The effectiveness of behavioral activation therapy in reducing apathy, hopelessness, and suicidal ideation in adolescents with major depressive disorder: A quasi-experimental study with a two-month follow-up

Document Type : Original Article

Authors

1 Ph.D. Student of Psychology, School of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

2 Professor, Psychology Departmen, School of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

3 M.D. professor of psychiatry,Ardabil University of Medical Science psychiatrist, Subspeciality in Child & Adolescent Psychiatry, Ardabil, Iran

Abstract

The aim of the present study was to investigate the effectiveness of group behavioral activation (BA) therapy on reducing apathy, hopelessness, and suicidal ideation in adolescents with major depressive disorder (MDD). The study employed a randomized controlled trial design with pre-test, post-test, and two-month follow-up assessments. The statistical population included all adolescents aged 12-19 years with MDD who were referred to counseling and psychology centers in three educational districts of Kermanshah during the 2023-2024 academic year. Forty participants were selected through purposive sampling and randomly assigned to experimental and control groups, each consisting of 20 individuals. The research instruments included the Behavioral Activation for Depression Scale (BADS), the Hopelessness Scale for Children (HSC), and the Beck Scale for Suicidal Ideation (BSSI). Data were analyzed using mixed ANOVA in SPSS version 27. The results showed a statistically significant group × time interaction for all variables, confirming the effectiveness of the BA intervention. BA significantly decreased apathy (F(1, 24) = 12.33, p < 0.001, η² = 0.24), hopelessness (F(1, 22) = 11.18, p < 0.001, η² = 0.22), and suicidal ideation (F(1, 52) = 29.92, p < 0.001, η² = 0.37) compared to the control group. Follow-up analyses confirmed that treatment gains were maintained at the two-month follow-up assessment. The effect size was strongest for reducing suicidal ideation (η² = 0.37), followed by apathy (η² = 0.24) and hopelessness (η² = 0.22). The findings suggest that behavioral activation is an effective, evidence-based, and cost-effective intervention for reducing core depressive symptoms and exerting a profound therapeutic effect on high-risk constructs such as hopelessness and suicidal ideation in adolescents. This study emphasizes the importance of implementing BA in clinical and educational settings.

Keywords

References

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