| Popis: |
Temperamental factors, specifically negative and positive affectivity (NA and PA) and effortful control (EC), have clear associations with brain structure and function and have demonstrated associations with mood and anxiety symptoms in children. In general, research supports that high NA, low PA, and low EC are associated with greater depressive severity. Further work has also demonstrated significant two-way and three-way interactions among these constructs on depressive severity. Work in adults exists to support the notion that temperament may be influenced by pharmaceutical interventions as well as cognitive therapy. To date, no studies examining the impact of biological or behavioral interventions on temperament constructs have been conducted in youth with mood disorders. The purpose of the present study was to examine the impacts of omega-3 supplementation and family-based cognitive behavioral therapy (CBT), alone and in combination, on the temperamental constructs of NA, PA, and EC in a sample of youth with mood disorders. Data are from a larger 12 week randomized, placebo controlled trial examining these same interventions on depressive and manic severity.178 youth aged seven to 14 years were recruited and screened from community advertisement and clinician referral. 95 of these youth met enrollment criteria and were randomized to one of four treatment cells: omega-3 monotherapy, CBT monotherapy with pill placebo, combined omega-3 and CBT intervention, and pill placebo only. Youth and their caregivers completed the Positive and Negative Affectivity Schedule (PANAS) to measure youth’s levels of affectivity throughout the study. Youth also completed the Effortful Control Scale (ECS) to measure EC throughout the study. These report forms were given at screening assessment, at baseline (time of randomization), and at two, four, six, nine, and 12 weeks post-randomization (i.e., total of seven time points of data). Families randomized to a CBT condition participated in twice weekly, 50-minute sessions. Two capsules (omega-3 or placebo) were given twice daily along with a daily multivitamin/mineral supplement. Hierarchical linear modeling (HLM) was used to model the impacts of treatment independently on NA, PA, and EC and also to examine the associations of treatment along with other treatment predictors. EC prior to treatment as well as changes in EC were examined as a treatment moderator and treatment correlate, respectively. Exploratory investigation of EC as a treatment mediator on end of study NA and PA was also examined.Overall, omega-3 and CBT interventions did not significantly impact NA, PA, or EC trajectories across time. While ECS total scores did not serve as a significant treatment moderator, lower initial ECS persistence-low distractibility subscale scores and combined treatment together were associated with faster declines in child-reported PA. Changes in EC during treatment had little association overall with trajectory of affectivity and was not generally associated with treatment. Omega-3 and CBT, alone or in combination, had minimal effects on affectivity or EC. Other indirect mechanisms to explain how affectivity and EC affect depressive and anxious severity should be investigated as potential treatment targets rather than examining modification of temperament factors directly. |
