Activating and Connecting Teens (ACT) Study (ACT)

April 10, 2024 updated by: Jessica Jenness, University of Washington

Targeted Intervention for Adolescents Following Child Maltreatment: Examining Neural and Behavioral Mechanisms Within the Positive Valence System

National data indicate over 650,000 children and adolescents are exposed to physical, sexual, or emotional abuse or physical or emotional neglect each year. Moreover, youth with a history of childhood maltreatment (CM) are at least twice as likely to develop depression and are at substantial risk for nonresponse to current best practice depression interventions (i.e., cognitive behavioral therapy and antidepressants) compared to non-maltreated peers. Research suggests that CM increases risk for depression through disruptions in the positive valence system, such as reward processing, and Behavioral Activation (BA) may be an alternative depression intervention that targets these deficits. This proposal will examine whether BA intervention reduces depression and anhedonia in a sample of depressed adolescents, aged 13-18, with variable histories of CM exposure (BA Group). A total of 30 depressed adolescents will be recruited to undergo a 12-week course of BA. All participants will undergo clinical assessment to measure depression symptoms and anhedonia at baseline (Week 0) and post- (Week 12) treatment.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

32

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Washington
      • Seattle, Washington, United States, 98105
        • Seattle Children's Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

8 years to 14 years (Child, Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria Behavioral Activation Group:

- current diagnosis of clinical depression (minor or major) will be recruited as study participants in the Behavioral Activation (BA) Group

Exclusion Criteria:

  • IQ < 80;
  • non-English speaking youth or parent;
  • current PTSD diagnosis;
  • lifetime history of a developmental (e.g., autism), neurological (e.g., epilepsy), psychotic, bipolar, or substance disorder;
  • current psychiatric (e.g., antidepressants) or other mood altering medication (e.g., steroids) other than AD/HD medication;
  • requiring a higher level of care (i.e., inpatient hospitalization) due to suicidality or other mental or physical health related problem.
  • Any youths who are currently being maltreated will not be enrolled to ensure that participants do not have active safety concerns.
  • Full course of other evidence-based depression intervention

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Behavioral Activation Arm
See treatment description for information on Behavioral Activation. Participants will receive 12 weekly sessions of Behavioral Activation.
The Adolescent Behavioral Activation Program (ABAP) will be used as the BA protocol. ABAP was developed and validated by McCauley, Dimidjian et al. to adapt BA to adolescents. ABAP is a 12-week protocol that utilizes an idiographic approach to foster rewarding experiences, effective problem solving, and goal attainment, and decrease avoidance, barriers to activation, and depressive rumination that may be contributing to depression severity and maintenance.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Depression
Time Frame: Week 12 (post-treatment)
Changes in depression symptoms will be measured with self-report on the Patient Health Questionnaire-9 (PHQ-9). Total score will be reported with a range of 0 to 27 with higher scores indicating greater symptoms of depression. Higher symptoms of depression are considered a worse outcome.
Week 12 (post-treatment)
Anhedonia/Activation
Time Frame: Week 12
Changes in feelings of loss of pleasure and interest (i.e., Anhedonia) will be measured via self-report on the Behavioral Activation for Depression Scale (BADS) total score. The range on the BADS is 0 to 150, with higher scores representing less activation. Higher scores are considered a worse outcome on this measure.
Week 12

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Anxiety
Time Frame: Symptoms will be measured weekly throughout the study (Weeks 0 to 12) and at a 3-month follow-up (Week 24). Diagnoses will be measure pre (Week 0), post treatment (Week 12), and at a 3-month follow-up (Week 24).
Changes in anxiety symptoms and diagnoses with diagnostic interviews and self-report.
Symptoms will be measured weekly throughout the study (Weeks 0 to 12) and at a 3-month follow-up (Week 24). Diagnoses will be measure pre (Week 0), post treatment (Week 12), and at a 3-month follow-up (Week 24).
Behavioral Problems
Time Frame: Pre- (Week 0) and post-treatment (Week 12)
Changes in commonly co-morbid behavioral problems with depression (i.e., attention deficit/hyperactivity disorder, conduct problems, oppositionality) and diagnoses will be measured.
Pre- (Week 0) and post-treatment (Week 12)
Hopelessness
Time Frame: Pre- (Week 0) and post-treatment (Week 12)
Changes in feelings of hopelessness (i.e., feeling like nothing is good, everything is bad, nothing can change it) will be measured by self-report.
Pre- (Week 0) and post-treatment (Week 12)
Suicidality
Time Frame: Weekly throughout treatment (Weeks 0-12) and at a 3-month follow-up (24 Week)
Changes in suicidal ideation, plans, and behaviors and self-harm thoughts and behaviors will be measured on a semi-structured interview and self-report.
Weekly throughout treatment (Weeks 0-12) and at a 3-month follow-up (24 Week)

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Behavioral Problems
Time Frame: Pre- (Week 0) and post-treatment (Week 12)
Changes in commonly co-morbid behavioral problems with depression (i.e., attention deficit/hyperactivity disorder, conduct problems, oppositionality) and diagnoses will be measured.
Pre- (Week 0) and post-treatment (Week 12)
Hopelessness
Time Frame: Pre- (Week 0) and post-treatment (Week 12)
Changes in feelings of hopelessness (i.e., feeling like nothing is good, everything is bad, nothing can change it) will be measured by self-report.
Pre- (Week 0) and post-treatment (Week 12)
Suicidality
Time Frame: Weekly throughout treatment (Weeks 0-12) and at a 3-month follow-up (24 Week)
Changes in suicidal ideation, plans, and behaviors and self-harm thoughts and behaviors will be measured on a semi-structured interview and self-report.
Weekly throughout treatment (Weeks 0-12) and at a 3-month follow-up (24 Week)
Anxiety
Time Frame: Symptoms will be measured at baseline, post-treatment, and 3-month follow-up.
Changes in anxiety symptoms and diagnoses with diagnostic interviews and self-report (SCARED).
Symptoms will be measured at baseline, post-treatment, and 3-month follow-up.
Ecological Momentary Assessment (EMA)
Time Frame: Questionnaires delivered 3x/day, 2 days/week from Weeks 0 to 12
Changes in self-reported activity engagement and mood will be delivered through a mobile application.
Questionnaires delivered 3x/day, 2 days/week from Weeks 0 to 12

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Jessica L Jenness, MD, University of Washington

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2018

Primary Completion (Actual)

March 31, 2023

Study Completion (Actual)

March 31, 2023

Study Registration Dates

First Submitted

February 5, 2018

First Submitted That Met QC Criteria

February 12, 2018

First Posted (Actual)

February 20, 2018

Study Record Updates

Last Update Posted (Actual)

May 2, 2024

Last Update Submitted That Met QC Criteria

April 10, 2024

Last Verified

April 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • STUDY00002283
  • K23MH112872 (U.S. NIH Grant/Contract)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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