Targeting Burdensomeness Among Clinic Referred Youth

Study Overview
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Brief Summary
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This study will develop and pilot test a novel intervention module targeting perceived burdensomeness toward others in 30 clinic referred youths who experience anxiety or depression and elevated levels of burdensomeness. All participants will be assigned to receive the intervention in this open trial.

Detailed Description
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Suicidal ideation is prevalent and impairing in youth, with approximately 15% of high school students reporting seriously considering a suicide attempt and making a specific plan for suicide in the past 12 months. Substantial evidence documents perceived burdensomeness towards others, or the belief that one is a burden or drain on others, as a risk factor for suicide ideation in youth. This evidence highlights the potential promise of perceived burdensomeness as a novel intervention target to prevent suicide ideation in youth. The current study will develop and preliminary evaluate a novel, brief behavioral treatment module targeting perceived burdensomeness in youth that can be embedded within existing psychosocial treatments. The study will use an open trial design. The first aim of this proposal is to develop a novel, brief psychosocial intervention module (the GIVE module) targeting perceived burdensomeness towards others that can be embedded within existing CBT protocols for youth internalizing problems. The second aim is to collect data relevant to client satisfaction and reductions in perceived burdensomeness. Participants will be N=30 clinic-referred youth ages 10 to 17 years with anxiety or depressive disorders in a university-based research clinic, who display elevated levels of perceived burdensomeness. In the context on ongoing CBT for anxiety or depression, participants will complete the GIVE module at sessions 6 and 7 of the CBT protocol. It is hypothesized that perceived burdensomeness will be significantly lower after the GIVE module is administered, and that client satisfaction will be high. Data collected in this study will provide the foundation for a subsequent randomized controlled trial of the GIVE module.

Official Title
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Targeting Burdensomeness Among Clinic Referred Youth

Conditions
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Perceived Burdensomeness Toward Others

Intervention / Treatment
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* Behavioral: GIVE Module


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of an anxiety disorder, persistent depressive disorder, or major depressive disorder Score > 4 on the youth self-report Interpersonal Needs Questionnaire- Perceived Burdensomeness Scale Exclusion Criteria: Clinical diagnosis of a Psychotic Disorder, Autism Spectrum Disorder or Intellectual Disability Show high risk of imminent self-injurious behaviors Be involved currently in another behavioral treatment Not live with a primary caregiver who is legally able to give consent for the youth's participation Be a victim of previously undisclosed abuse requiring investigation or ongoing supervision by the Department of Children and Families.

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: open label pilot study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: GIVE module<br>The GIVE module consists of one 50-minute treatment session and a second partial session (15-20 minutes) embedded within a larger cognitive behavioral treatment (CBT) protocol for anxiety or depression. The GIVE module uses cognitive behavioral principles to target youth's beliefs that they are a burden or drain on others. | Behavioral: GIVE Module<br>* The GIVE Module is a brief cognitive behavioral intervention targeting youths' beliefs that they are a burden or drain on others. It consists of two sessions embedded within a larger CBT protocol for anxiety or depression.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 6-item Youth Perceived Burdensomeness Subscale of the Interpersonal Needs Questionnaire | Youth self-ratings on perceived burdensomeness over the past week. Each item is scored 1-7 (1 = not at all true for me; 7 = very true for me), yielding a total between 6 and 42. Higher scores indicate higher levels of perceived burdensomeness (worse outcome). | post-intervention (within one week of completing the GIVE Module) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 10-item Youth Rated Warmth Subscale of the Child Report of Parental Behavior Inventory | Youth ratings on parental warmth over the past week. Each of 10 items is scored 1-3 (1 = not like parent; 3 = a lot like parent), yielding a total score of 10 to 30. Higher scores indicate higher levels of parental warmth (better outcome). | post-intervention (within one week of completing the GIVE Module) | 
| 10-item Parent Rated Warmth Subscale of the Parent Report of Parental Behavior Inventory | Parent self-ratings on parental warmth over the past week. Each of 10 items is scored 1-3 (1 = not like me; 3 = a lot like me), yielding a total score of 10 to 30. Higher scores indicate higher levels of parental warmth (better outcome). | post-intervention (within one week of completing the GIVE Module) | 
| 41-item Youth Rated Screen for Child Anxiety Related Emotional Disorders | Youth self-ratings on anxiety symptom severity. Each item is scored 0-2 (0 = not true; 2 = very true), yielding a total score of 0 to 82. Higher scores indicate higher levels of anxiety (worse outcome). | post-intervention (within one week of completing the GIVE Module) | 
| 41-item Parent Rated Screen for Child Anxiety Related Emotional Disorders | Parent ratings on youth anxiety symptom severity. Each item is scored 0-2 (0 = not true; 2 = very true), yielding a total score of 0 to 82. Higher scores indicate higher levels of anxiety (worse outcome). | post-intervention (within one week of completing the GIVE Module) | 
| 28-item Youth-rated Children's Depression Inventory - 2 | Youth self-ratings on depressive symptom severity. Each item is scored 0-2, yielding total scores of 0 to 56, with higher scores corresponding to more severe symptoms. | post-intervention (within one week of completing the GIVE Module) | 
| 17-item Parent Rated Children's Depression Inventory - 2 | Parent ratings on youth depressive symptom severity. Each item is scored 0-3, yielding total scores of 0 to 51, with higher scores corresponding to more severe symptoms. | post-intervention (within one week of completing the GIVE Module) | 
| 8-item Youth Rated Client Satisfaction Questionnaire | Youth ratings of satisfaction with the GIVE module. Each item is score 1-4 (1 = quite dissatisfied; 4 = very satisfied), yielding total scores of 8-32. Higher scores indicate higher satisfaction (better outcome). | post-intervention (within one week of completing the GIVE Module) | 
| 8-item Parent Rated Client Satisfaction Questionnaire | Parent ratings of satisfaction with the GIVE module. Each item is score 1-4 (1 = quite dissatisfied; 4 = very satisfied), yielding total scores of 8-32. | post-intervention (within one week of completing the GIVE Module) |