Early indicators of response to transdiagnostic treatment of pediatric anxiety and depression / Michelle ROZENMAN ; Araceli GONZALEZ ; David A. BRENT ; Giovanna PORTA ; Frances L. LYNCH ; John F. DICKERSON ; V. Robin WEERSING in Journal of Child Psychology and Psychiatry, 64-12 (December 2023)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 64-12 (December 2023) . - p.1689-1698 Titre : Early indicators of response to transdiagnostic treatment of pediatric anxiety and depression Type de document : Texte imprimé et/ou numérique Auteurs : Michelle ROZENMAN, Auteur ; Araceli GONZALEZ, Auteur ; David A. BRENT, Auteur ; Giovanna PORTA, Auteur ; Frances L. LYNCH, Auteur ; John F. DICKERSON, Auteur ; V. Robin WEERSING, Auteur Article en page(s) : p.1689-1698 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Background Pediatric anxiety and depression are prevalent, impairing, and highly comorbid. Available evidence-based treatments have an average response rate of 60%. One path to increasing response may be to identify likely non-responders midway through treatment to adjust course prior to completing an episode of care. The aims of this study, thus, were to identify predictors of post-intervention response assessing (a) mid-treatment symptom severity, (b) session-by-session treatment process factors, and (c) a model optimizing the combination of these. Method Data were drawn from the treatment arm (N=95, ages 8-16) of a randomized transdiagnostic intervention trial (Msessions=11.2). Mid-point measures of youth- and parent-reported anxiety and depression were collected, and therapists rated homework completion, youth and parent engagement, and youth therapeutic alliance at each session. Logistic regression was used to predict response on the Clinical Global Impression Improvement Scale (CGI-I ?2) rated by independent evaluators masked to treatment condition. Results Mid-point symptom measures were significant predictors of treatment response, as were therapist-ratings of youth and parent engagement, therapeutic alliance, and homework completion. Therapist ratings were significant when tested as mean ratings summing across the first eight sessions of treatment (all ps<.004) and at individual session points (all ps?<0.05). A combined prediction model included youth-reported anxiety, parent-reported depression, youth engagement at Session 2, and parent engagement at Session 8. This model correctly classified 76.5% of youth as non-responders and 91.3% as responders at post-treatment (Nagelkerke R2=.59, ?2 (4, 80)=46.54, p<.001). Conclusion This study provides initial evidence that response to transdiagnostic intervention for pediatric anxiety and depression may be reliably predicted by mid-point. These data may serve as foundational evidence to develop adaptive treatment strategies to personalize intervention, correct treatment course, and optimize outcomes for youth with anxiety and depression. En ligne : https://doi.org/10.1111/jcpp.13881 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=517 [article] Early indicators of response to transdiagnostic treatment of pediatric anxiety and depression [Texte imprimé et/ou numérique] / Michelle ROZENMAN, Auteur ; Araceli GONZALEZ, Auteur ; David A. BRENT, Auteur ; Giovanna PORTA, Auteur ; Frances L. LYNCH, Auteur ; John F. DICKERSON, Auteur ; V. Robin WEERSING, Auteur . - p.1689-1698. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 64-12 (December 2023) . - p.1689-1698 Index. décimale : PER Périodiques Résumé : Background Pediatric anxiety and depression are prevalent, impairing, and highly comorbid. Available evidence-based treatments have an average response rate of 60%. One path to increasing response may be to identify likely non-responders midway through treatment to adjust course prior to completing an episode of care. The aims of this study, thus, were to identify predictors of post-intervention response assessing (a) mid-treatment symptom severity, (b) session-by-session treatment process factors, and (c) a model optimizing the combination of these. Method Data were drawn from the treatment arm (N=95, ages 8-16) of a randomized transdiagnostic intervention trial (Msessions=11.2). Mid-point measures of youth- and parent-reported anxiety and depression were collected, and therapists rated homework completion, youth and parent engagement, and youth therapeutic alliance at each session. Logistic regression was used to predict response on the Clinical Global Impression Improvement Scale (CGI-I ?2) rated by independent evaluators masked to treatment condition. Results Mid-point symptom measures were significant predictors of treatment response, as were therapist-ratings of youth and parent engagement, therapeutic alliance, and homework completion. Therapist ratings were significant when tested as mean ratings summing across the first eight sessions of treatment (all ps<.004) and at individual session points (all ps?<0.05). A combined prediction model included youth-reported anxiety, parent-reported depression, youth engagement at Session 2, and parent engagement at Session 8. This model correctly classified 76.5% of youth as non-responders and 91.3% as responders at post-treatment (Nagelkerke R2=.59, ?2 (4, 80)=46.54, p<.001). Conclusion This study provides initial evidence that response to transdiagnostic intervention for pediatric anxiety and depression may be reliably predicted by mid-point. These data may serve as foundational evidence to develop adaptive treatment strategies to personalize intervention, correct treatment course, and optimize outcomes for youth with anxiety and depression. En ligne : https://doi.org/10.1111/jcpp.13881 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=517

Testing the interpersonal theory of suicide in adolescents: A multi-wave longitudinal study / David PAGLIACCIO in Journal of Child Psychology and Psychiatry, 65-5 (May 2024)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 65-5 (May 2024) . - p.668-679 Titre : Testing the interpersonal theory of suicide in adolescents: A multi-wave longitudinal study Type de document : Texte imprimé et/ou numérique Auteurs : David PAGLIACCIO, Auteur ; Alma BITRAN, Auteur ; Jaclyn S. KIRSHENBAUM, Auteur ; Kira L. ALQUEZA, Auteur ; Katherine DURHAM, Auteur ; Lauren S. CHERNICK, Auteur ; Karla JOYCE, Auteur ; Ranqing LAN, Auteur ; Giovanna PORTA, Auteur ; David A. BRENT, Auteur ; Nicholas B. ALLEN, Auteur ; Randy P. AUERBACH, Auteur Article en page(s) : p.668-679 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Background Suicide is a major public health crisis among youth. Several prominent theories, including the Interpersonal Theory of Suicide (IPTS), aim to characterize the factors leading from suicide ideation to action. These theories are largely based on findings in adults and require testing and elaboration in adolescents. Methods Data were examined from high-risk 13-18-year-old adolescents (N = 167) participating in a multi-wave, longitudinal study; 63% of the sample exhibited current suicidal thoughts or recent behaviors (n = 105). The study included a 6-month follow-up period with clinical interviews and self-report measures at each of the four assessments as well as weekly smartphone-based assessments of suicidal thoughts and behaviors. Regression and structural equation models were used to probe hypotheses related to the core tenets of the IPTS. Results Feelings of perceived burdensomeness were associated with more severe self-reported suicidal ideation (b = 0.58, t(158) = 7.64, p < .001). Similarly, burdensomeness was associated with more frequent ideation based on weekly smartphone ratings (b = 0.11, t(1460) = 3.41, p < .001). Contrary to IPTS hypotheses, neither feelings of thwarted belongingness, nor interactions between burdensomeness and thwarted belongingness were significantly associated with ideation (ps > .05). Only elevated depression severity was associated with greater odds of suicide events (i.e., suicide attempts, psychiatric hospitalizations, and/or emergency department visits for suicide concerns) during the follow-up period (OR = 1.83, t(158) = 2.44, p = .01). No effect of acquired capability was found. Conclusions Perceptions of burdensomeness to others reflect a critical risk factor for suicidal ideation among high-risk adolescents. Null findings with other IPTS constructs may suggest a need to adopt more developmentally sensitive models or measures of interpersonal and acquired capability risk factors for youth. Refining methods and theoretical models of suicide risk may help improve the identification of high-risk cases and inform clinical intervention. En ligne : https://doi.org/10.1111/jcpp.13868 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=526 [article] Testing the interpersonal theory of suicide in adolescents: A multi-wave longitudinal study [Texte imprimé et/ou numérique] / David PAGLIACCIO, Auteur ; Alma BITRAN, Auteur ; Jaclyn S. KIRSHENBAUM, Auteur ; Kira L. ALQUEZA, Auteur ; Katherine DURHAM, Auteur ; Lauren S. CHERNICK, Auteur ; Karla JOYCE, Auteur ; Ranqing LAN, Auteur ; Giovanna PORTA, Auteur ; David A. BRENT, Auteur ; Nicholas B. ALLEN, Auteur ; Randy P. AUERBACH, Auteur . - p.668-679. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 65-5 (May 2024) . - p.668-679 Index. décimale : PER Périodiques Résumé : Background Suicide is a major public health crisis among youth. Several prominent theories, including the Interpersonal Theory of Suicide (IPTS), aim to characterize the factors leading from suicide ideation to action. These theories are largely based on findings in adults and require testing and elaboration in adolescents. Methods Data were examined from high-risk 13-18-year-old adolescents (N = 167) participating in a multi-wave, longitudinal study; 63% of the sample exhibited current suicidal thoughts or recent behaviors (n = 105). The study included a 6-month follow-up period with clinical interviews and self-report measures at each of the four assessments as well as weekly smartphone-based assessments of suicidal thoughts and behaviors. Regression and structural equation models were used to probe hypotheses related to the core tenets of the IPTS. Results Feelings of perceived burdensomeness were associated with more severe self-reported suicidal ideation (b = 0.58, t(158) = 7.64, p < .001). Similarly, burdensomeness was associated with more frequent ideation based on weekly smartphone ratings (b = 0.11, t(1460) = 3.41, p < .001). Contrary to IPTS hypotheses, neither feelings of thwarted belongingness, nor interactions between burdensomeness and thwarted belongingness were significantly associated with ideation (ps > .05). Only elevated depression severity was associated with greater odds of suicide events (i.e., suicide attempts, psychiatric hospitalizations, and/or emergency department visits for suicide concerns) during the follow-up period (OR = 1.83, t(158) = 2.44, p = .01). No effect of acquired capability was found. Conclusions Perceptions of burdensomeness to others reflect a critical risk factor for suicidal ideation among high-risk adolescents. Null findings with other IPTS constructs may suggest a need to adopt more developmentally sensitive models or measures of interpersonal and acquired capability risk factors for youth. Refining methods and theoretical models of suicide risk may help improve the identification of high-risk cases and inform clinical intervention. En ligne : https://doi.org/10.1111/jcpp.13868 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=526

Weekly links among irritability and suicidal thoughts and behaviors in high-risk youth / Aleksandra KAURIN in Journal of Child Psychology and Psychiatry, 65-11 (November 2024)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 65-11 (November 2024) . - p.1429-1440 Titre : Weekly links among irritability and suicidal thoughts and behaviors in high-risk youth Type de document : Texte imprimé et/ou numérique Auteurs : Aleksandra KAURIN, Auteur ; Aidan G. C. WRIGHT, Auteur ; Giovanna PORTA, Auteur ; Edward HAMILTON, Auteur ; Kimberly POLING, Auteur ; Kelsey BERO, Auteur ; David BRENT, Auteur ; Tina R. GOLDSTEIN, Auteur Article en page(s) : p.1429-1440 Langues : Anglais (eng) Mots-clés : Suicidal behavior  emotional dysregulation  depression Index. décimale : PER Périodiques Résumé : Background Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait-like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within-person processes of elevated risk in clinically meaningful time periods. Methods The present study used clinical data from 689 adolescents aged 12?19?years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self-report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care. Results Overall, two-thirds of variance in weekly irritable mood was accounted for by between-person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity. Conclusions Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression. En ligne : https://doi.org/10.1111/jcpp.13988 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=537 [article] Weekly links among irritability and suicidal thoughts and behaviors in high-risk youth [Texte imprimé et/ou numérique] / Aleksandra KAURIN, Auteur ; Aidan G. C. WRIGHT, Auteur ; Giovanna PORTA, Auteur ; Edward HAMILTON, Auteur ; Kimberly POLING, Auteur ; Kelsey BERO, Auteur ; David BRENT, Auteur ; Tina R. GOLDSTEIN, Auteur . - p.1429-1440. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 65-11 (November 2024) . - p.1429-1440 Mots-clés : Suicidal behavior  emotional dysregulation  depression Index. décimale : PER Périodiques Résumé : Background Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait-like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within-person processes of elevated risk in clinically meaningful time periods. Methods The present study used clinical data from 689 adolescents aged 12?19?years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self-report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care. Results Overall, two-thirds of variance in weekly irritable mood was accounted for by between-person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity. Conclusions Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression. En ligne : https://doi.org/10.1111/jcpp.13988 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=537

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