Betsy Dohoney Kennard

Background: Suicidal ideation among youth is a public health crisis, creating a need to identify features that can prognosticate suicide-related outcomes. This study characterized trajectories of suicidal thoughts in youth with depression/suicidality and evaluated features predicting trajectories. Methods: Participants in the Texas Youth Depression and Suicide Research Network with self-reported suicidal ideation data available for baseline and ≥2 other time points were included ( n = 1,449). Group mixture models were used to identify trajectories of suicidal thoughts at four follow-up assessments during the succeeding 6 months. Random Forest analyses evaluated baseline clinical and sociodemographic variables that predicted trajectory group membership after splitting into training (two-thirds) and validation (one-third) samples. Results: Mean (standard deviation) age was 15.6 (2.7) years, and 72.8% were female. Three trajectories were identified: persistently no (43.3%), persistently low (44.2%), and persistently high (12.4%) suicidal thoughts. In Random Forest analyses, self-reported severity of suicide propensity (including pessimism, helplessness, perceived lack of social support, and despair) plus a clinical interview of suicidal ideation predicted these trajectories. The area under the curve in training and validation samples for predicting persistently no suicidal thoughts was 0.83 and 0.80, respectively, and for persistently high suicidal thoughts was 0.87 and 0.87, respectively. Conclusions: Three distinct trajectories of suicidal thoughts were identified. A combination of baseline self-reported measures of depression, pessimism, helplessness, perceived lack of social support, and despair, along with a clinical interview of suicidal ideation, predicted no or high suicidal thoughts over 6 months with high accuracy, providing a clinically useful predictive model of suicide risk.

Purpose This is a secondary analysis of a multi-site, cluster (site) randomized trial of the efficacy of a combined Health and Wellness Cognitive Behavior Therapy (H&W CBT) and medication management approach for depression in youth with HIV (YWH) compared to standard care. In this study, we explored the association between H&W CBT factors and depression outcomes after 24 weeks of treatment to discover treatment elements associated with symptom reduction. Methods Participants (12–24 years of age) were YWH in the United States (US) diagnosed with moderate to severe depression [Quick Inventory of Depressive Symptomatology (QIDS), Clinician-Rated score ≥ 11]. Thirteen US sites were randomly assigned to either the combination treatment approach or standard care. For site-level analyses, site-specific summary scores were used to account for the within site correlation. Results (all scores are site-level) The number of depressive symptoms [QIDS-Self Reported (QIDS-SR) score] after 24 weeks of H&W CBT was significantly negatively correlated with the mean total session duration (ρ = − 0.94), the total homework assigned (ρ = − 0.83), the total number of practice modules used (ρ = − 0.83), and the mean total booster sessions given (ρ = − 0.82). Conclusions Specific elements of the H&W CBT (e.g., dose, assignment of homework, greater skills practice, and use of booster sessions) were associated with improvement of depression outcomes in YWH. A focus on these elements in treatment may improve symptom reduction for YWH with depression.

Objective: The current study aimed to evaluate the psychometric features of the Quick Inventory of Depressive Symptomatology, Adolescent version (QIDS-A₁₇) and the clinician-rated Children’s Depression Rating Scale-Revised (CDRS-R). Methods: Altogether, 103 outpatients (8 to 17 years) completed the self-report QIDS-A₁₇-SR. Clinician interviews of adolescents (QIDS-A₁₇-C (Adolescent)) and of parents (QIDS-A₁₇-C (Parent)) were combined to create the QIDS-A₁₇-C(Composite) and the CDRS-R. Results: All QIDS-A₁₇ measures and the CDRS-R evidenced high total score correlations and internal consistency. Factor analysis found all four measures to be unidimensional. Item Response Theory (IRT) analysis found results that complemented the reliability results found in CTT. All four also demonstrated discriminant diagnostic validity based on logistic regression and ANOVA analyses. Conclusion: The psychometric properties of the self-report and composite versions of the QIDS-A₁₇ suggest acceptability as a measure of depression in adolescents either as a measure of depressive symptoms or severity of illness in adolescents. The self-report version may be a helpful tool in busy clinical practices.

The objective of this study was to identify baseline demographic and clinical factors associated with higher scores on the Reasons for Living Inventory for Adolescents (RFL-A) at baseline and over ...