Jami Young

• Ph.D.
• Professor at The Children's Hospital of Philadelphia

Objective: To examine short-term (i.e., postintervention) outcomes from a randomized controlled trial comparing a school-based telehealth-delivered depression prevention program, Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST), to services as usual (SAU). We expected IPT-AST would be acceptable and feasible and that IPT-AST adolesc...

Clinician distress about working with patients at risk for suicide is well documented in the literature, yet little work has examined its pervasiveness across clinical settings. We conducted a secondary analysis of qualitative data gathered from 26 clinicians in primary care and outpatient mental health clinics serving both adult and child clients...

Importance Suicide is a leading cause of death in US youths. Objective To assess whether screening with supplemental items 10 to 13 on the Patient Health Questionnaire–9 modified for teens (PHQ-9M) improves prediction of youth suicide attempts beyond the information provided by the first 9 items alone (the PHQ-9). Design, Setting, and Participant...

Accumulating evidence supports the presence of a general psychopathology dimension, the p factor (‘p’). Despite growing interest in the p factor, questions remain about how p is assessed. Although multi-informant assessment of psychopathology is commonplace in clinical research and practice with children and adolescents, almost no research has take...

Objective: To test potential cognitive and interpersonal moderators of two evidence-based youth depression prevention programs. Method: Two hundred four adolescents (Mage = 14.62 years, SD = 1.65; 56% female; 71% White, 11% Black, 11% multiracial, 5% Asian, 2% other races, 18% Hispanic/Latinx) were randomized to either a cognitive–behavioral (Copin...

Objective: Interpersonal psychotherapy (IPT) has been proposed for prevention of excess weight gain among adolescents with loss-of-control (LOC) eating. Mixed findings from a trial testing this conjecture warrant elucidation of potential outcome predictors. The therapeutic alliance (adolescent-facilitator emotional bond and task collaboration) may...

Objective The goal of the current study was to document patterns of stability and change in adolescent depression and suicide risk detected via universal depression screening in pediatric primary care and to determine who may go on to experience emerging risk. Methods Retrospective electronic health record information (sociodemographic data and de...

Parental depression is a well-established risk factor for youth psychopathology; however, depression is highly heterogeneous, and different parental symptom profiles may be differentially associated with risk mechanisms and youth psychopathology outcomes. Thus, this study examined associations between parental anhedonic symptoms of depression, spec...

Unique trajectories of adolescent depression symptoms have been identified, yet less is known about whether such patterns translate to real-world clinical settings. Because annual adolescent depression screening is becoming more prevalent in primary care, we examined whether longitudinal patterns of depression symptoms documented in the development...

Stress is one candidate mechanism posited to contribute to the intergenerational risk of psychopathology. However, the ways in which parent and child stress are related across adolescence, and the role that co-occurring parent and child stress may exert regarding bidirectional risk for internalizing symptoms, are not well understood. Using repeated...

Objective: Depression and stressors both increase during adolescence. The stress generation model posits that depression symptoms and associated impairment contribute to the generation of dependent stressors. Adolescent depression prevention programs have been shown to reduce the risk of depression. Recently, risk-informed personalization approach...

One Mind, in partnership with Meadows Mental Health Policy Institute, convened several virtual meetings of mental health researchers, clinicians, and other stakeholders in 2020 to identify first steps toward creating an initiative for early screening and linkage to care for youths (individuals in early adolescence through early adulthood, ages 10-2...

Objective: Adolescent mental health concerns increased during COVID-19, but it is unknown whether early increases in depression and suicide risk have been sustained. We examined changes in positive screens for depression and suicide risk in a large pediatric primary care network through May 2022. Methods: Using an observational repeated cross-se...

Promoting Resilience in Stress Management (PRISM) is a well-established resilience coaching program for youth with chronic illness. It is a one-on-one intervention targeting skills in stress management, goal-setting, cognitive reframing, and meaning-making. We aimed to (i) assess the feasibility and acceptability of PRISM and (ii) explore PRISM’s i...

Depression and anxiety frequently co-occur and share several risk factors. There is some evidence for transdiagnostic effects of prevention programs on depression and anxiety. In the Personalized Depression Prevention (PDP) study, youth (n = 98, Mage = 13.94 years, SD = 1.67) were classified as high or low on cognitive and interpersonal risk factor...

Childhood adversity places youth at risk for multiple negative outcomes. The current study aimed to understand how a constellation of risk and resilience factors influenced mental health outcomes as a function of adversities: socioeconomic status (SES) and traumatic stressful events (TSEs). Specifically, we examined outcomes related to psychosis an...

Background Limited research has simultaneously focused on sociodemographic differences in who receives recommended adolescent depression screening in primary care and who endorses elevated depression and suicide risk on these screeners. We describe screening and risk rates in a large pediatric primary care network in the United States after the net...

We sought to aggregate common barriers and facilitators to screening adolescents for sensitive health topics (e.g., depression, chlamydia) in primary care, as well as those that are unique to a given health topic. We conducted a literature search of three databases (PsycInfo, MEDLINE, and CINAHL) and reference lists of included articles. Studies fo...

Objective We identified common and unique barriers and facilitators of evidence-based suicide prevention practices across primary care practices with integrated behavioral health services and specialty mental health settings to identify generalizable strategies for enhancing future implementation efforts. Method Twenty-six clinicians and practice...

Depressive symptoms predict within-person change in physical symptoms of anxiety and social anxiety symptoms; however, potential mediators of these within-person associations remain understudied. The current study examined whether overall stress, interpersonal stress, and achievement stress mediate the associations between depressive symptoms and p...

This study evaluated the fidelity, feasibility, acceptability, and preliminary outcomes of a depression prevention program, interpersonal psychotherapy—adolescent skills training (IPT-AST), in urban pediatric primary care (PC) with a sample of primarily Black youth. Twenty-two adolescents with elevated depressive symptoms participated in this open...

Adolescence has long been purported to be a period of emotional upheaval, yet relatively little is known regarding normative patterns of change in youth positive and negative affect across the adolescent transition. This study addressed this gap by examining normative patterns of mean-level change in youth positive and negative affect from middle c...

Negative emotionality (NE) and multiple cognitive vulnerabilities (CVs) (negative inferential style, brooding, self-criticism, dependency, dysfunctional attitudes) independently predict internalizing outcomes. The present study examined whether NE and CVs could be structurally integrated into a common factor reflecting shared variance across risks,...

Background: Mental health concerns increased during the coronavirus disease 2019 pandemic, but previous studies have not examined depression screening in pediatric primary care. We aimed to describe changes in screening, depressive symptoms, and suicide risk among adolescents during the coronavirus disease 2019 pandemic. Methods: In a repeat cro...

Low reward responsiveness (RR) is associated with poor psychological well-being, psychiatric disorder risk, and psychotropic treatment resistance. Functional MRI studies have reported decreased activity within the brain’s reward network in individuals with RR deficits, however the neurochemistry underlying network hypofunction in those with low RR...

Nonsuicidal self-injury (NSSI) describes deliberate self-destructive behaviors without the intention to die. Little is known about what factors contribute to NSSI especially among youth. The current study tested two conceptual models for how chronic interpersonal stress and rumination may contribute to NSSI engagement across 18 months in a communit...

In the present work, we evaluated reciprocal, within-dyads associations between parents’ and adolescents’ depressive symptoms across two independent samples (N = 327 and N = 435 dyads; approximately 85% biological mothers) assessed every 3 months for 2 years (Study 1) to 3 years (Study 2). Results of random intercept cross-lagged panel models conve...

Coping that is adaptive in low-stress environments can be ineffective or detrimental in the context of poverty. Identifying coping profiles among adolescents facing varying levels of stress can increase understanding of when and for whom coping may be most adaptive. The present study applied latent profile analysis (LPA) to identify coping profiles...

Introduction: Individual differences in beliefs about the controllability of emotions are associated with a range of psychosocial outcomes, including depressive symptoms. Less is known, however, about factors contributing to individual differences in these beliefs. The current study examined prospective associations between negative emotionality (N...

Background Delivering physical and behavioral health services in a single setting is associated with improved quality of care and reduced health care costs. Few health systems implementing integrated care develop conceptual models and targeted measurement strategies a priori with an eye toward adoption, implementation, sustainment, and evaluation....

Background To characterize suicidality among youth with juvenile fibromyalgia syndrome (JFMS) receiving treatment from pediatric rheumatologists at a tertiary care center in order to determine the prevalence of suicidality in JFMS and to explore risk factors for persistent suicidal ideation. Methods We performed a cross-sectional cohort study of c...

Objective: The authors evaluated suicide risk rates detected via a depression screener administered within a large pediatric primary care system and examined 1-year follow-up care after adolescents' endorsement of suicide risk. Methods: Retrospective electronic health record data were extracted to examine both suicide risk rates from items endor...

Introduction Adolescent military-dependents face unique psychosocial stressors due to their parents’ careers, suggesting they may be particularly vulnerable to excess weight gain and symptoms of depression and anxiety. Despite these risk factors, there is a lack of tested preventative interventions for these youths. Given the transient nature of mi...

Objective To evaluate whether evidence-based depression prevention programs can be optimized by matching youth to interventions that address their psychosocial vulnerabilities. Method This randomized controlled trial included 204 adolescents (M = 14.26 years, SD = 1.65; 56.4% female). Youth were categorized as high or low on cognitive and interper...

Background: Suicide is a global health issue. There are a number of evidence-based practices for suicide screening, assessment, and intervention that are not routinely deployed in usual care settings. The goal of this study is to develop and test implementation strategies to facilitate evidence-based suicide screening, assessment, and intervention...

Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) is an evidence-based indicated depression prevention program that has been shown to reduce depression symptoms. Research is needed to identify moderators of IPT-AST’s effects. Although trauma history has emerged as a moderator of depression treatment outcomes, the impact of trauma on...

Developmental epidemiological work shows that rates of depression as assessed by diagnostic interviews increase from childhood through early adulthood. It could be assumed that the trajectory of depression as assessed by self-report questionnaire measures would be characterized by a similar pattern. We aimed to evaluate this assumption and more cle...

Background Anxiety symptoms are common in adolescence and are often considered developmentally benign. Yet for some, anxiety presents with serious comorbid nonanxiety psychopathology. Early identification of such “malignant” anxiety presentations is a major challenge. We aimed to characterize anxiety symptoms suggestive of risk for depression and s...

Objective Military adolescent boys report similar levels of disordered-eating as their female counterparts. Yet, interventions for the prevention of full-threshold eating disorders in adolescent boys are lacking. Interpersonal psychotherapy (IPT), an evidenced-based therapy adapted for the prevention of BED and adult obesity, has been studied in ad...

It is critical to understand the factors that increase risk for development of psychiatric disorders as well as promote resilience against disorders. The current study describes the development of a brief tool for risk/resilience assessment that takes a broad perspective of “risk” and “resilience” to characterize the phenomena, and assesses multipl...

Deficits in positive emotionality (PE) have been implicated in the etiology of both social anxiety and depression; however, factors that contribute to divergent social anxiety and depression outcomes among youth low in PE remain unknown. Extant research suggests that parent-child stress and peer stress demonstrate differential patterns of associati...

Objective: Multiple cognitive risks from different theoretical paradigms (dysfunctional attitudes, negative inferential style, self-criticism, dependency, brooding) predict depression, but may be transdiagnostic vulnerabilities for multiple psychopathologies. Risk factors can be identified as broadly transdiagnostic and relatively specific to psyc...

Background Recurrent depressive episodes during adolescence result in significant impairment and increased risk for subsequent adverse outcomes throughout the life span. Evidence suggests that early pubertal timing predicts the onset of depressive episodes (particularly for girls); however, it is not known if pubertal timing prospectively predicts...

Research shows that genetics and effortful control play an important role in the link between parenting and problem behavior. However, little is known about how these factors act simultaneously. This article used a moderated mediation model to examine whether effortful control mediated the link between parenting and externalizing problem behavior,...

Objectives Loneliness is a major public health problem and an estimated 17% of adults aged 18–70 in the USA reported being lonely. We sought to characterise the (online) lives of people who mention the words ‘lonely’ or ‘alone’ in their Twitter timeline and correlate their posts with predictors of mental health. Setting and design From approximate...

Background Universal depression screening in youth typically focuses on strategies for identifying current distress and impairment. However, these protocols also play a critical role in primary prevention initiatives that depend on correctly estimating future depression risk. Thus, the present study aimed to identify the best screening approach for...

Objective: Primary care has been promoted as a setting to identify and manage adolescent depression. This study examined primary care-based adolescent depression identification and follow-up care when elevated symptoms were identified. Methods: Data came from a large pediatric care network with an organizational recommendation to screen for depr...

The broaden-and-build theory of positive emotions suggests that the experience of positive affect (PA) and positive interpersonal experiences should mutually reinforce each other over time, potentiating upward spirals of PA and social well-being. Informed by this upward spirals hypothesis, the present study used parallel process latent growth curve...

Several adolescent depression prevention programs have demonstrated effects on depressive symptoms and overall functioning. Yet, despite an increasing emphasis on elucidating mechanisms of change in interventions, few studies have identified mediators of these preventive interventions. In this study, we examined interpersonal mediators of Interpers...

This research examines the contextual factors that facilitate development and change in attachment during later childhood, adolescence, and early adulthood using a longitudinal cohort design involving 690 children (7-19 years old) and their parents. At each wave, a variety of interpersonal variables (e.g., parent-child stress) were measured. We exa...

Few studies have examined the incremental validity of multi-informant depression screening approaches. In response, we examined how recommendations for using a multi-informant approach may vary for identifying concurrent or prospective depressive episodes. Participants included 663 youth (AgeM = 11.83; AgeSD = 2.40) and their caregiver who independ...

Cross-lagged panel models (CLPM) are often used to study anxiety-depression co-occurrence. However, the CLPM aggregates within- and between-person variance, which can lead to incorrect estimates. The latent curve model with structured residuals (LCM-SR) parses these sources of variance. We utilized the LCM-SR to examine prospective associations bet...

Previous research has found that insecure attachment is associated with depression. In the present study, we use an accelerated longitudinal cohort design to examine how the association between attachment and depression develops during childhood and adolescence. Specifically, 690 children from 3 distinct cohorts (grades 3, 6, and 9) completed self-...

Concurrent associations between parenting behaviors and youth depression are well established. A smaller body of work has demonstrated longitudinal associations between aspects of parenting and youth risk for depression; however, this limited longitudinal work has predominantly relied upon self- and parent-report questionnaire measures and is thus...

Developmental patterns of personality pathology traits are not well delineated from childhood through late adolescence. In the present study, participants (N = 675, 56% female) were recruited to create three cohorts of third (n = 205), sixth (n = 248), and ninth (n = 222) graders to form an accelerated longitudinal cohort design. We assessed six PD...

Background: Given the prevalence and consequences of adolescent depression, depression prevention has become an important area of research. While prevention programs like Interpersonal Psychotherapy - Adolescent Skills Training (IPT-AST) have demonstrated effectiveness, little research to date has studied the relationship between maternal depressi...

Evidence suggests that early pubertal timing may operate as a transdiagnostic risk factor (i.e., shared across syndromes of psychopathology) for both genders. The current study examined associations between pubertal timing and dimensional psychopathology, structured across different levels of three organizational models: (a) DSM-based syndrome mode...

Many longitudinal studies have investigated whether self‐esteem predicts depressive symptoms (vulnerability model) or the other way around (scar model) in adolescents. The most common method of analysis has been the cross‐lagged panel model (CLPM). The CLPM does not separate between‐person effects from within‐person effects, making it unclear wheth...

Adolescence represents a vulnerable developmental period for depression and an opportune time for prevention efforts. In this study, 186 adolescents with elevated depressive symptoms (M age = 14.01, SD = 1.22; 66.7% female; 32.2% racial minority) were randomized to receive either Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST; n =...

Background: Traumatic stressful events (TSEs) during childhood and adolescence are associated with increased risk for psychopathology and cognitive impairment. Aberrations in social cognition may contribute to the psychopathology risk. We examined performance differences on social cognitive measures between youths with high TSE exposure and no TSE...

Attachment theorists emphasize both the stability of attachment styles across time and their potential for change. The authors examined mean-level changes in attachment styles using an accelerated longitudinal cohort design. Specifically, 690 children, aged 8-19, completed self-report measures of attachment to their mothers 3 times over 3 years in...

Objective Pediatric loss of control (LOC) eating prospectively predicts the worsening of metabolic syndrome components. However, it is unknown if remission of LOC eating is associated with improvements in metabolic health. Therefore, we conducted a secondary analysis of a trial that enrolled adolescent girls with LOC eating, examining whether LOC r...

Background: Depression is highly comorbid with anxiety in youth. It is frequently reported that anxiety precedes depression; however, evidence surrounding the temporal precedence of anxiety over depression is mixed. Many studies of anxiety-depression co-occurrence lump distinct forms of anxiety, obscuring information regarding trajectories of spec...

Despite interest in psychosocial vulnerabilities to depression, little is known about reliable and valid individualized risk profiles that can be used to match individuals to evidence-based interventions for depression. This study investigated well-established cognitive and interpersonal vulnerabilities to depression among youth to discern an evide...

Traditionally, screening research tests how well a given symptom inventory can identify a concurrent depressive episode. Although developmental psychopathology could inform screening protocols for a myriad of depression outcomes (e.g., prospective depressive episodes), approaches typically used in research make it difficult to translate these findi...

Table S1. Variance–Covariance Matrices Study 1–3 Table S2. Measurement Invariance Models Study 1–3 Table S3. Measurement Invariance Within Measurement Waves Study 2 Table S4. Standardized RI‐CLPM Estimates Complete Case Analyses Study 1–3 Table S5. Standardized CLPM estimates Complete Case Analyses Study 1–3 Table S6. Model Fit Comparisons of RI‐CL...

Open Practices Disclosure

Developing culturally appropriate obesity prevention programs for African American (AA) adolescent girls that account for psychological risk factors is paramount to addressing health disparities. The current study was part of an investigation utilizing a community-based participatory research framework to gather qualitative data from urban AA girls...

We examined the prediction that the interaction between Glucocorticoid Receptor Gene (NR3C1) methylation, stress, and experienced maternal support predicts anxious and avoidant attachment development. This was tested in a general population sample of 487 children and adolescents (44% boys, Mage = 11.84, SDage = 2.4). These children were followed ov...

Interpersonal psychotherapy (IPT) prevents weight gain and reduces loss-of-control (LOC)-eating in adults. However, IPT was not superior to health-education (HE) for preventing excess weight gain and reducing LOC-eating over 1-year in adolescent girls at risk for excess weight gain and eating disorders. Limited data suggest that older and non-White...

Previous research has demonstrated the effectiveness of school-based depression prevention programs in reducing depressive symptoms and improving functioning. This study examined whether these programs have positive effects on school-related outcomes. Students at 10 middle and high schools in New Jersey were randomized to weekly sessions of Interpe...

Parenting behaviors influence clinical depression among youth, but little is known about the developmental processes that may account for this association. This study investigated whether parenting is associated with the onset of clinical depression and depressive symptoms through negative cognitive style, particularly under conditions of high expo...

Psychopathology is posited to be transdiagnostically linked to chronic stress. Yet efforts to understand the specificity and directionality of these links have been sparse, and the ubiquitous comorbidity of psychopathology has made the seemingly nonspecific links between psychological disorders and chronic stress difficult to interpret. The current...

Common emotional and behavioral symptoms co-occur and are associated with core temperament factors. This study investigated links between temperament and dimensional, latent psychopathology factors, including a general common psychopathology factor (p factor) and specific latent internalizing and externalizing liabilities, as captured by a bifactor...

Attention bias to emotion has been studied as a risk factor associated with depression. No study has examined whether attention bias within the context of measured genetic risk leads to increased risk for clinical depressive episodes over time. The current study investigated whether genetic risk, as indexed by the serotonin-transporter-linked polym...

This paper presents the first findings of an integrative data analysis of individual-level data from 19 adolescent depression prevention trials (n = 5210) involving nine distinct interventions across 2 years post-randomization. In separate papers, several interventions have been found to decrease the risk of depressive disorders or elevated depress...

Case Studies Within Psychotherapy Trials: Integrating Qualitative and Quantitative Methods presents a specific, mixed-methods approach, called the “Cases Within Trials” (CWT) model, to psychotherapy research combining the results from a randomized clinical trial (RCT); the results of richly and qualitatively detailed systematic case studies involvi...

Objective: Interpersonal psychotherapy (IPT) prevents weight gain in adults with obesity and binge-eating-disorder, and is especially effective among those with increased psychosocial problems. However, IPT was not superior to health education (HE) to prevent excess weight gain at 1-year follow-up in 113 adolescent girls at high-risk for excess we...

Dimensional models of psychopathology that posit a general psychopathology factor (i.e., p factor), in addition to specific internalizing and externalizing factors, have recently gained prominence. However, the stability of these factors and the specificity with which they are related to one another over time (e.g., homotypic or heterotypic continu...

This randomized controlled trial examined the longitudinal effects of two school-based indicated depression prevention programs on adolescents’ internalizing and externalizing symptoms, as measured by adolescents, their parents, and their teachers. One hundred eighty-six adolescents participated in this study. The average age was 14.01 (SD = 1.22)...

This article presents a brief case study of "Jane Doe," a 13-year-old, non-Hispanic White girl 2 participating in a clinical research trial of interpersonal psychotherapy-weight gain (IPT-WG). Girls at-risk for adult obesity and binge eating disorder (BED) were randomly assigned to take part in 12 weeks of preventative group treatment. Jane’s IPT-W...

This chapter describes the process of selecting adolescents to participate in Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST), including considerations regarding target population and level of prevention. This chapter includes a detailed discussion of how to conduct a clinical interview to determine appropriateness for this depress...

This chapter addresses common clinical issues that Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) group leaders have encountered. These issues include absences, engaging reluctant adolescents in group activities, difficult or defiant adolescents, breaches to confidentiality, challenging family situations, sensitive topics, and cri...

This chapter describes the content and structure of Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) booster sessions. These sessions are individually scheduled with adolescents following completion of the group. Booster sessions are offered to extend the effects of the group and to help teens apply interpersonal strategies to new s...

This chapter discusses the development of an interpersonally oriented depression prevention program for adolescents, Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST). Depression is a common and debilitating illness that rises in prevalence during the teenage years. Adolescence is therefore an opportune time to provide preventive int...

Adolescents in Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) participate in two individual pre-group sessions before the group begins. If two sessions are not feasible, a single 90-minute session can be offered. The goals of these sessions are to get to know the adolescent and build rapport; assess for depression symptoms over th...