Kognitive Verhaltenstherapie bei Depressionen im Kindes- und Jugendalter
Vorgehen, Wirksamkeit und Weiterentwicklungen
Abstract
Die Kognitive Verhaltenstherapie (KVT) bietet einen theoretisch und empirisch gut abgeleiteten Therapieansatz bei depressiven Kindern und Jugendlichen. Ihre Anwendung bei dieser Indikation ist gemäß vorliegenden Leitlinien und Wirksamkeitsstudien zu empfehlen. Vor allem im Hinblick auf die bisher ermittelten nur kleineren bis moderaten Effektgrößen sowie fehlenden Befunde zur langfristigen Wirksamkeit und zu Wirkfaktoren sind jedoch zusätzliche Forschung und konzeptionelle Weiterentwicklung erforderlich. Der Artikel gibt zunächst einen kurzen Überblick über Grundlagen und Inhalte der KVT bei depressiven Kindern und Jugendlichen. Im Weiteren werden neuere Befunde und Einschätzungen zu ihrer Wirksamkeit sowie aktuelle Weiterentwicklungen und Perspektiven vorgestellt.
Cognitive behavior therapy offers a theoretically and empirically valid therapeutic approach for children and adolescents suffering from depression. It can be recommended according to present guidelines and efficacy studies. Further research and conceptual development, however, is necessary especially regarding the small to moderate effect sizes as well as the lack of long-term efficacy and effect factors. This article gives a short overview of the basics and contents of cognitive behavior therapy for depressive children and adolescents. It furthermore presents the latest findings and an assessment of its efficacy and relevant developments and perspectives.
Literatur
2007). Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1503–1526.
. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.
(2010). Social competence, externalizing, and internalizing behavioral adjustment from early childhood through early adolescence: Developmental cascades. Development and Psychopathology, 22, 717–735.
(2008). The interplay of social competence and psychopathology over 20 years: Testing transactional and cascade models. Child Development, 79, 359–374.
(1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7–18.
(2007). Guidelines for adolescent depression in primary care (GLAD-PC). II. Treatment and ongoing management. Pediatric, 120, 1313–1326.
. (2009). Adaptive coping under conditions of extreme stress: Multilevel influences on the determinants of resilience in maltreated children. New Directions for Child and Adolescent Development, 124, 47–59.
(1998). The development of depression in children and adolescents. American Psychologist, 53, 221–241.
(2009). Gender differences in the longitudinal structure of cognitive diatheses for depression in children and adolescents. Journal of Clinical Psychology, 65, 1312–1326.
(2008). Evidence-based psychosocial treatments for child and adolescent depression. Journal of Clinical Child and Adolescent Psychiatry, 37, 62–104.
(2002). Attachment-based family therapy for depressed adolescents: A treatment development study. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1190–1196.
(2007). Dialectical behavior therapy in clinical practice. Applications across disorders and settings. New York: Guilford.
(2011). Counseling outcomes from 1990 to 2008 for school-age youth with depression: A meta-analysis. Journal of Counseling & Development, 89, 439–457.
(2002). Zum Zusammenhang von belastenden Lebensereignissen und Depression bei Kindern und Jugendlichen. In , Depressionen und komorbide Störungen bei Kindern und Jugendlichen (S. 57–80). Stuttgart: Wissenschaftliche Verlagsgesellschaft.
(2011). Dialektisch-behaviorale Therapie für Jugendliche. Berlin: Springer-Verlag.
(2002). What works for whom: A critical review of treatments for children and adolescents. New York: Guilford.
(2012). Depressed youth: Treatment outcome and changes in family functioning in individual and family therapy. Journal of Family Therapy, 34, 4–23.
(2009). The longitudinal effects of stressful life events on adolescent depression are buffered by parent-child closeness. Development and Psychopathology, 21, 621–635.
(2012). Brooding rumination and risk for depressive disorders in children of depressed mothers. Journal of Abnormal Child Psychology, 40, 317–326.
(2010). Cognition and depression: Current status and future directions. Annual Review of Clinical Psychology, 6, 285–312.
(2008). Diffusion of efficacious interventions for children and adolescents with mental health problems. Journal of Child Psychology and Psychiatry, 49, 335–352.
(2011). Akzeptanz und Achtsamkeit in der Kinder- und Jugendlichenpsychotherapie. Weinheim: Beltz.
(2002). Emotionsfokussierte Therapie: Lernen mit den eigenen Gefühlen umzugehen. Tübingen: dgvt-Verlag.
(2008). Was wirkt in der Therapie depressiver Kinder und Jugendliche wirklich? Kindheit und Entwicklung, 17, 242–250.
(2011a). Depressive Kinder und Jugendliche (2., überarb. Aufl.). Göttingen: Hogrefe.
(2011b). Wie wird mein Kind wieder glücklich? Praktische Hilfen gegen Depressionen. Bern: Huber.
(2012). Traurigkeit, Rückzug, Depression. Informationen für Betroffene, Eltern, Lehrer und Erzieher. Göttingen: Hogrefe.
(2009). Developmental origins of cognitive vulnerabilities to depression: Review of processes contributing to stability and change across time. Journal of Clinical Psychology, 65, 1327–1338.
(2010). Psychological treatment for adolescent depression: Perspectives on the past, present, and future. Behaviour Change, 27, 1–18.
(2011). Acceptance and commitment therapy for the treatment of adolescent depression: A pilot study in a psychiatric outpatient setting. Mindfulness. doi: 10.1007/s12671-011-0046-5
(2008). ACT-Training. Handbuch der Acceptance & Commitment Therapie. Paderborn: Junfermann.
(2007). Balance von Veränderung und achtsamer Akzeptanz: Die dritte Welle der Verhaltenstherapie. Psychotherapie, Psychosomatik, medizinische Psychologie, 57, 475.
(2005). Die Wirksamkeit familienbezogener Interventionsansätze bei Angststörungen und depressiven Störungen im Kindes- und Jugendalter: Stand der Evidenzbasierung. Kindheit und Entwicklung, 14, 13–21.
(2012). Leitfaden Kinder- und Jugendpsychotherapie. Depressionen. Göttingen: Hogrefe.
(2008). Empirical evidence of cognitive vulnerability for depression among children and adolescents: A cognitive science and developmental perspective. Clinical Psychology Review, 28, 759–782.
(1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell.
(2004). Feasibility of applying dialectical behavior therapy to suicidal adolescent inpatients. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 276–282.
(2005). Mediators of cognitive behavioral treatment for adolescents with comorbid major depression and conduct disorders. Journal of Consulting and Clinical Psychology, 73, 38–46.
(2007). Cognitive-behavioral therapy for adolescent depression: A meta-analytic investigation of changes in effect-size estimates. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1403–1413.
(2010). Mütterliche Depressivität, Erziehung und kindliche Erlebens- und Verhaltensprobleme. Kindheit und Entwicklung, 19, 109–118.
(2010). Perceived social competence, negative social interactions, and negative cognitive style predict depressive symptoms during adolescence. Journal of Clinical Child & Adolescent Psychology, 39, 603–615.
(2011). Parent-child interaction therapy emotion development: A novel treatment for depression in preschool children. Anxiety & Depression, 28, 153–159.
(1974). A behavioral approach to depression. In , The psychology of depression: Contemporary theory and research (pp. 157–185). New York: Wiley.
(1996). Dialektisch-behaviorale Therapie der Borderline-Persönlichkeitsstörung. München: CIP-Medien.
(in Vorbereitung). Schematherapie mit Kindern und Jugendlichen. Weinheim: Beltz.
(2011). Expanding behavioral activation to depressed adolescents: lessons learned in treatment development. Cognitive and Behavioral Practice, 18, 371–383.
(2007). Dialectical behavior therapy with suicidal adolescents. New York: Guilford.
(2010). Interpersonal Psychotherapy for Depressed Adolescents (IPT-A): Extending the reach from academic to community settings. Child and Adolescent Mental Health, 15, 66–72.
(2009). The ruminative response style in adolescents: An examination of its specific link to symptoms of depression. Cognitive Therapy and Research, 33, 21–32.
(2004). ACT with children, adolescents, and their parents. In , A practical guide to acceptance and commitment therapy (pp. 249–273). New York: Springer.
(2005). Depression in Children and young people. Identification and management in primary, community and secondary care. National Clinical Practice Guideline Number 28. London: British Psychological Society. Verfügbar unter www.nice.org.uk/nicemedia/pdf/CG028fullguideline.pdf
. (2011). Frühe Emotionsdysregulation: Ein Indikator für psychische Störungen im Kindesalter? Kindheit und Entwicklung, 20, 186–196.
(2012). Depression. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 40, 363–364.
(2009). Family processes in the development of youth depression: Translating the evidence to treatment. Clinical Psychology Review, 29, 294–316.
(2010). Genetics of childhood and adolescent depression: Insights into etiological heterogeneity and challenges for future genomic research. Genome Medicine, 2, 68.
(2011). Behavioral activation for depressed teens: A pilot study. Cognitive and Behavioral Practice, 18, 281–299.
(2009). Social competence and social support as mediators between comorbid depressive and conduct problems and functional outcomes in middle school children. Journal of Adolescence, 32, 535–553.
(2009). The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: A meta-analytic review. Clinical Psychology Review, 29, 607–616.
(2009). Social withdrawal in childhood. Annual Review of Psychology, 60, 141–171.
(2009). Life events, coping and depressive symptoms among young adolescents: A one-year prospective study. Journal of Affective Disorders, 177, 48–54.
(2010). Elterliche Psychopathologie, Aggression und Depression bei Kindern und Jugendlichen. Kindheit und Entwicklung, 19, 228–238.
(2010). Traumaentwicklungsstörung: Pro und Contra. Kindheit und Entwicklung, 19, 47–63.
(2008). Die achtsamkeitsbasierte Kognitive Therapie der Depression. Ein neuer Ansatz zur Rückfallprävention. Tübingen: dgvt.
(2011). Do positive and negative temperaments interact in predicting risk for depression? A resting EEG study of 329 preschoolers. Development and Psychopathology, 23, 551–562.
(2007). What are the active ingredients in cognitive and behavioral psychotherapy for anxious and depressed children? A meta-analytic review. Clinical Psychological Review, 27, 642–654.
(2012). Depression in adolescence. Lancet, 379, 1056–1067.
(2010). Maladaptive coping, adaptive coping, and depressive symptoms: Variations across age and depressive state. Behaviour Research and Therapy, 48, 459–466.
(2007). Childhood depression: A place for psychotherapy. An outcome study comparing individual psychodynamic psychotherapy and family therapy. European Child & Adolescent Psychiatry, 16, 157–167.
(2007). Psychotherapy for depression among children and adolescents: A systematic review. Acta Psychiatrica Scandinavica, 116, 84–95.
(2009). Core components of therapy in youth: Do we know what to disseminate? Behavior Modification, 33, 24–47.
(2006). Effects of psychotherapy for depression in children and adolescents. Psychological Bulletin, 132, 132–149.
(2005). Schematherapie. Paderborn: Junfermann.
(2007). Guidelines for adolescent depression in primary care (GLAD-PC): II. Treatment and ongoing management. Pediatrics, 120, 1313–1326.
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