Boost Camp’, a universal school-based transdiagnostic prevention program targeting adolescent emotion regulation; evaluating the effectiveness by a clustered RCT : a protocol paper

Abstract Background The transition from childhood into adolescence can be considered as a critical developmental period. Moreover, adolescence is associated with a decreased use of adaptive emotion regulation strategies and an increased use of maladaptive emotion regulation strategies increasing the risk of emotional problems. Targeting emotion regulation is therefore seen as an innovative prevention approach. The present study aims to evaluate the effectiveness of Boost camp, an innovative school-based prevention program targeting ER, on adolescents’ emotion regulation skills and emotional wellbeing. Also secondary outcomes and possible moderators will be included. Methods The aim is to reach 300 adolescents (16 class groups, 6 schools) in their first year of high school. A clustered Randomized Controlled Trial (RCT) with two conditions, intervention (n = 150) and control (n = 150), will be set up. Adolescents in the intervention condition will receive 14 lessons over the course of 2 days, followed by Booster sessions, and will be compared with adolescents in a non-intervention control group. The outcomes will be measured by self-report questionnaires at baseline, immediately after Boost camp, and at three and 6 months follow-up. Discussion Data-collection is planned to be completed in May 2018. Data-analyses will be finished the end of 2018. The presented paper describes the Boost camp program and the clustered RCT design to evaluate its effectiveness. It is expected that Boost camp will have beneficial effects. If found effective, Boost camp will have the potential to increase adolescent’s ER and well-being, and reduce the risk to become adults in need. The trials is registered on the 13th of June 2017 in ISRCTN registry [ISRCTN68235634]

Depression in early adolescence : the influence of emotion on cognitive control processes

Recent theories suggest that impaired cognitive control in response to emotional information plays a critical role in the development and maintenance of depression and underlie the emotion regulation problems that characterize depressed individuals. While specific cognitive control deficits when processing negative information have been clearly demonstrated in adults, the influence of emotional stimuli on cognitive control processes has received scant empirical attention in depressed or dysphoric adolescents. Therefore, the major aim of this project was to investigate the influence of emotion on three key executive processes (working memory, inhibition, and shifting) in adolescents with (sub)clinical depressive symptoms. In a first cross-sectional questionnaire study it was examined whether impairments in everyday executive functioning lead to depressive symptoms through emotion regulation ability. In the four subsequent experimental studies, we aimed to explore which specific EF impairments underlie emotion dysregulation in depressed adolescents. In study 2 and study 3 we focused on the effect of emotional information on WM performance with the use of an emotional n-back task (study 2) and a memory-guided saccadic eye movement task (study 3). In study 4, our goal was to explore interference and inhibition processes in dysphoric adolescents by employing a Negative Affective Priming Task. Finally, in the fifth study, we aimed to take another step further by exploring internal cognitive control instead of external cognitive control processes by using an Internal Shifting task. The results of the first study demonstrated that the association between executive functioning impairments and depressive symptoms is partially mediated by an increased use of maladaptive emotion regulation strategies and a decreased use of adaptive strategies. Curiously, two patterns of results emerged from the experimental studies, with one indicating unaffected cognitive control in the context of emotional information, while the other showed a deleterious effect of negative emotion on cognitive control processes in dysphoric adolescents. Clinically, the findings of the current project suggest impaired cognitive flexibility in response to emotional information in adolescents suffering from depressive symptoms. Future research is needed to replicate our findings and extend our results by conducting multiple tasks to measure one specific executive process in both depressed and dysphoric adolescents