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Gepubliceerd in: Child Psychiatry & Human Development 5/2019

16-04-2019 | Original Article

Do Immediate Gains Predict Long-Term Symptom Change? Findings from a Randomized Trial of a Single-Session Intervention for Youth Anxiety and Depression

Auteurs: Jessica L. Schleider, Madelaine R. Abel, John R. Weisz

Gepubliceerd in: Child Psychiatry & Human Development | Uitgave 5/2019

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Abstract

Single-session interventions (SSIs) can help reduce youth psychopathology, but SSIs may benefit some youths more than others. Identifying predictors of SSIs’ effectiveness may clarify youths’ likelihoods of benefitting from an SSI alone, versus requiring further treatment. We tested whether pre-to-post-SSI shifts in hypothesized symptom change mechanisms predicted subsequent reductions in youth internalizing symptoms. Data were from a trial evaluating whether an SSI teaching growth mindset (the belief that personality is malleable) reduced youth anxiety and depression. Youths (N = 96, ages 12–15) self-reported growth mindsets, perceived primary control, and perceived secondary control pre- and immediately post-intervention. They self-reported depression and anxiety symptoms at pre-intervention and 3, 6, and 9-month follow-ups. Larger immediate increases in primary control predicted steeper depressive symptoms declines across the follow-up; larger immediate increases in secondary control predicted steeper anxiety symptoms declines. Immediate shifts in proximal intervention “targets” may predict longer-term response to an SSI for youth internalizing distress.

Clinical Trials

Clinicaltrials.gov registration: NCT03132298.
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Voetnoten
1
In addition to youth-reported outcomes, parent-reported youth symptom trajectories were also collected as part of this study (see [22], which reports intervention effects on all youth- and parent-report study outcomes across the follow-up period). For the purposes of this study, we focused on youth-reported symptom trajectories only. All three hypothesized predictors (youths’ perceived primary control, perceived secondary control, and mindsets regarding personality) were subjective, youth-report constructs. Further, correlations between youth-reported predictors and parent-reported youth symptoms were small and inconsistently significant across the follow-up period. Thus, we did not expect immediate shifts in these variables to predict parents’ perceptions of youth symptom trajectories. Our focus on youth-reported symptom trajectories fits with prior recommendations to give preference to youth-reports for internalizing conditions, which are regarded as more evident and accessible to youths themselves than to their parents [26]. For completeness, Supplemental Table 1 includes tables reporting full results of mixed effects linear models testing the effects of all three study predictors (immediate improvements youth perceived primary control, perceived secondary control, and growth mindset) on parent-reported youth anxiety and depressive symptom trajectories. As expected, none of these predictors showed significant links to changes in parent-reported youth symptoms across the study period.
 
2
Both interventions took 25–30 min to complete, on average. To assess the intervention’ similarity on dimensions independent of their messages, youths rated (on a 1–5 scale) how much they understood the intervention’s content; tried their hardest on activities; and the degree to which they found the program interesting at the post-intervention assessment. No differences emerged by condition in youths’ content comprehension, t(94) = 0.35, p = 0.72, interest in material, t(94) = 1.14, p = 0.14, or effort on activities, t(94) = 0.90, p = 0.37.
 
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Metagegevens
Titel
Do Immediate Gains Predict Long-Term Symptom Change? Findings from a Randomized Trial of a Single-Session Intervention for Youth Anxiety and Depression
Auteurs
Jessica L. Schleider
Madelaine R. Abel
John R. Weisz
Publicatiedatum
16-04-2019
Uitgeverij
Springer US
Gepubliceerd in
Child Psychiatry & Human Development / Uitgave 5/2019
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI
https://doi.org/10.1007/s10578-019-00889-2

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