Mobile-enhanced Group CBT for Adolescents at Risk Severe Mood Disorders

University of California, Los Angeles91 enrolled

Overview

Although cognitive-behavioral therapy (CBT) has shown efficacy in reducing symptoms and rates of mood relapse in adolescents at high risk for severe mood disorders (SMD; i.e., bipolar I/II disorder and recurrent or unremitting major depression), a significant limitation to the CBT's efficacy is the low rate of participant adherence to the prescribed between-session homework tasks. Mobile health applications have the potential to improve adherence to and acceptance of treatment through embedded treatment content, skill-practice, thought and symptom monitoring, all of which are facilitated by reward contingencies and notifications. This study examines whether a mobile application-enhanced CBT can improve participant adherence and treatment acceptance for adolescents at high risk for SMD.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Adolescents Mood Disorders

Interventions

Eligibility

Sex: ALLMin age: 13 YearsMax age: 17 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Meet DSM-5 criteria for at least one past major depressive disorder, persistent depressive disorder, or unspecified bipolar disorder 2. Be 13-17 years old 3. English speaking and able to complete written questionnaires 4. Ability to attend pre-determined group session time(s) 5. Access to a smartphone to engage with the study app 6. Medication usage is acceptable, but not required Exclusion Criteria: 1. Regular use or current abuse of a psychoactive drug 2. Evidence of behavioral problems that are thought to interfere with group treatment 3. Suicidality that requires more intensive treatment 4. Meeting DSM 5 criteria for bipolar I or II disorder, a psychotic disorder, or significant psychiatric symptoms (e.g., self-injurious behavior) that require more intensive treatment 5. Concurrent participation in cognitive-behavioral therapy 6. Inability to travel to study sessions and assessments

Outcomes

Primary Outcomes

Treatment Skill Practice

Sum of all treatment skill practices completed through the course of the treatment (based on adolescent report).

Time frame: 9-week treatment period

Psychosocial Treatment Compliance Scale

Clinician-rated of participant overall treatment compliance. Scores range from 17-85 (17 5-point Likert scale items) with higher scores indicating greater treatment compliance.

Time frame: 9-week treatment

Mobile Application Use

Frequency of mobile application (app) usage within the condition that received the mobile application, ranging from 0 to unlimited maximum with higher scores indicating more app usage.

Time frame: 9-week treatment period

Secondary Outcomes

Mobile Application Usability Scale

Mobile application (app) acceptability as rated on a 5-point scale (i.e., minimum = 1, maximum = 5) with higher values indicating greater acceptability

Time frame: Measured at the end of the 9-week treatment period

Children's Depression Rating Scale, Revised

Measures depressive symptom severity. Scores range from 17-113 (14 7-point items and 3 5-point items) with higher scores indicating greater depressive severity.