Adolescent primary care patients' preferences for depression treatment.
ABSTRACT Despite efficacious treatments for depression in youth, current data indicate low rates of care. To better understand reasons for these low rates of care, we examined treatment preferences for depression treatment. Adolescents (N=444) who screened positive for depression at a primary care visit completed measures of predisposing, enabling, and need characteristics thought to be related to help seeking. Results indicated a strong tendency for adolescents to prefer active treatment (72%) versus watchful waiting (28%), and for youth to prefer counseling (50%) versus medication (22%). Female gender, prior treatment experience, and current depression and anxiety were related to preference for active treatment over watchful waiting. In multivariable analyses, female gender and current anxiety symptoms remained significant predictors of preference for active treatment. Ethnicity, attitudes about depression care, prior treatment experience, and anxiety symptoms were related to preference for medication over counseling. In multivariable analyses, those with negative attitudes about depression treatment generally, with positive attitudes about treatment via medication, or with current anxiety symptoms were more likely to prefer medication. Youth preference for counseling over medication may contribute to low adherence to medication treatment and underscores the importance of patient education aimed at promoting positive expectations for treatments.
- SourceAvailable from: Marc S Karver[Show abstract] [Hide abstract]
ABSTRACT: Efficacious treatments are only valuable to the extent that they are used. Given ethnic disparities in mental health service utilization, this preliminary study examined differences between Hispanic and non-Hispanic White (NHW) adolescents' ratings of the acceptability of depression treatments and related constructs. Female high school students (N = 67; 54% Hispanic) read a vignette describing a depressed adolescent and rated the acceptability of four single treatments for depression (i.e., cognitive-behavioral therapy, interpersonal therapy, family therapy, and pharmacotherapy) and three treatment combinations. Hispanic adolescents completed a self-report measure of acculturation and all adolescents were interviewed about their beliefs of the causes of depression. Results showed more similarities than differences between ethnic groups, with Hispanic and NHW adolescents favoring psychological treatments over pharmacotherapy. Among Hispanic participants, overall ratings of treatment acceptability were significantly higher for bicultural adolescents than Hispanic adolescents immersed predominantly in non-Hispanic culture. Hispanic and NHW adolescents generally showed similar beliefs about the causes of depression, with both groups endorsing personality and cognitions at high rates, but Hispanics were significantly less likely than NHWs to endorse trauma as a cause of depression. Implications for decreasing ethnic disparities in unmet need for treatment are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved).Cultural Diversity and Ethnic Minority Psychology 07/2013; 20(1). DOI:10.1037/a0033467 · 1.36 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: We assessed parental perceptions of benefits and risks of pediatric antidepressant use relative to another common treatment option, psychotherapy. We also explored sociodemographic and treatment variables that might influence these perceptions. A total of 501 caregivers of children presenting to community mental health centers completed a questionnaire assessing demographic characteristics, treatment history, and attitudes toward psychotherapy and antidepressant medications. Counseling was perceived as beneficial and having few risks, whereas antidepressant medications were perceived as both beneficial and risky. Fifty two percent of parents believed "somewhat" to "strongly" that antidepressants could make children want to harm themselves. African-American parents had less favorable views of antidepressants relative to parents of other ethnicities. Parental perceptions of benefits and risks of antidepressants predicted future medication visits, but only benefits predicted when controlling for other variables. A slight majority of all parents expected their children to see the physician at least every few weeks if prescribed an antidepressant. When educating parents about medication, prescribers should be aware that African American parents may hold more negative perceptions than other parents, and that many caregivers may expect a higher level of physician monitoring of pediatric antidepressant use than is available in most communities.Journal of child and adolescent psychopharmacology 07/2009; 19(3):289-96. DOI:10.1089/cap.2008.0129 · 3.07 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The purpose of this study was to evaluate the effects of a school-based intervention program for middle school adolescent girls with depression. The study was a pretest-posttest repeated-measure design with a nonequivalent control group. Fifty eight students with depressive symptoms were recruited from two middle schools in Seoul, Korea. The data were collected from the intervention (n=30) and the comparison group (n=28). The research instrument was Reynolds Adolescent Depression Scale. The intervention group greatly improved from baseline to 10 weeks and then saw a slight positive change between 10 and 13 weeks. The results of this research show that depression intervention programs are effective for young female adolescents. Thus the investigation has important school-based treatment implications, and should be integrated into school curriculums by school health nurses for early intervention of depressive symptoms in middle school adolescent girls.Journal of Korean Academy of Nursing 12/2012; 42(7):984-91. DOI:10.4040/jkan.2012.42.7.984 · 0.36 Impact Factor