Parent Intervention in CBT for Depressed Latino Youth

描述（由申请人提供）：尽管在治疗青少年精神障碍方面取得了进展，但对拉丁美洲人的干预措施知之甚少，拉丁美洲人现在是美国最大的少数民族。本研究探讨了通过父母参与8期心理教育干预（PPI）来提高有效干预的影响。这种PPI将被纳入12期的认知行为治疗方法CBT中，这是一种已经被证明对治疗青少年抑郁症有效的认知行为治疗方法。本研究将140名患有重度抑郁症的拉丁裔青少年随机分为两组，一组接受CBT治疗，另一组不接受PPI治疗。摄入诊断将通过结构化诊断访谈获得（儿童诊断访谈时间表-青少年disc和父母复合国际诊断访谈- cidi）。这项研究将集中在波多黎各青少年和他们的父母身上。主要目的是解决干预和治疗的功效和效果。疗效问题集中在有PPI和没有PPI的积极治疗在治疗12周后减少抑郁症状和诊断（DISC）和预防治疗后一年复发（DISC）的比较上。有效性问题集中在使用或不使用PPI治疗对更广泛的功能结果的影响。患者功能结局包括一般功能状态、家庭功能、上学出勤率和损耗率。将检验CBT在有和没有辅助父母干预的情况下对改善父母在精神痛苦和症状、患者疾病负担和工作出勤率方面的功能的相对价值。我们假设在治疗后，积极使用PPI治疗在减少抑郁方面优于不使用PPI。由于PPI旨在让父母参与进来，从而影响家庭系统的其他方面，因此这种治疗有望在几个功能领域产生更好的结果。为了验证干预的理论假设，我们还旨在研究假设的治疗特异性改变机制对调节短期结果和预测一年内长期复发的贡献。这项研究响应了NIH和NIMH关于减少少数民族和白人在健康和精神卫生保健方面的差距的倡议，并将有助于我们的知识库。

DESCRIPTION (provided by applicant): Despite progress in treating mental disorders in youth, little is known about these interventions with Latinos who are now the largest minority group in the United States. This study examines the impact of enhancing effective interventions through the involvement of parents in an 8 session of a psycho education intervention (PPI). This PPI will be incorporated into the 12-session CBT, a Cognitive Behavioral treatment method that has already been shown effective for the treatment of adolescent depression. This study will randomize 140 Latino adolescents with Major Depression to CBT with or without a PPI delivered in groups. Intake diagnoses will be obtained via structured diagnostic interviews (Diagnostic Interview Schedule for Children-DISC for adolescents and Composite International Diagnostic Interview-CIDI for parents). The study will focus on Puerto Rican adolescents and their parents. The primary aims address both the efficacy and effectiveness of the intervention and treatments. Efficacy questions focus on the comparison of the active treatment with and without the PPI for reducing depressive symptoms and diagnosis (DISC) after 12 weeks of treatment and for preventing relapse over the course of one year post-treatment (DISC). Effectiveness questions focus on the impact of the treatment with or without the PPI on broader functional outcomes. Patient functional outcomes include general functioning status, family functioning, school attendance, and attrition rates. The relative value of CBT with and without the adjunctive parent intervention for improved parent functioning regarding psychiatric distress and symptoms, burden of patient illness, and work attendance will be examined. We hypothesize that the active treatment with PPI will be superior to no PPI in reducing depression at post treatment. Because the PPI is designed to involve parents and thus impact other aspects of the family system, this treatment is expected to produce better outcomes in several of the functional domains. To test the theoretical assumptions of the intervention, we also aim to examine the contribution of hypothesized treatment-specific change mechanisms to mediate the short-term outcome and predict long-term relapse over one year. This study responds to NIH and NIMH initiatives on decreasing disparities in health and mental health care between minorities and White populations and will contribute to our knowledge base.