Effects of a brief ED-based alcohol and violence intervention on depressive symptoms

Abstract

Objective Depressive symptoms frequently co-exist in adolescents with alcohol use and peer violence. This paper’s purpose was to examine the secondary effects of a brief alcohol-and-violence-focused ED intervention on depressive symptoms. Method Adolescents (ages 14–18) presenting to an ED for any reason, reporting past year alcohol use and aggression, were enrolled in a randomized control trial (control, therapist-delivered brief intervention [TBI], or computer-delivered brief intervention [CBI]). Depressive symptoms were measured at baseline, 3, 6, and 12 months using a modified 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Poisson regression was used (adjusting for baseline age, gender, and depressive symptoms) to compare depressive symptoms at follow-up. Results Among 659 participants, higher baseline depressive symptoms, female gender, and age >16 were associated with higher depressive symptoms over time. At 3 months, CBI and TBI groups had significantly lower CESD-10 scores than the control group; at 6 months, intervention and control groups did not differ; at 12 months, only CBI had a significantly lower CESD-10 score than control. Conclusions A single-session brief ED-based intervention focused on alcohol use and violence also reduces depressive symptoms among at-risk youth. Findings also point to the potential efficacy of using technology in future depression interventions.

Future Directions in Single-Session Youth Mental Health Interventions

“…Indeed, these trials suggest the promise of at least two web-based SSIs, and at least one therapistdelivered SSI, for reducing depressive symptoms in adolescents 4-to 12-months later (Ranney et al, 2017;. It is also notable that no new trials have included SSIs explicitly targeting externalizing youth problems, although one new trial suggested that a growth mindset SSI failed to reduce adolescent conduct problems .…”

“…In fact, SSIs have been frequently evaluated in nontraditional settings for mental health treatment delivery, including primary care, emergency rooms, schools, and community centers (Schleider & Weisz, 2017), rendering them accessible to many more youths than those who access specialty mental health care. Likewise, selfadministered, web-based SSIs allow individuals to access therapeutic tools anywhere at any time, further increasing their adaptability (Cardamone-Breen et al, 2018;Ranney et al, 2017;. Future possibilities for optimizing this potential include personalizing web-based SSIs as "just-intime" interventions or matching youths to targeted SSIs based on symptom profiles.…”

Future Directions in Single-Session Youth Mental Health Interventions

“…Authors observed no significant reductions in adolescent depressive symptoms at a 3-month follow-up, versus a waitlist control (ds = 0.12 per youth report, -0.04 per parent report) (Cardamone-Breen et al, 2018). A separate study evaluated whether a computerized, 30-40 minute SSI using motivational interviewing techniques could reduce depressive symptoms at 3, 6, and 12-month follow-ups among adolescents presenting to an emergency department (Ranney et al, 2017). SSI-group adolescents reported lower depressive symptoms at 3 and 12 month follow-ups (d = 0.19 at 3 months) but not 6-month follow-up (d = 0.08), versus youths who received a list of local resources.…”

“…Indeed, these trials suggest the promise of at least two web-based SSIs, and at least one therapistdelivered SSI, for reducing depressive symptoms in adolescents 4-to 12-months later (Ranney et al, 2017;Schleider & Weisz, 2018;. It is also notable that no new trials have included SSIs explicitly targeting externalizing youth problems, although one new trial suggested that a growth mindset SSI failed to reduce adolescent conduct problems .…”

“…In fact, SSIs have been frequently evaluated in nontraditional settings for mental health treatment delivery, including primary care, emergency rooms, schools, and community centers (Schleider & Weisz, 2017), rendering them accessible to many more youths than those who access specialty mental health care. Likewise, selfadministered, web-based SSIs allow individuals to access therapeutic tools anywhere at any time, further increasing their adaptability (Cardamone-Breen et al, 2018;Ranney et al, 2017;Schleider & Weisz, 2018). Future possibilities for optimizing this potential include personalizing web-based SSIs as "just-intime" interventions or matching youths to targeted SSIs based on symptom profiles.…”