Mechanisms of Rumination Change in Adolescent Depression

Launched by OHIO STATE UNIVERSITY · Feb 27, 2019

Keywords

ClinConnect Summary

This clinical trial is studying a new type of treatment called rumination-focused cognitive behavioral treatment (RF-CBT) for adolescents with depression. This approach combines mindfulness techniques to help young people stop worrying excessively about their problems, which can contribute to depression. The research aims to see if this treatment can change how certain parts of the brain connect with each other and if these changes can help prevent depression from coming back in the following two years.

To be eligible for this trial, participants need to be between 14 and 17 years old and have been diagnosed with major depressive disorder, showing some improvement in their symptoms for at least two weeks. They also need to have a higher tendency to ruminate, meaning they often dwell on negative thoughts. Participants will need permission from their parents, and they should not have a history of certain serious mental health conditions or recent substance abuse. Throughout the study, participants will receive the treatment and may help researchers understand how it works and its effects on their mood and thoughts. It’s important to note that those with certain medical conditions or who are currently pregnant will not be able to participate.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Previous diagnosis of Major Depressive Disorder (full or partial remission for at least two weeks) according to Diagnostic and Statistical Manual (DSM-V) criteria confirmed by the Kiddie Schedule for affective disorders (KSADSPL). Partial remission is defined as not meeting full DSM-V criteria for MDD.
• • RRS score above the age and sex specific mean, T \> 50).
• • 14-17 years of age at enrollment (accounting for 2 year follow-up),
• • Postpubertal (Petersen Pubertal Developmental Scale)
• • Youth assent and parent consent
• • Intellectual Quotient (IQ) \> 75, determined by Wechsler Abbreviated Scale of Intelligence (WASI)
• Exclusion Criteria:
• • Endorsement of suicidality with plan or intent (assessed via KSADSPL and Children's Depression Rating Scale (CDRS-R) clinical interviews. Current or past (within previous three months) plan or intent is exclusionary.
• • Lifetime history of conduct disorder, autism, any psychotic disorder (or episode unexplained by other known medical causes), or bipolar disorder. Eating disorder or alcohol/substance abuse within the previous 6 months. (Lifetime history of an anxiety disorder, disruptive mood dysregulation disorder or oppositional defiant disorder, Attention Deficit Hyperactivity Disorder (ADHD) will not be exclusionary).
• • Current treatment with RF-CBT, Cognitive Behavioral Therapy (CBT), or variants thereof, or in the last 2 years. Likewise, detail oriented therapy beyond supportive therapy (e.g., homework, cognitive restructuring), in same time window (ability to recall elements of structured therapies with CBT focus).
• • Metal braces or retainers, tattoos with metal, or clothing with metal fibers.
• • Claustrophobia
• • Current pregnancy - Parents will be asked this information at the phone screen. At the clinic eligibility visit, female participants will be asked about sexual activity in a private room separate from their parents using the pregnancy script/screen that the investigators have created. This script details that if a female is ineligible due to pregnancy or inadequate birth control, this information will not be disclosed to her parent(s). Participants who are sexually active will be asked about birth control method. Abstinence will be considered an approved form of contraception.
• • Psychotropic medication outside of antidepressants such as mood stabilizers and antipsychotics will be exclusionary. Participants may have a history of current, stable antidepressant medication use, with no changes in dose for the past four weeks, no change in specific medication for six weeks.