1/2 Bending Adolescent Depression Trajectories Through Personalized Prevention

描述（由申请人提供）：抑郁症是一种普遍的精神疾病，对发病率有显著影响。为了减少这一巨大的公共卫生负担，重点是减少青少年抑郁症的风险和首次发病率是一个优先事项。该项目将创新性地将联合收割机风险因素研究和循证预防方案结合起来，将促进对个性化预防方法的了解，这些方法可能能够更好地“弯曲轨迹”，在整个青春期激增。这项合作研究的主要目标是研究抑郁症预防计划的效果是否可以通过将具有理论基础的风险特征的青年与适合他们需求的干预措施相匹配来最大化。这两个网站的研究将随机分配青少年高认知和/或人际关系的风险，旨在解决抑郁症的不同风险因素的两个预防性干预措施：应对压力（CWS），认知行为计划，和人际心理治疗-青少年技能培训（IPT-AST），人际关系计划。我们将这些匹配的配置文件的基础上预防前的数据，从一个良好的特征化样本的青年，我们一直在以下作为一个合作的多波自然主义研究的一部分，以预测抑郁症的发展轨迹（NIMH 5 R 01 MH 077195/MH 077178;汉金和杨，PI）。我们将包括青少年，从原来的第三和第六年级的队列，谁将在第七和第十年级的这项拟议的预防试验。来自丹佛大学和罗格斯大学两个研究中心的共210名参与者将根据认知和人际关系风险进行分层，并随机分配到两种预防条件下。独立评估人员将在基线、干预中期、干预后和随访（每6个月至干预后36个月）对参与者进行评估。这项研究的目的是：（1）通过检查随着时间的推移个人轨迹的变化，证明预防计划可以改变青少年的抑郁轨迹（预防方案实施前三年和实施后三年），并将预防青年的轨迹与同龄组的变化进行比较;（2）根据个人风险状况，通过将年轻人与CWS或IPT-AST匹配或不匹配，评估弯曲抑郁轨迹的个性化预防方法;（3）检查弯曲抑郁轨迹的机制，并测试预防计划是否通过其假设的过程进行操作;（4）探索遗传易感性，情绪调节和气质如何影响个体对IPT-AST和CWS的反应。通过在3年的前瞻性自然主义数据收集后实施循证预防计划，本研究将为个性化医疗和改变首发抑郁症的发展轨迹提供重要数据。

DESCRIPTION (provided by applicant): Depression is a prevalent mental illness contributing significantly to morbidity. To decrease this substantial public health burden, focus on reducing risk and first incidence of depression during adolescence is a priority. This project, which will innovatively combine risk factor research and evidence-based prevention programs, will advance knowledge on personalized approaches to prevention that may be able to better "bend trajectories" of depression that surge throughout adolescence. The primary goal of this collaborative R01 study is to examine whether the effects of depression prevention programs can be maximized by matching youth with theoretically-based risk profiles to interventions that fit their needs. This two site study will randomly assign adolescents with high cognitive and/or interpersonal risk to two preventive interventions that are designed to address distinct risk factors for depression: Coping with Stress (CWS), a cognitive behavioral program, and Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), an interpersonal program. We will base these matching profiles on pre-prevention data from a well-characterized sample of youth whom we have been following as part of a collaborative multi-wave naturalistic study to predict developmental trajectories of depression (NIMH 5R01 MH077195/MH077178; Hankin and Young, PIs). We will include adolescents, from the original 3rd and 6th grade cohorts, who will be in 7th and 10th grades for this proposed prevention trial. A total of 210 participants across two sites, University of Denver and Rutgers University, will be stratified on cognitive and interpersonal risk and randomized to the two prevention conditions. Independent evaluators will assess participants at baseline, mid-intervention, post-intervention and follow-up (every 6 months up to 36 months post-intervention). The goals of the study are to (1) demonstrate that prevention programs can modify depression trajectories among youth by examining within person changes in trajectories over time (three years before and three years after the prevention programs) and by comparing trajectories of prevention youth with changes in same aged cohorts; (2) evaluate a personalized prevention approach to bending depression trajectories by matching and mismatching youth to either CWS or IPT-AST based on individual risk profiles; (3) examine mechanisms of bending depression trajectories and test whether the prevention programs operate via their hypothesized processes; and (4) explore how genetic susceptibility, emotion regulation, and temperament may affect individual response to IPT-AST and CWS. By implementing evidence-based prevention programs after 3-years of prospective naturalistic data collection, this study will contribute essential data on personalized medicine and altering developmental trajectories of first-onset depression.