Prevention of Depression in School Children

描述（由研究者提供）：我们的主要目标是开发 以学校为基础的计划，可在早期有效预防抑郁症状 青春期。在过去的十年里，我们已经展示了有效的校本 教授认知能力的复原力计划（宾夕法尼亚大学复原力计划，或 PRP） 中学生缺乏解决问题的能力。在一项初步研究中 对于高危儿童，PRP 参与者报告抑郁症明显减少 通过两年的随访，症状优于匹配的对照（Giliham， 赖维奇、杰考克斯和塞利格曼，1995）。两年随访时 PRP 减半 中度至重度症状的发生率。过去的五年里，我们 以学校教师为对象进行 PRP 随机对照研究 三所学校的干预领导者（MH52270：P1 Seligman）。 PRP显着 通过 24 个月的随访，预防了其中两名患者的抑郁症状 三所学校。在此随访期间，19% 的对照组相比 10.5% 的 PRP 参与者在临床范围内得分 结构化临床访谈。 我们拟议研究的目标是提高 PRP 作为有针对性的药物的影响力 通过添加父组件和定期增强会话进行干预。我们 将选择具有高度抑郁症状的儿童参加研究。 这些儿童及其父母将被分配接受三项干预措施之一 条件。处于第一种情况的儿童将参加 PRP。儿童 第二种情况将参加 PRP，其父母将 参加为期 6 次的家长计划（宾夕法尼亚州弹性计划） 父母 - 或 PRPP）。第三个条件是无干预控制。 处于主动干预条件下的儿童将参加 6 后续前 2 1/2 年的强化课程。父母分配给 在此期间，家长计划将参加 4 次加强会议。作为 在我们目前的研究中，学校教师、辅导员、社会工作者和护士 将接受实施 PRP 的培训。辅导员和学校社交 工人将接受培训以实施 PRP PRPP。我们将跟随孩子们 三年来，针对抑郁症状和其他报道的结果 由孩子、老师和家长。 我们的主要假设是 I) PRP 可以预防抑郁症状，并且 该目标样本和 2) 父母的抑郁症临床水平 成分将增强这些预防效果。我们还将探讨几个 次要假设：其中，对焦虑症状、学业的影响 成就和心理健康。此外，我们还将评估 预防效果的潜在中介因素，包括改善 孩子的认知和应对能力以及家长的改善 认知和症状。如果我们的干预成功，这将表明 该计划可以广泛使用，以预防早期抑郁症 青春期的年轻人处于危险之中。

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.