Social Cognitive Training to Enhance the Efficacy of CBT for Depression in Youth: A Developmental Approach

社会认知训练可增强 CBT 对青少年抑郁症的疗效：一种发展方法

基本信息

批准号：
10684214
负责人：
JUDY GARBER
金额：
$ 44.93万
依托单位：
VANDERBILT UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-04 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10684214
关键词：
17 year old Adolescent Affect Aftercare Age Basic Science Behavior Belief Child Clinical Cognitive Cognitive Therapy Depressed mood Depressive disorder Development Developmental Course Diagnosis Disease Dose Early treatment Education Educational process of instructing Emotional Emotions Evaluation Goals Impairment Individual Interpersonal Relations Intervention Judgment Knowledge Learning Skill Link Measures Mediating Mediation Mental Depression Mind Participant Perception Phase Psychotherapy Public Health Randomized Randomized, Controlled Trials Readiness Recurrence Research Domain Criteria Sampling Services Social Functioning Social Processes System Testing Therapeutic Intervention Training Youth clinical care cognitive ability cognitive capacity cognitive development cognitive enhancement cognitive process cognitive reappraisal cognitive skill cognitive training depressive symptoms efficacious treatment efficacy testing follow-up improved individualized medicine innovation mental state novel personalized medicine post intervention programs psychosocial reduce symptoms sex skill acquisition skills social social cognition standard care theories treatment as usual uptake

项目摘要

PROJECT SUMMARY Depression in youth is a recurrent and impairing disorder. Although some treatments have shown modest effects in children and adolescents [e.g., cognitive behavior therapy (CBT)], there remains a critical need to improve upon these therapies in order to reach even more youths with depression. One variable hypothesized to affect children’s interpersonal relationships, as well as how well they learn the skills taught in CBT, is their level of social cognitive development on abilities particularly relevant to social functioning and to CBT (e.g., social perspective taking, theory of mind). The first phase (R61) of the proposed project will test whether a novel intervention that aims to increase children’s social cognitive (SC) abilities (the “target”) will improve children’s SC skills, and also their uptake of the strategies taught in CBT (e.g., cognitive reappraisal), with the goal of reducing levels of depression. Youths (ages 12-17; N=42) with depression diagnoses or clinical levels of depressive symptoms (CESD ≥ 20) and a deficit in the targeted SC skills will be randomly assigned to either the social cognitive training enhanced CBT (SCT-CBT) or to a usual care (UC) comparison condition. Pre- and post- treatment evaluations will assess the target (e.g., social cognitions) and depression. “Target” engagement will be defined as a medium effect size (≥.40) in the comparison of SCT-CBT vs. UC on the target SC measure at post-test, controlling for pre-test level of SC. We also will assess the target after sessions 3 and 6 to examine dose (i.e., at what point the target is reached). In the second phase (R33), we will conduct a replication trial with a new sample of 82 youths (ages 12-17) again randomized to either SCT-CBT or usual care. Youth will be evaluated with regard to the target SC abilities, as well as their knowledge of CBT skills, level of depressive symptoms, and social functioning at baseline and post-intervention (R61 and R33), and at a 4-month follow-up (R33). All analyses will control for age, sex, and IQ. Finally, in the R33 we will test for mediation – that increases in SC abilities partially account for the relation between Condition (SCT-CBT vs. UC) and decreases in depressive symptoms, and also between Condition and increases in CBT skills. If the SCT-CBT intervention significantly improves children’s SC abilities, increases their capacity to uptake CBT strategies, decreases their depressive symptoms, and improves their social functioning, then this will provide therapists with a more efficient and personalized treatment of depression, and thereby substantially improve clinical care.

项目摘要年轻人的抑郁症是一种复发和损害障碍。尽管某些治疗方法显示出适度的效果在儿童和青少年[ 采用这些疗法，以吸引更多抑郁症的年轻人。一个假设影响的变量儿童的人际关系，以及他们在CBT中学习技能的了解如何关于能力的社会认知发展与社会功能和CBT特别相关（例如，社会视角采取思想理论）。拟议项目的第一阶段（R61）将测试是否新颖旨在提高儿童社会认知能力（SC）能力（“目标”）的干预措施将改善儿童 SC技能，以及他们对CBT（例如认知重新评估）教授的策略的吸收，目的是降低抑郁水平。年轻人（12-17岁； n = 42），具有抑郁诊断或临床水平抑郁症状（CESD≥20）和目标SC技能中的防御将随机分配给社会认知训练增强了CBT（SCT-CBT）或通常的护理（UC）比较条件。前后治疗评估将评估目标（例如社会认知）和抑郁症。 “目标”参与将在SCT-CBT与目标SC测量的SCT-CBT与UC的比较中，被定义为中等效应大小（≥.40）测试后，控制SC的测试前水平。我们还将在第3和第6届会议后评估目标剂量（即，到达目标的时间）。在第二阶段（R33），我们将与再次将82名年轻人（12-17岁）的新样本随机分配给SCT-CBT或通常的护理。青年会对目标SC的能力以及他们对CBT技能的了解，抑郁水平进行了评估症状和干预后（R61和R33）的症状以及社交功能，以及4个月的随访（R33）。所有分析都将控制年龄，性别和智商。最后，在R33中，我们将测试调解 - 这增加了在SC的能力中，部分解释了状况（SCT-CBT与UC）之间的关系，并减少抑郁症症状，以及状况和CBT技能的提高之间。如果SCT-CBT干预显着提高儿童的SC能力，提高其吸收CBT策略的能力，减轻他们的抑郁症症状并改善其社交功能，然后将为治疗师提供更有效和更有效的个性化抑郁症治疗，从而大大改善临床护理。