1/2-Family Cognitive Behavioral Prevention of Depression in Youth and Parents

1/2-青少年和家长抑郁症的家庭认知行为预防

• 批准号: 8629038
• 负责人: Bruce E Compas
• 金额: $ 37.92万
• 依托单位: VANDERBILT 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/8629038
• 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.

项目总结/摘要 抑郁症是一个主要的公共卫生问题，每年影响超过1500万美国成年人， 在那些处于育儿年龄的人中普遍存在。抑郁父母的后代患抑郁症的风险增加， 因此是预防性干预的关键目标。部分是根据调查人员先前的工作， 该领域现在准备通过采用一种 创新的，以家庭为基础的方法，同时预防抑郁症的风险儿童和他们的 受影响的父母这种方法的基本原理是基于（a）我们的概念模型， 过程，压力源（特别是与父母抑郁症相关的压力源）和儿童的自我调节 面对压力的技能，（B）抑郁症家族性质的有力证据，（c） 以家庭和儿童为中心的抑郁症预防计划，（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，（e）越来越多的共识， 科学家、临床医生和政策制定者对以家庭为基础的医疗保健模式的需求。建议5- 一项为期一年的两个地点的随机对照试验将测试一项针对儿童的家庭抑郁症预防（FDP）计划 (ages 9-15）和他们的父母与抑郁症（过去或现在）。这种“双重预防”的做法是一种 从儿童预防和成人预防中提取的现有循证干预技术的新综合 治疗模式参与的家庭（N=300）将随机分配至FDP组（12周一次+ 3个月一次 会话）或书面信息控制（WI）条件。家长和孩子将在学前，中期， 以及干预后即刻和基线后6个月、12个月、18个月和24个月。该单个集成 干预旨在预防儿童和父母的抑郁症状和发作， 相关疾病，并改善功能（目的1）。我们亦会评估FDP的成本效益 相对于WI对照，并以儿童预防和成人 抑郁症治疗（目标1）。此外，我们将研究调解人（例如，父母教养行为 认知;儿童的应对），并评估儿童和父母过程之间的双向影响， （目标2）。最后，我们将探讨版主[例如，父母抑郁的严重程度（目标3）] 干预-结果关系。