| This study aims to examine the cognitive mechanisms of change in adolescent depression. Using the data from the Treatment for Adolescents with Depression Study (TADS, 2004), the present analyses investigated the relationship between hopelessness, dysfunctional attitudes, negative cognitive errors, suicidal ideation, social problem solving, and depression. Overall, there was a strong positive correlation between hopelessness, dysfunctional attitudes, negative cognitive errors, suicidal ideation, and depression, across all treatment groups, including placebo. Social problem solving was negatively correlated with hopelessness, dysfunctional attitudes, negative cognitive errors, suicidal ideation, and depression, i.e., as social problem solving increased, hopelessness, dysfunctional attitudes, negative cognitive errors, suicidal ideation, and depression, decreased. Of the cognitive components, hopelessness was the most highly correlated with depression, regardless of treatment group. Compared to medication groups, the therapy treatment groups had overall stronger correlations between depression and the cognitive component variables. The mechanism of cognitive change was evaluated by examining the relative improvement in each group over time. Effect sizes for therapy treatment group were larger than the medication group at 12 month follow up for depression, hopelessness, dysfunctional attitudes, suicidal ideation, and negative problem orientation. A hierarchical linear regression was conducted to further analyze the utility of changes in cognition in predicting depression. Results indicate that cognitive components account for a significant percentage of the variance in adolescent depression, regardless of treatment type. |
