title: Feasibility and Preliminary Efficacy of a Novel RDoC-Based Treatment Program for Adolescent Depression: "Training for Awareness Resilience and Action" (TARA)-A Pilot Study.
abstract: BACKGROUND
  The novel group treatment program Training for Awareness, Resilience, and Action (TARA) was developed to target specific mechanisms based on neuroscience findings in adolescent depression and framed within the National Institute of Mental Health Research Domain Criteria. TARA contains training of autonomic and emotional self-regulation, interoceptive awareness, relational skills, and value-based committed action.
  
  
  METHODS
  We performed a single-arm trial to test the feasibility and preliminary efficacy of TARA in reducing depression and anxiety levels and assessed whether the specific targeted domains of function reflected the hypothesized symptom change. Twenty-six adolescents (14-18 years old, 7 males and 19 females) participated in the 12-week group program. Assessment was performed before (T0), immediately after (T1), and 3 months after the end of TARA (T2).
  
  
  RESULTS
  Significant improvement was seen in depression symptoms (Reynolds Adolescent Depression Scale Second Edition) between T0-T1 (t-value = -3.56,p= 0.002, CI = -6.64, -1.77) and T0-T2 (t-value = -4.17,p< 0.001, CI = -11.20, -3.75) and anxiety symptoms (Multidimensional Anxiety Scale for Children) between T0-T1 (t-value = -2.26,p= 0.033, CI = -4.61, -0.21) and T0-T2 (t-value = -3.06,p= 0.006, 95% confidence interval = -9.02, -1.73). Significant improvements in psychological flexibility, sleep, and mindfulness skills were also found between T0 and T2.
  
  
  CONCLUSIONS
  The sample size was small without a control condition. The pilot design did not allow for testing the hypothesized brain changes and effect of TARA on relevant systemic biomarkers.
  
  
  CONCLUSIONS
  TARA is feasible in a sample of clinically depressed and/or anxious adolescents and preliminary efficacy was demonstrated by reduced depression and anxiety symptoms. The specific symptom and behavioral outcomes corresponded well with the hypothesized mechanisms of change.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Sciences, Umeå Universitet, Umeå, Sweden; Department of Psychiatry, Division of Child and Adolescent Psychiatry, UCSF Weill Institute for Neurosciences, University of California San Francisco (UCSF), San Francisco, CA, USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Henje Blom
authors.affiliation: Department of Radiology, University of California San Francisco (UCSF) , San Francisco, CA , USA.
authors.forename: Olga
authors.initials: O
authors.lastname: Tymofiyeva
authors.affiliation: The Osher Center for Integrative Medicine, University of California San Francisco (UCSF) , San Francisco, CA , USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Chesney
authors.affiliation: Neurosciences Program, Department of Psychology, Stanford University , Stanford, CA , USA.
authors.forename: Tiffany C
authors.initials: TC
authors.lastname: Ho
authors.affiliation: The Osher Center for Integrative Medicine, University of California San Francisco (UCSF) , San Francisco, CA , USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Moran
authors.affiliation: Department of Psychiatry, Division of Child and Adolescent Psychiatry, UCSF Weill Institute for Neurosciences, University of California San Francisco (UCSF) , San Francisco, CA , USA.
authors.forename: Colm G
authors.initials: CG
authors.lastname: Connolly
authors.affiliation: Department of Human Development and Family Studies, Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA; Department of Family Medicine and Community Health, Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA.
authors.forename: Larissa G
authors.initials: LG
authors.lastname: Duncan
authors.affiliation: Neurosciences Program, Department of Psychology, Stanford University , Stanford, CA , USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Baldini
authors.affiliation: The Osher Center for Integrative Medicine, University of California San Francisco (UCSF) , San Francisco, CA , USA.
authors.forename: Helen Y
authors.initials: HY
authors.lastname: Weng
authors.affiliation: The Osher Center for Integrative Medicine, University of California San Francisco (UCSF) , San Francisco, CA , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Acree
authors.affiliation: The Osher Center for Integrative Medicine, University of California San Francisco (UCSF) , San Francisco, CA , USA.
authors.forename: Veronica
authors.initials: V
authors.lastname: Goldman
authors.affiliation: The Osher Center for Integrative Medicine, University of California San Francisco (UCSF) , San Francisco, CA , USA.
authors.forename: Frederick M
authors.initials: FM
authors.lastname: Hecht
authors.affiliation: Department of Psychiatry, Division of Child and Adolescent Psychiatry, UCSF Weill Institute for Neurosciences, University of California San Francisco (UCSF) , San Francisco, CA , USA.
authors.forename: Tony T
authors.initials: TT
authors.lastname: Yang
keywords: Research Domain Criteria (RDoC); adolescent depression; autonomic regulation; emotion regulation; mindfulness-based; non-pharmacological; novel treatment development; yoga-based