2/2 Bending adolescent depression trajectories through personalized prevention

2/2 通过个性化预防改变青少年抑郁轨迹

• 批准号: 8743269
• 负责人: BENJAMIN L HANKIN
• 金额: $ 32.68万
• 依托单位: UNIVERSITY OF DENVER (COLORADO SEMINARY)
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-15 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8743269
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Behavioral; Childhood; Cognition; Cognitive; Data; Data Collection; Development; Disease; Endogenous depression; Enrollment; Exhibits; Genetic Predisposition to Disease; Goals; Impairment; Incidence; Individual; Intervention; Knowledge; Longitudinal Studies; Mediating; Medicine; Mental Depression; Mental disorders; Morbidity - disease rate; National Institute of Mental Health; Outcome; Participant; Persons; Predisposition; Prevalence; Prevention; Prevention Research; Prevention approach; Prevention program; Preventive Intervention; Principal Investigator; Process; Protocols documentation; Psychotherapy; Public Health; Randomized; Recurrence; Relative (related person); Research; Risk; Risk Factors; Sample Size; Sampling; Site; Strategic Planning; Stress; Symptoms; Temperament; Testing; Time; Universities; Youth; aged; base; child depression; cognitive system; cohort; coping; cost; depression prevention; depressive symptoms; design; developmental plasticity; emotion regulation; evidence base; experience; follow-up; improved; innovation; novel strategies; post intervention; programs; prospective; psychosocial; public health relevance; response; seventh grade; sixth grade; skills training; social; tenth grade; therapy design; third grade

DESCRIPTION (provided by applicant): Depression is a prevalent mental illness contributing to significant 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, principal investigators). 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.

描述（由申请人提供）：抑郁症是一种普遍存在的精神疾病，导致严重的发病率。为了减轻这一巨大的公共卫生负担，重点关注降低风险 青春期抑郁症的首次发病是当务之急。该项目将创新性地将风险因素研究和循证预防计划结合起来，将增进对个性化预防方法的了解，这些方法可能能够更好地“扭转”整个青春期激增的抑郁症的轨迹。这项 R01 合作研究的主要目标是检验是否可以通过将基于理论的风险状况的青少年与适合他们需求的干预措施相匹配来最大化抑郁症预防计划的效果。这两个地点的研究将随机分配具有高认知和/或人际交往风险的青少年接受两种旨在解决抑郁症不同危险因素的预防性干预措施：应对压力（CWS），一种认知行为计划，以及人际心理治疗-青少年技能培训（IPT-AST），一种人际计划。我们将这些匹配的资料建立在预防前数据的基础上，这些数据来自我们一直跟踪的一个具有良好特征的青少年样本，作为预测抑郁症发展轨迹的合作多波自然主义研究的一部分（NIMH 5R01 MH077195/MH077178；Hankin 和 Young，主要研究者）。我们将包括来自最初的三年级和六年级队列的青少年，他们将是七年级和十年级的青少年，参加这项拟议的预防试验。丹佛大学和罗格斯大学这两个地点的总共 210 名参与者将根据认知和人际风险进行分层，并随机分配到两种预防条件。独立评估员将在基线、干预中期、干预后和随访（干预后每 6 个月至 36 个月）对参与者进行评估。该研究的目标是（1）通过检查人体内轨迹随时间的变化（预防计划前三年和三年后）以及通过比较预防青少年的轨迹与同龄群体的变化，证明预防计划可以改变青少年的抑郁轨迹； (2) 根据个人风险状况，通过将青少年与 CWS 或 IPT-AST 进行匹配或不匹配，来评估扭转抑郁症轨迹的个性化预防方法； （3）检查弯曲凹陷轨迹的机制并测试预防计划是否通过其假设的过程发挥作用； (4) 探讨遗传易感性、情绪调节和气质如何影响个体对 IPT-AST 和 CWS 的反应。通过在三年的前瞻性自然数据收集后实施循证预防计划，这项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。