Preventing Depression within Salient Adolescent Contexts

描述（由申请人提供）：抑郁症的影响是显著的，青春期提供了一个主要的干预机会，特别是在学校。在拟议的应用程序中，我们着手进一步开发和测试一种基于抑郁症生态交易理论的新型预防方法（PTA：积极的思想和行动）。家庭教师联系会的创新之处在于，该方案积极地让家长参与预防过程，并关注可能导致青少年抑郁的突出问题，包括人际关系、学校功能和健康行为。PTA将认知、行为、人际关系和家庭方法整合到以学校为基础的项目中。在建议的研究中，我们将征求包括家长、学生和学校人员在内的消费者的意见，以确保PTA能够以最小的负担和最大的利益融入学校。我们将制定一个培训协议和实施工具来衡量保真度和群体过程。我们的手册和相关材料将根据消费者的意见和两位抑郁症预防专家的审查进行关键的改进，然后定稿。然后，从西雅图公立学校抽取的160名抑郁症状加重的七年级和八年级学生将被随机分组，接受PTA或简短的对照干预。我们将在基线、干预后和1年随访时测量抑郁症状，并将使用生长曲线模型来检查随时间的变化。我们还将研究目标领域（亲子沟通、社会功能、学校功能、健康行为）的工具结果的变化，以及对治疗利用和重度抑郁症发病的影响。

DESCRIPTION (provided by applicant): The impact of depression is significant, and adolescence presents a prime opportunity to intervene, particularly in the schools. In the proposed application, we set out to further develop and test a novel prevention approach (PTA: Positive Thoughts & Actions) based on ecological transactional theories of depression. PTA is innovative in that the program actively involves parents in the prevention process and attends to salient issues that may contribute to depression in adolescence, including relationships, school functioning, and health behaviors. PTA integrates cognitive, behavioral, interpersonal, and family approaches into its school-based program. In the proposed research study, we will solicit input from consumers, including parents, students, and school personnel, to ensure that PTA can be integrated into schools in a way that minimizes burden while maximizing the benefit. We will develop a training protocol and implementation tools to measure fidelity and group process. Our manual and related materials will undergo critical refinement based upon input from consumers and review from 2 experts in depression prevention before finalization. Then, 160 7th and 8th grade students with elevated depressive symptoms drawn from the Seattle Public Schools will be randomized to receive PTA or a brief control intervention. We will measure depressive symptoms at baseline, post- intervention and 1-year follow up, and will use growth curve modeling to examine change over time. We will also examine changes in instrumental outcomes from our targeted domains (parent-child communication, social functioning, school functioning, health behavior), as well as effects on treatment utilization and onset of Major Depressive Disorder. PUBLIC HEALTH RELEVANCE: Depression is a serious mental health problem in need of prevention, and adolescence presents a prime opportunity to intervene. Prevention efforts with youth to date have shown some promise, but effects are modest and may be short-lived. In the proposed application, we set out to further develop and test a novel prevention approach (PTA: Positive Thoughts & Actions) that is unique and innovative in addressing key contextual factors that contribute to and perpetuate depressive symptoms during the early adolescent years, including communication with parents, relationships, school functioning, and health behavior.