27 results on '"Schwartz, Karen T G"'
Search Results
2. Parent–child psychotherapy targeting emotion development: unpacking the impact of parental depression on child, parenting and engagement outcomes
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Schwartz, Karen T. G., Chronis-Tuscano, Andrea, Tillman, Rebecca, Whalen, Diana, Gilbert, Kirsten E., and Luby, Joan
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- 2023
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3. The Role of Family Support in Moderating Mental Health Outcomes for LGBTQ+ Youth in Primary Care.
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DelFerro, Joseph, Whelihan, Joseph, Min, Jungwon, Powell, Maura, DiFiore, Gabrielle, Gzesh, Ari, Jelinek, Scott, Schwartz, Karen T. G., Davis, Molly, Jones, Jason D., Fiks, Alexander G., Jenssen, Brian P., and Wood, Sarah
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- 2024
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4. A Qualitative Exploration of Research-School Partnerships During COVID: How to Better Serve Our Community Partners During Times of Crisis
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Schwartz, Karen T. G., primary, Shippen, Nellie A., additional, Lejeune, Julia A., additional, Zolli, Nicole, additional, Massey, Cameron S., additional, Chronis-Tuscano, Andrea, additional, and Meinzer, Michael C., additional
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- 2024
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5. Cognitive and Interpersonal Moderators of Two Evidence-Based Depression Prevention Programs.
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Jones, Jason D., Schwartz, Karen T. G., Davis, Molly, Gallop, Robert, Hankin, Benjamin L., and Young, Jami F.
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DEPRESSION in adolescence , *MENTAL depression , *COGNITIVE styles , *STRESS management , *SOCIAL skills - Abstract
Objective: To test potential cognitive and interpersonal moderators of two evidence-based youth depression prevention programs. Method: Two hundred four adolescents (Mage = 14.62 years, SD = 1.65; 56% female; 71% White, 11% Black, 11% multiracial, 5% Asian, 2% other races, 18% Hispanic/Latinx) were randomized to either a cognitive–behavioral (Coping With Stress [CWS]) or interpersonal (Interpersonal Psychotherapy–Adolescent Skills Training [IPT-AST]) prevention program. Potential moderators, selected based on theory and research, included rumination, negative cognitive style, dysfunctional attitudes, hopelessness, parent–adolescent conflict, negative interactions with parents and friends, and social support from parents and friends. Depression symptoms were assessed repeatedly through 18 months postintervention. Results: After adjusting for multiple comparisons, rumination (B = −2.02, SE =.61, p =.001, d =.47), hopelessness (B = −2.03, SE =.72, p =.005, d =.41), and conflict with father (B = 1.68, SE =.74, p =.02, d =.32) moderated intervention effects on change in depression symptoms from postintervention through 18-month follow-up. For example, at high levels of conflict with father, youth in IPT-AST reported a significant decrease in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. At low levels of conflict with father, youth in IPT-AST reported a significant increase in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. Conclusions: These exploratory secondary analyses of Personalized Depression Prevention study data highlight specific cognitive and interpersonal risk factors that could be considered when determining which prevention program may be most effective for a given adolescent. What is the public health significance of this article?: Adolescent depression is a major public health concern, and improving prevention efforts is critical. Study results suggest specific cognitive and interpersonal risk factors that may impact the effects of interventions for youth. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Emerging Risk of Adolescent Depression and Suicide Detected Through Pediatric Primary Care Screening
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Davis, Molly, primary, Jones, Jason D, additional, Schwartz, Karen T G, additional, Dysart, Gillian, additional, So, Amy, additional, and Young, Jami F, additional
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- 2023
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7. Prevention of Depression in At-Risk Adolescents: Identification of Course and Predictors of Intervention Response
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Schwartz, Karen T. G.
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Clinical psychology ,Adolescent Depression ,Longitudinal ,Prevention - Abstract
Depression is a prevalent and disabling disorder. Parental depression predicts onset and treatment resistance in offspring, and adolescent onset has been associated with severe and chronic course. Thus, much work has been done to prevent depression, particularly in adolescent offspring of depressed parents. Few prevention trials have evaluated disorder course. Understanding long-term patterns and predictors of prevention response in at-risk adolescents may inform new intervention development. As such, the current study aimed to empirically derive longitudinal patterns of response to prevention and test predictors of response. Adolescents (N = 316) at personal and familial risk for depression were enrolled in a multi-site randomized controlled trial testing a nine-month group-based cognitive-behavioral prevention program (CBP). The Depression Symptom Rating Scale (DSR) was used to establish patterns of prevention response across 6 years of study participation. Candidate predictors included intervention assignment, current parental depression at baseline, adolescent risk (i.e., a history of depressive episode, subsyndromal depressive symptoms, both), adolescent functioning, anxiety symptoms, and hopelessness. Repeated Measures Latent Class Analysis (RMLCA) was used to identify patterns of response across follow-up. Predictors of class membership were then analyzed using Multinomial Logistic Regression. All analyses employed an intent-to-treat design, used an alpha level of .05, and were run using Mplus8. RMLCA model fit indices (i.e., AIC = 3211.24, BIC = 3476.76, BLMRT: p < .001; entropy = 87%) supported a four-class solution: well/late onset (n = 213; 68.5%), recurrent/brief episodes (n = 38; 12.2%), recurrent/persistent episodes (n = 19; 6.1%), early discontinuation (i.e., n = 41; 13.2%). Multinomial logistic regression revealed that increased odds of categorization in the well/late onset class vs. the recurrent/persistent class were related to being randomized to CBP and having better functioning and less hopelessness at baseline. Interestingly, adolescents at highest risk for depression were also more likely categorized in the well/late onset class compared to the recurrent/persistent class. The four distinct trajectories of prevention response identified have implications for booster session timing and prevention program content. Results also support the feasibility of using RMLCA and multinomial logistic regression in future work, progressing the understanding long-term depression prevention effects in at-risk adolescents.
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- 2020
8. Emerging Risk of Adolescent Depression and Suicide Detected Through Pediatric Primary Care Screening.
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Davis, Molly, Jones, Jason D, Schwartz, Karen T G, Dysart, Gillian, So, Amy, and Young, Jami F
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DEPRESSION in adolescence ,PEDIATRIC therapy ,SUICIDE risk factors ,PRIMARY care ,MEDICAL screening ,HISPANIC Americans ,PUBLIC-private sector cooperation - Abstract
Objective The goal of the current study was to document patterns of stability and change in adolescent depression and suicide risk detected via universal depression screening in pediatric primary care and to determine who may go on to experience emerging risk. Methods Retrospective electronic health record information (sociodemographic data and depression screening results for 2 timepoints) was extracted for adolescents aged 12–17 who attended well-visits between November 15, 2017, and February 1, 2020, in a large pediatric primary care network. A total of 27,335 adolescents with 2 completed depression screeners were included in the current study. Results While most adolescents remained at low risk for depression and suicide across the 2 timepoints, others experienced emerging risk (i.e. low risk at time 1 but elevated risk at time 2), decreasing risk (i.e. high risk at time 1 but low risk at time 2) or stable high risk for depression or suicide. Odds of experiencing emerging depression and suicide risk were higher among adolescents who were female (compared to males), Black (compared to White), and had Medicaid insurance (compared to private insurance). Odds of experiencing emerging depression risk were also higher among older adolescents (compared to younger adolescents) as well as adolescents who identified as Hispanic/Latino (compared to non-Hispanic/Latino). Conclusions Findings can inform symptom monitoring and opportunities for prevention in primary care. [ABSTRACT FROM AUTHOR]
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- 2024
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9. The Child and Adolescent Services Assessment: Interrater Reliability and Predictors of Rater Disagreement
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Schwartz, Karen T. G., Bowling, Amanda A., Dickerson, John F., Lynch, Frances L., Brent, David A., Porta, Giovanna, Iyengar, Satish, and Weersing, V. Robin
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- 2018
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10. Implementing Task-Shared Child and Adolescent Psychological Interventions in Low- and Middle-Income Countries: A Scoping Review
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Rose, Alexandra L., primary, Jack, Helen E., additional, Wan, Christine, additional, Toloza, Emilia, additional, Bhattiprolu, Kavya, additional, Ragunathan, Meera, additional, Schwartz, Karen T. G., additional, and Magidson, Jessica F., additional
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- 2022
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11. Parent–child psychotherapy targeting emotion development: unpacking the impact of parental depression on child, parenting and engagement outcomes
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Schwartz, Karen T. G., primary, Chronis-Tuscano, Andrea, additional, Tillman, Rebecca, additional, Whalen, Diana, additional, Gilbert, Kirsten E., additional, and Luby, Joan, additional
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- 2022
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12. Moderators and Mediators of Treatments for Youth With Depression
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Weersing, V. Robin, primary, Schwartz, Karen T. G., additional, and Bolano, Carl, additional
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- 2015
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13. Transactional patterns of depressive symptoms between mothers and adolescents: The role of emotion regulation
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Felton, Julia W., primary, Schwartz, Karen T. G., additional, Oddo, Lauren E., additional, Lejuez, Carl W., additional, and Chronis‐Tuscano, Andrea, additional
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- 2021
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14. Cost-effectiveness of Brief Behavioral Therapy for Pediatric Anxiety and Depression in Primary Care
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Lynch, Frances L., primary, Dickerson, John F., additional, Rozenman, Michelle S., additional, Gonzalez, Araceli, additional, Schwartz, Karen T. G., additional, Porta, Giovanna, additional, O’Keeffe-Rosetti, Maureen, additional, Brent, David, additional, and Weersing, V. Robin, additional
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- 2021
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15. Evidence-Base Update of Psychosocial and Combination Treatments for Child and Adolescent Depression.
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Weersing, V. Robin, Goger, Pauline, Schwartz, Karen T. G., Baca, Selena A., Angulo, Felix, and Kado-Walton, Merissa
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COGNITIVE therapy , *INTERPERSONAL psychotherapy , *DEPRESSION in adolescence , *ADOLESCENT psychology , *ANTIDEPRESSANTS - Abstract
ObjectiveMethodResultsConclusionThis evidence-based update (EBU) builds on three previous reviews (1998, 2008, 2017) sponsored by the Society of Clinical Child and Adolescent Psychology with the aim of evaluating the empirical support for psychosocial interventions for depression in youth.In the current review period (2014–2022), 25 randomized controlled trials (RCT) were identified: four in children and 21 in adolescents. Descriptive effect sizes and number-needed-to-treat (NNT) ratios were calculated for primary outcomes. Results were integrated with prior reviews, and cumulative evidence used to classify treatments as well-established, probably efficacious, possibly efficacious, or experimental. Published secondary analyses of predictors, moderators, and mediators were examined.For adolescents, cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT-A), CBT in combination with antidepressant medication, and collaborative care programs were all classified as well-established. The evidence was considerably weaker for children, with no treatments achieving well-established or probably efficacious status. New developments include greater exploration of parent- and family-mediated treatment models and increasing evidence on technology-assisted interventions. Data on predictors, moderators, and mediators continued to be focused on adolescent depression samples and drawn from a limited number of RCT datasets.Since the prior EBU, there has been incremental progress in youth depression treatment research. There is an urgent need to: (a) develop innovative approaches to substantially improve on the modest effects seen in most RCTs, (b) expand the evidence base for children and other underserved groups, (c) craft evidence-based guidelines for choosing between interventions when multiple efficacious treatments do exist, and (d) address issues of treatment effectiveness and scalability to ameliorate the wide prevalence and high impact of depression in youth. [ABSTRACT FROM AUTHOR]
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- 2024
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16. Social and Non-social Reward: A Preliminary Examination of Clinical Improvement and Neural Reactivity in Adolescents Treated With Behavioral Therapy for Anxiety and Depression
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Schwartz, Karen T. G., primary, Kryza-Lacombe, Maria, additional, Liuzzi, Michael T., additional, Weersing, V. Robin, additional, and Wiggins, Jillian Lee, additional
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- 2019
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17. Comparing the Mental Health of Sexual Minority and Heterosexual Cancer Survivors: A Systematic Review.
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Gordon, Janna R., Baik, Sharon H., Schwartz, Karen T. G., and Wells, Kristen J.
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- 2019
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18. Evidence Base Update of Psychosocial Treatments for Child and Adolescent Depression
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Weersing, V. Robin, primary, Jeffreys, Megan, additional, Do, Minh-Chau T., additional, Schwartz, Karen T. G., additional, and Bolano, Carl, additional
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- 2016
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19. Evidence Base Update of Psychosocial Treatments for Child and Adolescent Depression.
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Weersing, V. Robin, Jeffreys, Megan, Do, Minh-Chau T., Schwartz, Karen T. G., and Bolano, Carl
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THERAPEUTICS ,MENTAL depression ,TREATMENT of depression in children ,DEPRESSION in adolescence ,RANDOMIZED controlled trials ,BEHAVIOR therapy - Abstract
Depression in youth is prevalent and disabling and tends to presage a chronic and recurrent course of illness and impairment in adulthood. Clinical trial research in youth depression has a 30-year history, and evidence-based treatment reviews appeared in 1998 and 2008. The current review of 42 randomized controlled trials (RCTs) updates these reviews to include RCTs published between 2008 and 2014 (N = 14) and reevaluates previously reviewed literature. Given the growing maturity of the field, this review utilized a stringent set of methodological criteria for trial inclusion, most notable for excluding trials based in subclinical samples of youth that had been included in previous reviews (N = 12) and including well-designed RCTs with null and negative findings (N = 8). Findings from the current review suggest that evidence for child treatments is notably weaker than for adolescent interventions, with no child treatments achievingwell-establishedstatus and the evidentiary basis of treatments downgraded from previous reports. Cognitive behavioral therapy (CBT) for clinically depressed children appears to bepossibly efficacious, with mixed findings across trials. For depressed adolescents, both CBT and interpersonal psychotherapy arewell-establishedinterventions, with evidence of efficacy in multiple trials by independent investigative teams. This positive conclusion is tempered by the small size of the interpersonal psychotherapy literature (N = 6) and concern that CBT effects may be attenuated in clinically complicated samples and when compared against active control conditions. Data on predictors, moderators, and mediators are examined and priorities for future research discussed. [ABSTRACT FROM PUBLISHER]
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- 2017
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20. Telehealth-delivered depression prevention: Short-term outcomes from a school-based randomized controlled trial.
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Young JF, Jones JD, Schwartz KTG, So A, Dysart GC, Kanine RM, Gillham JE, Gallop R, and Davis M
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Objective: To examine short-term (i.e., postintervention) outcomes from a randomized controlled trial comparing a school-based telehealth-delivered depression prevention program, Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), to services as usual (SAU). We expected IPT-AST would be acceptable and feasible and that IPT-AST adolescents would experience greater reductions in depression symptoms, anxiety symptoms, and impairment compared with SAU., Method: Adolescents ( N = 242; M
age = 14.80 years, SD = 0.70; 65% female; 21% Black; 13% Hispanic/Latinx) with elevated scores on the Center for Epidemiologic Studies Depression Scale (Radloff, 1977) at screening provided data at baseline, 2-month (midpoint of IPT-AST), and 3-month (postintervention) assessments. They reported depression symptoms on the Center for Epidemiologic Studies Depression Scale, anxiety symptoms on the Screen for Child Anxiety Related Emotional Disorders (Birmaher et al., 1997), and impairment on the Columbia Impairment Scale (Bird et al., 1993). Baseline depression diagnosis was examined as a moderator., Results: Hierarchical linear models showed that adolescents reported significant reductions in depression symptoms and impairment across conditions. IPT-AST adolescents reported significantly greater reductions in anxiety symptoms than SAU adolescents, d = .39, 95% CI [.05, .72], p = .003. Depression diagnosis moderated outcomes ( d s = .33-.34, p s ≤ .05), such that IPT-AST adolescents without a diagnosis at baseline showed greater improvements in depression and anxiety symptoms than SAU adolescents. Adolescents in SAU with a depression diagnosis at baseline showed greater improvements in impairment compared with IPT-AST. Attendance and satisfaction data demonstrated the feasibility and acceptability of telehealth-delivered IPT-AST., Conclusions: Results support telehealth-delivered IPT-AST as a promising intervention for improving short-term outcomes among adolescents with depression symptoms but without a depression diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).- Published
- 2024
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21. Adolescent, Parent, and Provider Perceptions of a Predictive Algorithm to Identify Adolescent Suicide Risk in Primary Care.
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Davis M, Dysart GC, Doupnik SK, Hamm ME, Schwartz KTG, George-Milford B, Ryan ND, Melhem NM, Stepp SD, Brent DA, and Young JF
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- Humans, Adolescent, Female, Male, Suicidal Ideation, Risk Assessment, Attitude of Health Personnel, Suicide psychology, Qualitative Research, Suicide Prevention, Machine Learning, Adult, Primary Health Care, Algorithms, Parents psychology
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Objective: To understand adolescent, parent, and provider perceptions of a machine learning algorithm for detecting adolescent suicide risk prior to its implementation primary care., Methods: We conducted semi-structured, qualitative interviews with adolescents (n = 9), parents (n = 12), and providers (n = 10; mixture of behavioral health and primary care providers) across two major health systems. Interviews were audio recorded and transcribed with analyses supported by use of NVivo. A codebook was developed combining codes derived inductively from interview transcripts and deductively from implementation science frameworks for content analysis., Results: Reactions to the algorithm were mixed. While many participants expressed privacy concerns, they believed the algorithm could be clinically useful for identifying adolescents at risk for suicide and facilitating follow-up. Parents' past experiences with their adolescents' suicidal thoughts and behaviors contributed to their openness to the algorithm. Results also aligned with several key Consolidated Framework for Implementation Research domains. For example, providers mentioned barriers inherent to the primary care setting such as time and resource constraints likely to impact algorithm implementation. Participants also cited a climate of mistrust of science and health care as potential barriers., Conclusions: Findings shed light on factors that warrant consideration to promote successful implementation of suicide predictive algorithms in pediatric primary care. By attending to perspectives of potential end users prior to the development and testing of the algorithm, we can ensure that the risk prediction methods will be well-suited to the providers who would be interacting with them and the families who could benefit., Competing Interests: Declaration of Competing Interest The authors declare there are no conflicts of interest relevant to the current manuscript. This work is funded by the National Institute of Mental Health. Authors receive additional funding from the National Institute of Mental Health and other federal granting agencies. Dr. Young receives royalties from Oxford University Press. Dr. Brent receives royalties from Guilford Press, eRT, and UpToDate and consulting fees from HealthWise. Dr. Brent also receives funding from the American Foundation for Suicide Prevention, the Beckwith Institute, and the Once Upon A Time Foundation. Dr. Melhem received an honorarium from Oakstone Publishing for providing a lecture for one of their courses., (Copyright © 2024 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)
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- 2024
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22. Brief Behavioral Therapy for Anxiety and Depression in Pediatric Primary Care: Breadth of Intervention Impact.
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Schwartz KTG, Kado-Walton M, Dickerson JF, Rozenman M, Brent DA, Porta G, Lynch FL, Gonzalez A, and Weersing VR
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- Adolescent, Child, Female, Humans, Male, Anxiety psychology, Anxiety Disorders therapy, Primary Health Care, Treatment Outcome, Behavior Therapy, Depression psychology
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Objective: To report on broad-based outcomes of the Brief Behavioral Therapy (BBT) trial for pediatric anxiety and depression. Secondary data analyses expand on previous reports by assessing diagnostic remission and independent functioning, impact on targeted psychopathology, and spillover effects on non-targeted outcomes., Method: Youth (N = 185; 8-16.9 years; 58% female; 78% White; 21% Hispanic) with anxiety and/or depression were eligible for this multi-site trial. Enrolled youth were randomly assigned to receive 8 to 12 sessions of BBT in primary care or assisted referral to outpatient care (ARC). Assessments were conducted 16 and 32 weeks post randomization., Results: BBT was superior to ARC on remission of all targeted diagnoses (week 16: 56.8% vs 28.2%, p < .001; week 32: 62.5% vs 38.9%, p = .004), clinician-rated independent functioning (week 16: 75.0% vs 45.7%, p < .001; week 32: 81.2% vs 55.7%, p < .001), and on measures of anxiety, depression, suicide items, total comorbid behavioral and emotional problems, and hyperactivity (d = 0.21-0.49). Moderation analyses revealed superior outcomes for Hispanic youth in BBT vs ARC for diagnostic remission, anxiety, emotional problems, and parent-child conflict. Youth depression at baseline moderated effects on peer problems and parent-child conflict, with effects favoring BBT. Significant main and moderated effects of BBT on change in non-targeted outcomes were largely mediated by change in anxiety (24.2%-49.3% of total effects mediated)., Conclusion: BBT has positive effects on youth, mediated by the strong impact of the intervention on anxiety. Analyses continue to support positive outcomes for Hispanic youth, suggesting that BBT is a broadly effective transdiagnostic treatment option for diverse populations., Clinical Trial Registration Information: Brief Cognitive Behavioral Therapy (CBT) for Pediatric Anxiety and Depression in Primary Care; https://clinicaltrials.gov; NCT01147614., (Copyright © 2022 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)
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- 2023
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23. Attention shifting in the context of emotional faces: Disentangling neural mechanisms of irritability from anxiety.
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Kryza-Lacombe M, Kiefer C, Schwartz KTG, Strickland K, and Wiggins JL
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- Adolescent, Anxiety epidemiology, Attention, Facial Expression, Humans, Magnetic Resonance Imaging, Prospective Studies, Anxiety Disorders epidemiology, Irritable Mood
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Background: Irritability predicts concurrent and prospective psychiatric disorders across the lifespan. Anxiety commonly co-occurs with irritability, and such comorbidity complicates care. Understanding the mechanisms of comorbid traits is necessary to inform treatment decisions. This study aimed to disentangle neural mechanisms of irritability from anxiety in the context of attentional shifting toward and away from emotional faces in youths from treatment-seeking families., Methods: Youths (N = 45), mean age = 14.01 years (standard deviation = 1.89) completed a dot-probe task during functional magnetic resonance imaging acquisition. Whole-brain activation analyses evaluated the effect of irritability on neural reactivity in the context of varying attentional shifting toward and away from emotional faces, both depending on and above and beyond anxiety (i.e., with anxiety as [a] a moderator and [b] a covariate, respectively)., Results: Higher irritability levels related to distinct task-related patterns of cuneus activation, depending on comorbid anxiety levels. Increased irritability also related to distinct task-related patterns of parietal, temporal, occipital, and cerebellar activation, controlling for anxiety. Overall, youths with higher levels of irritability evinced more pronounced fluctuations in neural reactivity across task conditions., Conclusion: The present study contributes to a literature delineating the unique and shared neural mechanisms of overlapping symptom dimensions, which will be necessary to ultimately build a brain- and behavior-based nosology that forms the basis for more targeted and effective treatments., (© 2020 Wiley Periodicals, Inc.)
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- 2020
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24. Brief Behavioral Therapy for Pediatric Anxiety and Depression in Primary Care: A Follow-up.
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Brent DA, Porta G, Rozenman MS, Gonzalez A, Schwartz KTG, Lynch FL, Dickerson JF, Iyengar S, and Weersing VR
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- Adolescent, Anxiety therapy, Child, Follow-Up Studies, Humans, Primary Health Care, Treatment Outcome, Anxiety Disorders therapy, Behavior Therapy, Depression therapy
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Objective: To report on the 32-week outcome of the Brief Behavioral Therapy (BBT) for Pediatric Anxiety and Depression in Primary Care clinical trial., Method: A total of 185 youths aged 8 to 17 years with anxiety and/or depression identified through 9 pediatric primary care (PPC) settings in San Diego and Pittsburgh were randomized to receive Assisted Referral to Care (ARC) or up to 12 sessions of BBT over 16 weeks. The primary outcome was clinical response across anxiety and depression, defined as a Clinical Global Impressions-Improvement Score of ≤2. Secondary outcomes included interview-rated functioning, depression, and anxiety. Here, we report on outcomes at 32 weeks after randomization. All analyses with primary outcomes are corrected for multiple comparisons using the false discovery rate procedure., Results: At 32 weeks, BBT was superior to ARC with respect to response (67.5% versus 43.1%, q = 0.03, number needed to treat [NNT] = 5) and functioning (d = 0.49, q = 0.04). BBT was superior to ARC with respect to its impact on anxiety (f = 0.21) but not depressive symptoms (f = 0.05). These findings persisted after controlling for the number of sessions received. Ethnicity moderated the impact of BBT on outcome (NNT for Hispanic youths = 2), because of a much lower response rate to ARC in Hispanic than in non-Hispanic youths (16.7% versus 49.2%, p = 0.04)., Conclusion: BBT is a promising intervention that can be effectively delivered in PPC and may be particularly effective for Hispanic patients. Further work is indicated to improve its impact on depressive symptoms and to test BBT against other treatments delivered in pediatric primary care., Clinical Trial Registration Information: Brief Cognitive Behavioral Therapy (CBT) for Pediatric Anxiety and Depression in Primary Care; http://clinicaltrials.gov; NCT01147614., (Copyright © 2019 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)
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- 2020
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25. Preschool- and School-Age Irritability Predict Reward-Related Brain Function.
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Dougherty LR, Schwartz KTG, Kryza-Lacombe M, Weisberg J, Spechler PA, and Wiggins JL
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- Amygdala physiology, Child, Child, Preschool, Female, Humans, Magnetic Resonance Imaging methods, Male, Parietal Lobe physiology, Prefrontal Cortex physiology, Brain physiology, Irritable Mood physiology, Reward
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Objective: Although chronic irritability in childhood is prevalent, impairing, and predictive of later maladjustment, its pathophysiology is largely unknown. Deficits in reward processing are hypothesized to play a role in irritability. The current study aimed to identify how the developmental timing of irritability during preschool- and school-age relates to reward-related brain function during school-age., Method: Children's irritability was assessed during the preschool period (wave 1; ages 3.0-5.9 years) and 3 years later (wave 2; ages 5.9-9.6 years) using a clinical interview. At wave 2, children (N = 46; 28 female and 18 male) performed a monetary incentive delay task in which they received rewards, if they successfully hit a target, or no reward regardless of performance, during functional magnetic resonance imaging., Results: Children with more versus less severe preschool irritability, controlling for concurrent irritability, exhibited altered reward-related connectivity: right amygdala with insula and inferior parietal lobe as well as left ventral striatum with lingual gyrus, postcentral gyrus, superior parietal lobe, and culmen. Children with more versus less severe concurrent irritability, controlling for preschool irritability, exhibited a similar pattern of altered connectivity between left and right amygdalae and superior frontal gyrus and between left ventral striatum and precuneus and culmen. Neural differences associated with irritability were most evident between reward and no-reward conditions when participants missed the target., Conclusion: Preschool-age irritability and concurrent irritability were uniquely associated with aberrant patterns of reward-related connectivity, highlighting the importance of developmental timing of irritability for brain function., (Copyright © 2018 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)
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- 2018
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26. Neural reactivity to reward in school-age offspring of depressed mothers.
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Wiggins JL, Schwartz KT, Kryza-Lacombe M, Spechler PA, Blankenship SL, and Dougherty LR
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- Child, Corpus Striatum physiology, Female, Humans, Magnetic Resonance Imaging, Male, Mother-Child Relations psychology, Motivation, Prefrontal Cortex physiology, Risk Factors, Temporal Lobe physiology, Brain physiology, Child of Impaired Parents psychology, Depression, Mothers psychology, Reward
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Background: Identifying neural profiles predictive of future psychopathology in at-risk individuals is important to efficiently direct preventive care. Alterations in reward processing may be a risk factor for depression. The current study characterized neural substrates of reward processing in children at low- and high-risk for psychopathology due to maternal depression status., Methods: Children with (n=27) and without (n=19) maternal depression (ages 5.9-9.6 years) performed a monetary incentive delay task in which they received rewards, if they successfully hit a target, or no reward regardless of performance, during fMRI acquisition., Results: Multiple dorsal prefrontal, temporal, and striatal regions showed significant Group (high- vs. low-risk)×Performance (hit vs. miss)×Condition (no reward vs. reward) interactions in a whole-brain analysis. All regions exhibited similar patterns, whereby the high-risk group showed blunted activation differences between trials with vs. without rewards when participants hit the target. Moreover, high-risk children showed activation differences between trials with vs. without rewards in the opposite direction, compared to the low-risk group, when they missed the target., Limitations: This study had a modest sample size, though larger than existing studies. Children with maternal depression are at elevated risk for future psychopathology, yet not all experience clinically significant symptoms; longitudinal research is necessary to fully track the pathway from risk to disorder., Conclusion: Children of depressed mothers exhibited attenuated neural activation differences and activation patterns opposite to children without depressed mothers. Our findings may provide targets for hypothesis-driven preventive interventions and lead to earlier identification of individuals at risk., (Copyright © 2017 Elsevier B.V. All rights reserved.)
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- 2017
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27. Treatment and Prevention of Depression and Anxiety in Youth: Test of Cross-Over Effects.
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Garber J, Brunwasser SM, Zerr AA, Schwartz KT, Sova K, and Weersing VR
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- Adolescent, Anxiety Disorders diagnosis, Anxiety Disorders psychology, Child, Comorbidity, Cross-Over Studies, Depressive Disorder psychology, Evidence-Based Medicine, Female, Humans, Male, Randomized Controlled Trials as Topic, Research Design, Anxiety Disorders therapy, Depressive Disorder therapy, Psychotherapy methods
- Abstract
Anxiety and depression are highly comorbid and share several common etiological processes. Therefore, it may be more efficient to develop interventions that treat or prevent these problems together rather than as separate entities. The present meta-analytic review examined whether interventions for children and adolescents that explicitly targeted either anxiety or depression showed treatment specificity or also impacted the other outcome (i.e. cross-over effects). We addressed this question both within the same type of study (i.e. treatment, prevention) and across study types. Only randomized controlled trials (RCTs) that assessed both constructs with dimensional measures were included in this review. For treatment studies, RCTs targeting anxiety (n = 18) showed significant effects on both anxious and depressive symptoms, although more strongly on anxiety than depression; similarly, RCTs treating depression (n = 9) yielded significant effects on both depressive and anxious symptoms, but stronger effects on depression than anxiety. Thus, there were cross-over effects in treatments purportedly targeting either anxiety or depression, and also treatment specificity, such that larger effects were seen for the target problem at which the treatment was aimed. Anxiety prevention studies (n = 14) significantly affected anxious, but not depressive symptoms, indicating no cross-over effect of anxiety prevention trials on depression. For depression prevention studies (n = 15), the effects were not significant for either depressive or anxiety symptoms, although the effect was significantly larger for depressive than for anxious symptoms. Post-hoc analyses revealed that the effect on depressive symptoms was significant in depression preventions trials of targeted but not universal samples. Implications for transdiagnostic interventions are discussed., Competing Interests: and Conflicts of Interest: The authors have no disclosures or conflicts of interest to report., (© 2016 Wiley Periodicals, Inc.)
- Published
- 2016
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