The proposed project is a clinical trial of three different psychotherapeutic interventions for adolescent suicide attempters with RDC major depression. One hundred twenty (120) nonpsychotic, non-bipolar depressed suicide attempters aged 13-18, will be randomly assigned to one of three treatments: (1) cognitive-behavioral therapy (CBI); (2) systemic-behavioral family therapy (SBFT); or (3) non-directive supportive therapy. Treatment will be 12-16 sessions in length to be delivered over a 12 week period, and will be monitored for integrity with the therapeutic model through intensive training and supervision, use of therapy manual, and monitoring a rating of videotaped sessions.
The aims of the study are to test the following hypotheses: (1) Patients treated with CBT and SBFR relative to patients treated with NST will show greater improvements in the prevalence and severity of depression and suicidality and in social competence, (2) At 3, 6, 9, and 12 month follow-up, CBT- and SBFr-treated patients will continue to show decreased prevalence and severity of depression and suicidality and superior social competency compared to NST-treated patients. Those factors predictive of responses to CBT vs. SBFR will also be explored.
|Dietz, Laura J; Marshal, Michael P; Burton, Chad M et al. (2014) Social problem solving among depressed adolescents is enhanced by structured psychotherapies. J Consult Clin Psychol 82:202-11|
|Bridge, Jeffrey A; Barbe, Remy P; Birmaher, Boris et al. (2005) Emergent suicidality in a clinical psychotherapy trial for adolescent depression. Am J Psychiatry 162:2173-5|
|Barbe, Remy P; Bridge, Jeffrey; Birmaher, Boris et al. (2004) Suicidality and its relationship to treatment outcome in depressed adolescents. Suicide Life Threat Behav 34:44-55|
|Gaynor, Scott T; Weersing, V Robin; Kolko, David J et al. (2003) The prevalence and impact of large sudden improvements during adolescent therapy for depression: a comparison across cognitive-behavioral, family, and supportive therapy. J Consult Clin Psychol 71:386-93|
|Brent, D A; Birmaher, B; Kolko, D et al. (2001) Subsyndromal depression in adolescents after a brief psychotherapy trial: course and outcome. J Affect Disord 63:51-8|
|Brent, D A (2001) Firearms and suicide. Ann N Y Acad Sci 932:225-39; discussion; 239-40|
|Stein, D; Brent, D A; Bridge, J et al. (2001) Predictors of parent-rated credibility in a clinical psychotherapy trial for adolescent depression. J Psychother Pract Res 10:1-7|
|Brent, D A (2001) Assessment and treatment of the youthful suicidal patient. Ann N Y Acad Sci 932:106-28; discussion 128-31|
|Brent, D A; Baugher, M; Birmaher, B et al. (2000) Compliance with recommendations to remove firearms in families participating in a clinical trial for adolescent depression. J Am Acad Child Adolesc Psychiatry 39:1220-6|
|Birmaher, B; Brent, D A; Kolko, D et al. (2000) Clinical outcome after short-term psychotherapy for adolescents with major depressive disorder. Arch Gen Psychiatry 57:29-36|
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