Activating and Connecting Teens (ACT) Study

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 study takes an innovative approach
integrating neural, behavioral, and novel mobile technologies to measure longitudinal change
in reward processing as a mechanism of BA intervention response among depressed adolescents
with a history of CM. Specifically, depressed adolescents with a history of CM will complete
pre- and post- BA intervention fMRI and behavioral measures of reward processing along with
daily passive mobile monitoring of physical (steps) and social (amount of texts, calls,
social media usage) activity to determine 1) how BA targets neural and behavioral reward
processing and real-world behavioral engagement (Specific Aim 1), and 2) whether change in
neural and behavioral reward processing predicts intervention response and maintenance
(Specific Aim 2).