Preventing Depression within Salient Adolescent Contexts

描述(由申请人提供)：抑郁症的影响是显著的，青春期是进行干预的最佳机会，特别是在学校。在建议的应用中，我们着手进一步开发和测试基于抑郁症生态交易理论的新的预防方法(PTA：积极的思想和行动)。PTA的创新之处在于，该计划积极让父母参与预防过程，并关注可能导致青春期抑郁的突出问题，包括关系、学校运作和健康行为。PTA将认知、行为、人际和家庭方法整合到其以学校为基础的项目中。在建议的研究性研究中，我们会征询消费者，包括家长、学生和学校人员的意见，以确保家长教师会以最小的负担和最大的利益的方式融入学校。我们将制定培训方案和实施工具，以衡量忠诚度和团队流程。在最终定稿之前，我们的手册和相关材料将根据消费者的意见和2名抑郁症预防专家的审查进行关键的改进。然后，从西雅图公立学校抽取的160名抑郁症状加重的7年级和8年级学生将被随机分配到接受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，并将使用增长曲线建模来检查随时间的变化。我们还将检查我们目标领域(亲子沟通、社会功能、学校功能、健康行为)的工具结果的变化，以及对治疗利用和严重抑郁障碍发病的影响。 公共卫生相关性：抑郁症是一种严重的心理健康问题，需要预防，青春期是干预的绝佳机会。到目前为止，针对青年的预防工作显示出一些希望，但效果不大，可能是短暂的。在拟议的应用中，我们着手进一步开发和测试一种新的预防方法(PTA：积极的思想和行动)，该方法在解决导致青少年早期抑郁症状并使其永久化的关键背景因素方面是独特和创新的，包括与父母的沟通、关系、学校功能和健康行为。

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.