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Study Shows Promising Results In Reducing Adolescent Depression

Rumination-focused cognitive behavioural therapy (RF-CBT) offers new hope for young adults battling depression

A recent collaborative study from The Ohio State University Wexner Medical Center, the University of Utah, and the University of Exeter in the UK has provided compelling evidence that Rumination-focused Cognitive Behavioral Therapy (RF-CBT) can effectively reduce rumination and lead to significant shifts in brain connectivity in adolescents struggling with depression.

The findings, published in the journal Biological Psychiatry Global Open Science, build on previous research and offer new hope for younger populations dealing with the burden of depressive relapse.

Ed Watkins, PhD, a distinguished professor specializing in experimental and applied Clinical Psychology at the University of Exeter, is the mastermind behind RF-CBT, a pioneering therapeutic approach. While it has shown success among adults with recurrent depression, the study aimed to adapt it for teenagers, to prevent the recurring cycle of depressive episodes.

Dr. Rachel Jacobs, an adjunct assistant professor of psychiatry and behavioural sciences at Northwestern University, conducted the pilot study in 2016. She noted that standard Cognitive Behavioral Therapy (CBT) tools often fell short of equipping young people with the means to break free from the mental loops that contribute to recurring depression.

In the recent trial, 76 teenagers aged 14 to 17, who had a history of depression, were randomly assigned to 10-14 sessions of RF-CBT, while the control group received standard treatment. The results were promising, with teens who received RF-CBT reporting significantly reduced rumination.

Another intriguing observation is that functional Magnetic Resonance Imaging (fMRI) revealed changes in brain connectivity. The left posterior cingulate cortex, known for self-referential thinking, showed reduced connectivity with the right inferior frontal gyrus and the right inferior temporal gyrus, responsible for processing emotional stimuli. These changes in brain connectivity suggest that RF-CBT may enhance the brain's ability to break the cycle of rumination.

This study is a pre-registered replication, demonstrating the same positive effects on both the brain and clinical outcomes in the Utah sample in 2023 as first reported in the Chicago sample in 2016.

Ed Watkins, the pioneer of RF-CBT, expressed excitement about these findings. "For the first time, this paper shows that the version of rumination-focused CBT we have developed at the University of Exeter leads to changes in connectivity in brain regions in adolescents with a history of depression. This is exciting, as it suggests the CBT either helps patients to gain more effortless control over rumination or makes it less habitual."

The researchers plan to further validate the efficacy of RF-CBT in a larger sample with an active treatment control, involving collaboration with Ohio State, Nationwide Children's Hospital, University of Exeter, University of Utah, and the Utah Center for Evidence-Based Treatment. Their future endeavours aim to enhance access to this treatment in clinical settings and gain a deeper understanding of how it can help youth with similar conditions.

Scott Langenecker, who initiated the project while at the University of Utah, emphasized the importance of the research, underlining the potential to break the cycle of rumination and foster healthier mental habits, regardless of age. He thanked the youths and families who participated in the study, highlighting their dedication to reducing the burden of depression through science and treatment, even amidst the challenges of a global pandemic.

This research was made possible through the support of the National Institutes of Mental Health and funds from the Huntsman Mental Health Institute. It is dedicated to researcher Kortni K. Meyers and others who have tragically lost their lives to depression.



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