Autumn Kujawa, Ph.D.
Fellow in Child & Adolescent Depression
James Waxmonsky, M.D.
Koraly Perez-Edgar, Ph.D.
Penn State College of Medicine
Neural Predictors of Response to Cognitive Behavior Therapy for Adolescent Depression
Depression is a prevalent disorder in adolescents and often leads to long-term impairments in functioning and risk of suicide. Although cognitive behavior therapy (CBT) is an effective treatment, many depressed youth fail to respond to CBT and few established measures are available for identifying those most likely to benefit. Brain-based measures seem to be powerful predictors of treatment response. However, they have yet to be extended to adolescent depression or to more economical, easily accessible measures such as electroencephalogram (EEG). The proposed study will test neural measures of both positive and negative valence systems as predictors of CBT response in adolescent depression. Adolescents with depression will complete an EEG assessment of reward responsiveness and emotion regulation prior to random assignment to an established group CBT program or to a waitlist control condition. Consistent with preliminary findings in adults, we expect that youth with blunted reward responsiveness will show greater reduction in symptoms following treatment, as components of CBT may target reward system functioning and best meet the needs of these individuals. Extending this work to processing of negative emotions, we predict that youth with impaired ability to regulate responses to sad images will show greater reduction in symptoms following treatment, as emotion regulation deficits may be a second target of CBT. This project will take a step towards improved prediction of response to treatment for adolescent depression, with the ultimate aim of informing more personalized approaches to treatment and improving long-term outcomes.