Personalized Depression Prevention Reduces Dependent Stressors Among Adolescents: Results from a Randomized Controlled Trial.
Personalized Depression Prevention Reduces Dependent Stressors Among Adolescents: Results from a Randomized Controlled Trial.
复制标题
个性化抑郁症预防可减少青少年的依赖性压力源：随机对照试验的结果。
DOI：
10.1080/15374416.2023.2188562
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Young,JamiF
中科院分区：
文献类型：
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作者：
Jones,JasonD;Long,ErinE;Hankin,BenjaminL;Gallop,Robert;Davis,Molly;Young,JamiF
目的抑郁和压力源在青春期均有增加。压力生成模型假设抑郁症状和相关的损伤有助于依赖应激源的生成。青春期抑郁症预防计划已被证明可以降低抑郁症的风险。近年来，风险知情的个性化方法被用来提高抑郁预防的有效性，初步证据支持个性化预防对抑郁症状的有益效果。鉴于抑郁与压力之间的密切联系，我们检验了个性化的抑郁预防计划将通过纵向跟踪减少青少年对依赖压力源(人际和非人际)的体验的假设。方法本研究包括204名青少年(56%的女孩，29%的少数民族)，他们被随机分为认知行为预防计划和人际预防计划。使用先前建立的风险分类系统，将年轻人在认知和人际风险上分为高风险和低风险。一半的青少年接受了与他们的风险状况相匹配的预防计划(例如，高认知风险随机分配到认知行为预防)；一半接受了不匹配的计划(例如，高人际风险随机分配到认知行为预防)。结果配对的青少年在干预后的随访期(d=.46，p=.002)和干预后18个月的基线(d=.35，p=.02)中报告的从属应激源比不匹配的青少年报告的依赖应激源更少。正如预期的那样，匹配和不匹配的青少年在独立压力体验上没有差异。结论这些发现进一步强调了个性化方法预防抑郁症的潜力，并展示了除了减轻抑郁症状之外的好处。
ObjectiveDepression and stressors both increase during adolescence. The stress generation model posits that depression symptoms and associated impairment contribute to the generation of dependent stressors. Adolescent depression prevention programs have been shown to reduce the risk of depression. Recently, risk-informed personalization approaches have been adopted to enhance the efficacy of depression prevention, and preliminary evidence supports the beneficial effects of personalized prevention on depression symptoms. Given the close association between depression and stress, we examined the hypothesis that personalized depression prevention programs would reduce adolescents’ experience of dependent stressors (interpersonal and non-interpersonal) over longitudinal follow-up.MethodThe present study included 204 adolescents (56% girls, 29% racial minority) who were randomized to receive either a cognitive-behavioral or an interpersonal prevention program. Youth were categorized as high or low on cognitive and interpersonal risk using a previously established risk classification system. Half of the adolescents received a prevention program that matched their risk profile (e.g., high cognitive risk randomized to cognitive-behavioral prevention); half received a mismatched program (e.g., high interpersonal risk randomized to cognitive-behavioral prevention). Exposure to dependent and independent stressors was assessed repeatedly over an 18-month follow-up period.ResultsMatched adolescents reported fewer dependent stressors during the post-intervention follow-up period (d= .46,p= .002) and from baseline through 18-months post-intervention (d= .35,p= .02) compared to mismatched youth. As expected, there were no differences between matched and mismatched youth on the experience of independent stressors.ConclusionsThese findings further highlight the potential of personalized approaches to depression prevention and demonstrate benefits that go beyond depression symptom reduction.