Het effect van de volgorden van CGT-componenten en de modererende rol van ernst in het verminderen van depressieve symptomen bij adolescenten

Abstract

Depression is one of the most common psychiatric problems in adolescence. Cognitive behavioral therapy (CBT) is an effective therapy in the prevention of adolescents with depressive symptoms. Within CBT, the most commonly used components are cognitive restructuring (CR), behavioral activation (BA), problem-solving (PS), and relaxation (RE). A recent study showed that the sequence of these elements is not relevant for the effect of CBT on depressive symptoms in adolescents in the context of indicated prevention. The present study investigated whether the effect of the sequence of the components is moderated by severity of the depressive symptoms (severe versus light) in adolescence after six months. It was expected that adolescents with severe depressive symptoms (0-2 symptoms) may benefit most from condition 1 (CR-BA-RE-PS) and condition 2 (BA-CR-RE-PS) and less from condition 3 (PS-BA-CR-RE) and condition 4 (RE-PS-BA-CR) and adolescents with light depressive symptoms (3-9 symptoms) may benefit most from condition 3 (PS-BA-CR-RE) and less from the other three conditions. A total of 158 participating adolescents (aged 12 to 18 years) with subclinical depressive symptoms were randomized across the four conditions. The hypotheses were examined by the PROCESS-macro analysis. Results showed that it does not matter whether the adolescent has light or severe depressive symptoms for the effect of the sequence of the CBT elements in indicated prevention. Follow-up research with a different severity operationalization, effects over time, a larger, generalizable and heterogeneous group and possibly other moderators is recommended.