Family Check-Up for Depression Prevention

描述(申请人提供)：非常需要新的抑郁症预防计划的研究和开发。在过去的几年里，我们已经开始发展家庭体检(FCU)，这是一种针对家庭功能的简短家庭干预，可能在预防抑郁症方面有效。FCU是仿照Miller，Sovereign，&Krege(1988)所描述的饮酒者体检。与饮酒者的体检一样，FCU包括评估、反馈和目标设定，并采用激励性面试风格进行。FCU是为成年人和年龄较大的青少年设计的。由于家庭功能不良是抑郁症的一个重要风险因素，我们相信FCU将通过改善家庭功能来预防抑郁症。 在目前的应用中，我们建议继续开发治疗的过程。来自FCU(n=32个家庭)公开试验的初步证据表明，它可以被家庭接受，并与抑郁症症状和家庭功能的改善有关。在这一点上，需要进一步的开发和试点测试。在这个项目的第一阶段，我们建议专门针对非裔美国人和拉美裔家庭进行FCU的公开试验。这将使我们能够确保将不同文化和种族群体的观点纳入治疗发展。我们还将创建依从性和能力测量，以及临床医生培训计划。在拟议项目的第二阶段，我们将在多民族和多种族家庭样本(n=60)中进行FCU的试点随机对照试验，作为抑郁症的选择性预防计划。FCU将与最低限度治疗对照组进行比较。报告家庭功能不佳且至少有一名家庭成员最近有抑郁症史(但目前没有严重抑郁症或恶劣心境障碍)的家庭将有资格参加。随机化后，家庭成员将被跟踪6个月，主要结果变量将是至少在基线和6个月随访之间有亚综合征水平的周数。次要结果变量包括主要抑郁发作的发生率和家庭功能的变化。第二阶段的目的是获得一个更大的随机对照试验的效应大小的估计。

DESCRIPTION (provided by applicant): There is a great need for new research and development of depression prevention programs. Over the past few years, we have begun to develop the Family Check-Up (FCU), a brief family intervention that targets family functioning and may be effective in preventing depression. The FCU is modeled on the Drinker's Check-up, as described by Miller, Sovereign, & Krege, (1988). Like the Drinker's Check-Up, the FCU consists of assessment, feedback, and goal-setting, and is conducted using a motivational interviewing style. The FCU is designed for use with adults and older adolescents. Because poor family functioning is a significant risk factor for depression, we believe that the FCU will prevent depression by improving family functioning. In the current application, we propose to continue the process of treatment development. Preliminary evidence from an open trial of the FCU (n = 32 families) suggests that it is acceptable to families and that it is associated with improvements in depression symptoms and family functioning. At this point, further development and pilot testing are needed, hi Phase 1 of this project, we propose to conduct an open trial of the FCU specifically with African-American and Latino families. This will allow us to ensure that perspectives of different cultural and racial groups are included in treatment development. We will also create adherence and competency measures, and a clinician-training program, hi Phase 2 of the proposed project, we will conduct a pilot randomized controlled trial of the FCU as a selective prevention program for depression in a multi-ethnic and multi-racial sample of families (n = 60). The FCU will be compared to a minimal treatment control group. Families who report poor family functioning and have at least one family member with a recent history of depression (but no current major depression or dysthymia) will be eligible to participate. Family members will be followed for 6-months after being randomized, and the primary outcome variable will be number of weeks with at least a subsyndromal level of depression between baseline and 6- month follow-up. Secondary outcome variables include incidence of major depressive episodes and change in family functioning. The purpose of Phase 2 is to gain an estimate of effect size for a larger randomized controlled trial.