Cognitive and Behavioral Treatment of Childhood Depression

  • Kevin D. Stark
  • Anne Smith


Historically there has been much debate about the existence and nature of depressive disorders during childhood. During the 1980s a consensus emerged within the literature that depressive disorders exist and that they are expressed in much the same fashion as adult variants with some developmental differences. Depressive disorders during childhood appear to be more common and of longer duration than previously thought. Onset of a depressive disorder during childhood is a risk factor for later episodes and impacts all areas of the youngster’s psychosocial functioning, the youngster’s family system, the parent-childs dyads, and has potentially life-threatening consequences. Perhaps due to a recognition of the seriousness of the disorder and the growing number of youths affected by it, research in the area has mushroomed over the past 15 years. Numerous advances have been made in our understanding of the nature of the disorder, its impact on the youngster and his or her family, its course, common cooccuring disturbances, and how to assess it. However, issues surrounding the treatment of depressed children have been sorely neglected and few developmentally sensitive treatment models have been proposed.


Depressive Symptom Social Skill Anxious Child Attributional Style Automatic Thought 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Abramson, L.Y., Metalsky, G.I. and Alloy, L.B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96, 358–372.CrossRefGoogle Scholar
  2. Abramson, L.Y., Seligman, M.E.P. and Teasdale, J. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 49–74.PubMedCrossRefGoogle Scholar
  3. Akiskal, H.S. and McKinney, W.T. (1975). Overview of recent research in depression: Integration of ten conceptual models into a comprehensive clinical frame. Archives of General Psychiatry, 32, 285–305.PubMedCrossRefGoogle Scholar
  4. Ambrose, B. and Rholes, W. (1993). Automatic cognitions and the symptoms of depression and anxiety in children and adolescents: An explanation of the content-specificity hypothesis. Cognitive Therapy and Research, 17, 153–171.CrossRefGoogle Scholar
  5. Arieti, S. and Bemporad, J.R. (1980). The psychological organization of depression. American Journal of Psychiatry, 137, 1360–1365.PubMedGoogle Scholar
  6. Asarnow, J.R. and Bates, S. (1988). Depression in child psychiatric inpatients: Cognitive and attributional patterns. Journal of Abnormal Child Psychology, 16, 601–615.PubMedCrossRefGoogle Scholar
  7. Asarnow, J.R., Carlson, G.A. and Guthrie, D. (1987). Coping strategies, self-perceptions, hopelessness, and perceived family environments in depressed and suicidal children. Journal of Consulting and Clinical Psychology, 55, 361–366.PubMedCrossRefGoogle Scholar
  8. Bandura, A. (1977), A social learning theory. Englewood Cliffs, N.J.: Prentice-Hall.Google Scholar
  9. Barkley, R.A. (1987). Defiant children: A clinician’s manual for parent training. New York: Guilford Press.Google Scholar
  10. Baron, R.M. and Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social psychology, 51, 1173–1182.PubMedCrossRefGoogle Scholar
  11. Beck, A.T. (1967). Depression: Clinical, experimental and theoretical aspects. New York: Hoeber.Google Scholar
  12. Beck, A.T. (1976), Cognitive therapy and the emotional disorders. New York: International Universities Press.Google Scholar
  13. Beck, A.T., Rush, A. J., Shaw, B.F. and Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.Google Scholar
  14. Bedrosian, R.C. (1989). Treating depression and suicidal wishes within the family context. In: N. Epstein, S.E. Schlesinger and W. Dryden (Eds.). Cognitive-behavioral therapy with families (pp. 292–324). New York: Brunner/Mazel.Google Scholar
  15. Bell-Dolan, D.J., Reaven, N.M. and Peterson, L. (1993). Depression and social functioning: A multidimensional study of the linkages. Journal of Clinical Child Psychology, 22, 306–315.CrossRefGoogle Scholar
  16. Benfield, C.Y., Palmer, D.J., Pfefferbaum, B. and Stowe, M.L. (1988). A comparison of depressed and nondepressed disturbed children on measures of attributional style, hopelessness, life stress and temperament. Journal of Abnormal Child Psychology, 16, 397–410.PubMedCrossRefGoogle Scholar
  17. Blechman, E.A., McEnroe, M.J., Carella, E.T. and Audette, D.P. (1986). Childhood competence and depression. Journal of Abnormal Psychology, 95, 223–227.PubMedCrossRefGoogle Scholar
  18. Brown, R.S., Ramirez, D.E. and Taub, J.M. (1978). The prescription of exercise for depression. Physician and sports Medicine, 6, 34–45.Google Scholar
  19. Burbach, D.J. and Borduin, CM. (1986). Parent-child relations and the etiology of depression: A review of methods and findings. Clinical Psychology Review, 6, 133–153.CrossRefGoogle Scholar
  20. Butler, L., Miezitis, S., Friedman, R. and Cole, E. (1980). The effect of two school-based intervention programs on depressive symptoms in préadolescents. American Educational Research Journal, 17, 111–119.CrossRefGoogle Scholar
  21. Clarkin, J.F., Haas, G.L., Glick, I.D. (1988). Affective disorders and the family: Assessment and treatment. New York: The Guilford Press.Google Scholar
  22. Cole, D. and Turner, J., Jr. (1993). Models of cognitive mediation and moderation in child depression. Journal of Abnormal Psychology, 102, 271–281.PubMedCrossRefGoogle Scholar
  23. Coyne, J.C. (1976). Toward an interactional description of depression. Psychiatry, 39, 28–40.PubMedGoogle Scholar
  24. Dixon, J.F. and Ahrens, A.H. (1992). Stress and attributional style as predictors of self-reported depression in children. Cognitive Therapy and Research, 16, 623–634.CrossRefGoogle Scholar
  25. Doyne, E.J., Chambless, D.L. and Beutler, L.E. (1983). Aerobic exercise as a treatment for depression in women. Behavior Therapy, 14, 434–440.CrossRefGoogle Scholar
  26. Doyne, E.J., Ossip-Klein, D.J., Bowman, E.D., Osborn, K.M., McDougall-Wilson, LB. and Neimeyer, R.A. (1987). Running versus weight lilting in the treatment of depression. Journal of Consulting and Clinical Psychology, 55, 748–754.PubMedCrossRefGoogle Scholar
  27. Faust, J., Baum, CG. and Forehand, R. (1985). An examination of the association between social relationships and depression in early adolescence. Journal of Applied Developmental Psychology, 6, 291–297.CrossRefGoogle Scholar
  28. Folkins, CH. (1976). Effects of physical training and mood. Journal of Clinical Psychology, 32, 385–388.PubMedCrossRefGoogle Scholar
  29. Forehand, R., Brody, G., Slotkin, J., Fauber, R., McCombs, A. and Long, N. (1988). Young adolescent and maternal depression: Assessment, interrelations, and predictors. Journal of Consulting and Clinical Psychology, 56, 422–426.PubMedCrossRefGoogle Scholar
  30. Frame, C, Matson, J.L., Sonis, W.A., Fialkov, M.J. and Kazdin, A.E. (1982). Behavioral treatment of depression in a prepubertal child. Journal of Behavior Therapy and Experimental Psychiatry, 3, 239–243.CrossRefGoogle Scholar
  31. Freemont, J. and Craighead, L.W. (1987). Aerobic exercise and cognitive therapy in the treatment of dysphoric moods. Cognitive Therapy and Research, 11(2), 241–251.CrossRefGoogle Scholar
  32. Garber, J. (1992). Cognitive models of depression: A developmental perspective. Psychological Inquiry, 3, 235–240.CrossRefGoogle Scholar
  33. Garber, J., Weiss, B. and Shanley, N. (1993). Cognitions, depressive symptoms, and development in adolescents. Journal of Abnormal Psychology, 102, 47–57.PubMedCrossRefGoogle Scholar
  34. Gotlib, L.H., Lewinsohn, P.M., Seeley, J.R., Rohde, P. and Redner, J.E. (1993). Negative cognitions and attributional style in depressed adolescents: An examination of stability and specificity. Journal of Abnormal Psychology, 102, 607–615.PubMedCrossRefGoogle Scholar
  35. Griest, J.H. (1987). Exercise intervention with depressed outpatients. In: W.P. Morgan and S.E. Goldston (Eds.). Exercise and Mental Health (pp. 111–115). Washington, DC: Hemiphere Publishing Corporation.Google Scholar
  36. Griest, J.H., Klein, M.H., Eischens, R.R., Fans, J., Gurman, A.S. and Morgan, W.P. (1979). Running as treatment for depression. Comprehensive Psychiatry, 20, 41–54.CrossRefGoogle Scholar
  37. Grossman, J.A., Poznanski, E.O., and Banegas, M.E. (1983). Lunch: Time to study family interactions. Journal of Psychosocial Nursing and Mental Health Services, 21, 19–22.PubMedGoogle Scholar
  38. Haley, B.M.T., Fine, S.L., Marriage, K., Moretti, M.M. and Freeman, R.J. (1985). Cognitive bias and depression in psychiatrically disturbed children and adolescents. Journal of Consulting and Clinical Psychology, 53, 535–537.PubMedCrossRefGoogle Scholar
  39. Hammen, C. (1991). Depression runs in families: The social context of risk and resilience in children of depressed mothers. New York: Springer-Verlag.CrossRefGoogle Scholar
  40. Hammen, C, Adrian, C. and Hiroto, D. (1988). A longitudinal test of the attributional vulnerability model in children at risk for depression. British Journal of Clinical Psychology, 27, 37–46.PubMedCrossRefGoogle Scholar
  41. Hammen, C. and Zupan, B.A. (1984). Self-Schemes, depression, and the processing of personal information in children. Journal of Experimental Child Psychology, 37, 598–608.PubMedCrossRefGoogle Scholar
  42. Jacobsen, R.H., Lahey, B.B. and Strauss, C. (1983). Correlates of depressed mood in normal children. Journal of Abnormal Child Psychology, 11, 29–40.PubMedCrossRefGoogle Scholar
  43. Jaenicke, C, Hammen, C, Zupan, B., Hiroto, D., Gordon, D., Adrian, C. and Bürge, D. (1987). Cognitive vulnerability in children at risk for depression. Journal of Abnormal Child Psychology, 15, 559–572.PubMedCrossRefGoogle Scholar
  44. Kashani, J.H., Ray, J.S. and Carlson, G.A. (1984). Depression and depressive-like states in preschool-age children in a child development unit. American Journal of Psychiatry, 141, 1397–1402.PubMedGoogle Scholar
  45. Kaslow, N.J., Rehm, L.P. and Siegel, A.W. (1984). Social-cognitive and cognitive correlaties of depression in children. Journal of Abnormal Child Psychology, 12, 605–620.PubMedCrossRefGoogle Scholar
  46. Kaslow, N.J., Stark, K.D., Printz, B., Livingston, R. and Tsai, Y. (1992). Cognitive Triad Inventory for Children: Development and relationship to depression and anxiety. Journal of Clinical Child Psychology, 21, 339–347.CrossRefGoogle Scholar
  47. Kazdin, A.E. (1989). Childhood depression, in: E.J. Mash and R.A. Barkley (Eds.), Treatment of childhood disorders (pp. 135–166) New York: The Guilford Press.Google Scholar
  48. Kazdin, A.E., Esveldt-Dawson, K., Sherick, R.B. and Colbus, D. (1985). Assessment of overt behavior and childhood depression among psychiatrically disturbed children. Journal of Consulting and Clinical Psychology, 53, 201–210.PubMedCrossRefGoogle Scholar
  49. Kazdin, A.E., Rodgers, A. and Colbus, D. (1986). The Hopelessness Scale for Children: Psychometric characteristics and concurrent validity. Journal of Consulting and Clinical Psychology, 54, 241–245.PubMedCrossRefGoogle Scholar
  50. Kendall, P.C. (1977). On the efficacious use of verbal self-instructional procedures with children. Cognitive Therapy and Research, 7, 331–341.CrossRefGoogle Scholar
  51. Kendall, P.C. and Braswell, L. (1993). Cognitive — behavioral therapy for impulsive children. New York: Guilford Press.Google Scholar
  52. Kendall, P.C., Stark, K.D. and Adam, T. (1990). Cognitive deficit or cognitive distortion in childhood depression. Journal of Abnormal Child Psychology, 18, 255–270.PubMedCrossRefGoogle Scholar
  53. Kenney, E., Spence, S.H. and Hensley, R. (1989). An examination of the relationship between childhood depression and social competence amongst primary school children. Journal of Child Psychology and Psychiatry, 30, 561–573.CrossRefGoogle Scholar
  54. King, A.C., Taylor, C.B., Haskell, W.L. and Debusk, R.F. (1989). Influence of regular aerobic exercise on psychological health: A randomized, controlled trial of healthy middle-aged adults. Health Psychology, 8, 305–324.PubMedCrossRefGoogle Scholar
  55. King, A.C., Taylor, C.B. and Haskell, W.L. (1983). Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in order adults. Health Psychology, 12, 292–300.CrossRefGoogle Scholar
  56. Kovacs, M. (1981). Rating scales to assess depression in school aged children. Acta Paedopsychiatrica, 46, 305–315.PubMedGoogle Scholar
  57. Lewinsohn, P.M., Clark, G.N., Hops, H. and Andrews, J. (1990). Cognitive-behavioral treatment for depressed adolescents. Behavior Therapy, 21 385–401.CrossRefGoogle Scholar
  58. Martinsen, E.W., Hoffart, A. and Solberg, O. (1989). Comparing aerobic with nonaerobic forms of exercise in the treatment of clinical depression: A randomized trial. Comprehensive Psychiatry, 30, 324–331.PubMedCrossRefGoogle Scholar
  59. Matson, J.L. (1989). Treating depression in children and adolescents. New York: Pergamon PressGoogle Scholar
  60. Matson, J.L. and Ollendick, T.H. (1988). Enhancing children’s social skills: Assessment and Training. New York: Pergamon Press.Google Scholar
  61. Matson, J.L., Rotatori, A.F. and Helsel, W. J. (1983). Development of a rating scale to measure social skills in children: The Matson Evaluation of Social Skills with Youngsters (MESSY). Behavioral Research and Therapy, 41, 335–340.CrossRefGoogle Scholar
  62. McCann, I.L. and Holmes, D.S. (1984). Influence of aerobic exercise on depression. Journal of Personality and Social Psychology, 46, 1142–1147.PubMedCrossRefGoogle Scholar
  63. Meichenbaum, D. (1977). Cognitive-Behavior modification. New York: Plenum Press.CrossRefGoogle Scholar
  64. Moilanen, D.L. (1993). Depressive experiences of nonreferred adolescents and young adults a cognitive-developmental perspective. Journal of Adolescent Research, 8, 311–325.CrossRefGoogle Scholar
  65. Morgan, W.P., Roberts, J. A., Brand, R.F. and Feinerman, A.D. (1970). Psychological effect of chronic physical activity. Medicine and Science in Sport, 2, 213–217.Google Scholar
  66. Mullins, L.L., Peterson, L., Wonderlich, S.A. and Reaven, N.M. (1986). The influence of depressive symptomatology in children on the social responses and perceptions of adults. Journal of Clinical Child Psychology, 15, 233–240.CrossRefGoogle Scholar
  67. Nolen-Hoeksema, S., Girgus, J.S. and Seligman, M.E.P. (1986). Learned helplessness in children: A longitudinal study of depression, achievement, and explanatory style. Journal of Personality and Social Psychology, 57, 435–442.CrossRefGoogle Scholar
  68. Peterson, L., Mullins, L.L. and Ridley-Johnson, R. (1985). Childhood depression: Peer reactions to depression and life styles. Journal of Abnormal Child Psychology, 13, 597–609.PubMedCrossRefGoogle Scholar
  69. Petti, T.A., Bornstein, M., Delamater, A. and Conner, CK. (1980). Evaluation and multimodality treatment of a depressed prepubertal girl. Journal of the American Academy of Child Psychiatry, 19, 690–702.PubMedCrossRefGoogle Scholar
  70. Poznanski, E.O. and Zrull, J. (1970). Childhood depression: Clinical characteristics of overtly depressed children. Archives of General Psychiatry, 23, 8–15.PubMedCrossRefGoogle Scholar
  71. Pieto, S.L., Cole, D.A. and Tageson, C.W. (1992). Depressive self-schemes in clinic and nonclinic children. Cognitive Therapy and Research, 16, 521–534.CrossRefGoogle Scholar
  72. Puig-Antich, J., Lukens, E., Davies, M., Goetz, D., Brennan-Quatrock, J. and Todak, G. (1985). Psychosocial functioning in prepubertal major depressive disorders; I. Interpersonal relationships during the depressive episode. Archives of General Psychiatry, 42, 500–507.PubMedCrossRefGoogle Scholar
  73. Reynolds, W.M., Anderson, G. and Bartell, N. (1985). Measuring depression in children: a multimethod assessment investigation. Journal of Abnormal Child Psychology, 13, 513–526.PubMedCrossRefGoogle Scholar
  74. Reynolds, W.M. and Coates, K.I. (1986). A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents. Journal of Consulting and Clinical Psychology, 54, 653–660.PubMedCrossRefGoogle Scholar
  75. Rholes, W., Blackwell, J., Jordan, C. and Walters, C. (1980). A developmental study of learned helplessness. Developmental Psychology, 16, 616–624.CrossRefGoogle Scholar
  76. Sacco, W.P. and Graves, D.J. (1984). Childhood depression, interpersonal problem-solving, and self-ratings of performance. Journal of Clinical Child Psychology, 13, 10–15.Google Scholar
  77. Schwartz, M., Friedman, R., Lindsay, P. and Narrol, H. (1982). The relationships between conceptual tempo and depression in children. Journal of Consulting and Clinical Psychology, 50, 488–490.PubMedCrossRefGoogle Scholar
  78. Seligman, M.E.P., Peterson, C. Kaslow, N.J., Tanenbaum, R.L., Alloy, L.B. and Abramson, L.Y. (1984). Attributional style and depressive symptoms among children. Journal of Abnormal Psychology, 93, 235–238.PubMedCrossRefGoogle Scholar
  79. Sime, W.E. (1987). Exercise in the prevention and treatment of depression. In: W.P. Morgan and S.E. Goldston (Eds.), Exercise and Mental Health (pp. 145–152).Google Scholar
  80. Stark, K.D. (1990). The treatment of depression during childhood: A school-based program. New York: Guilford Press.Google Scholar
  81. Stark, K.D. and Brookman, C. (1982). Childhood depression: Theory and family-school intervention. In: M.J. Fine and C. Carlson (Eds.), Family-school intervention: A systems perspective (pp. 247–271). Massachusetts: Allyn & Bacon.Google Scholar
  82. Stark, K.D., Humphrey, L.L., Crook, K. and Lewis, K. (1990). Perceived family environments of depressed and anxious children: Child’s and maternal figure’s perspectives. Journal of Abnormal Child Psychology, 18, 527–547.PubMedCrossRefGoogle Scholar
  83. Stark, K., Humphrey, L., Laurent, J., Livingston, R. and Christopher, J. (1993). Cognitive, behavioral, and family factors in the differentiation of depressive and anxiety disorders during childhood. Journal of Consulting and Clinical Psychology, 61, 878–886.PubMedCrossRefGoogle Scholar
  84. Stark, K.D,, Linn, J.D., MacGuire, M. and Kaslow, N.J. (in press a). The social functioning of depressed and anxious children: Social skills, social knowledge, automatic thoughts, and physical arousal. Journal of Clinical Child Psychology. Google Scholar
  85. Stark, K.D., Schmidt, K., Joiner, T.E. and Lux, M.G. (in press b). Depressive cognitive triad: Relationship to severity of depressive symptoms in children, parents’ cognitive triad, and perceived parental messages about the child him or herself, the world, and the future. Journal of Abnormal Child Psychology Google Scholar
  86. Stark, K.D., Reynolds, W.M. and Kaslow, N.J. (1987). A comparison of the relative efficacy of self-control therapy and a behavioral problem-solving therapy for depression in children. Journal of Abnormal Child Psychology, 15, 91–113.PubMedCrossRefGoogle Scholar
  87. Strauss, C.C., Forehand, R., Frame, C. and Smith, K. (1984). Characteristics of children with extreme scores on the Children’s Depression Inventory. Journal of Clinical Child Psychology, 16, 235–239.CrossRefGoogle Scholar
  88. Terns, C, Stewart, S., Skinner, J. Jr., Hughes, C. and Emslie, G. (1993). Cognitive distortions in depressed children and adolescents: Are they state dependent or trait like? Journal of Clinical Child Psychology, 22(3), 316–326.CrossRefGoogle Scholar
  89. Young, J. (1991). Cognitive therapy for personality disorders: A schema-focused approach. Sarasota, Florida: Professional Resource Exchange, Inc.Google Scholar
  90. Zupan, B.A., Hammen, C. and Jeanicke, C. (1987). The effects of current mood and prior depressive history on self-schematic processing in children. Journal of Experimental Child Psychology, 43, 149–158.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Kevin D. Stark
    • 1
  • Anne Smith
    • 1
  1. 1.Department of Educational PsychologyUniversity of Texas at AustinAustinUSA

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