Search

The aim of the present study was to examine the additive effect of elements of cognitive behavioral therapy (CBT) on the video game Mindlight in decreasing anxiety of children with an autism spectrum disorder (ASD). A non-concurrent multiple baseline design with 8 children with ASD in the age of 8-12 was used. CBT did not have the hypothesized additive effect on Mindlight in decreasing anxiety of children with ASD. Instead, multiple participants already experienced a decrease in anxiety during the Mindlight sessions. Yet, several participants did experience a stabilization in anxiety at a low level during the CBT sessions. For now, it can be concluded that CBT does not have an additive effect on Mindlight.

Adolescent depression is a major concern for public health and is associated with negative consequences and outcomes. Identifying adolescent characteristics that might relate to the risk for developing depression is crucial. This study investigated bidirectional associations between coping strategies and depressive symptoms over time. The participants were 1,341 secondary school students from the Netherlands (X-bar = 13.91, SD = 0.55, 47.5% girls) who completed self-report questionnaires at six waves over 2.5 years. Cross-lagged models were used to investigate the associations between coping strategies and depressive symptoms. Coping strategies did not predict depressive symptoms over time. However, there was an indication of the reverse relationship. When adolescents experienced elevated depressive symptoms, they used fewer adaptive techniques to target stress. Gender differences were found in the use of avoidance. The inconsistencies of these findings with earlier studies are discussed and provide new directions for future research on working mechanisms underlying depression prevention programs.

Parental psychopathology and parenting behavior are known to be related to adolescents depression and anxiety, but unique roles of mothers and fathers are not clear. Our aim was to examine the relation of maternal and paternal psychopathology, emotional support, and respect for autonomy, and their interaction to depression and anxiety symptoms in adolescents. In total, 142 female adolescents participated, together with 138 mothers and 113 fathers. Data were analyzed using latent growth curve modeling. Paternal emotional support was negatively related to adolescent baseline level of depression and anxiety symptoms. Further, we found that there was a positive association between respect for autonomy and depression symptoms in adolescents for higher levels of paternal symptoms of psychological problems. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety disorders during adolescence can have detrimental consequences. Both disorders are related to negative outcome in various areas during adolescence and are also predictive of depression and anxiety disorders later in life. Especially parental psychopathology and being female are risk factors that increase the probability of developing one of these disorders during adolescence. Research has shown that prevention programs have promising results, especially for adolescents who have these risk factors. Therefore, in this study, we will focus on the effectiveness of a prevention program 'A jump forward' that has been developed for adolescent girls with a familial risk of depression and/or anxiety. Methods/Design: We designed a randomized controlled trial to test the effectiveness of an indicated and selective prevention program aimed at depression and anxiety in adolescent girls. Adolescents aged between 11 and 15 years old with depressive and/or anxiety symptoms and with parents who show indicators of parental psychopathology will be randomly assigned to the experimental (N = 80) or control groups (N = 80). Participants in the experimental group will follow a preventive intervention, consisting of six sessions of 90 minutes each. All participants will complete baseline, intervention phase 1 (after session 2), intervention phase 2 (after session 4), post-intervention, 6 month follow-up, and 12 month follow-up assessments. Furthermore, parents will be asked to complete assessments at baseline, postintervention, and 12-month follow-up. Primary outcome will be depressive symptoms. Secondary outcomes will be anxiety symptoms, suicidal ideation, response style, negative cognitive errors, parental emotional support and parental control, parental psychopathology, parenting stress and adolescents' depression and anxiety symptoms according to the parents. Discussion: This paper described the study designed to evaluate a program for preventing depression and/or anxiety in high-risk adolescents over a 12-month follow-up period. If the program showed to be effective in reducing symptoms of depression and anxiety and preventing adolescents from developing clinical levels of these disorders, our results would be relevant to practice. Thus, the intervention could be used on a large scale. Moreover, this study aims to contribute to the evidence-based prevention of depression and anxiety of adolescents. [ABSTRACT FROM AUTHOR]

Importance: In the Netherlands, a growing group of young people request medical assistance in dying based on psychiatric suffering (MAID-PS). Little is known about this group, their characteristics, and outcomes., Objective: To assess the proportion of requests for and deaths by MAID-PS among young patients, outcomes of their application and assessment procedures, and characteristics of those patients who died by either MAID or suicide., Design, Setting, and Participants: This retrospective cohort study included Dutch individuals younger than 24 years requesting MAID-PS between January 1, 2012, and June 30, 2021, whose patient file had been closed by December 1, 2022, at the Expertisecentrum Euthanasie, a specialized health care facility providing MAID consultation and care., Main Outcomes and Measures: Outcomes of the MAID-PS assessment procedure (discontinued, rejected, or MAID-PS) and clinical characteristics of patients who died by MAID or suicide., Results: The study included 397 processed applications submitted by 353 individuals (73.4% female; mean [SD] age, 20.84 [1.90] years). Between 2012 and the first half of 2021, the number of MAID-PS applications by young patients increased from 10 to 39. The most likely outcome was application retracted by the patient (188 [47.3%]) followed by application rejected (178 [44.8%]). For 12 applications (3.0%), patients died by MAID. Seventeen applications (4.3%) were stopped because the patient died by suicide during the application process and 2 (0.5%) because the patient died after they voluntarily stopped eating and drinking. All patients who died by suicide or MAID (n = 29) had multiple psychiatric diagnoses (most frequently major depression, autism spectrum disorder, personality disorders, eating disorder, and/or trauma-related disorder) and extensive treatment histories. Twenty-eight of these patients (96.5%) had a history of suicidality that included multiple suicide attempts prior to the MAID application. Among 17 patients who died by suicide, 13 of 14 (92.9%) had a history of crisis-related hospital admission, and 9 of 12 patients who died by MAID (75.0%) had a history of self-harm., Conclusions and Relevance: This cohort study found that the number of young psychiatric patients in the Netherlands who requested MAID-PS increased between 2012 and 2021 and that applications were retracted or rejected for most. Those who died by MAID or suicide were mostly female and had long treatment histories and prominent suicidality. These findings suggest that there is an urgent need for more knowledge about persistent death wishes and effective suicide prevention strategies for this high-risk group.

Background: Suicidal thoughts and behaviors (STBs) among adolescents have hardly decreased despite preventative efforts. School-based prevention programs could have a great reach, yet suicide prevention is not an easy topic to address. To increase acceptability of school-based suicide prevention, it is important to evaluate whether programs that target known risk factors of STBs, such as depression, could be equally effective., Methods: We conducted a systematic literature search in major electronic databases. Outcomes were suicidal ideation and behaviors. Multivariate random effects meta-regression-analyses were conducted., Results: Eleven primary studies met the inclusion criteria, totalling 23,230 participants. The post-test effect size was small for both suicidal ideation (g = 0.15) and suicidal behaviors (g = 0.30). Meta-regression indicated that targeting known risk factors of STBs was not a significant modifier of effect size for ideation, indicating equal effectiveness. However, it was significant modifier of effect for behaviors, but only one intervention targeted know risk factors. Effects at follow-up (3-12 months) were also significant but small for both outcomes., Limitations: Substantial heterogeneity between studies was noted. Only few and small sample size studies could be included that targeted known risk factors of STBs. Therefore, these results should be interpreted with caution., Conclusions: School-based prevention of STBs shows some promise within three months post-test assessments, and potentially also have effects that are sustained over time. More studies are needed to make conclusions regarding school-based interventions that target risk factors of STBs., (Copyright © 2021. Published by Elsevier B.V.)

Depression is a major problem in youth mental health. Current treatment is on average effective, but adolescents are hesitant to seek help. Blended treatment could lower the barriers to seeking treatment. Evidence on effectiveness is, however, scarce. The present pragmatic quasi-experimental controlled trial aimed to compare the outcomes of blended cognitive behavioral therapy (CBT) to face-to-face CBT and treatment as usual. A total of 129 adolescents with clinical depression (82.2% female), aged 13-22 ( M = 16.60, SD = 2.03) received blended CBT, face-to-face CBT or treatment as usual. Clinical diagnosis, depressive symptoms, and secondary outcomes were assessed at baseline, post-intervention, and six-months follow-up. Participants receiving blended CBT were, compared to participants receiving face-to-face CBT and treatment as usual, evenly likely to be in remission from their depressive disorder at post-intervention and at six-month follow-up. Depressive symptoms decreased significantly over time in all three conditions, and changes were not significantly different between conditions. Other secondary outcomes (suicide risk, internalizing and externalizing symptoms, severity of depression, and global functioning) did not differ between treatment conditions at post-intervention and six-month follow-up. Since there was no evidence for favorable outcomes for face-to-face therapies above blended CBT, blended CBT may also be an effective treatment format in clinical practice.

Introduction: According to the network perspective, psychopathology is the result of interactions between symptoms. A previous study used network analysis to identify central symptoms of adolescent depression. The aim of the current study was replicate and extend this study by including suicide ideation as a symptom of depression and evaluating which depression symptoms are contributing factors to suicide ideation in adolescents., Method: A large community sample (N = 5,888) of adolescents aged 11-16 years completed the Children's Depression Inventory (CDI-2). Network analysis was used to identify the network structure of the CDI-2 and which symptoms were directly related to suicide ideation in the network. Additionally, the network structure of adolescents who did and did not experience suicide ideation were compared., Results: Results pertaining the depression network were highly similar to the study we aimed to replicate. The most central symptoms in the depression network were loneliness, sadness, self-hatred, fatigue, self-deprecation and crying. Loneliness explained most variance of suicide ideation. Adolescents who experience suicide ideation had a similar network structure as those who do not. Adolescents with suicide ideation scored higher on all depression symptoms., Limitations: The use of cross-sectional data indicates that only undirected networks and results based on between-subject data could be estimated., Conclusions: Loneliness was a central factor for depression networks and also the most contributing factor of suicide ideation. Preventative efforts should consider taking experiences of loneliness into account as these are especially prevalent in adolescents. Suicide ideation seems more representative of depression symptom severity in adolescents., (Copyright © 2020. Published by Elsevier B.V.)

Background and Objectives: In the clinical setting, a large proportion of children with an autism spectrum disorder (ASD) experience impairing anxiety symptoms. Recently, an applied videogame called Mindlight has been developed that focuses on decreasing anxiety in children. The present study involved a randomized controlled trial (RCT) investigating the effect of Mindlight on (sub)clinical anxiety symptoms in children with an ASD., Methods: In total, 109 children of 8-16 years old with an ASD and (sub)clinical anxiety symptoms were randomly assigned to the experimental (N = 53) or the control (N = 56) condition. Children in the experimental condition played Mindlight, children in the control condition played a commercial game (Triple Town) for 1 h per week, for six consecutive weeks. All children and parents completed assessments at baseline, post-intervention and 3-months follow-up., Results: Results showed no differences in decrease of child-rated anxiety symptoms between both conditions. However, the decrease of parent-rated anxiety symptoms was significantly larger in the experimental condition., Limitations: Mechanisms of change associated with treatment outcomes were not investigated in the present study. Therefore, it remains unclear which specific or non-specific factors contributed to the decrease in anxiety symptoms in both conditions., Conclusions: The present study provided some preliminary evidence that video games are a promising new intervention vehicle for children with an ASD and anxiety, at least according to parents. However, further research on working mechanisms is needed, in order to specify to what extent and for which children with ASD Mindlight could be an effective anxiety treatment., Competing Interests: Declaration of competing interest None., (Copyright © 2020 Elsevier Ltd. All rights reserved.)