# The Influence of Childhood Adversity on Psychotherapy Skill Acquisition in Adolescent Depression

> **NIH NIH K23** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $172,046

## Abstract

PROJECT SUMMARY/ABSTRACT
Nearly 60% of youths in the U.S. are exposed to childhood adversity, including violence exposure, abuse,
neglect, loss of caregivers, and living in poverty. Global and national data indicate that adversity accounts for
30-50% of the risk for depression onset from childhood through adolescence, and response to evidence-based
front-line interventions (e.g., cognitive behavioral therapy [CBT] and antidepressants) is notably poor among
adversity-exposed youths. Research demonstrates that exposure to adversity disrupts general learning
processes, including higher-order cognitive processes (i.e., cognitive control). Learning impairments may impede
one of the most common and critical intermediary treatment processes across evidence-based psychotherapies:
the acquisition of therapy skills. This proposal uses an innovative approach to investigate childhood adversity
exposure as a predictor of skill acquisition for the most commonly implemented CBT skill with depressed youths,
cognitive restructuring. To refine interventions and optimize effectiveness, it is critical to identify how existing
treatments break down. This study will use a repeated-measures, multiple levels of analysis approach to assess
acquisition and retention of an experimenter-introduced cognitive restructuring skill, among depressed
adolescents with population-level variability in lifetime adversity exposure (n=90). The candidate proposes to
investigate associations between adversity exposure and learning-related cognitive control processes in the
context of adolescent depression (Aim 1). Adversity exposure and cognitive control will be examined as direct
predictors of CBT skill acquisition and skill retention over six-months; an indirect pathway from adversity to skill
acquisition through cognitive control will also be examined (Aim 2). The candidate will further explore key
characteristics of adversity, namely the type (threat of harm versus deprivation of resources) and developmental
timing of exposure, as distinct predictors of skill acquisition (exploratory Aim 3). The proposed K23 builds on the
candidate’s prior training in environmental and biobehavioral risk for psychopathology, and evaluation of
treatment effectiveness, with new training in 1) experimental therapeutics; 2) developmental conceptualizations
of childhood adversity, and 3) behavioral assessments of cognitive and affective learning processes. The
Department of Psychiatry at the University of Pittsburgh is an ideal scientific setting to achieve the proposed
career development goals, and the candidate will receive training from a team of mentors (Drs. Goldstein, Luby,
and Sheridan) and consultants (Drs. Forbes, Lindhiem, and Wallace) with expertise in target-focused intervention
research, child adversity and risk for poor clinical course in youth depression, and developmental cognitive and
affective science. The near-term goal of this award is to identify sensitive markers of depression interve...

## Key facts

- **NIH application ID:** 10030193
- **Project number:** 1K23MH123685-01
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Rachel Vaughn-Coaxum
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $172,046
- **Award type:** 1
- **Project period:** 2020-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10030193

## Citation

> US National Institutes of Health, RePORTER application 10030193, The Influence of Childhood Adversity on Psychotherapy Skill Acquisition in Adolescent Depression (1K23MH123685-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10030193. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*