The Moderating Role of Child Maltreatment in Treatment Efficacy for Adolescent Depression
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The Moderating Role of Child Maltreatment in Treatment Efficacy for Adolescent Depression Sheree L. Toth 1 & Elizabeth D. Handley 1 & Jody Todd Manly 1 & Robin Sturm 1 & Tangeria R. Adams 1 & Elizabeth M. Demeusy 1 & Dante Cicchetti 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Adolescent girls are at heightened risk of depression, and because adolescent depression may initiate a negative developmental cascade, intervention early in adolescence has potential for altering a negative developmental trajectory. Identifying risk factors that impact response to intervention may inform decisions about the type of treatment to provide for adolescent girls with depression. Understanding moderators of outcomes in evidence-based treatment is critical to the delivery of timely and effective interventions. Matching patients effectively with optimal intervention will not only expedite the alleviation of patients’ distress, but will also reduce unnecessary time and resources spent on less advantageous interventions. The current investigation examines the efficacy of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) in a racially and ethnically diverse sample of 120 low-income adolescent girls age 13–15 with and without histories of child maltreatment. Adolescent and parent report of depressive symptoms were assessed at the beginning and end of treatment and a diagnosis of subsyndromal symptoms of depression or depression were required for purposes of inclusion. Results indicated that among adolescent girls who had experienced two or more subtypes of maltreatment, IPT-A was found to be more efficacious than Enhanced Community Standard (ECS) treatment. Importantly, when the subtype of maltreatment experienced was further probed, among girls with a history of sexual abuse, we found preliminary evidence that IPT-A was significantly more effective than ECS in reducing depressive symptoms, and the effect size was large. Thus, if a history of maltreatment is present, especially including sexual abuse, specifically addressing the interpersonal context associated with depressive symptoms may be necessary. Keywords Depression . Adolescence . Child maltreatment . Intervention . Developmental psychopathology . Interpersonal psychotherapy * Sheree L. Toth [email protected] Elizabeth D. Handley [email protected] Jody Todd Manly [email protected] Robin Sturm [email protected] Tangeria R. Adams [email protected] Elizabeth M. Demeusy [email protected] Dante Cicchetti [email protected] 1
Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street Rochester NY 14608 USA
2
University of Minnesota, Minneapolis MN USA
Adolescence is a time of considerable stress, even for teens who reside in relatively normative environments. It is a developmental period in which investigations guided by a developmental psychopathology perspective can be particularly compelling (Cicchetti & Rogosch, 2002; Cicchetti & Toth, 2016). Neurob
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