Date of Award

8-2019

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Dr. Scott T. Gaynor

Second Advisor

Dr. Amy Damashek

Third Advisor

Dr. Sheryl Lozowski-Sullivan

Fourth Advisor

Dr. Amy Naugle

Keywords

Adolescents, annedonia, behavior therapy, depression, RDoC

Abstract

Adolescent depression is a significant public health problem, however the current characterization of depression as a categorical label is problematic for understanding individual phenomenology, interindividual variability, and best treatment practices (Lewinsohn, Solomon, Seeley, & Zeiss, 2000). Anhedonia has been posited as a process underlying depression that may contribute to poorer outcomes (Gabbay, 2015). The current project examines large samples of adolescents diagnosed with depression to identify common features at a symptom level and the relationship these features have with behavioral therapy outcomes. Four phases of analyses were completed to 1) examine symptomology of multiple depressed adolescent samples in order to identify core features of depression in adolescents; 2) extend a factor analysis to a new sample to determine if the same factors on the Children’s Depression Rating Scale emerge; 3) determine if a prior finding that anhedonia is predictive of poorer outcomes replicates in a new sample from a large scale clinical trial; and 4) explore whether behaviorally oriented treatments appear to specifically target and diminish anhedonia symptoms. Results suggest that anhedonic symptoms, such as difficulty having fun, are among the most severely rated by adolescents. Factor analyses show a consistent anhedonia factor including difficulty having fun, social withdrawal, and depressed mood. This factor is predictive of poorer quality of life at the end of treatment in a large randomized controlled trial, particularly for females. Finally, it was found that activation oriented behavioral therapy significantly improved anhedonic symptoms of difficulty having fun, fatigue, and disturbed sleep. These results suggest that anhedonia may be a more clinically useful identifying feature and target for treatment in adolescents. Future research should examine anhedonia targeted treatments feasibility, efficacy, and effectiveness, as well as differences that may exist for males and females treated with behavioral therapy.

Access Setting

Dissertation-Open Access

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