Enhancing the effects of the treatment for depression in early adolescence: The role of emotion regulation.
Major depressive disorder (MDD) in children and adolescents is a severe and often recurrent illness associated with impaired psychosocial functioning and increased mortality. With a low prevalence during childhood, lifetime prevalence of MDD rises to a concerning 25% during adolescence and young adulthood. Importantly, past research documented continuity of depression throughout development. CBT shows moderate to good effect sizes for the treatment of depression. Longitudinal studies of depressed youth have however shown that relapse rates reach 20% to 60% by one to two years after remission. Since MDD may impede a child’s social, emotional, and cognitive development and is predictive of subsequent and more serious depressive episodes, more research on the improvement of the treatment is urgently needed.
In my presentation (1) I will first elaborate on the role of emotion regulation strategies in explaining depressive symptoms in 9 to 14 year-old young adolescents (N=400). I will test the hypothesis that, according to recent theoretical models, psychopathology results from the specific misuse of certain maladaptive emotion regulation (ER) strategies and the lack of specific adaptive strategies. Next, (2) I will show how we set up new research to explore the effects of learning ER strategies in early adolescents. In a first study 1 (N = 76), we examined whether young adolescents are able to use distraction and whether the effects of this strategy are similar to talking to one’s mother. In a next study (N = 184), we compared the effects of distraction, cognitive reappraisal, acceptance, and rumination. In both studies, participants received instructions on how to regulate their emotions after a standardized negative mood induction. In general, the results indicated that distraction, but also cognitive reappraisal and acceptance, had promising short-term effects on positive and negative affect in young adolescents. These findings inspired us by developing an ER training for depressed adolescents on top of the care as usual as the findings suggest that targeting adaptive ER skills, such as distraction, acceptance, and cognitive reappraisal, may be an important strategy to prevent or treat psychological problems in early adolescents.