Social Cognitive Training to Enhance the Efficacy of CBT for Depression in Youth: A Developmental Approach

社会认知训练可增强 CBT 对青少年抑郁症的疗效：一种发展方法

• 批准号: 10019707
• 负责人: JUDY GARBER
• 金额: $ 43.84万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-04 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10019707
• 关键词: 17 year old; Adolescent; Affect; Aftercare; Age; Basic Science; Behavior; Belief; Child; Clinical; Cognitive; Cognitive Therapy; Depressed mood; Depressive disorder; Development; Developmental Course; Diagnosis; Disease; Dose; Early treatment; Emotional; Emotions; Evaluation; Goals; Impairment; Individual; Interpersonal Relations; Intervention; Judgment; Knowledge; Learning Skill; Link; Measures; Mediating; Mediation; Mental Depression; Mind; Participant; Perception; Phase; Psychotherapy; Public Health; Randomized; Randomized Controlled Trials; Readiness; Recurrence; Research Domain Criteria; Sampling; Services; Social Functioning; Social Processes; System; Testing; Therapeutic Intervention; Training; Youth; clinical care; cognitive ability; cognitive capacity; cognitive development; cognitive enhancement; cognitive process; cognitive reappraisal; cognitive skill; cognitive training; depressive symptoms; efficacious treatment; efficacy testing; follow-up; improved; individualized medicine; innovation; mental state; novel; personalized medicine; post intervention; programs; psychosocial; reduce symptoms; sex; skill acquisition; skills; social; social cognition; standard care; theories; treatment as usual; uptake

PROJECT SUMMARY Depression in youth is a recurrent and impairing disorder. Although some treatments have shown modest effects in children and adolescents [e.g., cognitive behavior therapy (CBT)], there remains a critical need to improve upon these therapies in order to reach even more youths with depression. One variable hypothesized to affect children’s interpersonal relationships, as well as how well they learn the skills taught in CBT, is their level of social cognitive development on abilities particularly relevant to social functioning and to CBT (e.g., social perspective taking, theory of mind). The first phase (R61) of the proposed project will test whether a novel intervention that aims to increase children’s social cognitive (SC) abilities (the “target”) will improve children’s SC skills, and also their uptake of the strategies taught in CBT (e.g., cognitive reappraisal), with the goal of reducing levels of depression. Youths (ages 12-17; N=42) with depression diagnoses or clinical levels of depressive symptoms (CESD ≥ 20) and a deficit in the targeted SC skills will be randomly assigned to either the social cognitive training enhanced CBT (SCT-CBT) or to a usual care (UC) comparison condition. Pre- and post- treatment evaluations will assess the target (e.g., social cognitions) and depression. “Target” engagement will be defined as a medium effect size (≥.40) in the comparison of SCT-CBT vs. UC on the target SC measure at post-test, controlling for pre-test level of SC. We also will assess the target after sessions 3 and 6 to examine dose (i.e., at what point the target is reached). In the second phase (R33), we will conduct a replication trial with a new sample of 82 youths (ages 12-17) again randomized to either SCT-CBT or usual care. Youth will be evaluated with regard to the target SC abilities, as well as their knowledge of CBT skills, level of depressive symptoms, and social functioning at baseline and post-intervention (R61 and R33), and at a 4-month follow-up (R33). All analyses will control for age, sex, and IQ. Finally, in the R33 we will test for mediation – that increases in SC abilities partially account for the relation between Condition (SCT-CBT vs. UC) and decreases in depressive symptoms, and also between Condition and increases in CBT skills. If the SCT-CBT intervention significantly improves children’s SC abilities, increases their capacity to uptake CBT strategies, decreases their depressive symptoms, and improves their social functioning, then this will provide therapists with a more efficient and personalized treatment of depression, and thereby substantially improve clinical care.

项目概要 青少年抑郁症是一种复发性、损害性的疾病。尽管一些治疗显示出有限的效果 在儿童和青少年中[例如认知行为疗法（CBT）]，仍然迫切需要改进 这些疗法旨在惠及更多患有抑郁症的青少年。假设影响一个变量 儿童的人际关系，以及他们学习 CBT 所教授技能的程度，是他们的水平 与社会功能和 CBT 特别相关的能力的社会认知发展（例如，社交 观点采择、心理理论）。拟议项目的第一阶段（R61）将测试是否有新颖的 旨在提高儿童社交认知（SC）能力（“目标”）的干预措施将改善儿童的 SC 技能，以及他们对 CBT 中教授的策略（例如认知重新评估）的采用，目标是 降低抑郁程度。诊断为抑郁症或临床水平为抑郁症的青少年（12-17 岁；N=42） 抑郁症状 (CESD ≥ 20) 和目标 SC 技能缺陷将被随机分配到 社会认知训练增强 CBT (SCT-CBT) 或与常规护理 (UC) 比较条件。前和后 治疗评估将评估目标（例如社会认知）和抑郁症。 “目标”参与度将 被定义为在目标 SC 测量上 SCT-CBT 与 UC 比较中的中等效应大小 (≥.40) 测试后，控制 SC 的测试前水平。我们还将在第 3 节和第 6 节之后评估目标以检查 剂量（即达到目标的时间点）。在第二阶段（R33），我们将进行复制试验 82 名青少年（12-17 岁）的新样本再次随机接受 SCT-CBT 或常规护理。青春将是 评估目标 SC 能力、CBT 技能知识、抑郁水平 基线和干预后（R61 和 R33）以及 4 个月随访时的症状和社会功能 （R33）。所有分析都将控制年龄、性别和智商。最后，在 R33 中，我们将测试中介——这会增加 SC 能力的提高部分解释了状况（SCT-CBT 与 UC）和抑郁程度降低之间的关系 症状，以及状况与 CBT 技能提高之间的关系。如果 SCT-CBT 干预显着 提高儿童的 SC 能力，提高他们采用 CBT 策略的能力，减少他们的抑郁 症状，并改善他们的社会功能，那么这将为治疗师提供更有效和更有效的治疗方法 抑郁症的个性化治疗，从而显着改善临床护理。