Making Friends with Yourself--A Depression Prevention Program for Adolescent Girls

近年来，青少年人群中抑郁症的患病率急剧上升， 至少五分之一的青少年在高中毕业前经历抑郁障碍，还有更多 患有亚症候群症状。在高危人群中，六个月以上抑郁的发生率为 超过30%。青春期的抑郁症会增加滥用药物、肥胖、睡眠障碍的风险， 学习成绩差，行为危险。在这个关键的发育阶段预防抑郁症可以 在一生中增强心理健康和功能，但现有的基于行为的抑郁- 预防计划的效果规模很小，长期收益也很小。一个可接受的、可行的、 有效、可持续的行为预防计划可以在增进心理健康方面发挥关键作用 轨迹。来自对成人人口以及青少年发展的研究的初步证据 过程，建议一个涉及正念和自我同情训练的项目，设计 尤其是对患有亚综合征抑郁症的青少年来说，可能会对 预防抑郁症。该项目的主要目标是完善和测试一个 创新的抑郁症预防计划，“与自己交朋友”(一种适合发展的 青少年适应，基于成人正念自我同情方案)，与 青少年注意力控制计划，“照顾自己”(包括健康生活方式的教育) 他们正在经历亚综合征型抑郁症。“与自己交朋友”计划的目标是 与青少年抑郁相关的特定结构，如沉思(沉思)、消极 认知风格和羞耻感，并将包括正念、自我善良和认同感的训练 对我们共同的人性的欣赏。具体目标是：1)提炼和编撰《交友指南》 “你自己”(MFY)预防计划和可信的注意力控制计划“照顾你自己”(TCY)； 2)测试包含有意识的自我同情的探索性临床试验的可行性和可接受性 干预，MFY计划(治疗组)和比较注意控制，TCY计划，其中 14-18岁青少年亚综合征抑郁；3)探讨原发和继发结果 和调解人对最惠国待遇方案的反应，包括突发事件抑郁(主要结果)、复原力 和抑郁症状的变化(次要结果)；以及沉思，消极的认知方式，以及 羞耻(潜在的调解人)。该项目代表着NCCIH的高度方案优先事项，并可能导致 一项在预防青少年临床抑郁方面有显著影响的大规模试验。

The prevalence of depression in adolescent populations has increased dramatically in recent years, with at least 1 in 5 adolescents experiencing a depressive disorder before they graduate high school, and many more suffering from subsyndromal symptoms. The incidence of depression over six months in high-risk groups is greater than 30%. Depression in adolescence increases risk for substance abuse, obesity, sleep disorders, poor school performance, and risky behavior. Prevention of depression at this critical developmental stage can enhance mental health and functioning throughout the lifespan, but existing behaviorally based depression- prevention programs have had low effect sizes and minimal long-term gains. An acceptable, feasible, effective, and sustainable behavioral prevention program could play a key role in enhancing mental health trajectories. Preliminary evidence from research on adult populations, as well as on adolescent developmental processes, suggests that a program involving training in mindfulness and self-compassion, designed specifically for adolescents with subsyndromal depression, could have a significant positive impact on depression prevention. This project’s primary goal is to refine and test the feasibility and acceptability of an innovative depression-prevention program, “Making Friends with Yourself” (a developmentally appropriate adaptation for adolescents, based on the adult Mindful Self-Compassion program), in comparison to an attention-control program, “Taking Care of Yourself” (involving education of healthy lifestyles), with adolescents who are experiencing subsyndromal depression. The “Making Friends with Yourself” program will target specific constructs associated with depression in adolescents, such as rumination (brooding), negative cognitive style, and shame, and would include training in mindfulness, self-kindness, and recognition and appreciation of our common humanity. Specific aims are: 1) To refine and manualize the “Making Friends with Yourself” (MFY) prevention program and a credible attention control program, “Taking Care of Yourself” (TCY); 2) To test the feasibility and acceptability of an exploratory clinical trial involving a mindful self-compassion intervention, the MFY program (treatment group) and a comparison attention-control, the TCY program, among 14-18 year old adolescents with subsyndromal depression; 3) To explore primary and secondary outcomes and mediators in response to the MFY Program, including incident depression (primary outcome), resilience and change in depressive symptoms (secondary outcomes); and rumination, negative cognitive style, and shame (potential mediators). This project represents a high programmatic priority for NCCIH and could lead to a large scale trial with significant impact in preventing clinical depression among adolescents.