Risk factors for body dissatisfaction in adolescent girls: A longitudinal investigation.

Because few prospective studies have examined predictors of body dissatisfaction--an established risk factor for eating disorders--the authors tested whether a set of sociocultural, biological, interpersonal, and affective factors predicted increases in body dissatisfaction using longitudinal data from adolescent girls (N=496). Elevated adiposity, perceived pressure to be thin, thin-ideal internalization, and social support deficits predicted increases in body dissatisfaction, but early menarche, weight-related teasing, and depression did not. There was evidence of 2 distinct pathways to body dissatisfaction--1 involving pressure to be thin and 1 involving adiposity. Results support the contention that certain sociocultural, biological, and interpersonal factors increase the risk for body dissatisfaction, but suggest that other accepted risk factors are not related to this outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aggression in adolescent girls: Implications for policy, prevention, and treatment.

This review of literature focuses on aggression and adolescent girls. Official crime statistics from Statistics Canada show an increase in violent offenses by girls. This statistic has created considerable interest in a heretofore largely ignored area of childhood maladjustment. Differences regarding the development and expression of aggression with girls in contrast to boys is provided. The authors argue that, in the context of what is acknowledged to be a limited literature, there are important themes for human service-providers and policy-makers to consider in examining assessment, treatment, and prevention strategies for aggressive adolescent girls. Finally, an orientation towards furthering a research agenda in the area of aggression with adolescent girls is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biased processing of emotional information in girls at risk for depression.

Researchers have documented that children of depressed mothers are at elevated risk for developing a depressive disorder themselves. There is currently little understanding, however, of what factors place these children at elevated risk. In the present study, the authors investigated whether never-disordered daughters whose mothers have experienced recurrent episodes of depression during their daughters' lifetime are characterized by biased processing of emotional information. Following a negative mood induction, participants completed an emotional-faces dot-probe task. Daughters at elevated risk for depression, but not control daughters of never-disordered mothers, selectively attended to negative facial expressions. In contrast, only control daughters selectively attended to positive facial expressions. These results provide support for cognitive vulnerability models of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drug abuse risk and protective factors among black urban adolescent girls: A group-randomized trial of computer-delivered mother-daughter intervention.

A group-randomized design tested a mother-daughter intervention in which researchers aimed to increase protective factors in a community sample of Black urban adolescent girls. Girls and their mothers at 2 community agencies were pretested and, by agency, were randomized to either an intervention arm or a control arm. Intervention arm girls and their mothers received a program for improving mother- daughter rapport. Posttest data collected 3 weeks after program delivery revealed that intervention arm mothers and daughters improved more than did control arm mothers and daughters on measures of communication and closeness. At 3-month follow-up, intervention arm mothers, relative to control arm mothers, continued to report better communication with and closeness to their daughters. Girls and mothers in the intervention arm rated the computer program favorably on parameters of enjoyment, comfort, relevance, usefulness of information, improvements to their relationship with one another, and whether they would recommend the computer program to friends. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An effectiveness trial of a dissonance-based eating disorder prevention program for high-risk adolescent girls.

Efficacy trials indicate that an eating disorder prevention program involving dissonance-inducing activities that decrease thin-ideal internalization reduces risk for current and future eating pathology, yet it is unclear whether this program produces effects under real-world conditions. The present effectiveness trial tested whether this program produced effects when school staff recruit participants and deliver the intervention. Adolescent girls with body image concerns (N = 306; M age = 15.7, SD = 1.1) randomized to the dissonance intervention showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, dieting attempts, and eating disorder symptoms from pretest to posttest than did those assigned to a psychoeducational brochure control condition, with the effects for body dissatisfaction, dieting, and eating disorder symptoms persisting through 1-year follow-up. Effects were slightly smaller than those observed in a prior efficacy trial, suggesting that this program is effective under real-world conditions, but that facilitator selection, training, and supervision could be improved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing adolescent depression: An evaluation of the Problem Solving For Life program.

This study evaluated the effectiveness of the Problem Solving For Life program as a universal approach to the prevention of adolescent depression. Short-term results indicated that participants with initially elevated depressions scores (high risk) who received the intervention showed a significantly greater decrease in depressive symptoms and increase in life problem-solving scores from pre- to postintervention compared with a high-risk control group. Low-risk participants who received the intervention reported a small but significant decrease in depression scores over the intervention period, whereas the low-risk controls reported an increase in depression scores. The low-risk group reported a significantly greater increase in problem-solving scores over the intervention period compared with low-risk controls. These results were not maintained, however, at 12-month follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective predictors of body dissatisfaction in adolescent girls and boys: A five-year longitudinal study.

This study investigated prospective risk factors for increases in body dissatisfaction in adolescent girls and boys in the Eating Among Teens Project. At the time of first assessment (Time 1), participants were a cohort of early adolescent girls (N=440) and boys (N=366) and a cohort of middle adolescent girls (N=946) and boys (N=764). Participants were followed up 5 years later (Time 2). Potential prospective risk factors examined included body mass index, socioeconomic status, ethnicity, parent dieting environment, peer environment, and psychological factors. Predictors of Time 2 body dissatisfaction were Time 1 body dissatisfaction, body mass index, socioeconomic status, being African American, friend dieting and teasing, self-esteem, and depression. However, the profile of predictors differed across the samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: A randomized efficacy trial.

In this depression prevention trial, 341 high-risk adolescents (mean age = 15.6 years, SD = 1.2) with elevated depressive symptoms were randomized to a brief group cognitive-behavioral (CB) intervention, group supportive-expressive intervention, bibliotherapy, or assessment-only control condition. CB participants showed significantly greater reductions in depressive symptoms than did supportive-expressive, bibliotherapy, and assessment-only participants at posttest, though only the difference compared with assessment controls was significant at 6-month follow-up. CB participants showed significantly greater improvements in social adjustment and reductions in substance use at posttest and 6-month follow-up than did participants in all 3 other conditions. Supportive-expressive and bibliotherapy participants showed greater reductions in depressive symptoms than did assessment-only controls at certain follow-up assessments but produced no effects for social adjustment and substance use. CB, supportive-expressive, and bibliotherapy participants showed a significantly lower risk for major depression onset over the 6-month follow-up than did assessment-only controls. The evidence that this brief CB intervention reduced risk for future depression onset and outperformed alternative interventions for certain ecologically important outcomes suggests that this intervention may have clinical utility. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thinness and eating expectancies predict subsequent binge-eating and purging behavior among adolescent girls.

One's expectancies for reinforcement from eating or from thinness are thought to represent summaries of one's eating-related learning history and to thus influence the development of binge-eating and purging behavior. In a 3-year longitudinal study, the authors tested this hypothesis and the hypothesis that binge eating also influences subsequent expectancy development. The authors used trajectory analysis to identify groups of middle school girls who followed different trajectories of binge eating, purging, eating expectancies, and thinness expectancies. Initial eating and thinness reinforcement expectancies identified girls whose binge eating and purging increased during middle school, and expectancies differentiated girls who began these problem behaviors from girls who did not. Initial binge-eating scores differentiated among eating expectancy developmental trajectories. The onset of most behaviors can be understood in terms of learned expectancies for reinforcement from these behaviors. The same model can be applied to the risk for eating disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathways through adolescent smoking: A 7-year longitudinal grouping analysis.

This study examined longitudinal patterns of smoking among students (N = 852) followed from 6th through 12th grades using longitudinal grouping analysis. Six patterns (clusters) were identified: nonsmokers, quitters, experimenters, early escalators, late escalators, and continuous smokers. Baseline (6th-grade) differences in associated risk factors were examined. Growth curve modeling revealed meaningful intercluster differences in risk factor trends over the study period. In general, nonsmokers had the fewest baseline risk factors and slowest increase in risk factors, whereas continuous smokers had higher baseline and more rapidly increasing trends in risk factors. Results suggest that some clusters may respond to population-based antismoking interventions, whereas others (early escalators and continuous smokers) will probably require more focused interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of universal, indicated, and combined cognitive-behavioral approaches to the prevention of depression among adolescents.

A cluster, stratified randomized design was used to evaluate the impact of universal, indicated, and combined universal plus indicated cognitive- behavioral approaches to the prevention of depression among 13- to 15-year-olds initially reporting elevated symptoms of depression. None of the intervention approaches differed significantly from a no-intervention condition or from each other on changes in depressive symptoms, anxiety, externalizing problems, coping skills, and social adjustment. All high-symptom students, irrespective of condition, showed a significant decline in depressive symptoms and improvement in emotional well-being over time although they still demonstrated elevated levels of psychopathology compared with the general population of peers at 12-month follow-up. There were also no significant intervention effects for the universal intervention in comparison with no intervention for the total sample of students in those conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An alcohol expectancy-challenge prevention program for at risk college women.

Alcohol expectancy-challenge programs are effective in changing expectancies and reducing drinking in college men (J. Darker & M. S. Goldman. 1993. 1998); however, recent evidence suggests this protocol might not be effective for women (M. E. Dunn, C. Lau, & I. Y. Cruz, 2000). This study was designed to reevaluate the effectiveness of a social/sexual expectancy-challenge intervention in college women reporting moderate to heavy alcohol use. Forty-six undergraduate women were randomly assigned to the prevention or control condition. Participants reported alcohol expectancies at pre- and posttest and monitored their drinking patterns daily for 6 weeks. The program was effective in changing some expectancies but did not reduce drinking. This further confirms differences in the mechanisms by which expectancy-challenge programs function for men and women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls.

This prospective study tested whether early menarche partially accounts for the increases in depression, eating pathology, substance abuse, and comorbid psychopathology that occur among adolescent girls, with structured interview data from a community sample (N?=?496). Early menarche (prior to 11.6 years) was associated with elevated depression, substance abuse, and "any" disorder but did not confer increased risk for anorexia nervosa, bulimia nervosa, or binge eating disorder. Although there was significant comorbidity across all three classes of pathology, early menarche was associated only with comorbid depression and substance abuse. Results provide partial support for the assertion that early menarche is a general risk factor for psychopathology among adolescent girls but suggest that this risk may not apply to certain disorders and that the effects are modest in size. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screening older adults for depression in primary care settings.

Primary care is a logical environment for depression recognition in older adults. Most older adults are diagnosed and treated for depression by primary care providers. Recognition systems for depression in this setting are particularly needed because the prevalence of depression in older primary care patients may range from 7% to 36%, depending on the instrument and diagnostic criteria used. Implementing systematic detection systems in primary care settings has proven difficult. In one study, only one third of all physicians surveyed used any formal screening tool. Though a number of barriers to recognition of depression have been identified, the authors focus their discussion in this article on two, time and patient factors, and review two screening instruments, the Geriatric Depression Scale--Short Form and the Center for Epidemiologic Studies Depression Scale, that may be able to address these factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parent-child relationships as systems of support or risk for adolescent suicidality.

This study examined a process model of predicting adolescent suicidality. Adolescent emotional distress was hypothesized to mediate the relationship between parental behaviors and subsequent adolescent suicidality. The parental behaviors studied included parental warmth and parental hostility. A sample of 451 families from rural Iowa participated in this longitudinal study, which included both observational and self-report data. Models were tested with structural equation modeling. Adolescent emotional distress was found to be a mediating variable between paternal warmth and adolescent suicidality. Results indicated that maternal warmth predicted adolescent suicidality but not emotional distress. Parental hostility did not predict either latent variable. Clinical implications are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effective components of TORDIA cognitive–behavioral therapy for adolescent depression: Preliminary findings.

In this report, we conducted a secondary analysis of the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) study to explore the impact of specific cognitive–behavioral therapy (CBT) treatment components on outcome. In TORDIA, 334 youths (ages 12 to 18 years) with major depressive disorder who had failed to respond to an adequate course of selective serotonin reuptake inhibitor (SSRI) medication were randomized to a medication switch (either to an alternative SSRI or venlafaxine) with or without 12 weeks of adjunctive CBT. Participants who had more than 9 CBT sessions were 2.5 times more likely to have adequate treatment response than those who had 9 or fewer sessions. CBT participants who received problem-solving and social skills treatment components, controlling for number of sessions and other confounding variables, were 2.3 and 2.6 times, respectively, more likely to have a positive response. These preliminary findings underscore the importance of receiving an adequate number of sessions to attain an adequate clinical response. Finally, social skills and problem solving may be active elements in CBT for adolescent depression and should be considered in treatment by those working with seriously depressed youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist strategies for building involvement in cognitive–behavioral therapy for adolescent depression.

This study examined predictive relations between 9 therapist behaviors and client involvement in manual-guided, cognitive–behavioral therapy for adolescent depression. Analyses included 42 adolescents who met criteria for a depressive disorder (major depressive disorder, dysthymic disorder, or adjustment disorder with depressed mood) and who were treated in school-based clinics. Therapist behaviors hypothesized to promote client involvement were coded from Session 1 audiotapes; client involvement was coded from Session 2. Unlike prior research, the current study examined associations between behaviors and involvement while controlling for initial client resistance to isolate the therapist contribution to involvement. Results show that 3 therapist behaviors from Session 1 (attending to teen’s experience, exploring teen’s motivation, and less structure) predicted greater client involvement in Session 2, controlling for initial resistance. Only exploring motivation and less structure uniquely predicted Session 2 involvement when the 3 behaviors were examined simultaneously. Session 1 therapist behaviors predicted significant variance in involvement at Sessions 2, 4, and 8. Client initial presentation as resistant was associated with more exploring motivation and praising, but initial resistance did not explain associations between therapist behaviors and involvement. Implications for implementing evidence-based treatments are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk factors for binge eating onset in adolescent girls: A 2-year prospective investigation.

Because little is known about the predictors of binge eating (a risk factor for obesity), a set of putative risk factors for binge eating was investigated in a longitudinal study of adolescent girls. Results verified that binge eating predicted obesity onset. Elevated dieting, pressure to be thin, modeling of eating disturbances, appearance overvaluation, body dissatisfaction, depressive symptoms, emotional eating, body mass, and low self-esteem and social support predicted binge eating onset with 92% accuracy, Classification tree analysis revealed an interaction between appearance overvaluation, body mass, dieting, and depressive symptoms, suggesting qualitatively different pathways to binge eating and identifying subgroups at extreme risk for this outcome. Results support the assertion that these psychosocial and biological factors increase risk for binge eating. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal examination of familial risk factors for depression among inner-city African American adolescents.

This research examines longitudinally associations between family risk factors and child and parent depression in 302 urban, low-income, African American adolescents (ages 9-15) and their parents across 2 waves of data collection. Diagnostic data revealed that 7.3% of parents and 3.0% of children at Time 1 and 5.4% of parents and 2.8% of children at Time 2 were clinically depressed. Regression analyses revealed that changes in family functioning were concurrently associated with changes in depression for both children and parents. Specifically, increases in conflict and decreases in parental monitoring were associated with increases in child depressive symptomatology, and increases in conflict and decreases in positive parenting were associated with increases in parental depressive symptomatology. Findings are discussed within a framework of understanding family protective factors and the prevention of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The prevention of anxiety and depression: Theory, research and practice.

Reviews the book, The prevention of anxiety and depression: Theory, research and practice edited by David J. A. Dozois and Keith S. Dobson (2004). Dozois and Dobson have compiled an impressive volume whose chapters identify and then address the highly complex issues relevant to prevention of anxiety and depression, ending with an excellent summary and synthesis of the body of work covered in the text. The book features contributions by leading researchers in the area, the level of scholarship is consistently high, and the writing is clear and accessible. The essential message of this book is that the development of prevention interventions is a) necessary and b) foreseeable, if not in the immediate future. The book illustrates the charted territories of research on factors associated with the development of anxiety and depression, with successful treatment and with maintenance of treatment gains, but it also appropriately identifies large uncharted territories, such as our lack of understanding of comorbidity and of the development of specific disorders. At the same time, the book offers detailed guidelines for measuring and evaluating the success of prevention interventions. It thus provides an excellent road map for future work on prevention of anxiety and depression. This book is a very valuable contribution to knowledge and will be essential reading for researchers and clinicians interested in prevention and in anxiety and depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)