Prevention of Depression in Adolescents

拟议的指导以患者为导向的研究职业发展奖（K23）是一个五年计划，旨在将候选人发展成为独立的抑郁症预防干预研究人员。候选人概述了一个应用程序整合正式的课程，咨询既定的抑郁症和预防调查，以及一个独立的研究计划，这将使候选人：（1）发展预防科学的全面知识，特别是预防干预措施;（2）增加她对青少年抑郁症和与发展抑郁症相关的风险的理解;（3）接受为儿童和青少年进行随机预防试验的培训;（4）提高与分析预防试验数据以及调解和适度问题有关的技能。候选人建议通过学习人际心理治疗-青少年技能培训（IPT-AST）来扩展以前在抑郁症预防方面的工作，这是她对抑郁症青少年人际心理治疗（IPT-A）的修改。IPT-AST是一项以学校为基础的团体预防性干预措施，针对抑郁症状加重的青少年，重点是心理教育和人际交往技能建设。核心项目将是一项对照临床试验，比较IPT-AST、IPT-AST加3次额外的父母-青少年会议（增强型IPT-AST）和阈下抑郁青少年的常规护理。本研究拟对抑郁症状、抑郁障碍和人际功能进行即时和长期评估，以确定：（1）与常规护理相比，IPT-AST和增强的IPT-AST是否与抑郁症状的缓解和抑郁障碍的预防相关;（2）增强的IPT-AST中的父母-青少年会话对青少年的抑郁症状和功能有额外的影响;（3）初步证据表明，人际功能对干预效果起中介作用，年龄和性别起中介作用。拟议计划的最终目标是准备候选人提交一份成功的申请，以在一项更大的随机对照试验中测试最佳IPT-AST干预的疗效。

DESCRIPTION (provided by applicant): The proposed Mentored Patient-Oriented Research Career Development Award (K23) is a five-year plan to develop the candidate into an independent depression prevention intervention researcher. The candidate outlines a application integrating formal coursework, consultation with established depression and prevention investigators, and an independent research program that will enable the candidate to: (1) develop comprehensive knowledge of prevention science, particularly prevention interventions; (2) increase her understanding of adolescent depression and the risks associated with developing a depressive disorder; (3) acquire training in conducting randomized prevention trials for children and adolescents; and (4) enhance skills related to the analysis of data from prevention trials and issues of mediation and moderation. The candidate proposes to extend previous work in depression prevention by studying Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), her modification of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A). IPT-AST is a school-based group preventive intervention for adolescents with elevated depressive symptoms focusing on psychoeducation and interpersonal skill-building. The core project will be a controlled clinical trial comparing IPT-AST, IPT-AST plus 3 additional parent-adolescent sessions (enhanced IPT-AST), and usual care in adolescents with subthreshold depression. Immediate and long-term assessments of depression symptoms, depressive disorders, and interpersonal functioning are proposed to determine whether: (1) IPT-AST and enhanced IPT-AST are associated with relief of depressive symptoms and prevention of depressive disorders as compared to usual care; (2) the parent-adolescent sessions in enhanced IPT-AST have an additional impact on adolescents' depressive symptoms and functioning; (3) there is preliminary evidence that interpersonal functioning mediates, and age and gender moderate, the effects of the intervention. The ultimate goal of the proposed program is to prepare the candidate to submit a successful application to test the efficacy of the optimal IPT-AST intervention in a larger, randomized controlled trial.