Laura Pass

'It Was All My Fault'; Negative Interpretation Bias in Depressed Adolescents.

The extent to which cognitive models of development and maintenance of depression apply to adolescents is largely untested, despite the widespread application of Cognitive Behavior Therapy (CBT) for depressed adolescents. Cognitive models suggest that negative cognitions, including interpretation bias, play a role in etiology and maintenance of depression. Given that cognitive development is incomplete by the teenage years and that CBT is not superior to non-cognitive treatments in the treatment of adolescent depression, it is important to test the underlying model. The primary aim of this study was to test the hypothesis that interpretation biases are exhibited by depressed adolescents. Four groups of adolescents were recruited: clinically-referred depressed (n = 27), clinically-referred non-depressed (n = 24), community with elevated depression symptoms (n = 42) and healthy community (n = 150). Participants completed a 20 item ambiguous scenarios questionnaire. Clinically-referred depressed adolescents made significantly more negative interpretations and rated scenarios as less pleasant than all other groups. The results suggest that this element of the cognitive model of depression is applicable to adolescents. Other aspects of the model should be tested so that cognitive treatment can be modified or adapted if necessary.

Adapting brief Behavioural Activation (BA) for adolescent depression: a case example

There is an increasing evidence base for the effectiveness of Behavioural Activation in treating adult depression; however, there has been little investigation of using this approach with adolescents. This article reports on the adaptation of brief Behavioural Activation for Depression (BATD) for adolescents (BATD-A). A case study is reported to illustrate the brief structured approach, treatment response as indicated by routine outcome measures, and the family’s view of the intervention. The adaptations made to the adult BATD manual are discussed including parental input, adapted values and activities, and engagement issues. It is hoped that following further evaluation, BATD-A could be successfully delivered as a low-intensity intervention for depression.

Brief Behavioral Activation for Adolescent Depression Working With Complexity and Risk

Given the long-term negative outcomes associated with depression in adolescence, there is a pressing need to develop brief, evidence-based treatments that are accessible to more young people experiencing low mood. Behavioral Activation (BA) is an effective treatment for adult depression; however, little research has focused on the use of BA with depressed adolescents, particularly with briefer forms of BA. In this article, we outline an adaptation of brief Behavioral Activation Treatment of Depression (BATD) designed for adolescents and delivered in eight sessions (Brief BA). This case example illustrates how a structured, brief intervention was useful for a depressed young person with a number of complicating and risk factors.

Verbal Information Transfer in Real-Life: When Mothers Worry About Their Child Starting School

Verbal information transfer, one of Rachman’s three pathways to fear, may be one way in which vulnerability for anxiety may be transmitted from parents to children. A community sample of mothers and their preschool-aged children (N = 65) completed observational tasks relating to the child starting school. Mothers were asked to tell their child about social aspects of school; then children completed a brief play assessment involving ambiguous, school-based social scenarios. Mothers completed self-report questionnaires on social anxiety symptoms, general anxiety and depressive symptoms as well as a questionnaire on child anxiety symptoms and indicated whether they were personally worried about their child starting school. There was a significant difference in the information given to children about school between mothers who stated they were worried and those who stated they were not, with mothers who were worried more likely to mention unresolved threat, use at least one anxiety-related word, and show clear/consistent negativity (all ps < .01). Significant associations were also found between the emotional tone of mothers’ descriptions of school and children’s own representations of school. These findings support the theory that the information mothers give to their child may be influenced by their own concerns regarding their child, and that this verbal information affects child representations.

A short form of the ambiguous scenarios test for depression in adolescents: development and validation

The Ambiguous Scenarios Test for Depression in Adolescents (AST-DA) is a 20-item measure of depressive interpretation bias. It has good face and construct validity and discriminates between clinical and non-clinical samples. However, a shorter measure would reduce burden on young people and make the instrument more useful in clinical settings. The aim of this study was to develop a valid and reliable short-form of the AST-DA. Adolescents recruited from the community (N = 206) completed the 20 item measure. Based on theoretical considerations and statistical analyses we selected 9 items to create a short form of the AST. This 9-item version was tested on a clinical sample of 69 young people referred for depression to a child and adolescent mental health service in the UK. The validity and internal reliability of the Short-AST-DA were confirmed. These data suggest that the Short-AST-DA is a robust measure of depressive interpretation bias in young people. Future work should investigate the measure’s test-retest reliability, sensitivity to change and convergent validity.