Social problem-solving among adolescents treated for depression.
Studies suggest that deficits in social problem-solving may be associated with increased risk of depression and suicidality in children and adolescents. It is unclear, however, which specific dimensions of social problem-solving are related to depression and suicidality among youth. Moreover, rational problem-solving strategies and problem-solving motivation may moderate or predict change in depression and suicidality among children and adolescents receiving treatment. The effect of social problem-solving on acute treatment outcomes were explored in a randomized controlled trial of 439 clinically depressed adolescents enrolled in the Treatment for Adolescents with Depression Study (TADS). Measures included the Children's Depression Rating Scale-Revised (CDRS-R), the Suicidal Ideation Questionnaire--Grades 7-9 (SIQ-Jr), and the Social Problem-Solving Inventory-Revised (SPSI-R). A random coefficients regression model was conducted to examine main and interaction effects of treatment and SPSI-R subscale scores on outcomes during the 12-week acute treatment stage. Negative problem orientation, positive problem orientation, and avoidant problem-solving style were non-specific predictors of depression severity. In terms of suicidality, avoidant problem-solving style and impulsiveness/carelessness style were predictors, whereas negative problem orientation and positive problem orientation were moderators of treatment outcome. Implications of these findings, limitations, and directions for future research are discussed.
Becker-Weidman
Emily G
EG
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Abbott Hall, 710N. Lake Shore Drive, Chicago, IL 60611, USA. emilybw@gmail.com
Jacobs
Rachel H
RH
Reinecke
Mark A
MA
Silva
Susan G
SG
March
John S
JS
D000293:Adolescent; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D002648:Child; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012919:Social Behavior; D013405:Suicide; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine