Interpersonal Psychotherapy-Adolescent Skills Training: Anxiety Outcomes and Impact of Comorbidity

Abstract

Given the frequent comorbidity of anxiety and depression, it is important to study the effects of depression interventions on anxiety and the impact of comorbid anxiety on depression outcomes. This article reports on pooled anxiety and depression data from two randomized trials of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a depression prevention program. Ninety-eight adolescents were randomized to receive IPT-AST or school counseling (SC). Outcome and predictor analyses were performed utilizing hierarchical linear models. IPT-AST adolescents had significantly greater reductions in anxiety and depressive symptoms than SC adolescents during the intervention. Baseline anxiety symptoms predicted change in depressive symptoms for adolescents in both intervention conditions, with adolescents low in baseline anxiety demonstrating more rapid change in depressive symptoms than adolescents high in baseline anxiety. These findings indicate that IPT-AST is effective at decreasing both depressive and anxiety symptoms. For adolescents with comorbid symptoms of anxiety, there may be slower rates of change in depressive symptoms following prevention programs.

Acknowledgments

This study was funded by a Young Investigator Award from the National Alliance for Research on Schizophrenia and Depression and a Career Development Award (5K32 MH071320) from the National Institute of Mental Health to Dr. Young.

Notes

Note: Numerical values above are means (standard deviation). IPT-AST = Interpersonal Psychotherapy-Adolescent Skills Training; SC = school counseling; Anxiety = total Screen for Child Anxiety Related Emotional Disorders (SCARED) score; Panic = Panic/Somatic subscale of the SCARED; Generalized = Generalized Anxiety Disorder subscale of the SCARED; Social = Social Anxiety subscale of the SCARED; Depression = CES-D score.

^a N = 63.

^b N = 35.

Note: Slopes are on-average change per month. Standard errors of the estimates are in parentheses. The Panic/Somatic subscale is a square-root transformation. IPT-AST = Interpersonal Psychotherapy-Adolescent Skills Training; SC = school counseling; CI = confidence interval; Anxiety = total Screen for Child Anxiety Related Emotional Disorders (SCARED) score; Panic = Panic/Somatic subscale of the SCARED; Generalized = Generalized Anxiety Disorder subscale of the SCARED; Social = Social Anxiety subscale of the SCARED; Depression = Center for Epidemiologic Studies–Depression Scale score.

^a N = 63.

^b N = 35.

¹We also examined whether baseline anxiety moderated, rather than predicted, depression symptoms by including the interaction of baseline anxiety and intervention in our piecewise HLM model. The interaction term was not significant during the intervention phase, F(1, 92) = 0.05, p = .82, or follow-up phase, F(1, 92) = 0.87, p = .36.