Impact of Childhood Trauma on Treatment Outcome in the Treatment for Adolescents with Depression Study (TADS)

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Bibliographic Details
Title: Impact of Childhood Trauma on Treatment Outcome in the Treatment for Adolescents with Depression Study (TADS)
Language: English
Authors: Lewis, Cara C., Simons, Anne D., Nguyen, Lananh J.
Source: Journal of the American Academy of Child & Adolescent Psychiatry. Feb 2010 49(2):132-140.
Availability: Elsevier. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. Tel: 877-839-7126; Tel: 407-345-4020; Fax: 407-363-1354; e-mail: usjcs@elsevier.com; Web site: http://www.elsevier.com
Peer Reviewed: Y
Physical Description: PDF
Page Count: 9
Publication Date: 2010
Document Type: Journal Articles
Reports - Research
Descriptors: Sexual Abuse, Cognitive Restructuring, Rating Scales, Adolescents, Program Effectiveness, Depression (Psychology), Outcomes of Treatment, Behavior Modification, Classification, Interaction
DOI: 10.1016/j.jaac.2009.10.007
ISSN: 0890-8567
Abstract: Objective: The impact of childhood trauma was examined in 427 adolescents (54% girls, 74% Caucasian, mean = 14.6, SD = 1.5) with major depressive disorder participating in the Treatment for Adolescents with Depression Study (TADS). Method: TADS compared the efficacy of cognitive behavioral therapy (CBT), fluoxetine (FLX), their combination (COMB), and placebo (PBO). Teens were separated into four trauma history groups: (1) no trauma; (2) trauma, no abuse; (3) physical abuse; (4), and sexual abuse. The effects of treatment and trauma history on depression severity across 12 weeks of acute treatment, as measured by the Children's Depression Rating Scale-Revised (CDRS-R), were examined. Results: A significant trauma-by-treatment-by-time interaction indicated that trauma history moderated treatment. The Week 12 primary efficacy findings previously reported by TADS were replicated in the no trauma group (n = 201): COMB = FLX greater than CBT = PBO. No significant differences in treatment arms were observed among the trauma, no abuse, or physical abuse group. Teens with a history of sexual abuse treated with COMB, FLX, and PBO showed significant and equivalent improvement on the CDRS-R (mean less than 45), whereas the mean CDRS-R for the CBT group tended to remain in the depressed range (mean greater than 45). Baseline suicidality and self-reported depression were significantly related to a history of sexual abuse. Conclusions: The study was limited by the level of detail regarding childhood traumatic experiences. Results are discussed in terms of the implications for treating depressed adolescents with traumatic backgrounds. Clinical Trials Registry Information: Treatment for Adolescents with Depression Study; NCT00006286. (Contains 4 figures and 4 tables.)
Abstractor: As Provided
Entry Date: 2011
Accession Number: EJ944735
Database: ERIC
Description
Abstract:Objective: The impact of childhood trauma was examined in 427 adolescents (54% girls, 74% Caucasian, mean = 14.6, SD = 1.5) with major depressive disorder participating in the Treatment for Adolescents with Depression Study (TADS). Method: TADS compared the efficacy of cognitive behavioral therapy (CBT), fluoxetine (FLX), their combination (COMB), and placebo (PBO). Teens were separated into four trauma history groups: (1) no trauma; (2) trauma, no abuse; (3) physical abuse; (4), and sexual abuse. The effects of treatment and trauma history on depression severity across 12 weeks of acute treatment, as measured by the Children's Depression Rating Scale-Revised (CDRS-R), were examined. Results: A significant trauma-by-treatment-by-time interaction indicated that trauma history moderated treatment. The Week 12 primary efficacy findings previously reported by TADS were replicated in the no trauma group (n = 201): COMB = FLX greater than CBT = PBO. No significant differences in treatment arms were observed among the trauma, no abuse, or physical abuse group. Teens with a history of sexual abuse treated with COMB, FLX, and PBO showed significant and equivalent improvement on the CDRS-R (mean less than 45), whereas the mean CDRS-R for the CBT group tended to remain in the depressed range (mean greater than 45). Baseline suicidality and self-reported depression were significantly related to a history of sexual abuse. Conclusions: The study was limited by the level of detail regarding childhood traumatic experiences. Results are discussed in terms of the implications for treating depressed adolescents with traumatic backgrounds. Clinical Trials Registry Information: Treatment for Adolescents with Depression Study; NCT00006286. (Contains 4 figures and 4 tables.)
ISSN:0890-8567
DOI:10.1016/j.jaac.2009.10.007