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Depression: HELP
Articles by Randy P. Auerbach
Based on 42 articles published since 2010
(Why 42 articles?)
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Between 2010 and 2020, R. Auerbach wrote the following 42 articles about Depression.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review Cognitive Vulnerability to Major Depression: View from the Intrinsic Network and Cross-network Interactions. 2016

Wang, Xiang / Öngür, Dost / Auerbach, Randy P / Yao, Shuqiao. ·From the Medical Psychological Institute of Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China (Drs. Wang and Yao) · Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA (Drs. Öngür and Auerbach). ·Harv Rev Psychiatry · Pubmed #27148911.

ABSTRACT: Although it is generally accepted that cognitive factors contribute to the pathogenesis of major depressive disorder (MDD), there are missing links between behavioral and biological models of depression. Nevertheless, research employing neuroimaging technologies has elucidated some of the neurobiological mechanisms related to cognitive-vulnerability factors, especially from a whole-brain, dynamic perspective. In this review, we integrate well-established cognitive-vulnerability factors for MDD and corresponding neural mechanisms in intrinsic networks using a dual-process framework. We propose that the dynamic alteration and imbalance among the intrinsic networks, both in the resting-state and the rest-task transition stages, contribute to the development of cognitive vulnerability and MDD. Specifically, we propose that abnormally increased resting-state default mode network (DMN) activity and connectivity (mainly in anterior DMN regions) contribute to the development of cognitive vulnerability. Furthermore, when subjects confront negative stimuli in the period of rest-to-task transition, the following three kinds of aberrant network interactions have been identified as facilitators of vulnerability and dysphoric mood, each through a different cognitive mechanism: DMN dominance over the central executive network (CEN), an impaired salience network-mediated switching between the DMN and CEN, and ineffective CEN modulation of the DMN. This focus on interrelated networks and brain-activity changes between rest and task states provides a neural-system perspective for future research on cognitive vulnerability and resilience, and may potentially guide the development of new intervention strategies for MDD.

2 Review Mapping anhedonia-specific dysfunction in a transdiagnostic approach: an ALE meta-analysis. 2016

Zhang, Bei / Lin, Pan / Shi, Huqing / Öngür, Dost / Auerbach, Randy P / Wang, Xiaosheng / Yao, Shuqiao / Wang, Xiang. ·Medical Psychological Institute, The Second Xiangya Hospital of Central South University, 139 Renmin (M) Road, Changsha, Hunan, 410011, People's Republic of China. · Key Laboratory of Biomedical Information Engineering of Education Ministry, Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shanxi, 710049, People's Republic of China. · Department of Psychology, Shanghai Normal University, Shanghai, 200234, People's Republic of China. · Harvard Medical School and McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA. · Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China. · Medical Psychological Institute, The Second Xiangya Hospital of Central South University, 139 Renmin (M) Road, Changsha, Hunan, 410011, People's Republic of China. wang0916xia@gmail.com. ·Brain Imaging Behav · Pubmed #26487590.

ABSTRACT: Anhedonia is a prominent symptom in neuropsychiatric disorders, most markedly in major depressive disorder (MDD) and schizophrenia (SZ). Emerging evidence indicates an overlap in the neural substrates of anhedonia between MDD and SZ, which supported a transdiagnostic approach. Therefore, we used activation likelihood estimation (ALE) meta-analysis of functional magnetic resonance imaging studies in MDD and SZ to examine the neural bases of three subdomains of anhedonia: consummatory anhedonia, anticipatory anhedonia and emotional processing. ALE analysis focused specifically on MDD or SZ was used later to dissociate specific anhedonia-related neurobiological impairments from potential disease general impairments. ALE results revealed that consummatory anhedonia was associated with decreased activation in ventral basal ganglia areas, while anticipatory anhedonia was associated with more substrates in frontal-striatal networks except the ventral striatum, which included the dorsal anterior cingulate, middle frontal gyrus and medial frontal gyrus. MDD and SZ patients showed similar neurobiological impairments in anticipatory and consummatory anhedonia, but differences in the emotional experience task, which may also involve affective/mood general processing. These results support that anhedonia is characterized by alterations in reward processing and relies on frontal-striatal brain circuitry. The transdiagnostic approach is a promising way to reveal the overall neurobiological framework that contributes to anhedonia and could help to improve targeted treatment strategies.

3 Review Adolescent depression: stress and reward dysfunction. 2014

Auerbach, Randy P / Admon, Roee / Pizzagalli, Diego A. ·From the Department of Psychiatry, Harvard Medical School; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA. ·Harv Rev Psychiatry · Pubmed #24704785.

ABSTRACT: LEARNING OBJECTIVES: After participating in this educational activity, the physician should be better able to 1. Evaluate the relationship between reward processes, stress, and depression. 2. Assess the characteristics of the three etiological models of stress and reward processes. 3. Identify the biological basis for stress and reward processes. Adolescence is a peak period for the onset of depression, and it is also a time marked by substantial stress as well as neural development within the brain reward circuitry. In this review, we provide a selective overview of current animal and human research investigating the relationship among reward processes, stress, and depression. Three separate, but related, etiological models examine the differential roles that stress may play in relation to reward dysfunction and adolescent depression. First, the reward mediation model suggests that both acute and chronic stress contribute to reward deficits, which, in turn, potentiate depressive symptoms or increase the risk for depression. Second, in line with the stress generation perspective, it is plausible that premorbid reward-related dysfunction generates stress--in particular, interpersonal stress--which then leads to the manifestation of depressive symptoms. Third, consistent with a diathesis-stress model, the interaction between stress and premorbid reward dysfunction may contribute to the onset of depression. Given the equifinal nature of depression, these models could shed important light on different etiological pathways during adolescence, particularly as they may relate to understanding the heterogeneity of depression. To highlight the translational potential of these insights, a hypothetical case study is provided as a means of demonstrating the importance of targeting reward dysfunction in both assessment and treatment of adolescent depression.

4 Review Processes of change in CBT of adolescent depression: review and recommendations. 2012

Webb, Christian A / Auerbach, Randy P / Derubeis, Robert J. ·Department of Psychology, University of Pennsylvania, 3815 Walnut Street, Philadelphia, PA 19104-1696, USA. webb@sas.upenn.edu ·J Clin Child Adolesc Psychol · Pubmed #22867130.

ABSTRACT: A growing body of research supports the efficacy of cognitive-behavioral therapy (CBT) for adolescent depression. The mechanisms through which CBT exerts its beneficial effects on adolescent patients suffering from depression, however, remain unclear. The current article reviews the CBT for adolescent depression process literature. Our review focuses on several process variables: the therapeutic alliance, patient cognitive change, and therapist adherence to, and competence in, the theory-specified techniques of therapy. Given that the vast majority of CBT process research has been conducted in the context of adult psychotherapy, we also review relevant adult research as a framework for understanding adolescent process research and to inform future investigations. Methodological issues are addressed and recommendations for future process research are raised.

5 Article Image acquisition and quality assurance in the Boston Adolescent Neuroimaging of Depression and Anxiety study. 2020

Siless, Viviana / Hubbard, Nicholas A / Jones, Robert / Wang, Jonathan / Lo, Nicole / Bauer, Clemens C C / Goncalves, Mathias / Frosch, Isabelle / Norton, Daniel / Vergara, Genesis / Conroy, Kristina / De Souza, Flavia Vaz / Rosso, Isabelle M / Wickham, Aleena Hay / Cosby, Elizabeth Ann / Pinaire, Megan / Hirshfeld-Becker, Dina / Pizzagalli, Diego A / Henin, Aude / Hofmann, Stefan G / Auerbach, Randy P / Ghosh, Satrajit / Gabrieli, John / Whitfield-Gabrieli, Susan / Yendiki, Anastasia. ·Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. · Massachusetts Institute of Technology, Cambridge, MA, United States; University of Nebraska, Lincoln, Lincoln, NE, United States. · Massachusetts Institute of Technology, Cambridge, MA, United States. · Massachusetts Institute of Technology, Cambridge, MA, United States; Northeastern University, Department of Psychology, Boston, MA, United States. · McLean Hospital, Belmont, MA, United States. · Boston University, Boston, MA, United States. · Massachusetts General Hospital, Boston, MA, United States. · McLean Hospital, Belmont, MA, United States; Harvard Medical School, Boston, MA, United States. · Columbia University, New York, NY, United States. · Harvard Medical School, Boston, MA, United States; Massachusetts Institute of Technology, Cambridge, MA, United States. · Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: ayendiki@mgh.harvard.edu. ·Neuroimage Clin · Pubmed #32339824.

ABSTRACT: The Connectomes Related to Human Diseases (CRHD) initiative was developed with the Human Connectome Project (HCP) to provide high-resolution, open-access, multi-modal MRI data to better understand the neural correlates of human disease. Here, we present an introduction to a CRHD project, the Boston Adolescent Neuroimaging of Depression and Anxiety (BANDA) study, which is collecting multimodal neuroimaging, clinical, and neuropsychological data from 225 adolescents (ages 14-17), 150 of whom are expected to have a diagnosis of depression and/or anxiety. Our transdiagnostic recruitment approach samples the full spectrum of depressed/anxious symptoms and their comorbidity, consistent with NIMH Research Domain Criteria (RDoC). We focused on an age range that is critical for brain development and for the onset of mental illness. This project sought to harmonize imaging sequences, hardware, and functional tasks with other HCP studies, although some changes were made to canonical HCP methods to accommodate our study population and questions. We present a thorough overview of our imaging sequences, hardware, and scanning protocol. We detail similarities and differences between this study and other HCP studies. We evaluate structural-, diffusion-, and functional-image-quality measures that may be influenced by clinical factors (e.g., disorder, symptomatology). Signal-to-noise and motion estimates from the first 140 adolescents suggest minimal influence of clinical factors on image quality. We anticipate enrollment of an additional 85 participants, most of whom are expected to have a diagnosis of anxiety and/or depression. Clinical and neuropsychological data from the first 140 participants are currently freely available through the National Institute of Mental Health Data Archive (NDA).

6 Article A positive psychology intervention for patients with bipolar depression: a randomized pilot trial. 2020

Celano, Christopher M / Gomez-Bernal, Federico / Mastromauro, Carol A / Beale, Eleanor E / DuBois, Christina M / Auerbach, Randy P / Huffman, Jeff C. ·Harvard Medical School, Boston, MA, USA. · Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. · Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA, USA. ·J Ment Health · Pubmed #30366513.

ABSTRACT:

7 Article Brain Volume Abnormalities in Youth at High Risk for Depression: Adolescent Brain and Cognitive Development Study. 2019

Pagliaccio, David / Alqueza, Kira L / Marsh, Rachel / Auerbach, Randy P. ·Columbia University, New York; New York State Psychiatric Institute, New York. · Columbia University, New York; New York State Psychiatric Institute, New York; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY. Electronic address: rpa2009@cumc.columbia.edu. ·J Am Acad Child Adolesc Psychiatry · Pubmed #31634568.

ABSTRACT: OBJECTIVE: Children of parents with depression are two to three times more likely to develop major depressive disorder than children without parental history; however, subcortical brain volume abnormalities characterizing major depressive disorder risk remain unclear. The Adolescent Brain and Cognitive Development (ABCD) Study provides an opportunity to identify subcortical differences associated with parental depressive history. METHOD: Structural magnetic resonance data were acquired from 9- and 10-year-old children (N = 11,876; release 1.1, n = 4,521; release 2.0.1, n = 7,355). Approximately one-third of the children had a parental depressive history, providing sufficient power to test differences in subcortical brain volume between low- and high-risk youths. Children from release 1.1 were examined as a discovery sample, and we sought to replicate effects in release 2.0.1. Secondary analyses tested group differences in the prevalence of depressive disorders and clarified whether subcortical brain differences were present in youths with a lifetime depressive disorder history. RESULTS: Parental depressive history was related to smaller right putamen volume in the discovery (release 1.1; Cohen's d = -0.10) and replication (release 2.0.1; d = -0.10) samples. However, in release 1.1, this effect was driven by maternal depressive history (d = -0.14), whereas in release 2.0.1, paternal depressive history showed a stronger relationship with putamen volume (d = -0.09). Furthermore, high-risk children exhibited a near twofold greater occurrence of depressive disorders relative to low-risk youths (maternal history odds ratio =1.99; paternal history odds ratio = 1.45), but youths with a lifetime depressive history did not exhibit significant subcortical abnormalities. CONCLUSION: A parental depressive history was associated with smaller putamen volume, which may affect reward learning processes that confer increased risk for major depressive disorder.

8 Article Gender commonalities and differences in risk and protective factors of suicidal thoughts and behaviors: A cross-sectional study of Spanish university students. 2019

Miranda-Mendizabal, Andrea / Castellví, Pere / Alayo, Itxaso / Vilagut, Gemma / Blasco, Maria Jesús / Torrent, Aina / Ballester, Laura / Almenara, José / Lagares, Carolina / Roca, Miquel / Sesé, Albert / Piqueras, José Antonio / Soto-Sanz, Victoria / Rodríguez-Marín, Jesús / Echeburúa, Enrique / Gabilondo, Andrea / Cebrià, Ana Isabel / Bruffaerts, Ronny / Auerbach, Randy P / Mortier, Philippe / Kessler, Ronald C / Alonso, Jordi. ·Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain. · Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain. · Department of Psychology, University of Jaén, Jaén, Spain. · Program 6: Health Services Evaluation, CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. · Health and Life Sciences Faculty, Pompeu Fabra University (UPF), Barcelona, Spain. · Department of Psychology, Girona University (UdG), Girona, Spain. · Department of Biomedicine, Biotechnology and Public Health, University of Cadiz (UCA), Cádiz, Spain. · Department of Psychology, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain. · Department of Health Psychology, Miguel Hernandez University of Elche (UMH), Alicante, Spain. · Department of Personality, Psychological Evaluation and Treatment, University of the Basque Country (UPV-EHU), Bilbao, Spain. · Department of Mental Health and Psychiatric Care, Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Biodonosti Health Research Institute, San Sebastian, Spain. · Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain. · Department of Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven (UPC-KUL), Leuven, Belgium. · Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. · Department of Child and Adolescent Psychiatry, Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts. · Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts. ·Depress Anxiety · Pubmed #31609064.

ABSTRACT: AIM: To assess gender differences in the association between risk/protective factors and suicidal thoughts and behaviors (STB); and whether there is any gender-interaction with those factors and STB; among Spanish university students. METHODS: Data from baseline online survey of UNIVERSAL project, a multicenter, observational study of first-year Spanish university students (18-24 years). We assessed STB; lifetime and 12-month negative life-events and family adversities; mental disorders; personal and community factors. Gender-specific regression models and gender-interactions were also analyzed. RESULTS: We included 2,105 students, 55.4% women. Twelve-month prevalence of suicidal ideation (SI) was 10%, plans 5.7%, attempts 0.6%. Statistically significant gender-interactions were found for lifetime anxiety disorder, hopelessness, violence between parents, chronic health conditions and family support. Lifetime mood disorder was a common risk factor of SI for both genders (Females: OR= 5.5; 95%CI 3.3-9.3; Males: OR= 4.4; 95%CI 2.0-9.7). For females, exposure to violence between parents (OR= 3.5; 95%CI 1.7-7.2), anxiety disorder (OR= 2.7; 95%CI 1.6-4.6), and alcohol/substance disorder (OR= 2.1; 95%CI 1.1-4.3); and for males, physical childhood maltreatment (OR= 3.6; 95%CI 1.4-9.2), deceased parents (OR= 4.6; 95%CI 1.2-17.7), and hopelessness (OR= 7.7; 95%CI 2.8-21.2), increased SI risk. Family support (OR= 0.5; 95%CI 0.2-0.9) and peers/others support (OR= 0.4; 95%CI 0.2-0.8) were associated to a lower SI risk only among females. CONCLUSIONS: Only mood disorder was a common risk factor of SI for both genders, whereas important gender-differences were observed regarding the other factors assessed. The protective effect from family and peers/others support was observed only among females. Further research assessing underlying mechanisms and pathways of gender-differences is needed.

9 Article Frontoinsular Network Markers of Current and Future Adolescent Mood Health. 2019

Kaiser, Roselinde H / Peterson, Elena / Kang, Min Su / Van Der Feen, Julie / Aguirre, Blaise / Clegg, Rachel / Goer, Franziska / Esposito, Erika C / Auerbach, Randy P / Pizzagalli, Diego A. ·Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado. Electronic address: Roselinde.Kaiser@colorado.edu. · Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado. · Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts. · Adolescent Partial Hospitalization Program, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. · Three East Girls Intensive and Step-Down Program, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. · Department of Psychiatry, Columbia University, New York, New York; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, New York. · Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. ·Biol Psychiatry Cogn Neurosci Neuroimaging · Pubmed #31155512.

ABSTRACT: BACKGROUND: Adolescence is a developmental period in which depression and related mood syndromes often emerge, but few objective markers exist to guide diagnosis or predict symptoms. One potential mood marker is the functioning of frontoinsular networks, which undergo substantial development in adolescence and have been implicated in adult depression. To test this hypothesis, we used task-based neuroimaging to evaluate whether frontoinsular network dysfunction was linked to current and prospective mood health in adolescents. METHODS: Adolescents (n = 40, 13-19 years of age) reporting varying levels of depressive symptom severity performed an emotional working memory task with neuroimaging. Next, teens completed a 2-week follow-up consisting of a daily diary report of negative affect and final report of depressive symptoms (n = 28 adherent). Analyses tested associations between task-related functional connectivity in frontoinsular networks and baseline or prospective measures of mood health over 2-week follow-up. RESULTS: Frontoinsular task response was associated with higher current depression severity (p = .049, η CONCLUSIONS: These findings indicate that frontoinsular imbalances are related to both current depression and changes in mood health in the near future and suggest that frontoinsular markers may hold promise as translational tools for risk prediction.

10 Article Examining the effectiveness of a web-based intervention for symptoms of depression and anxiety in college students: study protocol of a randomised controlled trial. 2019

Karyotaki, Eirini / Klein, Anke M / Riper, Heleen / Wit, Leonore de / Krijnen, Lisa / Bol, Eline / Bolinski, Felix / Burger, Simone / Ebert, David D / Auerbach, Randy P / Kessler, Ronald C / Bruffaerts, Ronny / Batelaan, Neeltje / van der Heijde, Claudia M / Vonk, Peter / Kleiboer, Annet / Wiers, Reinout W / Cuijpers, Pim. ·Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. · Amsterdam Public Health Research Institute, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. · Addiction, Development, and Psychopathology Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands. · Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany. · Department of Psychiatry, Columbia University, New York, New York, USA. · Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA. · Universitair Psychiatrisch Centrum, Centre for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium. · Department of Psychiatry and Department of Epidemiology and Biostatistics, VU University Medical Centre Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. · Department of Epidemiology and Biostatistics, VU University Medical Centre Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. · Department of Research, Development and Prevention, Student Health Service University of Amsterdam, Amsterdam, The Netherlands. ·BMJ Open · Pubmed #31092668.

ABSTRACT: INTRODUCTION: The college years are a peak period for the onset of common mental disorders. Poor mental health is associated with low academic attainment, physical, interpersonal and cognitive impairments. Universities can use online approaches to screen students for mental disorders and treat those in need. The present study aims to assess the effectiveness of a guided web-based transdiagnostic individually tailored intervention to treat students with symptoms of depression and/or anxiety. TRIAL REGISTRATION NUMBER: NTR6797; Pre-results.

11 Article Abnormal frontoinsular-default network dynamics in adolescent depression and rumination: a preliminary resting-state co-activation pattern analysis. 2019

Kaiser, Roselinde H / Kang, Min Su / Lew, Yechan / Van Der Feen, Julie / Aguirre, Blaise / Clegg, Rachel / Goer, Franziska / Esposito, Erika / Auerbach, Randy P / Hutchison, R Matthew / Pizzagalli, Diego A. ·Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA. Roselinde.Kaiser@colorado.edu. · Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, USA. · Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA. · Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA. · McLean Hospital, Belmont, MA, USA. · Department of Psychiatry, Harvard Medical School, Belmont, USA. · Department of Psychology, State University of New York, Albany, NY, USA. · Department of Medical and Human Sciences, University of Manchester, Manchester, USA. · Department of Psychology, University of Rochester, Rochester, NY, USA. · Department of Psychiatry, Columbia University, New York, USA. · Department of Clinical Developmental Neuroscience, Sackler Institute, New York, USA. · Department of Psychology, Harvard University, Cambridge, USA. · Biogen, Cambridge, MA, USA. · McLean Imaging Center, McLean Hospital, Belmont, MA, USA. ·Neuropsychopharmacology · Pubmed #31035283.

ABSTRACT: Clinical depression commonly emerges in adolescence, which is also a time of developing cognitive ability and related large-scale functional brain networks implicated in depression. In depressed adults, abnormalities in the dynamic functioning of frontoinsular networks, in particular, have been observed and linked to negative rumination. Thus, network dynamics may provide new insight into teen pathophysiology. Here, adolescents (n = 45, ages 13-19) with varying severity of depressive symptoms completed a resting-state functional MRI scan. Functional networks were evaluated using co-activation pattern analysis to identify whole-brain states of spatial co-activation that recurred across participants and time. Measures included: dwell time (proportion of scan spent in that network state), persistence (volume-to-volume maintenance of a network state), and transitions (frequency of moving from state A to state B). Analyses tested associations between depression or trait rumination and dynamics of network states involving frontoinsular and default network systems. Results indicated that adolescents showing increased dwell time in, and persistence of, a frontoinsular-default network state involving insula, dorsolateral and medial prefrontal cortex, and posterior regions of default network, reported more severe symptoms of depression. Further, adolescents who transitioned more frequently between the frontoinsular-default state and a prototypical default network state reported higher depression. Increased dominance and transition frequency of frontoinsular-default network states were also associated with higher rumination, and rumination mediated the associations between network dynamics and depression. Findings support a model in which abnormal frontoinsular dynamics confer vulnerability to maladaptive introspection, which in turn contributes to symptoms of adolescent depression.

12 Article Cognitive versus behavioral skills in CBT for depressed adolescents: Disaggregating within-patient versus between-patient effects on symptom change. 2019

Webb, Christian A / Stanton, Colin H / Bondy, Erin / Singleton, Paris / Pizzagalli, Diego A / Auerbach, Randy P. ·Center for Depression, Anxiety, and Stress Research and Department of Psychiatry, Harvard Medical School-McLean Hospital. · Division of Child and Adolescent Psychiatry, Columbia University. ·J Consult Clin Psychol · Pubmed #30998049.

ABSTRACT: OBJECTIVE: Despite a growing body of research supporting the efficacy of cognitive-behavioral therapy (CBT) for depressed adolescents, few studies have investigated the role of the acquisition and use of CBT skills in accounting for symptom improvement. The present study examined the role of cognitive versus behavioral skills in predicting symptom improvement in depressed youth. Analyses considered different raters of patient skills (patient vs. therapist) as well as disaggregated between-patient versus within-patient effects. METHOD: Data were derived from a 12-week clinical trial of CBT for depressed adolescent females (N = 33; ages 13-18 years; 69.7% White). Both therapist-report and patient-report measures of CBT skills (skills of cognitive therapy) were acquired at 5 time points throughout therapy: Sessions 1, 3, 6, 9, and 12. Depressive symptoms (Beck Depression Inventory-II) were assessed at every session. RESULTS: Therapist and patient ratings of CBT skills showed small to moderate associations (rs = .20-.38). Intraclass correlation coefficients indicated that the majority of the variance in skills scores (61-90%) was attributable to within-patient variance from session to session, rather than due to between-patient differences. When disaggregating within-patient and between-patient effects, and consistent with a causal relationship, within-patient variability in both patient-rated (b = -2.55; p = .025) and therapist-rated (b = -2.41; p = .033) behavioral skills predicted subsequent symptom change. CONCLUSIONS: Analyses highlight the importance of the acquisition and use of behavioral skills in CBT for depressed adolescents. Findings also underscore the importance of disentangling within-patient from between-patient effects in future studies, an approach infrequently used in process-outcome research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

13 Article The World Health Organization World Mental Health International College Student initiative: An overview. 2019

Cuijpers, Pim / Auerbach, Randy P / Benjet, Corina / Bruffaerts, Ronny / Ebert, David / Karyotaki, Eirini / Kessler, Ronald C. ·Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. · Department of Psychiatry, Columbia University, New York, New York. · Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. · Center for Public Health Psychiatry, Dept. Neurosciences, KU Leuven, Leueven, Belgium. · Department of Psychology, Clinical Psychology and Psychotherapy, Friedrich-Alexander University Nuremberg-Erlangen, Erlangen, Germany. · Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts. ·Int J Methods Psychiatr Res · Pubmed #30614123.

ABSTRACT: OBJECTIVES: The college years are a developmentally crucial period and a peak age for the onset of mental disorders. METHODS: The World Health Organization World Mental Health International College Student (WMH-ICS) initiative is aimed at developing and implementing a system for improving prevention and early interventions for mental health problems among college students. RESULTS: The initiative consists of three core elements. The first element is a web-based survey to assess the magnitude and nature of emotional problems, the effects of these problems on students' functioning, and barriers to seeking treatment. All first-year students in participating colleges are invited to participate, and we plan to expand the survey to all students in the future. The second element is an infrastructure to test internet-based interventions aimed at the prevention and early intervention in mental health problems. Participating colleges can develop and test internet-based interventions in randomized trials. The first pilot tests on such interventions now been done. The third element is the dissemination and continuous quality improvement monitoring of the evidence-based interventions developed in WMH-ICS. CONCLUSIONS: By addressing these three core elements, the WMH-ICS aims to integrate epidemiological and clinical research to offer scalable and effective evidence-based interventions for mental health problems at a critical life course stage.

14 Article Prediction of major depressive disorder onset in college students. 2019

Ebert, David D / Buntrock, Claudia / Mortier, Philippe / Auerbach, Randy / Weisel, Kiona K / Kessler, Ronald C / Cuijpers, Pim / Green, Jennifer G / Kiekens, Glenn / Nock, Matthew K / Demyttenaere, Koen / Bruffaerts, Ronny. ·Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nüuremberg, Erlangen, Germany. · Department of Neurosciences, Universitair Psychiatrisch Centrum KU Leuven, Belgium. · Department of Psychiatry, Harvard Medical School, Boston, MA, USA. · Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. · Department for Health Care Policy, Harvard Medical School, Boston, MA, USA. · EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands. · School of Education, Boston University, Boston, MA, USA. · Department of Psychology, Harvard University, Cambridge, MA, USA. ·Depress Anxiety · Pubmed #30521136.

ABSTRACT: BACKGROUND: Major depressive disorder (MDD) in college students is associated with substantial burden. AIMS: To assess 1-year incidence of MDD among incoming freshmen and predictors of MDD-incidence in a representative sample of students. METHOD: Prospective cohort study of first-year college students (baseline: n = 2,519, 1-year follow-up: n = 958) RESULTS: The incidence of MDD within the first year of college was 6.9% (SE = 0.8). The most important individual-level predictors of onset were prior suicide plans and/or attempts (OR = 9.5). The strongest population-level baseline predictors were history of childhood-adolescent trauma, stressful experience in the past 12 months, parental psychopathology, and other 12-month mental disorder. Multivariate cross-validated prediction (cross-validated AUC = 0.73) suggest that 36.1% of incident MDD cases in a replication sample would occur among the 10% of students at highest predicted risk (24.5% predicted incidence in this highest-risk subgroup). CONCLUSIONS: Screening at college entrance is a promising strategy to identify students at risk of MDD onset, which may improve the development and deployment of targeted preventive interventions.

15 Article Non-Suicidal self-injury and suicide in depressed Adolescents: Impact of peer victimization and bullying. 2019

Vergara, Genesis A / Stewart, Jeremy G / Cosby, Elizabeth A / Lincoln, Sarah Hope / Auerbach, Randy P. ·Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. · Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Columbia University, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA. Electronic address: rpa2009@columbia.edu. ·J Affect Disord · Pubmed #30448758.

ABSTRACT: BACKGROUND: While prior research has demonstrated that peer victimization and bully perpetration contribute to non-suicidal self-injury (NSSI) and suicidal thoughts and behaviors (STBs), it remains unclear whether these interpersonal processes differentiate self-injuring adolescent suicide ideators and attempters. METHODS: The study included adolescents aged 13-18 years (n = 223; M = 15.31, SD = 1.34) recruited from an acute inpatient program. Participants were divided into two groups: (1) NSSI RESULTS: NSSI LIMITATIONS: The study is cross-sectional, and reports of peer victimization and bully perpetration rely on self-report assessment. CONCLUSIONS: Peer victimization and bully perpetration differentiated adolescent suicide ideators and attempters, highlighting the need to address bully perpetration in addition to peer victimization in suicide interventions and research.

16 Article The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviors. 2018

Kiekens, G / Hasking, P / Boyes, M / Claes, L / Mortier, P / Auerbach, R P / Cuijpers, P / Demyttenaere, K / Green, J G / Kessler, R C / Myin-Germeys, I / Nock, M K / Bruffaerts, R. ·Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium; School of Psychology, Curtin University, Perth, Australia. Electronic address: Glenn.Kiekens@kuleuven.be. · School of Psychology, Curtin University, Perth, Australia. · Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium. · Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium. · Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA. · Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. · School of Education, Boston University, Boston, MA, USA. · Harvard Medical School, Department of Health Care Policy, Harvard University, Boston, MA, USA. · Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium. · Department of Psychology, Harvard University, Cambridge, MA, USA. · Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium; Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, MI, USA. ·J Affect Disord · Pubmed #30014957.

ABSTRACT: BACKGROUND: Theoretical and empirical literature suggests that non-suicidal self-injury (NSSI) is an important correlate of suicide risk. The present study was designed to evaluate: (a) whether NSSI is associated with increased odds of subsequent onsets of suicidal thoughts and behaviors (STB) independent of common mental disorders, (b) whether NSSI is associated with increased risk of transitioning from suicide ideation to attempt, and (c) which NSSI characteristics are associated with STB after NSSI. METHOD: Using discrete-time survival models, based on retrospective age of onset reports from college students (n = 6,393, 56.8% female), we examined associations of temporally prior NSSI with subsequent STB (i.e., suicide ideation, plan, and attempt) controlling mental disorders (i.e., MDD, Broad Mania, GAD, Panic Disorder, and risk for Alcohol Dependence). NSSI characteristics associated with subsequent STB were examined using logistic regressions. RESULTS: NSSI was associated with increased odds of subsequent suicide ideation (OR = 2.8), plan (OR = 3.0), and attempt (OR = 5.5) in models that controlled for the distribution of mental disorders. Further analyses revealed that NSSI was associated with increased risk of transitioning to a plan among those with ideation, as well as attempt among those with a plan (ORs = 1.7-2.1). Several NSSI characteristics (e.g., automatic positive reinforcement, earlier onset NSSI) were associated with increased odds of experiencing STB. LIMITATIONS: Surveys relied on self-report, and thus, there is the potential for recall bias. CONCLUSIONS: This study provides support for the conceptualization of NSSI as a risk factor for STB. Investigation of the underlying pathways accounting for these time-ordered associations is an important avenue for future research.

17 Article Severe role impairment associated with mental disorders: Results of the WHO World Mental Health Surveys International College Student Project. 2018

Alonso, Jordi / Mortier, Philippe / Auerbach, Randy P / Bruffaerts, Ronny / Vilagut, Gemma / Cuijpers, Pim / Demyttenaere, Koen / Ebert, David D / Ennis, Edel / Gutiérrez-García, Raul A / Green, Jennifer Greif / Hasking, Penelope / Lochner, Christine / Nock, Matthew K / Pinder-Amaker, Stephanie / Sampson, Nancy A / Zaslavsky, Alan M / Kessler, Ronald C / Anonymous881081. ·Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. · Pompeu Fabra University (UPF), Barcelona, Spain. · CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. · Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium. · Department of Psychiatry, Harvard Medical School, Boston, MA, USA. · Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. · Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. · Department for Psychology, Clinical Psychology and Psychotherapy Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany. · School of Psychology, Ulster University, Londonderry, United Kingdom. · Campus Salamanca, De La Salle Bajio University, León, Mexico. · School of Education, Boston University, Boston, MA, USA. · School of Psychology & Speech Pathology, Curtin University, Perth, Australia. · SAMRC/UCT/SU Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa. · Department of Psychology, Harvard University, Cambridge, MA, USA. · Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. ·Depress Anxiety · Pubmed #29847006.

ABSTRACT: BACKGROUND: College entrance is a stressful period with a high prevalence of mental disorders. AIMS: To assess the role impairment associated with 12-month mental disorders among incoming first-year college students within a large cross-national sample. METHODS: Web-based self-report surveys assessing the prevalence of DSM-IV mental disorders and health-related role impairment (Sheehan Disability Scale) were obtained and analyzed from 13,984 incoming first-year college students (Response = 45.5%), across 19 universities in eight countries. Impairment was assessed in the following domains: home management, work (e.g., college-related problems), close personal relationships, and social life. RESULTS: Mean age of the sample was 19.3 (SD = 0.59) and 54.4% were female. Findings showed that 20.4% of students reported any severe role impairment (10% of those without a mental disorder vs. 42.9% of those with at least one disorder, P < 0.01). In bivariate analyses, panic disorder, and mania were associated most frequently with severe impairment (60.6% and 57.5%, respectively). Students reporting three or more mental disorders had almost fivefold more frequently severe impairment relative to those without mental disorders. Multiple logistic regression showed that major depression (OR = 4.0; 95%CI = 3.3, 4.8), generalized anxiety (OR = 3.9; 95%CI = 3.1, 4.8), and panic disorder (OR = 2.9; 95%CI 2.4, 4.2) were associated with the highest odds of severe impairment. Only minimal deviations from these overall associations were found across countries. CONCLUSION: Mental disorders among first-year college students are associated with substantial role impairment. Providing preventative interventions targeting mental disorders and associated impairments is a critical need for institutions to address.

18 Article The DSM-5 nonsuicidal self-injury disorder among incoming college students: Prevalence and associations with 12-month mental disorders and suicidal thoughts and behaviors. 2018

Kiekens, Glenn / Hasking, Penelope / Claes, Laurence / Mortier, Philippe / Auerbach, Randy P / Boyes, Mark / Cuijpers, Pim / Demyttenaere, Koen / Green, Jennifer G / Kessler, Ronald C / Nock, Matthew K / Bruffaerts, Ronny. ·Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium. · School of Psychology, Curtin University, Perth, Australia. · Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium. · Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium. · Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA. · Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. · School of Education, Boston University, Boston, MA, USA. · Harvard Medical School, Department of Health Care Policy, Harvard University, Boston, MA, USA. · Department of Psychology, Harvard University, Cambridge, MA, USA. · Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, MI, USA. ·Depress Anxiety · Pubmed #29697881.

ABSTRACT: BACKGROUND: Approximately one in five college students report a history of nonsuicidal self-injury. However, it is unclear how many students meet criteria for the recently proposed DSM-5 nonsuicidal self-injury disorder (NSSI-D). In this study, we used full NSSI-D criteria to identify those students most in need of clinical care. METHODS: Using data from the Leuven College Surveys (n = 4,565), we examined the 12-month prevalence of DSM-5 NSSI-D in a large and representative sample of incoming college students. We also explored the optimal frequency threshold as a function of interference in functioning due to NSSI, and examined comorbidity patterns with other 12-month mental disorders (i.e., major depressive disorder, broad mania, generalized anxiety disorder, panic disorder, and alcohol dependence) and suicidal thoughts and behaviors (STB). RESULTS: Twelve-month NSSI-D prevalence was 0.8% and more common among females (1.1%) than males (0.4%). The proposed 5+ diagnostic threshold was confirmed as yielding highest discrimination between threshold and subthreshold cases in terms of distress or disability due to NSSI. A dose-response relationship was observed for NSSI recency-severity (i.e., 12-month NSSI-D, subthreshold 12-month NSSI-D, past NSSI, no history of NSSI) with number of 12-month mental disorders and STB. NSSI-D occurred without comorbid disorders for one in five individuals, and remained associated with severe role impairment when controlling for the number of comorbid disorders. CONCLUSIONS: These findings offer preliminary evidence that DSM-5 NSSI-D is uncommon among incoming college students, but may help to improve the deployment of targeted resource allocation to those most in need of services. More work examining the validity of NSSI-D is required.

19 Article Effectiveness of an Internet- and App-Based Intervention for College Students With Elevated Stress: Randomized Controlled Trial. 2018

Harrer, Mathias / Adam, Sophia Helen / Fleischmann, Rebecca Jessica / Baumeister, Harald / Auerbach, Randy / Bruffaerts, Ronny / Cuijpers, Pim / Kessler, Ronald C / Berking, Matthias / Lehr, Dirk / Ebert, David Daniel. ·Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany. · Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany. · Department of Psychiatry, Columbia University, New York, NY, United States. · Universitair Psychiatrisch Centrum, Katholieke Universiteit Leuven, Leuven, Belgium. · Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands. · Department of Health Care Policy, Harvard Medical School, Boston, MA, United States. · Division of Online Health Trainings, Innovation Incubator, Leuphana University, Lüneburg, Germany. ·J Med Internet Res · Pubmed #29685870.

ABSTRACT: BACKGROUND: Mental health problems are highly prevalent among college students. Most students with poor mental health, however, do not receive professional help. Internet-based self-help formats may increase the utilization of treatment. OBJECTIVE: The aim of this randomized controlled trial was to evaluate the efficacy of an internet-based, app-supported stress management intervention for college students. METHODS: College students (n=150) with elevated levels of stress (Perceived Stress Scale 4-item version, PSS-4 ≥8) were randomly assigned to either an internet- and mobile-based stress intervention group with feedback on demand or a waitlist control group. Self-report data were assessed at baseline, posttreatment (7 weeks), and 3-month follow-up. The primary outcome was perceived stress posttreatment (PSS-4). Secondary outcomes included mental health outcomes, modifiable risk and protective factors, and college-related outcomes. Subgroup analyses were conducted in students with clinically relevant symptoms of depression (Center for Epidemiological Studies' Depression Scale >17). RESULTS: A total of 106 participants (76.8%) indicated that they were first-time help-seekers, and 77.3% (intervention group: 58/75; waitlist control group: 58/75) showed clinically relevant depressive symptoms at baseline. Findings indicated significant effects of the intervention compared with the waitlist control group for stress (d=0.69; 95% CI 0.36-1.02), anxiety (d=0.76; 95% CI 0.43-1.09), depression (d=0.63; 95% CI 0.30-0.96), college-related productivity (d=0.33; 95% CI 0.01-0.65), academic work impairment (d=0.34; 95% CI 0.01-0.66), and other outcomes after 7 weeks (posttreatment). Response rates for stress symptoms were significantly higher for the intervention group (69%, 52/75) compared with the waitlist control group (35%, 26/75, P<.001; number needed to treat=2.89, 95% CI 2.01-5.08) at posttest (7 weeks). Effects were sustained at 3-month follow-up, and similar findings emerged in students with symptoms of depression. CONCLUSIONS: Internet- and mobile-based interventions could be an effective and cost-effective approach to reduce consequences of college-related stress and might potentially attract students with clinically relevant depression who would not otherwise seek help. TRIAL REGISTRATION: German Clinical Trial Register DRKS00010212; http://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00010212 (Archived by WebCite at http://www.webcitation.org/6w55Ewhjd).

20 Article A longitudinal investigation of the Concise Health Risk Tracking Self-Report (CHRT-SR) in suicidal patients during and after hospitalization. 2018

Villegas, Ana C / DuBois, Christina M / Celano, Christopher M / Beale, Eleanor E / Mastromauro, Carol A / Stewart, Jeremy G / Auerbach, Randy P / Huffman, Jeff C / Hoeppner, Bettina B. ·Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. · Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. · Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. · Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: bhoeppner@mgh.harvard.edu. ·Psychiatry Res · Pubmed #28954699.

ABSTRACT: The Concise Health Risk Tracking Self-Report (CHRT-SR) scale is a brief self-report instrument to assess suicide risk. Initial investigations have indicated good psychometric properties in psychiatric outpatients. The aims of this paper were to examine the construct validity and factor structure of the twelve- (CHRT-SR12) and seven-item (CHRT-SR7) versions and to test if clinically expected within-person changes in suicide risk over time were measurable using the CHRT-SR in two study cohorts hospitalized for suicidal ideation or behavior: (1) patients with major depressive disorder (MDD) who participated in a psychological intervention trial, n = 65, and (2) participants with bipolar disorder or MDD in an observational study, n = 44. The CHRT-SR12 and self-report measures of hopelessness, depression, and positive psychological states were administered during admission and several times post-discharge. Both versions showed good internal consistency in inpatients and confirmed the three-factor structure (i.e., hopelessness, perceived lack of social support and active suicidal ideation and plans) found in outpatients. CHRT-SR scores had strong correlations with negative and positive affective constructs in the expected directions, and indicated decreases in suicide risk following discharge, in line with clinical expectations. The CHRT-SR12 and CHRT-SR7 are promising self-report measures for assessing suicide risk in very high-risk patient populations.

21 Article Peer Victimization and Suicidal Thoughts and Behaviors in Depressed Adolescents. 2018

Stewart, Jeremy G / Valeri, Linda / Esposito, Erika C / Auerbach, Randy P. ·Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA. jstewart@mclean.harvard.edu. · Center for Depression, Anxiety and Stress Research, McLean Hospital, Mailstop 331, de Marneffe building, room 239, 115 Mill Street, Belmont, MA, 02478-9106, USA. jstewart@mclean.harvard.edu. · Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA. · Psychiatric Biostatistics Laboratory, McLean Hospital, Mailstop 331, 115 Mill Street, Belmont, MA, 02478-9106, USA. · Center for Depression, Anxiety and Stress Research, McLean Hospital, Mailstop 331, de Marneffe building, room 239, 115 Mill Street, Belmont, MA, 02478-9106, USA. ·J Abnorm Child Psychol · Pubmed #28444481.

ABSTRACT: Suicide is a leading cause of death among youth worldwide, and depressed adolescents are at a significantly elevated risk to report suicidal ideation, planning, and attempts. Peer victimization is a robust predictor of adolescent suicidal thoughts and behaviors (STBs), but little research has focused on why bullying leads to suicidal thoughts and behaviors. To address this empirical gap, we recruited 340 (246 female) depressed adolescents ages 13-19 (M = 15.59, SD = 1.41) within 48 h of admission for acute psychiatric treatment. At the initial assessment, participants were administered clinical interviews characterizing psychopathology, nonsuicidal self-injury, and STBs (ideation, plans, and attempts). Further, they completed questionnaires assessing 3 forms of victimization (overt, relational, and reputational), recent risky behavior engagement, and psychiatric symptom severity. Controlling for internalizing symptoms and age, overt and reputational bullying were associated with more frequent past month suicide attempts, but not suicide ideation. Past month risky behavior engagement, but not NSSI, mediated the relation between victimization and attempts. However, sex differences revealed that this effect only held for males whereas bullying was directly associated with suicide attempts among females. In contrast, overt and relational bullying were non-linearly associated with suicide plans, and these relations were not mediated by risky behaviors or NSSI. Results highlight the complex network of factors that lead victimized adolescents to engage in STBs and may inform targeted suicide prevention and intervention programs.

22 Article Neuroanatomical Prediction of Anhedonia in Adolescents. 2017

Auerbach, Randy P / Pisoni, Angela / Bondy, Erin / Kumar, Poornima / Stewart, Jeremy G / Yendiki, Anastasia / Pizzagalli, Diego A. ·Department of Psychiatry, Harvard Medical School, Boston, MA, USA. · Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. · Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. · McLean Imaging Center, McLean Hospital, Belmont, MA, USA. ·Neuropsychopharmacology · Pubmed #28165037.

ABSTRACT: Anhedonia is a transdiagnostic risk factor implicated in mental illness onset, treatment non-response, and suicidal behaviors. Prior cross-sectional research in adults has shown that anhedonia is associated with reduced dorsal striatal volume, but it is unknown whether this relationship extends to adolescents and whether reduced striatal volume prospectively predicts anhedonia. To address these gaps, the current study investigated whether striatal volume predicted anhedonia severity in adolescents. At baseline, healthy female adolescents aged 12-14 years (n=50) completed a clinical assessment, and structural MRI data were acquired on a 3 Tesla MR scanner. While in the scanner, participants also completed a peer feedback task where subjective ratings following peer 'acceptance' or 'rejection' were obtained. At the three-month follow-up, participants provided self-report assessments of anhedonia, depression, and anxiety symptoms. Three main findings emerged. First, in cross-sectional analyses, right nucleus accumbens volume was inversely related to anhedonia severity. Second, reduced bilateral putamen volume prospectively predicted anhedonia severity while controlling for baseline anhedonia, depression, and anxiety symptoms. Third, a blunted subjective response to peer acceptance (ie, neutral response to positive feedback), but not a more negative subjective response to peer rejection, contributed to anhedonia severity, but only among youth with smaller putamen volume. Collectively, these results suggest that smaller volume in striatal regions critically implicated in reward processing is associated with current and future anhedonic symptoms among healthy female youth. These anatomical features may confer vulnerability to anhedonia and thus, may inform early identification of individuals at high risk for mental illness.

23 Article Internet-based cognitive behavior therapy for major depressive disorder: A randomized controlled trial. 2017

Rosso, Isabelle M / Killgore, William D S / Olson, Elizabeth A / Webb, Christian A / Fukunaga, Rena / Auerbach, Randy P / Gogel, Hannah / Buchholz, Jennifer L / Rauch, Scott L. ·Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. · Department of Psychiatry, Harvard Medical School, Boston, MA, USA. · Department of Psychology, University of Arizona, Tucson, AZ, USA. ·Depress Anxiety · Pubmed #28009467.

ABSTRACT: BACKGROUND: Prior research has shown that the Sadness Program, a technician-assisted Internet-based cognitive behavioral therapy (iCBT) intervention developed in Australia, is effective for treating major depressive disorder (MDD). The current study aimed to expand this work by adapting the protocol for an American population and testing the Sadness Program with an attention control group. METHODS: In this parallel-group, randomized controlled trial, adult MDD participants (18-45 years) were randomized to a 10-week period of iCBT (n = 37) or monitored attention control (MAC; n = 40). Participants in the iCBT group completed six online therapy lessons, which included access to content summaries and homework assignments. During the 10-week trial, iCBT and MAC participants logged into the web-based system six times to complete self-report symptom scales, and a nonclinician technician contacted participants weekly to provide encouragement and support. The primary outcome was the Hamilton Rating Scale for Depression (HRSD), and the secondary outcomes were the Patient Health Questionnaire-9 and Kessler-10. RESULTS: Intent-to-treat analyses revealed significantly greater reductions in depressive symptoms in iCBT compared with MAC participants, using both the self-report measures and the clinician-rated HRSD (d = -0.80). Importantly, iCBT participants also showed significantly higher rates of clinical response and remission. Exploratory analyses did not support illness severity as a moderator of treatment outcome. CONCLUSIONS: The Sadness Program led to significant reductions in depression and distress symptoms. With its potential to be delivered in a scalable, cost-efficient manner, iCBT is a promising strategy to enhance access to effective care.

24 Article Abnormal neural responses to feedback in depressed adolescents. 2017

Webb, Christian A / Auerbach, Randy P / Bondy, Erin / Stanton, Colin H / Foti, Dan / Pizzagalli, Diego A. ·Department of Psychiatry, Harvard Medical School. · Department of Psychology, Yale University. · Department of Psychological Sciences, Purdue University. ·J Abnorm Psychol · Pubmed #27935729.

ABSTRACT: Depression rates surge in adolescence, particularly among females. Recent findings suggest that depressed adolescents are characterized by hypersensitivity to negative outcomes and blunted responsiveness to rewards. However, our understanding of the pathophysiology and time course of these abnormalities remains limited. Due to their high temporal resolution, event-related potentials (ERPs) provide an ideal probe to investigate these processes. In the present study, healthy (n = 25) and depressed (n = 26) female adolescents (13-18 years) completed a gambling task during 128-channel ERP recording. Time-domain analyses focused on ERPs linked to initial processing of negative versus rewarding outcomes (feedback-related negativity; FRN), and later, elaborative processing (late positive potential; LPP). Additionally, time-frequency analyses were used to decompose the FRN into its 2 constituent neural signals: loss-related theta and reward-related delta activity, thereby allowing us to separately probe these 2 putative mechanisms underlying FRN abnormalities in depression. Relative to healthy adolescents, depressed youth showed potentiated FRN (loss vs. reward) responses. Time-frequency analyses revealed that this group difference in the FRN was driven by increased loss-related theta activity in depressed youth, and not by reward-related delta activity. For the LPP, healthy adolescents exhibited sustained positivity to rewards versus losses, whereas depressed adolescents showed the opposite pattern. Moreover, an enhanced LPP to losses was associated with rumination. In summary, the LPP may be a sensitive probe of depressive rumination, whereas FRN-linked theta activity may represent a neural marker of hypersensitivity to negative outcomes in depressed youth. Implications for treatment and future ERP research are discussed. (PsycINFO Database Record

25 Article Psychological interventions to reduce suicidality in high-risk patients with major depression: a randomized controlled trial. 2017

Celano, C M / Beale, E E / Mastromauro, C A / Stewart, J G / Millstein, R A / Auerbach, R P / Bedoya, C A / Huffman, J C. ·Harvard Medical School,Boston, MA,USA. · Department of Psychiatry,Massachusetts General Hospital,Boston, MA,USA. ·Psychol Med · Pubmed #27876105.

ABSTRACT: BACKGROUND: Positive psychological constructs have been associated with reduced suicidal ideation, and interventions to cultivate positive feelings have the potential to reduce suicide risk. This study compares the efficacy of a 6-week, telephone-based positive psychology (PP) intervention against a cognition-focused (CF) control intervention among patients recently hospitalized for depression and suicidal ideation or behavior. METHOD: A total of 65 adults with a current major depressive episode reporting suicidal ideation or a recent suicide attempt were enrolled from participating in-patient psychiatric units. Prior to discharge, participants were randomized to the PP (n = 32) or CF (n = 33) intervention. In both interventions, participants received a treatment manual, performed weekly PP (e.g. gratitude letter) or CF (e.g. recalling daily events) exercises, and completed weekly one-on-one telephone sessions over 6 weeks. Between-group differences in hopelessness (primary outcome), depression, suicidality and positive psychological constructs at 6 and 12 weeks were tested using mixed-effects models accounting for intensity of post-hospitalization psychiatric treatment. RESULTS: Compared with PP, the CF intervention was associated with significantly greater improvements in hopelessness at 6 weeks (β = -3.15, 95% confidence interval -6.18 to -0.12, effect size = -0.84, p = 0.04), but not 12 weeks. Similarly, the CF intervention led to greater improvements in depression, suicidal ideation, optimism and gratitude at 6 and 12 weeks. CONCLUSIONS: Contrary to our hypothesis, the CF intervention was superior to PP in improving hopelessness, other suicide risk factors and positive psychological constructs during a key post-discharge period among suicidal patients with depression. Further study of this CF intervention is warranted in populations at high suicide risk.

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