2/2-Family Cognitive Behavioral Prevention of Depression in Youth and Parents

2/2-青少年和家长抑郁症的家庭认知行为预防

• 批准号: 8629385
• 负责人: V Robin Weersing
• 金额: $ 35.83万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-03-01 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8629385
• 关键词: Adopted; Adult; Affect; Age; American; Anxiety; Behavioral; Benchmarking; Characteristics; Child; Cognition; Cognitive; Cognitive Therapy; Consensus; Coordination and Collaboration; Coping Skills; Data; Demographic Factors; Depressed mood; Depressive disorder; Disease; Disruptive Behavior Disorder; Doctor of Philosophy; Ethnic Origin; Evidence based intervention; Family; Goals; Healthcare; Incidence; Individual; Institute of Medicine (U.S.); Intervention; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Metric; Modeling; Morbidity - disease rate; National Institute of Mental Health; National Research Council; Nature; Outcome; Parenting behavior; Parents; Pediatrics; Prevalence; Prevention; Prevention approach; Prevention program; Preventive; Preventive Intervention; Process; Protocols documentation; Psychopathology; Public Health; Quality-Adjusted Life Years; Race; Randomized; Randomized Controlled Trials; Recurrence; Relapse; Relative (related person); Research Personnel; Risk; Robin bird; Running; Sampling; Scientist; Severities; Site; Stress; Symptoms; Techniques; Testing; Time; Universities; Work; Writing; Youth; base; child depression; coping; cost effective; cost effectiveness; depression prevention; depressive symptoms; design; disability; efficacy testing; experience; improved functioning; innovation; intervention effect; meetings; novel; offspring; post intervention; prevent; programs; public health priorities; public health relevance; sex; single episode major depressive disorder; skills; stressor; therapy design

PROJECT SUMMARY / ABSTRACT Depression is a major public health problem affecting over 15 million U.S. adults annually and is especially prevalent in those of parenting age. Offspring of depressed parents are at increased risk of depression and therefore are a critical target for preventive interventions. Informed in part by the investigators' prior work, the field is now poised to make significant advances toward reducing the rate of depression by adopting an innovative, family-based approach to simultaneously preventing depression in at-risk children and in their affected parents. The rationale for this approach is based on (a) our conceptual model that integrates parenting processes, stressors (particularly those associated with parental depression), and children's self-regulatory skills in the face of stress, (b) strong evidence of the familial nature of depression, (c) promising results from family- and child-focused depression prevention programs, (d) evidence that in adults, cognitive-behavioral therapy (CBT) reduces both depressive episodes and their recurrence, and (e) growing consensus among scientists, clinicians, and policymakers on the need for family-based models of healthcare. The proposed 5- year, two-site randomized controlled trial will test a Family Depression Prevention (FDP) program for children (ages 9-15) and their parents with depressive disorders (past or current). This "dual prevention" approach is a novel synthesis of existing evidence-based intervention techniques drawn from child prevention and adult treatment models. Participating families (N=300) will be randomized to either FDP (12 weekly + 3 monthly sessions) or a written information control (WI) condition. Parents and children will be evaluated at pre-, mid-, and immediately post-intervention, and at 6-, 12-, 18-, and 24-months from baseline. This single integrated intervention aims to prevent depressive symptoms and episodes in both children and parents, reduce associated disorders, and improve functioning (Aim 1). We also will assess the cost-effectiveness (CE) of FDP relative to the WI control and benchmarked against the CE of landmark studies in child prevention and adult depression treatment (Aim 1). Additionally, we will examine mediators (e.g., parenting behaviors; parents' cognitions; children's coping) and evaluate bidirectional effects between child and parent processes and outcomes (Aim 2). Finally, we will explore moderators [e.g., parental depression severity (Aim 3)] of the intervention-outcome relation.

项目摘要 /摘要 抑郁是一个主要的公共卫生问题，每年都会影响超过1500万美国成年人，尤其是 在育儿年龄的人中流行。沮丧的父母的后代有抑郁症的风险增加， 因此是预防干预措施的关键目标。调查人员的事先工作的一部分信息， 现在，现场有望通过采用一种 创新的，基于家庭的方法，同时防止处于危险的儿童及其 受影响的父母。这种方法的理由是基于（a）我们整合育儿的概念模型 过程，压力源（尤其是与父母抑郁症相关的压力源）以及儿童的自我调节 面对压力的技能，（b）有力的抑郁家族性质的有力证据，（c） 家庭和儿童预防抑郁症计划，（d）证据表明，在成年人中，认知行为 治疗（CBT）减少抑郁发作及其复发，以及（e）在 科学家，临床医生和政策制定者对基于家庭的医疗保健模式的需求。提议的5- 年份，两场随机对照试验将测试儿童家庭抑郁症（FDP）计划 （9-15岁）及其父母患有抑郁症（过去或现在）。这种“双重预防”方法是 从预防儿童和成人中提取的现有基于证据的干预技术的新型综合 治疗模型。参与家庭（n = 300）将被随机分为FDP（每周12 + 3个月300 会议）或书面信息控制（WI）条件。父母和孩子将在前，中期进行评估 并立即干预后，以及基线的6、12、12、18和24个月。这个单个集成 干预旨在防止儿童和父母的抑郁症状和发作，减少 相关疾病并改善功能（目标1）。我们还将评估FDP的成本效益（CE） 相对于WI控制和针对预防儿童和成人的Landmark研究的基准测试 抑郁症治疗（目标1）。此外，我们将检查调解人（例如，育儿行为；父母的行为； 认知；儿童的应对）并评估子女过程之间的双向效应 结果（目标2）。最后，我们将探索主持人[例如，父母的抑郁严重程度（AIM 3）] 干预结果关系。