Christian A. Webb, PhD

Dr. Webb’s Treatment and Etiology of Depression in Youth (TEDY) Laboratory uses a multimodal approach (EEG, fMRI, ecological momentary assessment, passive smartphone sensor data, and laboratory-based experiments) to investigate the etiology and pathophysiology of depression in adolescents, as well as the mechanisms of change in psychotherapeutic and pharmacological treatments for depression.

Within these areas of focus, Dr. Webb and his staff study the mechanisms underlying symptom change in psychotherapy.

There is a large body of treatment outcome research attesting to the efficacy of psychotherapies, in particular, cognitive behavioral therapy (CBT) for depression. However, the mechanisms through which patients improve—and why many fail to sufficiently improve—remain largely unknown, particularly for the treatment of depression in youth. A clearer understanding of the “active ingredients” of treatment and underlying mechanisms of symptom change may ultimately inform the development of more targeted—and ideally more effective and efficient—treatments for depression.

Dr. Webb’s lab conducts this research in the context of clinical trials of CBT and behavioral activation (BA) therapy. Within these studies, Dr. Webb and his colleagues have examined the role of therapist adherence to, and competence in, CBT techniques in predicting symptom improvement. In addition, they have examined the role of patient acquisition and use of various cognitive and behavioral skills, as well as the therapist-patient relationship.

Dr. Webb’s lab also focuses on predicting treatment response in depression. Greater knowledge of variables predicting better or worse treatment response prior to the start of treatment may have important clinical implications regarding which interventions are best suited for whom, thus informing treatment selection.

To date, we have strikingly little empirical data to usefully guide the selection of treatments for depressed individuals. In current clinical practice, treatment selection for depressed individuals is largely based on trial and error and clinician/patient preference. Rates of non-response to first-line depression treatment in primary care are high (~50-70%), resulting in protracted depressive episodes until an adequate treatment is found.

Consistent with the goals of precision medicine, Dr. Webb’s most recent work is aimed at developing actionable, algorithm-guided treatment recommendations to improve outcomes for depressed individuals by matching them to the optimal intervention. He is currently conducting this research within the context of randomized clinical trials and within real-world psychiatric clinics.

In parallel with his treatment research, Dr. Webb also investigates the etiology of depression. Depression rates are low in childhood but surge in adolescence. By age 18, approximately 15% of teens will have experienced at least one episode of clinical depression. A clearer understanding of factors that cause and maintain depressive symptoms in adolescents can ultimately help inform and improve interventions aimed at treating and preventing depression in this age group.