College Park,
Maryland
20742
Purpose:
The purpose of this study is to develop a modified behavioral activation program in
adolescents with ADHD to be implemented by school mental health providers in an urban,
low-income school district. Subsequently we will examine its effectiveness in reducing
depressive symptoms and improving emotion regulation and reward responsivity, compared to
usual care.
Study summary:
Children with ADHD are at elevated risk for depression in adolescence and young adulthood,
and this comorbidity is associated with far greater impairment than either disorder alone,
including higher rates of inpatient hospitalization and increased risk for suicidal ideation
and behavior. Despite these adverse outcomes, existing evidence-based interventions for ADHD
have not demonstrated effects in reducing depressive symptoms nor do established depression
prevention programs work as well for adolescents with ADHD. Reward responsivity (RR) and
emotion regulation (ER) are two key factors demonstrated to mediate the association between
ADHD and depression and are thus key targets for prevention. In an effort to address the gap
between access and utilization of mental health care, which is especially stark among
adolescents with ADHD, we aim to develop and test a modified behavioral activation prevention
program [Behaviorally Enhancing Adolescents' Mood in Schools (BEAM-S)] that incorporates
modules to directly target these purported mechanisms. In line with the Deployment-Focused
Model of Intervention Development and Testing, we will develop a program that can be easily
implemented and sustainable in the high school setting as delivered by school mental health
staff that reduces depression and improves overall functioning in adolescents with ADHD, by
way of improving RR and ER. As a first step, we will conduct focus groups with community
stakeholders (e.g., school mental health providers, school administration, adolescents,
parents, teachers) to develop an acceptable and sustainable selected and indicated prevention
program for school staff to utilize. We will then initially train school staff to deliver
this prevention program via to pilot the intervention for implementation of the prevention
program in a case series to evaluate preliminary feasibility. We will then conduct a stage 1
RCT with a hybrid-type 1 implementation effectiveness design in three high schools where
adolescents will be randomized to either the BEAM-S condition (n= 54) or treatment as usual
(n = 54). Finally, qualitative and quantitative data from aims 1-3 will be used to prepare
final procedures for a future large-scale effectiveness trial R01 (aim 4).
Criteria:
Inclusion Criteria:
- Enrolled in a participating Baltimore City Public High School
- DSM-5 Diagnosis of attention-deficit/hyperactivity disorder (ADHD)
- Depressive symptoms above T=65 on the Children's Depression Inventory (CDI)
Exclusion Criteria:
- History of seizures or neurological problems
- DSM-diagnosis of Pervasive Developmental Disorder
- Full scale IQ below 70
- Current depressive symptoms or active suicidality at severe levels where more
intensive services would be warranted
Primary Contact:
Principal Investigator
Michael Meinzer, PhD
University of Maryland, College Park
Andrea Chronis-Tuscano, PhD
Phone: 301-405-9640
Email: achronis@umd.edu