Abstract
Studies have shown that cognitive behavioral therapy may be a useful method for alleviating the symptoms of depression. Depression is a growing issue among college adolescents in Nigeria. This study examined the effects of group cognitive behavioural therapy on depressive symptoms in a sample of college adolescents. We employed a randomized controlled trial design with 162 college adolescents in Southeastern region of Nigeria. One screening tool was used to ascertain the severity of depressive symptoms among the study participants at pre-treatment, post-treatment, and follow-up evaluations. In order to analyze the data collected, repeated measures analysis of variance and t test statistics were employed. Effect size of the intervention was determined using partial eta squared. The findings of the experiment showed that level of depressive symptoms of adolescents enrolled in the group cognitive behavioural therapy group was significantly reduced compared to the waitlisted control group at post-treatment evaluation. We also found that this significant reduction in depressive symptoms was maintained at follow-up.
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References
Abel, W. D., Bailey-Davidson, Y., Gibson, R. C., Martin, J. S., Sewell, C. A., James, S., et al. (2012). Depressive symptoms in adolescents in Jamaica. West Indian Medical Journal, 61(5), 494–498.
Adeniyi, A. F., Okafor, N. C., & Adeniyi, C. Y. (2011). Depression and physical activity in a sample of Nigerian adolescents: Levels, relationships and predictors. Child and Adolescent Psychiatry and Mental Health, 5, 16.
Adewuya, O. A., Ola, B. A., & Aloba, O. O. (2007). Prevalence of major depressive disorders and a validation of the beck depressive inventory among Nigerian Adolescents. European Child Adolescent Psychiatry, 16, 287–292.
Al-Busaidi, Z., Bhargava, K., Al-Ismaily, A., Al-Lawati, H., Al-Kindi, R., Al-Shafaee, M., et al. (2011). Prevalence of depressive symptoms among University Students in Oman. Oman Medical Journal, 26(4), 235–239.
Allen, J. P. (2003). An overview of Beck’s cognitive theory of depression in contemporary literature. Retrieved September 20, 2017 from http://www.personalityresearch.org/papers/allen.html.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
Bahls, S. C. (2002). Epidemiology of depressive symptoms in adolescents of a public school in Curitiba, Brazil. Revista Brasileira de Psiquiatria, 24(2), 63–67.
Bansal, V., Goyal, S., & Srivastava, K. (2009). Study of prevalence of depression in adolescent students of a public school. Industrial Psychiatry Journal, 18, 43–46.
Beck, A. T. (1967). Depression: Causes and treatment. Pennsylvania: University of Pennsylvania Press.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). New York, NY: Guilford Press.
Birmaher, B., & Brent, D. (2007). AACAP work group on quality issues, practice parameter for the assessment and treatment of children and adolescents with depressive disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46(11), 1503–1526.
Birmaher, B., Ryan, N. D., Williamson, D. E., Brent, D. A., Kaufman, J., Dahl, R. E., et al. (1996). Childhood and adolescent depression: A review of the past 10 years. Part I. American Academy of Child and Adolescent Psychiatry, 35, 1427–1439.
Bjornstad, G., Timmons, L., Sonthalia, S., Rouse, B., & Axford, N. (2017). Cognitive behavioural interventions for mild depression in adolescents: Title for a systematic review and network meta-analysis. Retrieved October 16, 2018 from https://campbellcollaboration.org/media/k2/attachments/SWCG_Bjornstad_Title.pdf.
Brent, D. A. (1993). Depression and suicide in children and adolescents. Pediatrics Review, 14, 380–388.
Charman, T. (1994). The stability of depressed mood in young adolescents: A school-based survey. Journal of Affective Disorders, 30, 109–116.
Chinawa, J. M., Manyike, P. C., Obu, H. A., Aronu, A. E., Odutola, O., & Chinawa, A. T. (2015). Depression among adolescents attending secondary schools in South East Nigeria. Annals of African Medicine, 14, 46–51.
Clark, D. A. (2014). Cognitive restructuring. In S. G. Hofmann (Ed.), The Wiley handbook of cognitive behavioral therapy (1st ed.). Hoboken, NJ: Wiley.
Clarke, G. N., Hornbrook, M., Lynch, F., Polen, M., Gale, J., Beardslee, W., et al. (2001). A randomized trial of a group cognitive intervention for preventing depression in adolescent offspring of depressed parents. Archives of General Psychiatry, 58(12), 1127–1134.
Compton, S. N., March, J. S., Brent, D., Albano, A. M., Weersing, R., & Curry, J. (2004). Cognitive–behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: An evidence-based medicine review. American Academy of Child and Adolescent Psychiatry, 43, 930–959.
David, D., Kangas, M., Schnur, J. B., & Montgomery, G. H. (2004). REBT depression manual; Managing depression using rational emotive behavior therapy. Cluj-Napoca: Babes-Bolyai University (BBU).
David, D., Lynn, S. J., & Ellis, A. (Eds.). (2010). Rational and irrational beliefs: Research, theory and clinical practice. New York, NY: Oxford University Press.
DePrince, A. P., & Shirk, S. R. (2013). Adapting cognitive–behavioral therapy for depressed adolescents exposed to interpersonal trauma: A case study with two teens. Cognitive and Behavioral Practice, 20, 189–201.
DePrince, A. P., Zurbriggen, E. L., Chu, A. T., & Smart, L. (2010). Development of the trauma appraisal questionnaire. Journal of Aggression, Maltreatment, & Trauma, 19, 275–299. https://doi.org/10.1080/10926771003705072.
Dobson, D., & Dobson, K. S. (2009). Evidence-based practice of cognitive–behavioral therapy. New York, NY: Guilford Press.
Ellis, A. (1962). Reason and emotion in psychotherapy. New York: Stuart.
Eseadi, C., Onwuka, G. T., Otu, M. S., Umoke, P. I., Onyechi, K. C. N., Okere, A. U., et al. (2017). Effects of rational emotive cognitive behavioural coaching on depression among type 2 diabetic inpatients. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 35(4), 363–382.
Fatrigun, A. A., & Kumapayi, T. E. (2014). Prevalence and correlates of depressive symptoms among in-school adolescents in a rural district in southwest Nigeria. Journal of Adolescence, 37(2), 197–203.
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175.
Faulstich, M. E., Carey, M. P., Ruggiero, L., Enyart, P., & Gresham, F. (1986). Assessment of depression in childhood and adolescence: An evaluation of the Center for Epidemiological Studies Depression Scale for Children (CES-DC). American Journal of Psychiatry, 143(8), 1024–1027.
Fendrich, M., Warner, V., & Weissman, M. M. (1990). Family risk factors, parental depression, and psychopathology in offspring. Developmental Psychology, 26, 40–50.
Fennell, M., Bennett-Levy, J., & Westbrook, D. (2004). Depression. In J. Bennett-Levy, G. Butler, M. Fennell, A. Hackmann, M. Mueller, & D. Westbrook (Eds.), Oxford guide to behavioural experiments in cognitive therapy (pp. 205–222). Oxford: Oxford University Press.
Fowers, B. J., & Richardson, F. C. (1996). Why is multiculturalism good? American Psychologist, 51, 609–621.
Garber, J., Clarke, G. N., Weersing, V. R., Beardslee, W. R., Brent, D. A., Gladstone, T. R., et al. (2009). Prevention of depression in at-risk adolescents. JAMA, 301(21), 2215–2224.
Garrison, C. Z., Addy, C. L., Jackson, K. L., McKeown, R. E., & Waller, J. L. (1997). Incidence of major depressive disorder and dysthymia in young adolescents. American Academy of Child and Adolescent Psychiatry, 36, 458–465.
Garvik, M., Idsoe, T., & Bru, E. (2014). Effectiveness study of a CBT based adolescent coping with depression course. Emotional and Behavioural Difficulties, 19(2), 195–209.
Goldberg, I. K. (1993). Goldberg depression questionnaire, a screening test for depression. Retrieved September 15, 2017 from http://www.psychcentral.com/depquiz.htm.
Greenberger, D., & Padesky, C. A. (1995). Mind over mood: Change how you feel by changing the way you think. New York, NY: Guilford Press.
Hauck, P. A. (1971). An RET theory of depression. Rational Living, 6(2), 24–32.
Hofmann, S. G., & Smits, J. A. (2008). Cognitive–behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychiatry, 69, 621–632.
Kazdin, A. E., & Marciano, P. L. (1998). Childhood and adolescent depression. In E. Mash & R. Barkley (Eds.), Treatment of childhood disorders (2nd ed., pp. 211–248). New York: The Guilford Press.
Kessler, R. C., & Walters, E. E. (1998). Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the national comorbidity survey. Depression Anxiety, 7, 3–14.
Klein, J. B., Jacobs, R. H., & Reinecke, M. A. (2007). Cognitive–behavioral therapy for adolescent depression: A meta-analytic investigation of changes in effect-size estimates. American Academy of Child and Adolescent Psychiatry, 6(11), 1403–1413.
Kolko, D. J., Brent, D. A., Baugher, M., Bridge, J., & Birmaher, B. (2000). Cognitive and family therapies for adolescent depression: Treatment specificity, mediation, and moderation. Journal of Consulting and Clinical Psychology, 68(4), 603–614.
Kovacs, M. (1996). The course of childhood-onset depressive disorders. Psychiatric Annals, 26, 326–330.
Laberge, B., Gauthier, J. G., Côté, G., Plamondon, J., & Cormier, H. J. (1993). Cognitive behavioral therapy of panic disorder with secondary major depression: A preliminary investigation. Journal of Consulting and Clinical Psychology, 61, 1028–1037.
Lewinsohn, P. M., Clarke, G. N., Seeley, J. R., & Rohde, P. (1994). Major depression in community adolescents: Age at onset, episode duration, and time to recurrence. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 809–818.
Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R., & Andrews, J. A. (1993). Adolescent psychopathology: Prevalence and incidence of depression and other DSM-III—R disorders in high school students. Journal of Abnormal Psychology, 102(1), 133–144. https://doi.org/10.1037/0021-843x.102.1.133.
Luby, J. L. (2009). Early childhood depression. American Journal of Psychiatry, 166, 974–979.
Mathet, F., Martin-Guehl, C., Maurice-Tison, S., & Bouvard, M. P. (2003). Prevalence of depressive disorders in children and adolescents attending primary care. A survey with the Aquitaine Sentinelle Network. Encephale, 29, 391–400.
Mirza, K. A. H. (1996). Major depression in children and adolescents. British Journal of Hospital Medicine, 55, 57–61.
Moscovitz, D. A., Hofmann, S. G., Suvak, M. K., & In-Albon, T. (2005). Mediation of changes in anxiety and depression during treatment of social phobia. Journal of Consulting and Clinical Psychology, 73, 945–952.
Nalugya-Sserunjogi, J., Rukundo, G. Z., Ovuga, E., Kiwuwa, S. M., Musisi, S., & Nakimuli-Mpungu, E. (2016). Prevalence and factors associated with depression symptoms among school-going adolescents in Central Uganda. Child Adolescent Psychiatry Mental Health, 10, 39.
National Institute for Health and Care Excellence, NICE. (2015). Clinical guideline addendum 28.1 depression in children and young people. National Institute for Health and Care Excellence. Retrieved January 22, 2018 from https://www.nice.org.uk/guidance/cg28/resources/cg28-depression-in-children-and-young-people-full-guideline-2.
Ogbuanya, T. C., Eseadi, C., Orji, C. T., Anyanwu, J. I., Ede, M. O., & Bakare, J. (2017). Effect of rational-emotive behavior therapy on negative career thoughts of students in technical colleges in Nigeria. Psychological Reports, 121(2), 356–374.
Olsson, G., & von Knotting, A. L. (1997). Depression among Swedish adolescents measured by the self rating scale Center for Epidemiology Studies- Depression Child (CES-DC). European Child & Adolescent Psychiatry, 6(2), 81–87.
Onuigbo, L. N., Eseadi, C., Ebifa, S., Ugwu, U. C., Onyishi, C. N., & Oyeoku, E. K. (2018). Effect of rational emotive behavior therapy program on depressive symptoms among university students with blindness in Nigeria. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 37, 17–38. https://doi.org/10.1007/s10942-018-0297-3.
Pataki, C. S., & Carlson, G. A. (1995). Childhood and adolescent depression: A review. Harvard Review of Psychiatry, 3(3), 140–151.
Reed, M. (1994). Social skills training to reduce depression in adolescents. Adolescence, 29, 293–304.
Riper, H., Andersson, G., Hunter, S. B., de Wit, J., Berking, M., & Cuijpers, P. (2013). Treatment of comorbid alcohol use disorders and depression with cognitive–behavioural therapy and motivational interviewing: A meta-analysis. Addiction, 109, 394–406.
Rosselló, J., & Bernal, G. (1999). The efficacy of cognitive–behavioral and interpersonal treatments for depression in Puerto Rican adolescents. Journal of Consulting and Clinical Psychology, 67, 734–745.
Rosselló, J., & Bernal, G. (2015). Treatment manual for cognitive behavioral therapy for depression. Retrieved November 20, 2017 from http://ipsi.uprrp.edu/pdf/manuales_tara/group_manual_eng.pdf.
Rutherford, H. J. V., & Joormann, J. (2017). The role of attentional bias in prenatal and postpartum depression. Women’s Health Research, 1(1), 1–10.
Saghaei, M. (2004). Random allocation software for parallel group randomized trials. BMC Medical Research Methodology, 4, 26. https://doi.org/10.1186/1471-2288-4-26.
Schoenbach, V. J., Kaplan, B. H., Wagner, E. H., Grimson, R. C., & Miller, F. T. (1983). Prevalence of self-reported depressive symptoms in young adolescents. American Journal of Public Health, 73(11), 1281–1287. https://doi.org/10.2105/ajph.73.11.1281.
Tee, J., & Kazantzis, N. (2011). Collaborative empiricism in cognitive therapy: A definition and theory for the relationship construct. Clinical Psychology: Science and Practice, 18, 47–61.
Thomas, M. L. (2006). The contributing factors of change in a therapeutic process. Contemporary Family Therapy, 28, 201–210.
Titov, N., Gibson, M., Andrews, G., & McEvoy, P. (2009). Internet treatment for social phobia reduces comorbidity. Australian and New Zealand Journal of Psychiatry, 43, 754–759.
Tummala-Narra, P. (2015). Cultural competence as a core emphasis of psychoanalytic psychotherapy. Psychoanalytic Psychology, 32(2), 275–292.
van Beek, Y., & Dubas, J. S. (2008). Decoding basic and non-basic facial expressions and depressive symptoms in late childhood and adolescence. Journal of Nonverbal Behavior, 32(1), 53–64.
Weersing, V. R., & Brent, D. A. (2006). Cognitive behavioral therapy for depression in youth. Child and Adolescent Psychiatric Clinics of North America, 15, 939–957.
Weersing, V. R., Iyengar, S., Kolko, D. J., Birmaher, B., & Brent, D. A. (2006). Effectiveness of cognitive–behavioral therapy for adolescent depression: A benchmarking investigation. Behavior Therapy, 37, 36–48.
Weersing, V., Rozenman, M., & Gonzalez, A. (2009). Core components of therapy in youth: Do we know what to disseminate? Behavior Modification, 33, 24–47.
Weissman, M. M., Orvaschel, H., & Padian, N. (1980). Children’s symptom and social functioning self report scales: Comparison of mothers’ and children’s reports. Journal of Nervous Mental Disorders, 168(12), 736–740.
Weisz, J. R., Mccarty, C. A., & Valeri, S. M. (2006). Effects of psychotherapy for depression in children and adolescents: A meta-analysis. Psychological Bulletin, 132(1), 132–149.
Wells, A. (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. Chichester: Wiley.
Wright, J. H., & McCray, L. W. (2012). Breaking free from depression: Pathways to wellness. New York, NY: Guilford Press.
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The authors appreciate the study participants. We thank the research assistants who assisted us in the course of this study.
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Ede, M.O., Igbo, J.N., Eseadi, C. et al. Effect of Group Cognitive Behavioural Therapy on Depressive Symptoms in a Sample of College Adolescents in Nigeria. J Rat-Emo Cognitive-Behav Ther 38, 306–318 (2020). https://doi.org/10.1007/s10942-019-00327-1
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DOI: https://doi.org/10.1007/s10942-019-00327-1