Vignesh Subramanian ’24
Depression is a mood disorder involving persistent feelings of dejection or hopelessness, difficulty with control of emotions, and loss of interest or pleasure in regular activities. As depressive disorders are increasingly recognized as a legitimate medical issue and treatment is destigmatized, younger generations in the United States have consistently reported higher rates of experiencing such conditions. However, less than half of afflicted adolescents report accessing care for depression or having sufficient mental health supports in their lives, underscoring the need to make alternative clinical interventions widely available. Online single-session interventions (SSIs) – free self-help modules involving questionnaires to identify symptoms and real-time feedback – have emerged as a promising option, but often differ strongly in their quality and effectiveness. Researchers led by Dr. Schleider of Stony Brook University worked to compare the outcomes of various active SSIs and highlight their best practices.
The researchers first recruited over 2,400 adolescents between the ages 13-16 over social media and collected self-reported descriptions of clinically elevated depressive symptom severity at baseline. The subjects were then randomly submitted to one of three SSIs: a growth mindset (GM) SSI offering guidance on how to reshape personal traits, a behavioral activation (BA) SSI promoting engagement in pleasurable and accomplishment-focused activities, or a supportive control not teaching any particular skills. Follow-up surveys and post-hoc exploratory analyses were conducted to assess post-intervention outcomes (impacts on feelings of hopelessness, or, conversely, agency) and three-month outcomes (impacts on depression-, generalized anxiety-, or eating habits-related symptoms and COVID-19-related trauma induced by school closures and social isolation protocols implemented).
The researchers found that both the GM and BA SSIs led to significant improvements in reported depressive symptoms among treated youth from baseline to the three-month follow-up (demonstrating an average reduction of 2.64 points on the CDI-SF, a metric for cognitive, affective, and behavioral signs of depression). Furthermore, both active interventions contributed to decreases in reported hopelessness and increases in perceived agency noted during the more immediate post-intervention follow-ups. Improvements in sensitivity to pre-registered secondary outcomes, including pandemic-related trauma, anxiety, and restrictive eating habits, were also observed. Taken together, these findings affirm the efficacy of online SSIs for treatment of adolescent depression, and suggest that such modules may also have an expanded clinical utility with regard to other mental health conditions. When coupled with psychotherapy, use of these tools may indicate a route to full remission of depressive symptoms.
 J. Schleider, et al., A randomized trial of online single-session interventions for adolescent depression during COVID-19. Nature Human Behavior 6, 258-268 (2022). doi: 10.1038/s41562-021-01235-0
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