Journal article
Anxiety-Related Difficulties in Goal-Directed Behavior Predict Worse Treatment Outcome Among Adolescents Treated for Suicidal Ideation and Depressive Symptoms
Psychotherapy (Chicago, Ill.), v 58(4), pp 523-532
01 Dec 2021
PMID: 34881927
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Although treatments for youth at risk for suicide have been successful, they are not similarly effective for everyone. Anxiety may interfere with adolescents' ability to engage with therapy and explain why some adolescents do not respond as well as others to treatment. The current study tested whether an anxiety diagnosis predicted treatment outcome among a sample of adolescents with suicidal ideation and depressive symptoms participating in either attachment-based family therapy or family-enhanced nondirective supportive therapy (N = 129; M-age = 14.87, SD = 1.68; 81.9% female). The data set that the current study used had a high representation of Black/African American adolescents (48.8% of sample), which is valuable, as few studies have included adequate representation of this population. A significant indirect effect (.88; 95% confidence interval [.01, 2.64]) showed that across both treatment conditions, participants who met criteria for an anxiety disorder had greater difficulties engaging in goal-directed behavior midtreatment, and these difficulties, in turn, predicted more posttreatment suicidal ideation. The effect of anxiety on treatment outcome via difficulties with goal-directed behavior was nonspecific to the treatment condition. However, attachment-based family therapy was superior to family-enhanced nondirective supportive therapy in improving this aspect of emotion regulation among adolescents who did not have anxiety. In addition, difficulties with goal-directed behavior on treatment outcome were worse for adolescents' who reported greater attachment avoidance to their parents. Future research should test whether targeting goal-directed behavior and attachment avoidance would result in better treatment outcome for adolescents with suicidal ideation and anxiety.
Clinical Impact Statement Question: This study tested applied clinical questions about the psychotherapy process. Findings: Findings suggest that suicidal youth with anxiety experience worse treatment outcome if they are unable to engage in goal-directed behavior when distressed. Meaning: Key implications include the role of goal-directed behavior in the treatment of suicidal adolescents with anxiety. Next Steps: Future research should test the incremental validity of therapy modules that target emotion regulation for suicidal adolescents with anxiety.
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Details
- Title
- Anxiety-Related Difficulties in Goal-Directed Behavior Predict Worse Treatment Outcome Among Adolescents Treated for Suicidal Ideation and Depressive Symptoms
- Creators
- Joanna Herres - College of New JerseyKiera M. James - Binghamton UniversityNadia Bounoua - University of DelawareE. Stephanie Krauthamer Ewing - Drexel UniversityRoger Kobak - University of DelawareGuy S. Diamond - Drexel University
- Publication Details
- Psychotherapy (Chicago, Ill.), v 58(4), pp 523-532
- Publisher
- Amer Psychological Assoc
- Number of pages
- 10
- Grant note
- R01-MH091059 / National Institute of Mental Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Counseling and Family Therapy; Center for Family Intervention Science
- Web of Science ID
- WOS:000728148500012
- Scopus ID
- 2-s2.0-85122374123
- Other Identifier
- 991019168608504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Psychology, Clinical