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.
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
Emily G
EG
Becker-Weidman
Rachel H
RH
Jacobs
Mark A
MA
Reinecke
Susan G
SG
Silva
John S
JS
March
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