Trajectories of change in general psychopathology levels among depressed adolescents in short-term psychotherapies

Fiorini, Guilherme Pacheco; Fonagy, Peter; Midgley, Nick

doi:10.1080/10503307.2022.2040751

Cited by 12 publications

(11 citation statements)

References 31 publications

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“…We found that children whose families were randomized to the FCU showed steeper declines in the p factor from ages 2–4 than did controls, which predicted lower levels of the p factor at age 7.5, which in turn predicted lower levels of adolescents’ p factor and polydrug use. Results are consistent with prior intervention studies that similarly found that following psychosocial treatments for depression, adolescents showed declines in the p factor (Aitken et al, 2020; Constantinou et al, 2019; Fiorini et al, 2022). Thus, the early childhood FCU improved myriad problematic outcomes into adolescence by decreasing risk for co-occurring externalizing and internalizing problems represented by the p factor across childhood.…”

Section: Discussionsupporting

confidence: 89%

“…Several prior studies have examined the effects of psychosocial treatments on growth patterns of the p and specific factors. For example, two studies showed that following psychosocial treatment of depression in an adolescent clinical sample, participants in every treatment condition showed reductions in the p factor, and these reductions were more consistent than decreases in specific forms of psychopathology (Aitken et al, 2020; Fiorini et al, 2022). Another study examined growth in bifactor model factors from ages 11 to 18 over a psychosocial intervention and found that, following treatment, the p factor decreased over time and within-person (Constantinou et al, 2019).…”

Section: Co-occurring Internalizing and Externalizing Problems And Th...mentioning

confidence: 99%

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The role of early intervention for adolescent mental health and polydrug use: Cascading mediation through childhood growth in the general psychopathology (p) factor.

Tein¹,

Wang²,

Oro³

et al. 2023

Developmental Psychology

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This study is a secondary data analysis that extends knowledge about the effects of the early childhood Family Check-Up (FCU) intervention to trajectories of general psychopathology problems (p factor) across early and middle childhood, and effects on adolescent psychopathology and polydrug use. The Early Steps Multisite study (ClinicalTrials.gov Identifier NCT00538252) is a randomized controlled trial of the FCU and consists of a large, racially and ethnically diverse sample of children who grew up in low-income households in Pittsburgh, Pennsylvania; Eugene, Oregon; and Charlottesville, Virginia (n = 731; 49% female; 27.6% African American, 46.7% European American, 13.3% Hispanic/Latinx). To represent a comorbid presentation of internalizing and externalizing problems, we fit a bifactor model that included a general psychopathology (p) factor at eight ages in early childhood (ages 2–4), middle childhood (ages 7.5–10.5), and adolescence (age 14). Latent growth curve modeling was conducted to examine trajectories of the p factor across ages within the developmental periods of early and middle childhood. The effects of FCU on the reductions in growth in the childhood p factor had cascading effects on adolescent p factor (i.e., within-domain effect) and polydrug use (i.e., across-domain effect). Findings underscore the utility of the early FCU in preventing a host of maladaptive adolescent outcomes across diverse settings and populations.

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Section: Discussionsupporting

confidence: 89%

Section: Co-occurring Internalizing and Externalizing Problems And Th...mentioning

confidence: 99%

The role of early intervention for adolescent mental health and polydrug use: Cascading mediation through childhood growth in the general psychopathology (p) factor.

Tein¹,

Wang²,

Oro³

et al. 2023

Developmental Psychology

View full text Add to dashboard Cite

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“…Hence, it contains variance from all psychopathology items of the measures included (examples of items are “I feel miserable or unhappy,” “I worry a lot of the time,” “I get mad easily,” “I talk or move to avoid bad luck”). More details about the measures used and the methodology to estimate the p factor in the IMPACT study are reported elsewhere (Aitken et al, 2020; Fiornini et al, n.d.). Research in clinic and community samples have supported the reliability and validity of the general psychopathology factor (Constantinou et al, 2019; Carragher et al, 2016; Haltigan et al, 2018; Patalay et al, 2015).…”

Section: Methodsmentioning

confidence: 99%

The alliance–outcome association in the treatment of adolescent depression.

Cirasola¹,

Midgley²,

Fonagy³

et al. 2021

Psychotherapy

Self Cite

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A growing body of research has consistently demonstrated a relationship between alliance and treatment outcomes in youth psychotherapy. However, past research often suffered methodological issues that prevented detailed investigation of temporal relationships between alliance and symptomatology. The current study explored the directions of effect between alliance and outcome by examining the associations between early alliance and subsequent outcome while controlling for patients' baseline severity and prior symptom change. It also examined potential moderators of this association. Data were drawn from the IMPACT study, a randomized controlled trial comparing cognitive-behavioural therapy (CBT) and short-term psychoanalytic psychotherapy (STPP) versus a brief psychosocial intervention (BPI) in the treatment of adolescent depression. Adolescents (N=224) and therapist (n=139) rated the alliance 6 weeks after randomization. Depression severity and overall psychopathology were assessed at baseline, 6, 12, 36, 52 and 86 weeks after randomization. Patients' age, gender, baseline depression severity, conduct disorder symptoms and treatment type were examined as potential moderators of the alliance-outcome association. Data were analysed using multilevel models. Findings suggested that higher early alliance ratings were associated with subsequent symptom reduction, even after controlling for prior symptom change and baseline severity.There was evidence that the strength of this association was strongest in CBT patients, weaker in STPP, and statistically indistinguishable from zero in BPI. These findings suggest that early therapeutic alliance with adolescents may influence subsequent outcome independent of prior symptom change and initial severity but that the effect of the alliance on outcome might vary across treatment types.

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“…The p factor was also shown to have strong links with common etiological risk factors, including physical, sexual abuse, and neglect (H. Green, McGinnity, Meltzer, Ford, & Goodman, 2005; J. G. Green et al, 2010). Further research has shown that p was better at describing treatment outcomes in young populations than more narrowly focused assessment tools (Fiorini et al, 2022). Even more interesting with respect to the present research is that researchers have also identified emotion dysregulation as an early developmental feature of p, that cuts across all disorders (Caspi et al, 2014;Deutz et al, 2019), which lends further support to the notion that emotion dysregulation is an important transdiagnostic mechanism in mental ill-health (Lukas et al, 2018).…”

Section: Study 2 -Emotion and Self-dysregulation Or Psychopathology?mentioning

confidence: 99%

Disentangling the developmental and conceptual links between emotion dysregulation, self-regulation and internalizing and externalizing difficulties in childhood: a longitudinal investigation

Moltrecht¹,

Patalay²,

Deighton³

et al. 2023

Preprint

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There is a close association between emotion regulation and mental ill-health but how they influence each other over time is unclear. The close association between the constructs also raises the question of how conceptually distinct or similar they are. We use data from the UK Millennium Cohort Study to investigate temporal and conceptual relationships between emotion regulation and mental health difficulties in childhood.Data from 16,859 children were analysed. The analytic sample included 48.85% female and 51.15% male participants. Ethnic representation was 82.3% White, 3.04% Mixed, 9.4% Asian, and 3.6% as Black or Black British. Study 1 used a cross-lagged model to assess bi-directional effects and temporal sequencing between internalizing and externalizing symptoms and emotion regulation at ages 3, 5, 7 years. We found cascading effects across all ages, whereby emotion dysregulation predicted later mental health difficulties, and externalizing symptoms predicted later emotion dysregulation. Study 2 used a hierarchical bi-factor model, which demonstrated a substantial overlap between the constructs during childhood, with the bi-factor explaining between .52 and .58 of the variance. We also tested the predictive utility of the included factors, of which the bifactor was the best predictor of self-harm and depression symptoms at age 14. Our findings demonstrate a significant overlap between emotion regulation and mental ill-health, which are intrinsically linked with no clear indication of which comes first. Further investigation of this relationship with more comprehensive measures is necessary to reliably inform intervention and prevention efforts.

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Trajectories of change in general psychopathology levels among depressed adolescents in short-term psychotherapies

Cited by 12 publications

References 31 publications

The role of early intervention for adolescent mental health and polydrug use: Cascading mediation through childhood growth in the general psychopathology (p) factor.

The role of early intervention for adolescent mental health and polydrug use: Cascading mediation through childhood growth in the general psychopathology (p) factor.

The alliance–outcome association in the treatment of adolescent depression.

Disentangling the developmental and conceptual links between emotion dysregulation, self-regulation and internalizing and externalizing difficulties in childhood: a longitudinal investigation

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