title: A pilot study of depressed adolescents' cortisol patterns during parent-adolescent conflict and response to interpersonal psychotherapy (IPT-A).
abstract: BACKGROUND
  This study examined functioning of the Hypothalamic Pituitary Adrenal (HPA) axis, a neurobiological stress system centrally implicated in depression, as a predictor of treatment response to Interpersonal Psychotherapy for Depressed Adolescents (IPT-A; Mufson et al., 2004. Interpersonal psychotherapy for depressed adolescents. (second ed.). New York, Guilford Press).
  
  
  METHODS
  The sample consisted of fifteen depressed adolescents (age 12-17; mean age=15.2; 86.7% female) experiencing high levels of conflict with their parents who were recruited to participate in a pilot study of individual IPT-A and IPT-A delivered with greater and more structured involvement of parents. Adolescents came primarily from low-income Latino (93.3%) families. Prior to treatment, adolescents participated in a 15 min conflict negotiation task with their parents in which salivary cortisol was collected prior to and 10, 20, and 30 min post-conflict. Adolescents' depression symptoms were assessed pre-treatment and post-treatment (week 16) using the Children's Depression Rating Scale (CDRS-R).
  
  
  RESULTS
  Higher levels of cortisol 30 min after the conflict task were associated with greater improvement in depression symptoms with IPT-A, controlling for baseline levels of depression.
  
  
  CONCLUSIONS
  The study has a small sample size.
  
  
  CONCLUSIONS
  This is the first study to examine HPA functioning as a predictor of depressed adolescents' response to a psychotherapeutic intervention. If replicated with larger samples, these results have important implications for advancing the use of neurobiological markers to personalize psychotherapeutic interventions for depressed adolescents.
authors.affiliation: Department of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, New York, NY, USA. mgunlick@umn.edu
authors.forename: Meredith
authors.initials: M
authors.lastname: Gunlicks-Stoessel
authors.forename: Laura
authors.initials: L
authors.lastname: Mufson
authors.forename: Kathryn R
authors.initials: KR
authors.lastname: Cullen
authors.forename: Bonnie
authors.initials: B
authors.lastname: Klimes-Dougan
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D003865:Major Depressive Disorder / Q000378:metabolism* / Q000628:therapy; D054541:Family Conflict; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D008297:Male; D009518:New York; D010287:Parent-Child Relations; D010865:Pilot Projects; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D011613:Psychotherapy / Q000379:methods; D012463:Saliva / Q000737:chemistry / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D006854:Hydrocortisone
keywords: Adolescent; Depressive disorder; Hydrocortisone; Psychotherapy; Treatment outcome