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Gepubliceerd in: Research on Child and Adolescent Psychopathology 12/2019

18-05-2019

Latent Profiles of Cognitive and Interpersonal Risk Factors for Adolescent Depression and Implications for Personalized Treatment

Auteurs: Meredith Gunlicks-Stoessel, Dikla Eckshtain, Susanne Lee, Kristina Reigstad, Laura Mufson, John Weisz

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 12/2019

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Abstract

A personalized approach to treatment with patients being matched to the best-fit treatment has been proposed as one possible solution to the currently modest treatment response rates for adolescent depression. Personalized treatment involves identifying and characterizing subgroups likely to respond differently to different treatments. We investigated the feasibility of this approach, by focusing on two key risk factors that are the purported treatment targets of cognitive behavioral therapy (CBT) and interpersonal psychotherapy for depressed adolescents (IPT-A): negative unrealistic cognitions and interpersonal relationship difficulties, respectively. We sought to learn whether subgroups high and low on the two risk factors, respectively, might be identified in a large sample of depressed, treatment-seeking adolescents. Latent class analysis (LCA) was conducted on measures of the two risk factors among 431 adolescents (age 12–17) in the Treatment for Adolescents with Depression Study. LCA identified three classes: (1) adolescents with high levels of problems in both family relationships and cognitions (21.6% of sample), (2) adolescents with moderate levels of problems in both domains (52.4%), and (3) adolescents with low levels of problems in both domains (26.0%). These subgroups did not predict treatment outcome with CBT or CBT + fluoxetine (COMB). The results challenge a current assumption about how treatments could be personalized, and they support a multi-causal model of depression rather than a risk-factor-specific model. Strategies other than risk factor-based personalizing for case assignment to CBT vs. IPT-A are discussed.
Voetnoten
1
Mixed models including race and SES in addition to age and gender as covariates yielded similar results. Because of the smaller sample size from missing data in race and SES, results using only age and gender as covariates are reported.
 
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Metagegevens
Titel
Latent Profiles of Cognitive and Interpersonal Risk Factors for Adolescent Depression and Implications for Personalized Treatment
Auteurs
Meredith Gunlicks-Stoessel
Dikla Eckshtain
Susanne Lee
Kristina Reigstad
Laura Mufson
John Weisz
Publicatiedatum
18-05-2019
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 12/2019
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-019-00552-3