title: Components Analyses of a School-Based Cognitive Behavioral Treatment for Youth Depression.
abstract: The current study sought to build upon research on cognitive behavioral therapy (CBT) as the first-line treatment for depressed youth by investigating the effects of the various components of a CBT treatment on changes in depressive symptoms in young female participants. Female participants 9-14 years of age (n = 40; M age = 10.58 years) with a diagnosis of a depressive disorder from the CBT-only treatment condition of a larger randomized clinical trial were included in the current study. Participants engaged in a 20-session, 11-week, school-based CBT group intervention (ACTION Treatment; Stark et al., 2006). Depressive symptoms were assessed pre- and posttreatment, and intervention components were coded based on review of audio recordings of treatment sessions. Data were examined using two-level mixed-effects models using hierarchical linear modeling with full maximum likelihood estimation. Results indicated that higher quality behavioral intervention components were associated with greater improvement in posttreatment depression scores, higher quality cognitive intervention components were marginally associated with worsening posttreatment depression scores, and relational intervention components were not associated with depression outcome. Age significantly moderated the relationships between intervention components and depression outcome, with younger female participants benefiting most from higher quality behavioral and relational intervention components. These findings provide preliminary evidence about the differential impact of CBT components on depression treatment outcome for young female participants, with consideration of age as a moderator. This study highlights the importance of continuing to dismantle CBT treatment components for youth depression, as such findings can be used to design more potent, developmentally tailored interventions.
authors.affiliation: a Department of Psychology , Pace University.|b Division of Child and Adolescent Psychiatry , University of Maryland School of Medicine.
authors.forename: Prerna G
authors.initials: PG
authors.lastname: Arora
authors.affiliation: c Department of Psychology , Tulane University.
authors.forename: Courtney N
authors.initials: CN
authors.lastname: Baker
authors.affiliation: d Cambridge Health Alliance , Harvard Medical School.
authors.forename: Lauren Krumholz
authors.initials: LK
authors.lastname: Marchette
authors.affiliation: e Department of Educational Psychology , University of Texas Austin.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Stark
mesh_terms: D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012574:Schools / Q000592:standards*; D016896:Treatment Outcome