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Behavioral activation for late adolescents with subthreshold depression: a randomized controlled trial

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Abstract

The main behavioral characteristic of subthreshold depression that is observed in adolescents is the low frequency of exposure to environmental rewards. Therefore, it was considered that a simple intervention conducted in short sessions, focusing on increasing access to positively reinforcing activities, would be efficacious in increasing the availability of rewards. We conduct a randomized controlled trial to examine the efficacy of such a behavioral activation program that was conducted weekly for 5 weeks in 60-min sessions. Late adolescent university students aged 18–19 years with subthreshold depression were randomly allocated to a treatment (n = 62) or a control group (n = 56). The primary outcome of the study was the Beck Depression Inventory-II score. Results indicated that late adolescent students in the treatment group showed significant improvements in their depressive symptoms (effect size −0.90, 95 % CI −1.28 to −0.51) compared to the control group. Students in the treatment group also showed significant improvements in self-reported rating of quality of life and in behavioral characteristics. It is concluded that this intervention had a large and significant effect despite being short and simple and that this low-intensity cognitive behavioral therapy program could be conducted in many different types of institutions. It is suggested that the long-term effects of the treatment program should be targeted for investigation in future studies.

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Acknowledgments

The authors would like to thank the participants. This research was supported by a Grant-in-Aid for Scientific Research on Innovative Areas (23118004; Adolescent Mind & Self-Regulation) from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

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Authors and Affiliations

  1. Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Koki Takagaki, Yasumasa Okamoto, Ran Jinnin, Asako Mori, Yoshiko Nishiyama, Takanao Yamamura, Satoshi Yokoyama, Syouichi Shiota & Shigeto Yamawaki

  2. Health Service Center, Hiroshima University, 1-7-1, Kagamiyama, Higashihiroshimashi, Hiroshima, 739-8511, Japan

    Yuri Okamoto & Yoshie Miyake

  3. Department of Psychology, Hiroshima University, 1-1-1, Kagamiyama, Higashihiroshimashi, Hiroshima, 739-8511, Japan

    Akiko Ogata

  4. Department of Psychology, School of Human Sciences, Senshu University, 2-1-1, Higashi-Mita, Tama, Kawasaki, 214-8580, Japan

    Yoshihiko Kunisato

  5. Department of Psychiatry of Mental Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Haruki Shimoda & Norito Kawakami

  6. Department of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyouto University Graduate school of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan

    Toshi A. Furukawa

Authors
  1. Koki Takagaki
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  2. Yasumasa Okamoto
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  3. Ran Jinnin
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  4. Asako Mori
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  5. Yoshiko Nishiyama
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  6. Takanao Yamamura
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  7. Satoshi Yokoyama
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  8. Syouichi Shiota
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  9. Yuri Okamoto
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  10. Yoshie Miyake
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  11. Akiko Ogata
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  12. Yoshihiko Kunisato
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  13. Haruki Shimoda
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  14. Norito Kawakami
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  15. Toshi A. Furukawa
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  16. Shigeto Yamawaki
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Corresponding author

Correspondence to Yasumasa Okamoto.

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Conflict of interests

TAF has received lecture fees from Eli Lilly, Meiji, Mochida, MSD, Otsuka, Pfizer, and Tanabe-Mitsubishi, and consultancy fees from Sekisui Chemicals and Takeda Science Foundation. He has received grant or research support from the Japanese Ministry of Education, Science, and Technology, the Japanese Ministry of Health, Labor and Welfare, the Japan Foundation for Neuroscience and Mental Health, Tanabe-Mitsubishi, and Mochida. He is diplomate of the Academy of Cognitive Therapy. Other authors report no financial or other interests related to the subject of this manuscript.

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Takagaki, K., Okamoto, Y., Jinnin, R. et al. Behavioral activation for late adolescents with subthreshold depression: a randomized controlled trial. Eur Child Adolesc Psychiatry 25, 1171–1182 (2016). https://doi.org/10.1007/s00787-016-0842-5

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  • DOI: https://doi.org/10.1007/s00787-016-0842-5

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