Effectiveness Trial of an Adolescent Depression Prevention Program

Summary

Principal Investigator: PAUL D ROHDE
Affiliation: Oregon Research Institute
Country: USA
Abstract: The goal of the proposed project is to conduct a large-scale effectiveness trial that will test whether a brief group cognitive-behavioral (CBT) depression prevention program, which has produced significant reductions in depressive symptoms and reduced risk for onset of future depressive episodes in preliminary efficacy trials, produces intervention effects when school personnel are responsible for screening, recruitment, and delivery of this selective prevention program. In contrast to efficacy trials, where researchers have substantial control over intervention implementation with homogeneous samples, effectiveness trials examine the effects of interventions that are delivered by endogenous providers to heterogeneous samples in natural settings (e.g., schools). The secondary aim is to test whether a CBT-based self-help book (CBT bibliotherapy) also produces positive intervention effects, as was observed in two preliminary trials. It seemed particularly important to investigate bibliotherapy within an effectiveness trial because it would be much less expensive and easier to disseminate to large numbers of adolescents than a group-based intervention. We believe that the proposed study would be the first large-scale evaluation of CBT bibliotherapy for the prevention of adolescent depression. Over a 3-year period, 390 high school adolescents at risk for depression due to elevated depressive symptoms will be randomized to (1) a 6-session group CBT intervention, (2) CBT bibliotherapy, or (3) a monitored control condition. Participants will complete surveys and diagnostic interviews at pre, post, and 6, 12, 18, and 24-month follow-ups. We hypothesize that participants in the group CBT and CBT bibliotherapy conditions will show significantly greater reductions in depressive symptoms and reduced risk for onset of major depression than controls through follow-up, but expect significantly larger effect sizes for group CBT relative to CBT bibliotherapy for many outcomes, as observed in our largest preliminary study. We will also test whether decreases in negative cognitions and negative attributional style, increases in pleasant activities, knowledge of CBT principles, and use of cognitive and behavioral coping skills mediate any effects of the interventions on depression outcomes. Further, we will examine moderators that potentiate (verbal intelligence, coping skills, motivation) or mitigate (negative life events, social support deficits) intervention effects. Analyses will test whether, relative to monitored controls, participants in either of the CBT interventions show improvements in ecologically meaningful outcomes, including psychosocial functioning, days of school or work missed because of mental health problems, substance use/abuse, or mental health care utilization over the 2- year follow-up. We specifically hypothesize that group CBT will show significantly greater improvements on the broadest array of outcomes. Public Health Relevance: This project would be the first large-scale trial of two empirically supported depression prevention programs for high-risk adolescents in real-world settings. As such, it will provide vital information necessary for disseminating the most effective and cost efficient methods of preventing this pernicious condition, which is crucial because no depression prevention program has been widely disseminated.
Funding Period: -------------------- - --------------------
more information: NIH RePORT

Top Publications

  1. pmc Efficacy trial of a brief cognitive-behavioral depression prevention program for high-risk adolescents: effects at 1- and 2-year follow-up
    Eric Stice
    Department of Psychology, University of Texas at Austin, USA
    J Consult Clin Psychol 78:856-67. 2010
  2. pmc Reduced substance use as a secondary benefit of an indicated cognitive-behavioral adolescent depression prevention program
    Paul Rohde
    Oregon Research Institute, Eugene, OR 97403, USA
    Psychol Addict Behav 26:599-608. 2012
  3. pmc Effects of three depression prevention interventions on risk for depressive disorder onset in the context of depression risk factors
    Paul Rohde
    Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA
    Prev Sci 13:584-93. 2012
  4. pmc Indicated cognitive behavioral group depression prevention compared to bibliotherapy and brochure control: Acute effects of an effectiveness trial with adolescents
    Paul Rohde
    Oregon Research Institute
    J Consult Clin Psychol 82:65-74. 2014
  5. pmc Moderators of two indicated cognitive-behavioral depression prevention approaches for adolescents in a school-based effectiveness trial
    Frédéric N Brière
    Universite de Montreal, 90 Vincent d Indy Avenue, H2V 2S9 Québec, Canada School Environment Research Group, 7101 ave du Parc, H3N 1X7 Québec, Canada Electronic address
    Behav Res Ther 53:55-62. 2014
  6. pmc Cognitive-behavioral group depression prevention compared to bibliotherapy and brochure control: nonsignificant effects in pilot effectiveness trial with college students
    Paul Rohde
    Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA Electronic address
    Behav Res Ther 55:48-53. 2014
  7. pmc Effects of an indicated cognitive-behavioral depression prevention program are similar for Asian American, Latino, and European American adolescents
    Erica Marchand
    Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA
    Behav Res Ther 48:821-5. 2010
  8. pmc Relation of depression to perceived social support: results from a randomized adolescent depression prevention trial
    Eric Stice
    Department of Psychology, University of Texas at Austin, USA
    Behav Res Ther 49:361-6. 2011

Scientific Experts

Detail Information

Publications8

  1. pmc Efficacy trial of a brief cognitive-behavioral depression prevention program for high-risk adolescents: effects at 1- and 2-year follow-up
    Eric Stice
    Department of Psychology, University of Texas at Austin, USA
    J Consult Clin Psychol 78:856-67. 2010
    ..To evaluate the effects of a brief group cognitive-behavioral (CB) depression prevention program for high-risk adolescents with elevated depressive symptoms at 1- and 2-year follow-up...
  2. pmc Reduced substance use as a secondary benefit of an indicated cognitive-behavioral adolescent depression prevention program
    Paul Rohde
    Oregon Research Institute, Eugene, OR 97403, USA
    Psychol Addict Behav 26:599-608. 2012
    ..Findings supported the hypothesis that, relative to a nonactive comparison condition, reductions in depressive symptoms mediated the effects of Group CB prevention on substance use escalation...
  3. pmc Effects of three depression prevention interventions on risk for depressive disorder onset in the context of depression risk factors
    Paul Rohde
    Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA
    Prev Sci 13:584-93. 2012
    ....
  4. pmc Indicated cognitive behavioral group depression prevention compared to bibliotherapy and brochure control: Acute effects of an effectiveness trial with adolescents
    Paul Rohde
    Oregon Research Institute
    J Consult Clin Psychol 82:65-74. 2014
    ..PsycINFO Database Record (c) 2014 APA, all rights reserved). ..
  5. pmc Moderators of two indicated cognitive-behavioral depression prevention approaches for adolescents in a school-based effectiveness trial
    Frédéric N Brière
    Universite de Montreal, 90 Vincent d Indy Avenue, H2V 2S9 Québec, Canada School Environment Research Group, 7101 ave du Parc, H3N 1X7 Québec, Canada Electronic address
    Behav Res Ther 53:55-62. 2014
    ....
  6. pmc Cognitive-behavioral group depression prevention compared to bibliotherapy and brochure control: nonsignificant effects in pilot effectiveness trial with college students
    Paul Rohde
    Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA Electronic address
    Behav Res Ther 55:48-53. 2014
    ..Conduct a pilot trial testing whether a brief cognitive-behavioral (CB) group reduced depressive symptoms and secondary outcomes relative to bibliotherapy and brochure controls in college students with elevated depressive symptoms...
  7. pmc Effects of an indicated cognitive-behavioral depression prevention program are similar for Asian American, Latino, and European American adolescents
    Erica Marchand
    Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA
    Behav Res Ther 48:821-5. 2010
    ..These findings suggest that this indicated depression prevention intervention is similarly efficacious for Asian American, Latino and European American adolescents...
  8. pmc Relation of depression to perceived social support: results from a randomized adolescent depression prevention trial
    Eric Stice
    Department of Psychology, University of Texas at Austin, USA
    Behav Res Ther 49:361-6. 2011
    ..Results provide experimental support for the theory that depressive symptoms are inversely related to perceived social support, but imply that this effect may be specific to friend vs. parental support for adolescents...