Parental Conflict and Neural Response to Social Reward as Predictors of Response to Cognitive Behavioral Therapy for Depressed Adolescents
Depression is a prevalent disorder among adolescents, with evidence that rates have been increasing over the past 10 years. Cognitive behavioral therapy (CBT) is a leading evidence- based treatment option, but it is not effective for all depressed adolescents, raising questions about who benefits the most. Past research has separately identified low social support and an enhanced reward positivity (RewP) event-related potential (ERP) component to be predictive of decreased responsivity to treatment; however, these factors have not been examined within the same study. This study followed 70 adolescents with depression (14-18 years old) across 16 sessions of group CBT. Baseline parental conflict and RewP in an EEG social reward task were examined as predictors of clinician-rated improvement across treatment. Results showed that while both maternal and paternal conflict were predictive of lower clinician-rated improvement within treatment, only paternal-child conflict was significant when accounting for baseline depression and anxiety symptoms. Additionally, the association between RewP and parental conflict was not significant. Future research is needed to identify various interventions that would increase the efficacy of CBT for individuals who are less likely to succeed in treatment. The results indicate that it may be helpful for clinicians to assess parental-child conflict at the beginning of treatment to determine whether the patient is likely to respond to CBT and to administer individualized interventions accordingly. This thesis was created in conjunction with the Honors Program for Psychological Sciences (PSY-PC 4998, Honors Thesis) and the Mood, Emotion, and Development Lab led by Dr. Autumn Kujawa.