Lauren D Gulley1, Lauren B Shomaker2, Nichole R Kelly3, Kong Y Chen4, Cara H Olsen5, Marian Tanofsky-Kraff6, Jack A Yanovski7. 1. Human Development & Family Studies, Colorado State University, Campus Delivery 1570, Fort Collins, CO 80523, USA; Pediatrics, Section of Endocrinology, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, 13123 E 16th Avenue, B265, Aurora, CO 80045, USA. Electronic address: lauren.gulley@colostate.edu. 2. Human Development & Family Studies, Colorado State University, Campus Delivery 1570, Fort Collins, CO 80523, USA; Pediatrics, Section of Endocrinology, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, 13123 E 16th Avenue, B265, Aurora, CO 80045, USA; Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA. 3. Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Counseling Psychology & Human Services and the Prevention Science Institute, College of Education, University of Oregon, 1215 University of Oregon, Eugene, OR 97403, USA. 4. Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), NIH, 10 Center Drive, Bethesda, MD 20892, USA. 5. Preventative Medicine & Biometrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA. 6. Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA; Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA. 7. Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA.
Abstract
OBJECTIVE: Depression in adolescence is linked to risk for type 2 diabetes (T2D). In this secondary data analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) to a control program to ameliorate insulin resistance via reducing depression symptoms, we examine which CBT change mechanisms (e.g., behavioral activation, cognitive restructuring) contributed to decreased depression and subsequent improvements in body mass index (BMI), percent body fat, and insulin resistance. METHODS: Girls 12-17y with overweight/obesity and family history of T2D were randomized to six-week group CBT (n = 61) or health education (HealthEd; n = 58). At baseline and post-treatment, adolescents completed questionnaires assessing activities, thoughts, and depression symptoms. At baseline, post-treatment, and one-year, BMI was calculated and insulin outcomes were derived from two-hour oral glucose tolerance testing. At baseline and one-year, percent body fat was assessed with dual-energy x-ray absorptiometry. Indirect effects of CBT components were tested on one-year changes in BMI, percent body fat, and insulin indices through decreases in depression symptoms during treatment. Intervention was tested as a moderator. RESULTS: In CBT, but not HealthEd, there was an indirect effect of increased physical activity during treatment on decreased one-year BMI via reductions in depression symptoms during treatment. Also, there were conditional indirect effects in CBT of increased pleasantness of physical and social activity during treatment on decreased one-year BMI via decreased depression symptoms during treatment. CONCLUSION: Behavioral activation may be a useful intervention to decrease depression and reduce excess weight gain in the targeted prevention of T2D in at-risk adolescent girls. NCT01425905, clinicaltrials.gov.
OBJECTIVE: Depression in adolescence is linked to risk for type 2 diabetes (T2D). In this secondary data analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) to a control program to ameliorate insulin resistance via reducing depression symptoms, we examine which CBT change mechanisms (e.g., behavioral activation, cognitive restructuring) contributed to decreased depression and subsequent improvements in body mass index (BMI), percent body fat, and insulin resistance. METHODS: Girls 12-17y with overweight/obesity and family history of T2D were randomized to six-week group CBT (n = 61) or health education (HealthEd; n = 58). At baseline and post-treatment, adolescents completed questionnaires assessing activities, thoughts, and depression symptoms. At baseline, post-treatment, and one-year, BMI was calculated and insulin outcomes were derived from two-hour oral glucose tolerance testing. At baseline and one-year, percent body fat was assessed with dual-energy x-ray absorptiometry. Indirect effects of CBT components were tested on one-year changes in BMI, percent body fat, and insulin indices through decreases in depression symptoms during treatment. Intervention was tested as a moderator. RESULTS: In CBT, but not HealthEd, there was an indirect effect of increased physical activity during treatment on decreased one-year BMI via reductions in depression symptoms during treatment. Also, there were conditional indirect effects in CBT of increased pleasantness of physical and social activity during treatment on decreased one-year BMI via decreased depression symptoms during treatment. CONCLUSION: Behavioral activation may be a useful intervention to decrease depression and reduce excess weight gain in the targeted prevention of T2D in at-risk adolescent girls. NCT01425905, clinicaltrials.gov.
Authors: Glenn A Phillips; William R Shadish; David M Murray; Martha Kubik; Leslie A Lytle; Amanda S Birnbaum Journal: Multivariate Behav Res Date: 2006-06-01 Impact factor: 5.923
Authors: Aaron S Kelly; Marsha D Marcus; Jack A Yanovski; Susan Z Yanovski; Stavroula K Osganian Journal: Int J Obes (Lond) Date: 2018-10-03 Impact factor: 5.095
Authors: Elissa Jelalian; Barbara Jandasek; Jennifer C Wolff; Lourah M Seaboyer; Richard N Jones; Anthony Spirito Journal: J Clin Child Adolesc Psychol Date: 2016-06-16