Depressiepreventie bij adolescenten: Wat maakt dat Cognitieve Gedragstherapie werkt? De mediërende rol van cognitieve fouten en betrokkenheid bij activiteiten binnen Cognitieve Gedragstherapie
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Background. Depression is one of the most prevalent disorders among adolescents. Cognitive Behavioral Therapy (CBT) is one of the most effective forms of therapy in preventing depression. Even though CBT has proven to be effective in preventing and treating (subclinical) depression in adolescents, less is known about the way it works. The STARr-project is a preventive programme for adolescents based on the CBT-components, focused on reducing depressive symptoms. STARr also studies the effectiveness of the CBT-components (cognitive restructuring, behavioral activation, problem solving and relaxation) (Van den Heuvel et al., under review). The current study is part of the STAr researchproject. Aim. The current study was aimed at providing insight into the working mechanisms of CBT. Including possible mediators in a study can increase successful prevention. Professionals can then focus their practice on these parts that prove to provide change in depressive symptoms, for more treatment success. This study relates to the STARr project by investigating these proposed mediators from Van den Heuvel et al. Namely cognitive errors (for cognitive restructuring) and involvement in activities (for behavioral activation), and whether they are unique to these components. Methods. The sample consisted of adolescents aged 11 to 18 (M=13.83, 55.9% girls) which all participated in the STARr-prevention program for depression (N=222). Participants were randomly assigned to a condition, which all started with a different CBT-component. Depressive symptoms (CDI-2), cognitive errors (CNCEQ-R) and involvement in activities (BADS) were all measured before the start and after completing one component. The data was analyzed with PROCESS. Results. No mediation effects were found. However, results suggest that a change in cognitive errors and a change in involvement in activities are both predictors for a change in depressive symptoms, independently from the type of component that was used as the independent variable. Conclusions. More research is needed to gain insight in what are the active mechanisms of CBT (Van den Heuvel et al., under review; Shirk et al., 2013). Future research should study the exact role and position of the discussed mediators within CBT.