A feasibility randomised controlled trial of a brief early intervention for adolescent depression that targets emotional mental images and memory specificity (IMAGINE).

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Publisher: Elsevier Science Publishers
Document Type: Report
Length: 454 words

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Keywords Depression; Adolescence; Mental imagery; Imagery rescripting; Autobiographical memory; Memory specificity training Highlights * Trial evaluated a mechanistically focused intervention for adolescent depression. * Imagery-based intervention (ICBI) compared to non-directive supportive therapy. * All continuation rules were met for feasibility and acceptability. * Large between group differences in depressive symptoms and memory specificity. * Definitive trial indicated to determine treatment efficacy of ICBI. Abstract Brief, evidence-based interventions for adolescent depression are urgently required, particularly for school-settings. Cognitive mechanisms research suggests dysfunctional mental imagery and overgeneral memory could be promising targets to improve mood. This feasibility randomised controlled trial with parallel symptomatic groups (n = 56) compared a novel imagery-based cognitive behavioural intervention (ICBI) to non-directive supportive therapy (NDST) in school settings. Blind assessments (of clinical symptoms and cognitive mechanisms) took place pre-intervention, post-intervention and follow-up three months later. The trial aimed to evaluate the feasibility and acceptability of the methodology and interventions, and estimate the likely range of effects of the intervention on self-reported depression. The pre-defined criteria for proceeding to a definitive RCT were met: full recruitment occurred within eleven months; retention was 89%; ICBI acceptability was above satisfactory; and no harm was indicated. Intention-to-treat analysis found large effects in favour of ICBI (relative to NDST) at post-intervention in reducing depressive symptoms (d = -1.34, 95% CI [-1.87, -0.80]) and improving memory specificity (d = 0.79 [0.35, 1.23]), a key cognitive target. The findings suggest that ICBI may not only improve mood but also strengthen abilities associated with imagining and planning the future, critical skills at this life stage. A fully powered evaluation of ICBI is warranted. Trial Registration: https://www.isrctn.com/; ISRCTN85369879. Author Affiliation: (a) Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK (b) Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK (c) Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Germany (d) Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK (e) Mood Disorders Centre, University of Exeter, UK (f) Department of Psychology, Uppsala University, Uppsala, Sweden (g) Sweden and Division of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (h) Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK * Corresponding author. Department of Psychology, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK. Article History: Received 14 April 2020; Revised 1 October 2020; Accepted 19 April 2021 Byline: Victoria Pile (a), Patrick Smith (a), Mary Leamy (b), Abigail Oliver (a), Eleanor Bennett (a), Simon E. Blackwell (c), Richard Meiser-Stedman (d), Dominic Stringer (h), Barnaby D. Dunn (e), Emily A. Holmes (f,g), Jennifer Y.F. Lau [jennifer.lau@kcl.ac.uk] (a,*)

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Gale Document Number: GALE|A665686086