Prevention of Depression in School Children

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DESCRIPTION (provided by investigator): Our primary aim is the development of school-based programs that robustly prevent depressive symptoms during early adolescence. Over the last decade, we have shown efficacious a school-based resiliency program (the Penn Resiliency Program, or PRP) that teaches cognitive arid problem-solving skills to middle-school children. In an initial study with at risk children, PRP participants reported significantly fewer depressive symptoms than matched controls through two years of follow-up (Giliham, Reivich, Jaycox, & Seligman, 1995). The PRP at the two-year follow-up halved rates of moderate to severe symptoms. Over the past five years, we have been conducting a randomized controlled study of PRP using schoolteachers as intervention leaders in three schools (MH52270: P1 Seligman). PRP significantly prevented depressive symptoms through the 24 month follow-up in two of the three schools. During this follow-up period, 19 percent of controls as compared with 10.5 percent of PRP participants scored in the clinical range on structured clinical interviews. Our goal in the proposed study is to increase the impact of PRP as a targeted intervention by adding a parent component and periodic booster sessions. We will select into the study children with high levels of depressive symptoms. These children and their parents will be assigned to one of three intervention conditions. Children in the first condition will participate in PRP. Children in the second condition will participate in PRP and their parents will participate in a 6-session parent program (the Penn Resiliency Program for Parents - or PRPP). The third condition will be a no intervention control. Children in both the active intervention conditions will participate in 6 booster sessions over the first 2 1/2 years of follow-up. Parents assigned to the parent program will participate in 4 booster sessions during this time. As in our current study, school teachers, counselors, social workers and nurses will be trained to implement the PRP. Guidance counselors and school social workers will be trained to implement the PRP+PRPP. We will follow the children for three years, targeting depressive symptoms and other outcomes as reported by children, teachers, and parents. Our primary hypotheses are that I) PRP will prevent depressive symptoms and clinical levels of depression in this targeted sample and 2) the parent component will enhance these prevention effects. We will also explore several secondary hypotheses: among them, the effects on anxiety symptoms, academic achievement, and psychological well-being. In addition, we will evaluate potential mediators of the prevention effect, including improvements in children's cognitions and coping skills, and improvements in parents' cognitions and symptoms. Should our interventions succeed, this would suggest that this program can be used on a wide scale to prevent depression in early adolescence in young people at risk.