A Randomized Controlled Trial Comparing two Cognitive-Behavioral Programs for Adolescent Girls with Subclinical Depression: A School-Based Program (Op Volle Kracht) and a Computerized Program (SPARX)

Limited research has indicated the effectiveness of the school-based Cognitive Behavioral Therapy (CBT) prevention program ‘Op Volle Kracht (OVK)’ and the computerized CBT program ‘SPARX’ in decreasing depressive symptoms. Therefore, a randomized controlled trial of the effectiveness of OVK and SPARX was conducted among Dutch female adolescents (n = 208, mean age = 13.35) with elevated depressive symptoms. Participants were randomly assigned to one of four conditions: OVK only (n = 50), SPARX only (n = 51), OVK and SPARX combined (n = 56) and a monitoring control condition (n = 51). Participants in the first three conditions received OVK lessons and/or the SPARX game. Depressive symptoms were assessed before interventions started, weekly during the interventions, and immediately after the interventions ended, with follow-up assessments at 3, 6 and 12 months. Intention to treat results showed that depressive symptoms decreased in all conditions (F(12, 1853.03) = 14.62, p < .001), with no difference in depressive symptoms between conditions. Thus, all conditions, including the monitoring control condition, were equally effective in reducing depressive symptoms. Possible explanations for the decrease of depressive symptoms in all conditions are discussed and suggestions for future research are provided. Dutch Trial Register: NTR3737

A Game-Based School Program for Mental Health Literacy and Stigma on Depression (Moving Stories): Cluster Randomized Controlled Trial

Background: Depressive symptoms are highly prevalent among adolescents in Western countries. However, although treatment for depressive symptoms is available, many adolescents do not seek help when they need it. Important barriers to help-seeking among adolescents include low mental health literacy and high stigma. Therefore, we have developed a game-based school program, Moving Stories, which combines mental health literacy training for depression with contact with someone with lived experience both in the digital and nondigital world. Objective: The aim of this study is to conduct a first test of the effectiveness of the newly developed game-based program, Moving Stories, using a cluster randomized controlled trial. Methods: A total of 185 adolescents participated, divided over 10 classes from 4 schools. Half of the classes were randomly selected to follow the Moving Stories program, whereas the other half were in the control group, where no intervention was provided. The adolescents filled out digital questionnaires at 4 time points, with questions on mental health literacy, stigma, depressive symptoms, and the program itself (before the program, after the program, 3-month follow-up, and 6-month follow-up). Using R (R Foundation for Statistical Computing), we ran linear mixed-effects models for all continuous outcome variables and generalized linear mixed-effects models for all binary outcome variables. Results: Compared with the control group, participants in the Moving Stories group improved after the program in personal stigma (b=−0.53, 95% CI −1.02 to −0.03; t179.16=−2.08; P=.04). Effects on personal stigma lasted over time (3-month follow-up: b=−0.57, 95% CI −1.11 to −0.03; t174.39=−2.07; P=.04). Most adolescents in the Moving Stories group participated in the introduction (97/99, 98%) and contact session (93/99, 94%), played the game for 4 or 5 days (83/99, 83%), and indicated that they would recommend the game to their peers (90/98, 92%). Conclusions: The results of this study show the potential of Moving Stories as a stigma reduction program. With changes in the program to improve its effects on mental health literacy, Moving Stories could be implemented in schools to improve help-seeking in adolescents and reduce the negative consequences and burden of depressive symptoms

Adolescents’ Conformity to Their Peers’ Pro-Alcohol and Anti-Alcohol Norms: The Power of Popularity

Research on adolescent development suggests that peer influence may play a key role in explaining adolescents’ willingness to drink, an important predictor of drinking initiation. However, experiments that thoroughly examine these peer influence effects are scarce. This study experimentally examined whether adolescents adapted their willingness to drink when confronted with the pro-alcohol and anti-alcohol norms of peers in a chat room session and whether these effects were moderated by the social status of peers

An experimental study on the effects of peer drinking norms on adolescents' drinker prototypes

Adolescents form impressions about the type of peers who drink (i.e., drinker prototypes). The evaluation of, and perceived similarity to these prototypes are related to adolescents’ drinking. Peer drinking norms play an important role in the formation of prototypes. We experimentally examined whether manipulation of peer norms changed the evaluation of and perceived similarity to drinker prototypes and whether these changes were moderated by peers’ popularity

The effectiveness of a web-based Dutch parenting program to prevent overweight in children 9–13 years of age:Results of a two-armed cluster randomized controlled trial

INTRODUCTION: Although parental support is an important component in programs designed to prevent overweight in children, current programs pay remarkably little attention to the role of parenting. We therefore developed a web-based parenting program entitled “Making a healthy deal with your child”. This e-learning program can be incorporated into existing overweight prevention programs. The aim of this study was to determine the effectiveness of this e-learning program. MATERIALS AND METHODS: The effectiveness was examined in a two-armed cluster randomized controlled trial. The participants were 475 parent-child dyads of children 9–13 years of age in the Netherlands who participated in an existing schoolclass-based overweight prevention program. At the school grade level, parents were randomly assigned to either the intervention or the control condition. Measurements were taken from both parents and children at baseline, and 5 and 12 months after baseline. Primary outcomes included the child’s dietary and sedentary behavior, and level of physical activity. Secondary outcomes included general parenting style, specific parenting practices, and parental self-efficacy. Linear mixed effects models and generalized linear mixed effects models were conducted in R. RESULTS: Intention-to-treat analyses and completers only revealed no significant effects between the intervention and control condition on energy balance-related behaviors of the child and parenting skills after correction for multiple testing. The parents’ mean satisfaction with the e-learning program (on a 10-point scale) was 7.0±1.1. CONCLUSIONS: Although parents were generally satisfied with the parenting program, following this program had no significant beneficial effects regarding the children’s energy balance-related behaviors or the parenting skills compared to the control condition. This program may be more beneficial if used by high-risk groups (e.g. parents of children with unhealthy energy balance-related behaviors and/or with overweight) compared to the general population, warranting further study

Relative Effectiveness of CBT-Components and Sequencing in Indicated Depression Prevention for Adolescents: A Cluster-Randomized Microtrial

Objective: Cognitive Behavioral Therapy (CBT) was dismantled into four modules of three sessions each: cognitive restructuring (Think), behavioral activation (Act), problem solving (Solve) and relaxation (Relax). We investigated the modules’ relative effectiveness in indicated depression prevention for adolescents and examined variations in sequencing of these modules. Method: We performed a pragmatic cluster-randomized microtrial with four parallel conditions: (1) Think-Act-Relax-Solve (n = 14 clusters, n = 81 participants); (2) Act-Think-Relax-Solve (n = 13, n = 69); (3) Solve-Act-Think-Relax (n = 13, n = 77); and (4) Relax-Solve-Act-Think (n = 12, n = 55). The sample consisted of 282 Dutch adolescents with elevated depressive symptoms (Mage = 13.8; 55.7% girls, 92.9% Dutch). In total 52 treatment groups were randomized as a cluster. Assessments were conducted at baseline, after each module and at 6-month follow-up with depressive symptoms as primary outcome. Results: None of the modules (Think, Act, Solve, Relax) was associated with a significant decrease in depressive symptoms after three sessions and no significant differences in effectiveness were found between the modules. All sequences of modules were associated with a significant decrease in depressive symptoms at post-intervention, except the sequence Relax-Solve-Act-Think. At 6-month follow-up, all sequences showed a significant decrease in depressive symptoms. No significant differences in effectiveness were found between the sequences at post-intervention and 6-month follow-up. Conclusions: Regardless of the CBT technique provided, one module of three sessions may not be sufficient to reduce depressive symptoms. The sequence in which the CBT components cognitive restructuring, behavioral activation, problem solving and relaxation are offered, does not appear to significantly influence outcomes at post- intervention or 6-month follow-up. Abbreviations: CDI-2:F: Children’s Depression Inventory-2 Full-length version; CDI-2:S: Children’s Depression Inventory-2 Short version; STARr: Solve, Think, Act, Relax and repeat

A Game-based Assessment of the Effects of Rejection on Young Adults

Rejection consists of a range of behaviors from ignoring another to explicitly excluding someone from an encounter. Currently available experimental tasks have shown that rejection has strong emotional, behavioral, and physical effects, but the tasks have some limitations. We argue that video games can address these limitations and have developed a new experimental task (ScrollQuest) to show the potential of video games as rejection research tools. The primary goal of the present study was to explore the effects of ScrollQuest. We analyzed data from 116 young adults who played both ScrollQuest and the rejection experimental task Cyberball. Playing ScrollQuest had more negative effects on mood, more negative interpretation effects were observed after playing ScrollQuest, and ScrollQuest was perceived as more enjoyable, compared to Cyberball. Our findings suggest that ScrollQuest might be an effective new experimental task to study rejection in a digital environment, but more work is needed to improve ScrollQuest

Gender differences in the association between alexithymia and emotional eating in obese individuals

Objective: Women have been reported to use more emotionregulation strategies than do men and to have more abilities to regulate their emotions in a different way. The aim of the present study was to examine gender differences in the relationships of alexithymia, negative mood, and the combination of alexithymia and negative mood with emotional eating in obese persons. Methods: Four hundred thirteen obese individuals [343 females and 70 males, aged 18–60 years, mean=43.6 years, body mass index (BMI)=38.4F6.6 kg/m2] completed self-report questionnaires, including the Symptom Checklist-90 (SCL-90) questionnaire, the Dutch Eating Behavior Questionnaire (DEBQ), and the Toronto Alexithymia Scale (TAS). Results: Hierarchical regression analysis showed a significant interaction between gender and alexithymia. More difficulty in identifying or describing feelings was specifically associated with more emotional eating in men. Conclusion: These findings suggest that alexithymia is more strongly involved in emotional eating of obese men than women. This offers indications for designing gender-specific treatments for emotional eating among obese persons.