The impact of perceived interpersonal functioning on treatment for adolescent depression: IPT-A versus treatment as usual in school-based health clinics.

Abstract

Objective This study examined aspects of depressed adolescents' perceived interpersonal functioning as moderators of response to treatment among adolescents treated with interpersonal psychotherapy for depressed adolescents (IPT-A) or treatment as usual (TAU) in school-based health clinics. Method Participants were 63 adolescents (ages 12-18) participating in a clinical trial examining the effectiveness of IPT-A (Mufson, Dorta, Wickramaratne, et al., 2004). The sample consisted of 53 (84.1%) female and 10 (15.9%) male adolescents (mean age = 14.67). Adolescents were 74.6% Latino, 14.3% African American, 1.6% Asian American, and 9.5% other, and they came primarily from low-income families. Adolescents were randomly assigned to receive IPT-A or TAU delivered by school-based mental health clinicians. Assessments were completed at baseline and weeks 4, 8, and 12 (or at early termination) and included the HRSD, CBQ-20, and SAS-SR. Results Multilevel modeling indicated that treatment condition interacted with adolescents' baseline reports of conflict with their mothers and social dysfunction with friends to predict the trajectory of adolescents' depressive symptoms over the course of treatment, controlling for baseline levels of depression. The benefits of IPT-A over TAU were particularly strong for the adolescents who reported high levels of conflict with their mothers and social dysfunction with friends. Conclusions Replication with larger samples would suggest that IPT-A may be particularly helpful for depressed adolescents who are reporting high levels of conflict with their mothers or interpersonal difficulties with friends.

Excess weight gain prevention in adolescents: Three-year outcome following a randomized controlled trial.

“…Our findings may be only generalizable to adolescent girls who are above-average weight, but not severely obese, with reported LOC eating, and without clinically significant psychological disorders. In addition, our post-hoc analyses, although based on theory (Weissman et al, 2000) and prior data (Gunlicks-Stoessel, Mufson, Jekal, & Turner, 2010; Young, Gallop, & Mufson, 2009; Young, Mufson, & Davies, 2006b), were added after the initiation of the study and thus should be considered a limitation. Future studies are needed to determine whether reported social-adjustment problems, anxiety and/or LOC eating are required for IPT to exert beneficial weight outcomes.…”

“…We hypothesized that over a 3-year follow-up, adolescent girls randomized to IPT would experience greater age-adjusted BMI (BMIz) loss and less adiposity gain (unadjusted gain is expected in growing youth who are not obese) than girls who received HE. Further, data from adolescent depression trials have demonstrated that baseline social-adjustment problems and anxiety moderate outcome, such that those with more problems experience greater reductions in depression following IPT compared to standard of care (Gunlicks-Stoessel, Mufson, Jekal, & Turner, 2010; Young, Gallop, & Mufson, 2009; Young, Mufson, & Davies, 2006b). Such findings are consistent with interpersonal theory (Weissman et al, 2000).…”

Evidence Base Update of Psychosocial Treatments for Child and Adolescent Depression

“…As noted in Table 7, poor social functioning and heightened family conflict predicted poor response across both IPT and control; however, these variables also operated as moderators. The positive effect of IPT (relative to TAU within the school setting) was particularly strong for adolescents who reported at baseline higher levels of conflict with their mothers and more difficulties in their peer relationships (Gunlicks-Stoessel et al, 2010), providing indirect support for a compensation model of IPT response.…”

Mechanisms of change in interpersonal therapy (IPT)

“…Studies have examined the moderating effects of EE on cognitive behavior therapy (Chambless & Steketee, 1999), but not on IPT. Interestingly, a recent study of IPT for adolescents found IPT more efficacious for teens who at baseline had a prominent conflict with a parent (Gunlicks-Stoessel, Mufson, Jekal, & Turner, 2010), raising the possibility that lowering EE may lead to improvement.…”