Computerized Information-Processing Bias Retraining in Depressed Adolescents

Major Depression is a markedly impairing disorder that affects up to 20% of adolescents
before adulthood, and is associated with significant impairment in adolescents' emotional
and social development. While antidepressant medication and psychotherapy are effective in
treating some depressed adolescents, approximately 30% fail to respond to a combination of
these treatments. Furthermore, many families are reluctant to pursue antidepressant
medication for depressed adolescents because of concerns about potentially increasing risk
of suicidal ideation. Thus, there is a critical need for effective, non-pharmacological
treatments for this population. One promising new intervention consists of modifying
negative information-processing biases associated with depression. Recent research has
suggested that these biases may be modified using a computerized program that provides
repeated exposure to positive interpretations of salient, ambiguous situations, with the
goal of interpreting ambiguity less negatively. These modification programs have been
efficacious in altering interpretation biases and reducing anxiety in adults with social and
specific phobias. Therefore, the proposed study aims to examine the efficacy of an adapted
interpretation bias modification program for depressed adolescents. Specifically, the study
will examine the efficacy of four sessions of the modification program in altering
interpretation biases and reducing symptoms of depression, anxiety, and negative affect. A
total of 60 adolescents (ages 14-21) with symptoms of major depression will be randomly
assigned to either the active intervention condition (four sessions of the modification
program over two weeks) or an attention control condition. Measures will include a
diagnostic interview, self-report measures of depression, anxiety, and negative affect, and
a test of interpretation bias in response to ambiguous situations. It is hypothesized that:
1) Compared to adolescents in the attention control condition, adolescents who receive four
sessions of the positive interpretive training will experience a significantly larger
decrease from baseline to post-treatment in negative interpretation bias (e.g., more
positive and fewer negative interpretations of ambiguous situations) on a measure of
interpretation bias; and, 2)Compared to adolescents in the attention control condition,
adolescents who receive the positive interpretation training will experience a significantly
larger decrease from baseline to post-treatment in self-reported state depression, anxiety,
and negative affect.