Table 3.
Study Characteristics and Findings—Secondary Analyses Testing PS as a Predictor, Moderator, or Mediator of Treatment Response
| Study | Country | N | Participant age range (mean) in years | Diagnostic Status | Recruitment Setting | Overarching intervention(s) | Effect type | Operationalization of problem solving | Outcome | Effect |
|---|---|---|---|---|---|---|---|---|---|---|
| Becker-Weidman et al. [70] | USA | 439 a | 12–17 (14.6) | MDD | Clinical |
1. Fluox 2. CBT 3. Fluox + CBT 4. Placebo |
Pred / Mod | Baseline PPO, NPO, AS, ICS, RPS, |
Depression severity (CDRS-R) |
NPO, PPO, AS = Pred** |
| Kennard et al. [71] | USA | 166 b | 12–18 (16.0) | MDD (TR) | Clinical |
Switch to: 1. Diff SSRI 2. Diff. SSRI + CBT 3. Ven 4. Ven + CBT |
Pred | Receipt of PS training as part of CBT vs. no receipt | Treatment response (CDRS-R & CGI-I) | PS training receipt = Pred* |
| Kaufman et al. [72] | USA | 93 a | 13–17 (15.1) | MDD & CD | Community |
1. CWD-A 2. LST |
Med | Δ self-reported PS in specific situations |
Depression severity (BDI-II & HDRS) |
No significant effect |
| Dietz et al. [73] | USA | 63 a | 13–18 (15.6) | MDD | Clinical |
1. CBT 2. SBFT 3. NST |
Med | Δ observed interpersonal PS interactions between youth and mothers |
MDD remission (K-SADS & BDI). |
Δ in PS interactions associated with outcome in CBT** and SFBT* but test for formal mediation not significant |
Note. Δ: Change in; AS: Avoidance Style; BDI: Beck Depression Inventory [74]; CD: Conduct disorder; CDRS-R: Children’s Depression Rating Scale—Revised [75]; CGI-I: Clinical Global Impression Scale—Improvement [76]; CWD-A: Adolescent Coping with Depression Course; Diff: different; Fluox: Fluoxetine; ICS: Impulsivity/Carelessness Style; K-SADS: The Kiddie Schedule for Affective Disorders and Schizophrenia [77]; LST: Lifeskills training; MDD: Major Depressive Disorder; Med: Mediator; Mod: Moderator; NPO: Negative Problem Orientation; NST: Nondirective supportive therapy; PPO: Positive Problem Orientation; Pred: Predictor; RPS: Rational Problem Solving Style; SBFT: Systemic Behaviour Family Therapy; SPSI-R: Social Problem-Solving Inventory Revised [78]; SSRI: Selective serotonin reuptake inhibitors; TR: Treatment-resistant; Ven: Venlafaxine
* p < .05; ** p < .01; *** p < .001
a The total sample size reported is the number of participants randomized to intervention and control conditions
b The total sample size reported here is the number of participants randomized to an SSRI + CBT intervention arm