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Research on Child and Adolescent Psychopathology

Gepubliceerd in:

21-04-2023

Neural Predictors of Improvement With Cognitive Behavioral Therapy for Adolescents With Depression: An Examination of Reward Responsiveness and Emotion Regulation

Auteurs: Lindsay Dickey, Samantha Pegg, Emilia F. Cárdenas, Haley Green, Anh Dao, James Waxmonsky, Koraly Pérez-Edgar, Autumn Kujawa

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 8/2023

Abstract

Earlier depression onsets are associated with more debilitating courses and poorer life quality, highlighting the importance of effective early intervention. Many youths fail to improve with evidence-based treatments for depression, likely due in part to heterogeneity within the disorder. Multi-method assessment of individual differences in positive and negative emotion processing could improve predictions of treatment outcomes. The current study examined self-report and neurophysiological measures of reward responsiveness and emotion regulation as predictors of response to cognitive-behavioral therapy (CBT). Adolescents (14–18 years) with depression (N = 70) completed monetary reward and emotion regulation tasks while electroencephalogram (EEG) was recorded, and self-report measures of reward responsiveness, emotion regulation, and depressive symptoms at intake. Adolescents then completed a 16-session group CBT program, with depressive symptoms and clinician-rated improvement assessed across treatment. Lower reward positivity amplitudes, reflecting reduced neural reward responsiveness, predicted lower depressive symptoms with treatment. Larger late positive potential residuals during reappraisal, potentially reflecting difficulty with emotion regulation, predicted greater clinician-rated improvement. Self-report measures were not significant predictors. Results support the clinical utility of EEG measures, with impairments in positive and negative emotion processing predicting greater change with interventions that target these processes.

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When covarying current substance use disorder in our models, results remained consistent with primary analyses, showing RewP significantly predicted depressive symptom changes in both intent-to-treat and treatment completer models ps < .03, while reappraisal-related LPP predicted clinician-rated improvement for treatment completers p = .03.

We conducted three-level multilevel models to account for clustering within treatment groups. Differences between groups only accounted for a small amount of variance in outcomes and primary results were generally consistent with those presented in the manuscript (see Tables S2 and S3 in the Supplemental Information). As such, we opted to focus on the simpler regression models for the primary results presented here.

Dysphoric IAPS images: 2455, 2053, 2141, 2205, 2276, 2301, 2345, 2375, 2456, 2457, 2700, 2703, 2750, 2799, 2800, 2900, 3180, 3230, 3300, 3350, 6311, 9041, 9220, 9332, 9927.

Neutral IAPS images: 2200, 2190, 2210, 2215, 2221, 2480, 2493, 2512, 2516, 2570, 2840, 5500, 7000, 7002, 7009, 7010, 7020, 7025, 7035, 7050, 7080, 7100, 7150, 7170, 7217.

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Titel: Neural Predictors of Improvement With Cognitive Behavioral Therapy for Adolescents With Depression: An Examination of Reward Responsiveness and Emotion Regulation
Auteurs: Lindsay Dickey
Samantha Pegg
Emilia F. Cárdenas
Haley Green
Anh Dao
James Waxmonsky
Koraly Pérez-Edgar
Autumn Kujawa
Publicatiedatum: 21-04-2023
Uitgeverij: Springer US
Gepubliceerd in: Research on Child and Adolescent Psychopathology / Uitgave 8/2023
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI: https://doi.org/10.1007/s10802-023-01054-z

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