CBT vs, CBT + Parent Training for Girls with Depression

儿童时期的抑郁障碍是一种特别严重、持续时间较长的疾病，是未来抑郁发作和其他精神障碍发展的风险因素。抑郁症的发生有多种途径。一个可能的途径是一个功能失调的家庭环境。研究表明，不支持、冲突的环境、糟糕的沟通、低水平的愉快活动和不适应的育儿行为与抑郁障碍有关。这些干扰既可能对儿童的情绪调整产生直接影响，也可能通过影响儿童对自我、世界和未来的发展而产生间接影响。家庭环境是青春期前女孩发展的一个特别重要的背景。在儿童时期，抑郁障碍的患病率在不同性别之间是相似的。年龄在13到15岁之间。与男孩相比，女孩患抑郁症的人数会增加，直到达到2：1的比例。在女孩和男孩之间的抑郁表达以及与抑郁相关的变量上发现了性别差异。女孩可能不会像男孩那样从标准的CBT中受益，因为治疗可能不会针对对青春期前女孩至关重要的干扰和技能。到目前为止，对儿童时期抑郁障碍的治疗进行的研究还很少。虽然家庭在儿童适应中的重要性得到普遍认可，但现有的抑郁症儿童治疗结果研究值得注意的是，调查人员未能干预家庭环境。这似乎会将这些青少年重新置于压力环境中，这可能是导致这种疾病发展和维持的原因。本研究的主要目的是评估CBT和CBT加家长训练(PT)与最小接触控制(MCC)条件对青春期前女孩抑郁障碍的治疗效果。在学校通过多门筛查和评估程序被诊断为抑郁障碍的儿童将被随机分配到CBT、CBT+PT或MCC。以学校为基础的治疗旨在对性别和年龄敏感。多个评分员将在前、后和每年的跟踪调查中完成多项措施，最长可达四年。每学期提供三次助推器课程，以便进行维护。干预措施的能力，通过高危的13-15岁预防未来的抑郁症发作。将对期间进行评估。将评估干预措施对青少年在学校表现和家庭环境的实际影响。评估干预措施对家长适应能力的影响。将对可能影响治疗结果的变量进行系统评估。

Depressive disorders during childhood are especially virulent, long-lasting disorders that are a risk factor for the development of future depressive episodes and other psychiatric difficulties. There are multiple pathways to the development of depression. One possible pathway is a dysfunctional family environment. Consistencies are emerging from research suggesting that an unsupportive, conflictual environment, poor communication, low levels of pleasant activities, and maladaptive parenting behaviors are related to depressive disorders. These disturbances may have both direct effects on the child's emotional adjustment and an indirect effect through their impact on the child's developing sense of self, world, and future. The family environment is an especially salient context for the development of preadolescent girls. During childhood, the prevalence of depressive disorders across genders is similar. Between the ages of 13 to 15 y.o. the number of girls who become depressed increases relative to boys until it reaches a 2-to-1 ratio. Gender differences have been found in the expression of depression between girls and boys and in the variables that are associated with depression. Girls may not benefit as much as boys from standard CBT because the treatments may not target disturbances and skills that are critical for preadolescent girls. To date a paucity of research has been conducted into the treatment of depressive disorders during childhood. While the importance of the family in the adjustment of children is generally recognized, the existing treatment outcome research for depressed children is noteworthy for the failure of investigators to intervene in the family environment. This would appear to place the youngsters back into the stressful environment that may have contributed to the development and maintenance of the disorder. The primary objectives of this investigation are to evaluate the efficacy of CBT and CBT plus Parent Training (PT) vs. minimal contact control (MCC) condition for the treatment of depressive disorders among preadolescent girls. Children who have been diagnosed with a depressive disorder through a multiple-gate screening and assessment procedure in their schools will be randomly assigned to CBT, CBT+PT, or MCC. The school- based treatment is designed to be gender and age sensitive. Multiple measures will be completed by multiple raters at pre, post, and annual follow-ups for up to four years. Three booster sessions are provided each school semester to program for maintenance. The ability of the interventions to prevent future episodes of depression through the high-risk 13-15 y.o. period will be evaluated. The practical impact of the interventions on the youngsters' school performance and home environments will be evaluated. The impact of the interventions on the parent's adjustment be evaluated. Variables that may mediate treatment outcome will be systematically evaluated.