relationship Between Stress and Childhood Depression

The goal of this study is to explore the relationship between students’ self-reported stress and teacher-informed depression, and to determine whether students’ resilience, self-concept, and social skills moderate this relationship. The sample included 481 participants aged 7–10 years, with a total of 252 boys (52.4%) and 229 girls (47.6%). The participants were selected from schools in the Basque country, 59.5% from public schools (n?=?286) and 40.5% from private/subsidized schools (n?=?195). To measure the variables under study, we requested the teachers to complete a questionnaire on depressive symptomatology for each of their students (CDS-teacher), and the students completed another four assessment tools to evaluate their levels of stress (IECI), their self-concept (CAG), social skills (SSiS), and resilience (RSCA). We found a positive correlation between depression and school stress and a negative one between depression and intellectual self-concept, sense of control, social skills (cooperation and responsibility), and variables that make up resilience (optimism, adaptability, trust, support, and tolerance). We found that self-concept, social skills, and resilience all moderated the relationship between stress and childhood depression. The amount of variance explained in the moderation models obtained ranged from 18 to 76%. The results obtained may be useful for the design of prevention and intervention programs for childhood depression, including strengthening children’s self-concept, social skills, and resilience as protective factors against depression.     

Social Skills Training for Adolescents with Asperger Syndrome and High-Functioning Autism

The effectiveness of a social skills training group for adolescents with Asperger syndrome and high-functioning autism (AS/HFA) was evaluated. Parents of six groups of adolescents (n = 46, 61% male, mean age 14.6) completed questionnaires immediately before and after the 12-week group. Parents and adolescents were surveyed regarding their experience with the group. Significant pre- to post-treatment gains were found on measures of both social competence and problem behaviors associated with AS/HFA. Effect sizes ranged from .34 to .72. Adolescents reported more perceived skill improvements than did parents. Parent-reported improvement suggests that social skills learned in group sessions generalize to settings outside the treatment group. Larger, controlled studies of social skills training groups would be valuable.     

A step too far?

Abstract.Objective: To test the hypothesis that depressed adolescents given brief cognitive behaviour therapy by trained social workers will be less depressed after this treatment than depressed adolescents who have routine care from their social workers.Method: Open study, two randomized parallel groups. 86 social workers were randomized to training in brief CBT or delayed training by remote telephone randomization. 25 social workers who attended CBT training recruited 29 depressed adolescents. 22 social workers in the control group recruited 23 depressed adolescents.Results: Social workers perceptions of their knowledge and skills in dealing with adolescent depression were better after the training than before. However, in intention to treat analyses, adolescents who had therapy from trained social workers had a similar level of depression post treatment (mean depression score 17.5, 95% CI 11.8 to 23.3) to those who did not have such therapy (mean depression score 16.7, 95 % CI 11.3 to 22.1). There were no significant differences between the groups on other outcomes or at follow-up.Conclusions: This study failed to recruit enough cases and probably did not therefore have enough statistical power to detect an effect of the intervention. It was also based on a severely impaired sample with many comorbid problems. However, the results suggest that training community-based social workers in cognitive behaviour therapy is neither practical nor effective in improving the outcomes of their clients.     

Social Skills Development in Children with Autism Spectrum Disorders: A Review of the Intervention Research

Social reciprocity deficits are a core feature of the autism spectrum disorders (ASD). This review summarizes the state of research in group-based social skills training programs for school-age children and adolescents with ASD. All published studies of group social skills interventions between 1985 and 2006 were reviewed, as well as dissertations examining group-based social skills intervention programs. To assess the state of the science, a template developed by an NIMH work group was applied to 14 identified studies. Based on this review, the empirical support for this approach is incomplete, but promising intervention strategies were identified. Recommendations for the design of future treatment trials to guide clinical practice are offered.     

Social skills training for schizophrenic individuals at risk for relapse

Two studies were conducted to evaluate the clinical efficacy of intensive social skills training in medicated schizophrenic inpatients at risk for relapse. In study 1, three patients were treated; two showed reductions in psychopathology and rehospitalization and improved social functioning 9 months following discharge. In study 2, social skills training was compared with holistic health treatment in 28 patients. Both groups showed reduced psychopathology 2 years after discharge; patients treated with social skills training had better social functioning, spent less time hospitalized, and had fewer symptomatic relapses. The results support the utility of social skills training as a psychosocial treatment for schizophrenia.     

Work-related social skills training for people with schizophrenia in Hong Kong

This article describes a prospective blinded outcome study of a vocational social skills training program developed in Hong Kong for people affected by chronic schizophrenia. The aim was to improve their ability to find and keep a job. Participants were randomly assigned to three groups: a social skills training group with followup support, a social skills training group without followup support, and a comparison group who received standard after-care treatment. Participants who had participated in either of the training groups statistically outperformed those in the comparison group. Those receiving the training plus followup were statistically much more successful at finding and keeping a job than participants in either of the other two groups. A comparatively small amount of followup contact (a monthly group meeting or phone call) for 3 months after the training finished had a very significant effect on participants' success rate.     

Entraînement aux habiletés sociales pour adolescents souffrant de troubles psychiatriques sévères : étude exploratoire de l’impact sur l’assertivité

Objectives

Adolescence is a crucial period involving numerous acquisitions of social skills. These skills were experienced in peer relationships. In this context, assertivity is a fundamental ability allowing individuals to act in function of their own interests and defend their point of view without denying the rights of others. However, for some adolescents such acquisition is not easy. Thus, anxiety, social withdraw or emotion regulation difficulties impaired the socialization process. More specifically, psychiatric illness (such as mood disorder, anxiety or psychosis disorder) during this period interferes dramatically with such acquisition. However, training targeting social skills improvement, in a population presenting psychiatric disorders may help to enhance interpersonal functioning. In this perspective, the present study aimed (1) to assess the effect on assertivity of the training and (2) to specify the patient's type which reports the most benefit of such training.

Materials and methods

Thirty-eight adolescents (19 suffering from anxiety/mood disorders and 19 suffering from psychotic disorders) participated in a social skill training. Their assertivity was assessed with the Rathus assertivity scale which is a 30-item self-report questionnaire. The participant respond on a Likert scale composed of 6 points (from “totally true” to “totally false”). The Rathus assertivity scale allows to differentiate adolescents in: Inhibited, assertive, assertive-aggressive. The scale was administered before and after the social skills training.

Results

A general improvement on assertivity after the social skills training (partial eta square (η2) = 0.131: moderate effect size) was observed. More specifically, adolescents suffering from anxiety/mood disorder (partial eta square (η2) = 0.206, moderate effect size) and the “inhibited” adolescents (η2 = 0.311, strong effect size) showed the higher benefit from the social skills training.

Conclusions

The social skill training was reported by the adolescents to be an effective treatment allowing enhancing the assertivity of these population. Furthermore, the patients with anxiety/mood disorders reported the highest benefit compared to the patients with psychosis. This result raised the question about the usefulness of self-report questionnaire, as the patients with psychosis were observed, at a clinical level, to have better social abilities after the treatment, but did not report such effect on the self-assessment. In addition, the inhibited patients reported the highest benefits of such treatment. Three main factors could help us to interpret the results: (a) the composition of the groups, (b) the therapeutic approach, and (c) the team giving the social skill training. Firstly, the composition of the groups is heterogeneous like in the social reality of the youths. Thus, the heterogeneity of the psychopathologies composing the groups involved that the youths experienced a wide variety of social interactions with peers. Furthermore, some adolescents could experiment to be a model for others. However, related to our results, we could assume that adolescents with anxious/mood disorders benefit the most from the heterogeneity of the groups and the fact to be a model for others. Secondly, the therapeutic tools used seem also to be an important factor. Indeed, the training is based on cognitive and behavioral approach (using tools like psycho-education, cognitive restructuration, etc.) and social learning which are frequently used in this type of training. Thus, psycho-education allows acquiring new knowledge about their difficulties, for example. In particular, we could understand the most important increase in adolescents with anxiety/mood disorders by the fact that relaxation exercises could reduce their symptoms and so increase their assertivity. In contrast, for adolescent with psychosis disorders, this is not sufficient. Perhaps, their dysfunctional believes had to be reduced before they could benefit from the social skills training. Thirdly, the team giving the social skill training is also important. They all receive a complete training and have a lot of experience in working with such population. More generally, learning new social abilities in protected context, through experiencing positive social interaction may be beneficial for interpersonal function of the patients.     

Self-concept in adolescence: A longitudinal study on reciprocal effects of self-perceptions in academic and social domains

Fostering social and academic self-concepts are central educational goals. During mid-adolescence academic engagement and success seem to be devalued by peers and to be negatively associated with students' social standing. For this age group, is the development of a positive academic self-concept compatible with the development of a positive social self-concept? We investigated relations among academic self-concept, social self-concept, and academic achievement. 1282 students (47.60% female) participated in three-waves of measurement in Grade 5, 6, and 8. Earlier social self-concept of acceptance negatively predicted changes in academic self-concept over time while earlier social self-concept of assertion positively predicted changes in academic self-concept. There were no significant relations between social self-concepts and achievement but positive reciprocal relations between academic self-concept and achievement. Results indicate that fostering adolescents self-concept in social and academic domains are compatible goals. However, some students need support in managing the challenge to coordinate social and academic goals.     

Brief report: Performing on the stage,the field,or both? Australian adolescent extracurricular activity participation and self-concept

The relationship between Australian adolescents' participation in extracurricular activities and their self-concepts was investigated. A total of 1489 adolescents (56% female; mean age 13.8 years) completed measures of social self-concept, academic self-concept, and general self-worth, and reported on their extracurricular activity participation. In general, participation in any type of extracurricular activity was associated with a higher social and academic self-concept, and general self-worth, compared to no participation. Adolescents who participated in both sports and non-sports also reported a more positive social self-concept and general self-worth, compared to those who only participated in one of the activity types. This research provides support for extracurricular activities as a context facilitative of positive self-concept, and demonstrates the importance of a mixed participation profile for an adolescent's self-concept.     

School-based treatment for anxious african-american adolescents: a controlled pilot study

OBJECTIVE: To evaluate the feasibility and effectiveness of a school-based group cognitive-behavioral treatment (CBT) for anxiety disorders with African-American adolescents. METHOD: Twelve adolescents (mean age = 15.6 years) with anxiety disorders were randomly assigned to CBT (n = 6) or a group attention-support control condition (AS-Control; n = 6). Both groups met for 10 sessions in the same high school. Key treatment ingredients in CBT involved exposure, relaxation, social skills, and cognitive restructuring. Key ingredients in AS-Control involved therapist and peer support. At pre- and posttreatment, diagnostic interviews were conducted, and adolescents completed self-report measures of anxiety. RESULTS: At posttreatment and among those who attended more than one treatment session, 3/4 adolescents in CBT no longer met diagnostic criteria for their primary anxiety disorder, compared with 1/5 in AS-Control. Clinician ratings of impairment and self-report levels of overall anxiety were significantly lower at posttreatment in CBT compared with AS-Control. Teenagers in both groups reported lower levels of social anxiety from pre- to posttreatment. CONCLUSIONS: Findings support the feasibility of implementing a manual-based CBT in an urban school setting. Responder rates among African-American adolescents were similar to those found in studies with white youths.     

Impact of epilepsy in adolescence: a UK controlled study

PURPOSE: The goals of the work described here were to investigate the psychological and social impact of epilepsy on adolescents and to identify to what degree clinical and demographic variables and knowledge of epilepsy could influence psychosocial functioning. METHODS: Seventy adolescents with epilepsy were compared with healthy controls (matched for age, sex, and reading ability) on measures of self-esteem, social adjustment, depression, and obsession. Within the epilepsy group, the impact of seizure frequency, seizure severity, and knowledge of epilepsy on the above measures was also determined. RESULTS: Adolescents with epilepsy showed significantly higher levels of depression, anhedonia, and social anxiety and significantly higher numbers of obsessive symptoms than the adolescents without epilepsy. Among the adolescents with epilepsy, high seizure frequency was significantly associated with low self-esteem, and tonic-clonic seizures were specifically associated with higher levels of depression. Finally, low levels of epilepsy knowledge were significantly associated with higher levels of depression, lower levels of self-esteem, and higher levels of social anxiety. CONCLUSIONS: Epilepsy has a significant psychosocial impact on adolescents at this difficult time of life. Social support and access to appropriate information about epilepsy could be of help.     

A pilot randomised controlled trial of a group based social skills intervention for adults with autism spectrum disorder

BackgroundSocial skills training is commonly used for children and adolescents with ASD. There are few studies considering its efficacy in adults and those that exist usually compare it to standard treatment, as opposed to controlling for non-specific improvements that may result from receiving an intervention. We conducted a pilot study to investigate whether social skills training is more effective than non-specific support for adults with ASD.Methods19 adults with ASD were randomised to either social skills training or non-specific social interaction groups for 16 weeks. The Reading the Mind in the Eyes and Reading the Mind in the Voice Tasks were used to assess social cognition while the Social Responsiveness Scale (SRS-2) and the Weiss Functional Impairment Rating Scale (WFIRS-S) were used to measure real-life change pre- and post-treatment.ResultsTaken together, both groups improved across the course of the study on the ‘Eyes’ task (p = 0.049), SRS-2 (p = 0.03) and WFIRS-S (p = 0.053). However, there were no significant differences between the groups. There was some trend-level evidence that the social skills group improved more on the tests of social cognition (p ≤ 0.1 for group x time interaction). This was not the case for the SRS-2 (p = 0.25) and for the WFIRS-S there was a trend for the social interaction group to show greater improvements (p = 0.07).ConclusionsThis study did not show clear evidence of benefit from social skills training compared to facilitated social interaction, although larger studies are required to draw firm conclusions about efficacy.     

Clinical Correlates of Comorbid Obsessive–Compulsive Disorder and Depression in Youth

A burgeoning body of literature addresses the comorbidity of depression and OCD in adults. The purpose of this study was to extend this area of research to children and adolescents by examining the clinical correlates associated with co-occurring depressive disorders in a clinical sample of youth with OCD. Participants included children and adolescents seeking treatment at a university-based research clinic. One group was comprised of 28 children (ages 10–17 years) who met diagnostic criteria for OCD but had no comorbid depressive disorders, whereas the second group consisted of 28 children matched for age and gender who met diagnostic criteria for OCD and co-occurring depressive disorder. The two groups were compared on measures of broad-band psychopathology, internalizing problems, social difficulties, and family characteristics. As anticipated, findings revealed comorbid depression and OCD was associated with more severe internalizing problems, more extensive obsessive–compulsive symptomatology, and more social problems. Youth with comorbid depression and OCD also had higher family conflict and lower family organization compared to those with OCD and no depression. These results may have implications for the treatment of youth with comorbid OCD and depression.     

Investigation of problem solving skills among psychiatric patients

According to our present knowledge depression and hopelessness play an important role in attempted suicide and the development of hopelessness seems to be closely associated with poor problem solving skills. In the present study we have used the internationally well-known MEPS (Means-Ends Problem Solving Test; a measure of social problem solving ability) in Hungary for the first time and combined with other tests. We intended to explore the cognitive risk factors that potentially play a role in the suicidal behavior in clinical population. In our study we compared a group of individuals who had attempted suicide to a nonsuicidal psychiatric control group and a normal control group (61 subjects in each group). Our results confirm the findings of others that psychiatric patients have difficulties in social problem solving compared to normal controls. Moreover, they generate less and poorer solutions. According to our data problem solving skills of the two clinical groups were similar. A strong positive correlation was found between poor problem solving skills, depression and hopelessness which may suggest that the development of problem solving skills could help to reduce negative mood.     

Social skills training for hospitalized male arsonists

According to the clinical literature, many arsonists have very poor interpersonal skills. In the present study, social skills training and a control treatment were compared as methods of increasing the social skills of male arsonists in a maximum security psychiatric hospital. Two groups of five patients received eight sessions of both treatments, one group receiving social skills training first, the other receiving the control treatment first. Testing occurred prior to treatment, between treatments, and at the end of both treatments. Behavioral role-playing assessments revealed significant improvements in both groups as a result of social skills training (P < 0.05) but not as a result of the control treatment. Results on a written test, while not significant, were in the same direction. A one year follow-up showed none of the patients has been involved in further firesetting behavior.     

Adaptive behaviour in children and adolescents with foetal alcohol spectrum disorders: a comparison with specific learning disability and typical development

Foetal alcohol spectrum disorders (FASD) is a leading cause of intellectual disability in the western world. Children and adolescents with FASD are often exposed to a double burden in life, as their neurological sequelae are accompanied by adverse living surroundings exposing them to further environmental risk. In the present study, the adaptive abilities of a group of children and adolescents with FASD were examined using the Vineland Adaptive Behaviour Scales (VABS) and compared to those of a group of IQ-matched children with specific learning disorder (SLD) as well as with typically developing controls (CON). The results showed significantly different adaptive abilities among the groups: Children with FASD performed worse than IQ-matched children with SLD, who in turn performed worse than typically developing children on all domains (communication, daily living skills and socialization) on the VABS. Compared to the other groups, social skills declined with age in the FASD group. These results support previous studies of adaptive behaviour deficits in children with FASD and provide further evidence of the specificity of these deficits. On a societal level, more efforts and resources should be focused on recognizing and diagnosing FASD and supporting communication skills, daily living skills and most of all social skills across diagnostic groups within FASD. Without adequate intervention, adolescents and young adults with FASD run a great risk of marginalization and social maladjustment, costly not only to society but also to the lives of the many young people with FASD.     

Recognition of Facial Affect by Children and Adolescents Diagnosed with Social Phobia

This study compared the ability of children with social phobia and children with no psychiatric disorder to accurately judge facial affect. Fifteen children and adolescents with social phobia and 14 control children were asked to identify emotions depicted in slides from the Pictures of Facial Affect. In addition, they rated their level of anxiety on a pictorial Likert scale prior to and upon completion of the facial recognition task. The results indicated that children with social phobia had significantly poorer facial affect recognition skills than normal controls and reported greater anxiety upon completion of the recognition task. Multivariate analysis revealed significant differences between groups in the number of errors based on the type of facial affect. Post-hoc analysis indicated that deficits were most pronounced for facial representations of happiness, sadness, and disgust. The results are discussed in relation to an integrated model of social skills training that includes facial affect recognition training as a integral component in treatment programs for children and adolescents with social phobia. Directions for future research with larger samples of more ethnically diverse children and adolescents are presented.     

Efficacy of interpersonal psychotherapy for depressed adolescents.

BACKGROUND: Psychotherapy is widely used for depressed adolescents, but evidence supporting its efficacy is sparse. METHODS: In a controlled, 12-week, clinical trial of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), 48 clinic-referred adolescents (aged 12-18 years) who met the criteria for DSM-III-R major depressive disorder were randomly assigned to either weekly IPT-A or clinical monitoring. Patients were seen biweekly by a "blind" independent evaluator to assess their symptoms, social functioning, and social problem-solving skills. Thirty-two of the 48 patients completed the protocol (21 IPT-A-assigned patients and 11 patients in the control group). RESULTS: Patients who received IPT-A reported a notably greater decrease in depressive symptoms and greater improvement in overall social functioning, functioning with friends, and specific problem-solving skills. In the intent-to-treat sample, 18 (75%) of 24 patients who received IPT-A compared with 11 patients (46%) in the control condition met recovery criterion (Hamilton Rating Scale for Depression score < or =6) at week 12. CONCLUSIONS: These preliminary findings support the feasibility, acceptability, and efficacy of 12 weeks of IPT-A in acutely depressed adolescents in reducing depressive symptoms and improving social functioning and interpersonal problem-solving skills. Because it is a small sample consisting largely of Latino, low socioeconomic status adolescents, further studies must be conducted with other adolescent populations to confirm the generalizability of the findings.