53 research outputs found
Recommended from our members
Associations between interpretation bias and depression in adolescents
Interpretation biases have been shown to play a role in adult depression and are a target in cognitive behavioural therapy. Adolescence is a key risk period for the development of depression and a period of rapid cognitive and emotional development but little research has investigated the relationship between interpretation biases and depression in adolescents. This study adapted a measure of interpretation bias, the Ambiguous Scenarios Test for Depression, for adolescents and evaluated its reliability and validity. A community sample of 206 young people aged 12 to 18 years completed a validated measure of depression symptoms (Mood and Feelings Questionnaires) and the adapted Ambiguous Scenarios Test. The Ambiguous Scenarios Test for Depression in Adolescents had good internal consistency and split half reliability. Depression symptoms were associated with participants’ ratings of the valence of ambiguous situations and with interpretation biases. Importantly, symptoms of depression and anxiety were independently associated with interpretation bias. This research suggests that interpretation biases can be measured in this age group, that negative interpretation biases exist in adolescents and that these are associated with depression symptoms
Recommended from our members
Clinical characteristics of adolescents referred for treatment of depressive disorders
Background: Adolescence is a period of increased risk for the development of depression. Epidemiological and clinical studies suggest that the phenomenology of depression may differ during childhood and adolescence. However, participants in these studies may not reflect depressed young people referred to routine clinical services. The aim of this paper is to describe referrals for depression to a UK routine public healthcare service for children and adolescents with mental health difficulties.
Method: This paper describes a consecutive series of adolescents (N = 100, aged 12-17 years), referred for depression to a routine public healthcare child and adolescent mental health service, in the south of England. Young people and their caregivers completed a structured diagnostic interview and self report measures of anxiety and depression.
Results: Fewer than half of young people referred for depression met diagnostic criteria for a depressive disorder. The key symptoms reported by those with depression were low mood or irritability, cognitive disturbances, sleep disturbances and negative self-perceptions. Suicidal ideation was common and was considerably higher than reported in other studies. Caregiver and young person’s accounts of adolescent symptoms of depression and anxiety were uncorrelated. Caregivers also reported fewer symptoms of depression in their child than adolescents themselves.
Conclusions: These data have direct relevance to the design and delivery of public mental health services for children and adolescents. However, we do not know how representative this sample is of other clinical populations in the UK or in other countries. There is a need to collect routine data from other services to assess the needs of this group of high risk adolescents
Recommended from our members
'I am tired, sad and kind': self-evaluation and symptoms of depression in adolescents
Although self-evaluation i.e., negative perceptions of the self is a common depression symptom in adolescents, little is known about how this population spontaneously describe their self and available data on adolescent self-evaluation is limited. This study aimed to generate and report on a list of words used by healthy adolescents and those with elevated depression symptoms to describe their self-evaluation. Linguistic analysis (LIWC) was then used to compare self-evaluation between the two groups. Adolescents aged 13-18 years (n = 549) completed a measure of depression symptoms (the Mood and Feelings Questionnaire) and a measure of self-evaluation (the Twenty Statements Test). Responses were then collated and presented in a freely accessible resource and coded using Linguistic Inquiry Word Count (LIWC) analysis. Self-evaluation words generated by adolescents were uploaded to a publicly accessible site for future research: https://doi.org/10.15125/BATH-01234 . Adolescents with elevated depression symptoms described themselves as 'Tired' and 'Sad' more than healthy adolescents. However, there was no difference between groups in respect to their use of specific positive, prosocial self-evaluation 'words' (i.e., 'Caring' and 'Kind). Following Linguistic Inquiry Word Count (LIWC) analysis, adolescents with elevated depression symptoms generated significantly more words than healthy adolescents, generated more words classified as negative emotion, anxiety and sadness and generated fewer words classified positive emotion than healthy adolescents. As predicted by the cognitive model of depression, our findings suggest that adolescents with elevated symptoms of depression generated more negative self-evaluation words than healthy adolescents; however they also generated prosocial positive self-evaluation words at the same rate as non-depressed adolescents. These novel data therefore identify an 'island' of resilience that could be targeted and amplified by psychological treatments for adolescent depression, and thus provide an additional technique of change
Recommended from our members
Psychometric properties of the Thai Mood and Feelings Questionnaire (MFQ) for adolescent depression
Background
The Mood and Feelings Questionnaire (MFQ) is a widely used screening tool for child and adolescence depression but has not been validated with young people in Thailand. This study aimed to assess the reliability and validity and to determine the optimal clinical cut-off of the Thai MFQ.
Methods
The Thai MFQ was evaluated in two parts. In part 1, The MFQ was translated and back translated into the Thai language and piloted on a small number of Thai adolescents. Then 1275 young people aged 12–18 years from three secondary schools in Thailand completed the MFQ and related measures of depression. In part 2, 138 students were invited to take part in a structured diagnostic interview (the Thai translation of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children -Present and Lifetime Version (the K-SADS-PL). Of those, 103 students were interviewed and completed the Thai MFQ a second time to assess test–retest reliability. Receiver Operating Characteristics (ROC) analyses were conducted to evaluate diagnosis accuracy and examine the optimal cut-off score of the Thai MFQ.
Results
The Thai MFQ had excellent internal consistency (α = 0.92) and good to moderate test–retest reliability in 2-week and 4-week intervals. The Thai MFQ also had good convergent validity with related measures of depression. The ROC analyses demonstrated that the Thai MFQ also had excellent accuracy distinguishing between depressed and non-depressed adolescents [AUC = 0.95, 95% CI [0.92, 0.99]. A total score of 28 on the Thai MFQ was the optimal cut-off score (sensitivity was 0.97 and specificity was 0.83).
Discussion
The Thai MFQ demonstrated excellent psychometric properties and accurately distinguished between depressed and non-depressed adolescents. It is appropriate to use as a screening measure to identify adolescents with depression in community settings in Thailand
Recommended from our members
The effect of non-pharmacological sleep interventions on depression symptoms: a meta-analysis of randomised controlled trials
Poor sleep is a significant risk factor for depression across the lifespan and sleep problems have been hypothesised to contribute to the onset and maintenance of depression symptoms. However, sleep problems are usually not a direct target of interventions for depression. A range of non-pharmacological treatments can reduce sleep problems but it is unclear whether these interventions also reduce other depression symptoms. The aim of this review was to examine whether non-pharmacological interventions for sleep problems are effective in reducing symptoms of depression. We carried out a systematic search for randomised controlled trials of non-pharmacological sleep interventions that measured depression symptoms as an outcome. Forty-nine trials (n=5908) were included in a random effects meta-analysis. The pooled standardised mean difference for depression symptoms after treatment for sleep problems was -0.45 (95% CI: -0.55,-0.36). The size of the effect on depression symptoms was moderated by the size of the effect on subjective sleep quality. In studies of participants with mental health problems, sleep interventions had a large effect on depression symptoms (d=-0.81, 95% CI: -1.13,-0.49). The findings indicate that non-pharmacological sleep interventions are effective in reducing the severity of depression, particularly in clinical populations. This suggests that non-pharmacological sleep interventions could be offered as a treatment for depression, potentially improving access to treatment
Recommended from our members
The effect of non-pharmacological sleep interventions on depression symptoms: a meta-analysis of randomised controlled trials
Poor sleep is a significant risk factor for depression across the lifespan and sleep problems have been hypothesised to contribute to the onset and maintenance of depression symptoms. However, sleep problems are usually not a direct target of interventions for depression. A range of non-pharmacological treatments can reduce sleep problems but it is unclear whether these interventions also reduce other depression symptoms. The aim of this review was to examine whether non-pharmacological interventions for sleep problems are effective in reducing symptoms of depression. We carried out a systematic search for randomised controlled trials of non-pharmacological sleep interventions that measured depression symptoms as an outcome. Forty-nine trials (n=5908) were included in a random effects meta-analysis. The pooled standardised mean difference for depression symptoms after treatment for sleep problems was -0.45 (95% CI: -0.55,-0.36). The size of the effect on depression symptoms was moderated by the size of the effect on subjective sleep quality. In studies of participants with mental health problems, sleep interventions had a large effect on depression symptoms (d=-0.81, 95% CI: -1.13,-0.49). The findings indicate that non-pharmacological sleep interventions are effective in reducing the severity of depression, particularly in clinical populations. This suggests that non-pharmacological sleep interventions could be offered as a treatment for depression, potentially improving access to treatment
Recommended from our members
Cognitive biases predict symptoms of depression, anxiety and wellbeing above and beyond neuroticism in adolescence
Adolescence represents a period of vulnerability to affective disorders. Neuroticism is considered a heritable risk factor for depression, but is not directly amenable to intervention. Therefore, it is important to identify the contributions of modifiable risk factors. Negative cognitive biases are implicated in the onset and maintenance of affective disorders in adults, and may represent modifiable risk factors in adolescence. This study sought to assess to what extent cognitive biases are able to predict depression, anxiety and wellbeing beyond that of neuroticism in adolescents. Adolescents (N = 99), recruited from Scottish secondary schools (54.5% female; mean age = 14.7), ensured a sample representing the breadth of the mental health spectrum. In line with prevalence estimates, 18% of this sample demonstrated clinical levels of depression symptoms. Cognitive biases of autobiographical memory, self-referential memory, ambiguous scenarios interpretation, facial expression recognition, rumination and dysfunctional attitudes were assessed. Depression, anxiety, and wellbeing were indexed using the Mood and Feelings Questionnaire, Spence Children's Anxiety Scale and the BBC Subjective Wellbeing Scale. Regression analyses demonstrated neuroticism to significantly predict depression, anxiety and wellbeing. The addition of cognitive biases resulted in a significant increase of explained variance with final models explaining just over 50% of variances of depression, anxiety and wellbeing. These findings demonstrate that cognitive biases explain mental health symptoms over and above that of neuroticism. Depressive symptomology was particularly related to self-referential memory bias, while anxiety was predicted by interpretive bias. The key clinical implication is that targeting specific biases based on diagnostic features may be of particular benefit in alleviating distress and promoting wellbeing
The experience of sleep problems for adolescents with depression in short-term psychological therapy
A growing body of literature demonstrates a strong relationship between sleep disturbances and depression in adolescence. In spite of this, few studies have explored how adolescents with depression experience sleep problems. The present study aimed to qualitatively explore the experience of sleep problems in adolescents with depression, including their understanding of how a psychological therapy impacted on these sleep difficulties. The sample included 12 adolescents with sleep disturbances who had been offered treatment for depression through a large, multi-centre, randomised controlled trial. Semi-structured interviews conducted after treatment and 1-year post treatment were analysed using thematic analysis. Two main themes were identified. Both themes demonstrated how an overarching desire to escape impacted the adolescents’ sleep in distinct ways; ‘thinking about the ‘bad stuff’’ was characterised by ruminative thinking, which prevented sleep, whereas ‘sleep as an escape’ indicated a desire to sleep excessively due to feelings of helplessness. Overall, the findings demonstrate a nuanced relationship between sleep and depression in adolescence, and imply that the underlying meaning of the sleep difficulties for each young person should be considered in the delivery of therapy for adolescent depression
Recommended from our members
Adolescents’ perceived barriers and facilitators to seeking and accessing professional help for anxiety and depressive disorders: a qualitative interview study
Anxiety and depressive disorders are the most common mental health disorders in adolescents, yet only a minority of young people with these disorders access professional help. This study aims to address this treatment gap by improving our understanding of barriers and facilitators to seeking/accessing professional help as perceived by adolescents with anxiety/depressive disorders identified in the community. Twenty-two adolescents, aged 11–17 years, who met diagnostic criteria for a current anxiety and/or depressive disorder were identified through school-based screening. In-depth qualitative interviews were conducted one-to-one with each adolescent and adolescents’ parents were interviewed separately for the purpose of data triangulation. Data were analysed using reflexive thematic analysis. We identified four themes capturing adolescent perceived barriers and facilitators to seeking/accessing professional help for anxiety and depressive disorders: (1) making sense of difficulties, (2) problem disclosure, (3) ambivalence to seeking help, and (4) the instrumental role of others. Barriers/facilitators identified within each theme reflect important developmental characteristics of adolescence, such as a growing need for autonomy and concerns around negative social evaluation. At the same time, the results highlight adolescents’ dependency on other people, mainly their parents and school staff, when it comes to successfully accessing professional help for their mental health difficulties. This study identifies a number of barriers/facilitators that influence help-seeking behaviour of adolescents with anxiety and/or depressive disorders. These factors need to be addressed when targeting treatment utilisation rates in this particular group of young people
Recommended from our members
Can air purification improve sleep quality? A 2-week randomised controlled crossover pilot study in healthy adults
Insufficient quantity and quality of sleep is a public health concern which can be addressed by interventions for improving sleep outcomes. Environmental factors such as poor air quality are a potential target for intervention, particularly in light of associations between air pollution and worse sleep. The aim of this pilot study was to investigate the effects of using an air purifier on sleep outcomes and mood in 30 healthy adults. There were two conditions (i) air purifier with a High Efficiency Particulate Air (HEPA) filter (ii) air purifier with a placebo filter. Participants undertook both conditions, each over two weeks with a two-week washout, following a counterbalanced, double-blind design. Daily sleep outcomes were measured with actigraphy watches and sleep diaries, whilst daily mood was assessed with the Positive and Negative Affect Schedule. The Insomnia Severity Index, the Pittsburgh Sleep Quality Index, and symptoms of anxiety and depression were measured pre and post. The purifier filter was associated with increased total sleep time for an average of 12 minutes per night and increased total time in bed for an average of 19 minutes per night relative to the placebo. There were several sleep and mood outcomes for which no changes were observed, and time awake after sleep onset was higher for the purifier filter. Air quality was better during the HEPA filter condition. These findings offer positive indications that environmental interventions which improve air quality can have benefits for sleep outcomes in healthy populations who are not exhibiting clinical sleep disturbances
- …