title: The role of readiness to change in response to treatment of adolescent depression.
abstract: The effect of readiness to change on treatment outcome was examined among 332 adolescents (46% male, 74% Caucasian), ages 12 through 17 years (M = 14.6, SD = 1.5), with major depressive disorder who were participating in the Treatment for Adolescents With Depression Study (TADS). TADS is a randomized clinical trial comparing the effectiveness of fluoxetine (an antidepressant medication), cognitive-behavioral therapy, their combination, and a pill placebo. An abbreviated Stages of Change Questionnaire was used to obtain 4 readiness to change scores: precontemplation, contemplation, action, and maintenance. The association between each readiness score and depression severity across 12 weeks of acute treatment for depression, as measured by the Children's Depression Rating Scale--Revised, was examined. Although treatment response was not moderated by any of the readiness scores, baseline action scores predicted outcome: Higher action scores were associated with better outcome regardless of treatment modality. Furthermore, treatment effects were mediated by change in action scores during the first 6 weeks of treatment, with increases in action scores related to greater improvement in depression. Assessing readiness to change may have implications for tailoring treatments for depressed adolescents.
authors.affiliation: Department of Psychology, University of Oregon, Eugene, OR 97403, USA. clewis@uoregon.edu
authors.forename: Cara C
authors.initials: CC
authors.lastname: Lewis
authors.forename: Anne D
authors.initials: AD
authors.lastname: Simons
authors.forename: Susan G
authors.initials: SG
authors.lastname: Silva
authors.forename: Paul
authors.initials: P
authors.lastname: Rohde
authors.forename: David M
authors.initials: DM
authors.lastname: Small
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Murakami
authors.forename: Robin R
authors.initials: RR
authors.lastname: High
authors.forename: John S
authors.initials: JS
authors.lastname: March
mesh_terms: D000293:Adolescent; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D002648:Child; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009042:Motivation; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine