Abstract
BackgroundTreatment innovation for depressive symptoms in adolescence is urgently needed. Adult research suggests interventions targeting underlying cognitive mechanisms, such as dysfunctional mental imagery and overgeneral memory, are promising. Here, we describe and evaluate in a case series a brief imagery-based intervention for depressive symptoms that targets these cognitive mechanisms.MethodsNine participants completed the four-session intervention, whose principle components were imagery rescripting and memory specificity training. Questionnaires and experimental tasks (assessing symptomatology and cognitive mechanisms) were administered at three time points: pre-intervention, post-intervention and 3-month follow-up.ResultsThe intervention was feasible to deliver and acceptable to participants. There was a large reduction in depression symptom scores from pre to post intervention (d = 1.32; 67% showed reliable improvement, RI) and this was maintained at follow-up (d = 1.46; RI = 75%). There were also reductions in anxiety (post: d = 1.15, RI = 44%; follow-up: d = 1.67, RI = 63%), increases in self-esteem (post: d = − 0.70, RI = 44%; follow-up: d = − 1.20, RI = 50%) and noteworthy changes in memory specificity (post: d = − 1.80, RI = 67%; follow-up: d = − 0.94, RI = 63%).ConclusionsThis is the first study to use imagery rescripting and memory specificity training in adolescence. Initial evidence is provided that the intervention is acceptable and may have clinical utility. Future randomised controlled trials are needed to further assess the intervention.
Highlights
Depression in adolescence is common and impairing (Birmaher and Brent 2007; Cook et al 2009)
Recent advances in treatment development for adults have capitalised on findings that symptoms of depression are associated with dysfunctional mental imagery and overgeneral memory (OGM) (Dalgleish and Werner-Seidler 2014; Holmes et al 2016)
We have developed a brief manualised early intervention for depressive symptoms that can be delivered in schools
Summary
Depression in adolescence is common and impairing (Birmaher and Brent 2007; Cook et al 2009). Recent advances in treatment development for adults have capitalised on findings that symptoms of depression are associated with dysfunctional mental imagery (of past memories and future events) and overgeneral memory (OGM) (Dalgleish and Werner-Seidler 2014; Holmes et al 2016). As these cognitive mechanisms characterise depressive symptoms in adolescence (Hitchcock et al 2014; Pile and Lau 2018), targeting them could be a powerful and novel intervention approach. Adult research suggests interventions targeting underlying cognitive mechanisms, such as dysfunctional mental imagery and overgeneral memory, are promising. Future randomised controlled trials are needed to further assess the intervention
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