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. 2024 Aug;48(4):781-790.
doi: 10.1007/s10608-024-10474-0. Epub 2024 Mar 28.

Cognitive Behavioral Therapy Factors Related to Outcomes in Depression Among Youth with HIV

Betsy D Kennard  1 , Larry K Brown  2 , Kristin Baltrusaitis  3 , Miriam Chernoff  3 , Graham J Emslie  1 , Jessica Jones  1 , Sarah Buisson  4 , Jaime Deville  5 , Megan Wilkins  6 , Amber Bunch  7 , Chivon McMullen Jackson  8 , Christy Beneri  9 , David E Shapiro  3 ; IMPAACT 2002 Team
Affiliations

Cognitive Behavioral Therapy Factors Related to Outcomes in Depression Among Youth with HIV

Betsy D Kennard et al. Cognit Ther Res. 2024 Aug.

Abstract

Purpose: This is a secondary analysis of a multi-site, cluster (site) randomized trial of the efficacy of a combined Health and Wellness Cognitive Behavior Therapy (H&W CBT) and medication management approach for depression in youth with HIV (YWH) compared to standard care. In this study, we explored the association between H&W CBT factors and depression outcomes after 24 weeks of treatment to discover treatment elements associated with symptom reduction.

Methods: Participants (12-24 years of age) were YWH in the United States (US) diagnosed with moderate to severe depression [Quick Inventory of Depressive Symptomatology (QIDS), Clinician-Rated score ≥ 11]. Thirteen US sites were randomly assigned to either the combination treatment approach or standard care. For site-level analyses, site-specific summary scores were used to account for the within site correlation.

Results all scores are site-level: The number of depressive symptoms [QIDS-Self Reported (QIDS-SR) score] after 24 weeks of H&W CBT was significantly negatively correlated with the mean total session duration (ρ = - 0.94), the total homework assigned (ρ = - 0.83), the total number of practice modules used (ρ = - 0.83), and the mean total booster sessions given (ρ = - 0.82).

Conclusions: Specific elements of the H&W CBT (e.g., dose, assignment of homework, greater skills practice, and use of booster sessions) were associated with improvement of depression outcomes in YWH. A focus on these elements in treatment may improve symptom reduction for YWH with depression.

Keywords: Cognitive therapy; Depression; HIV; Treatment factors.

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Conflict of interest statement

Dr. Kennard has research support from American Foundation for Suicide Prevention, National Institutes of Health, Patient-Centered Outcomes Research Institute, and the State of Texas. Dr. Kennard receives royalties from Guilford Press and is on the board of the Jerry M. Lewis MD Research Foundation and the George G. and Alva Hudson Smith Foundation. Dr. Emslie is a consultant for Lundbeck, Neuronetics, and Otsuka, and he receives research support from American Foundation for Suicide Prevention, Janssen Research & Development, LLC, National Institutes of Health, Patient-Centered Research Outcomes Institute (PCORI), and the State of Texas. Dr. Baltrusaitis and Dr. Shapiro have research support (to their institution) from National Institutes of Health (for this study) and from ViiV/GSK and Gilead (for other IMPAACT studies). Larry K. Brown, Miriam Chernoff, Jessica Jones, Sarah Buisson, Jaime Deville, Megan Wilkins, Amber Bunch, Chivon McMullen Jackson, Christy Beneri declare that they have no conflict of interest.

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