Prevention of Depression in Adolescents

项目描述（由申请人提供）：拟获得导师患者导向研究职业发展奖（K23），是一个五年计划，旨在培养候选人成为一名独立的抑郁症预防干预研究人员。候选人概述了一份应用程序，将正式课程、与知名抑郁症和预防研究者的咨询以及一个独立的研究项目结合起来，使候选人能够：(1)发展全面的预防科学知识，特别是预防干预；(2)增加其对青少年抑郁及发展为抑郁障碍相关风险的认识；(3)接受开展儿童青少年随机预防试验的培训；(4)提高与预防试验数据分析和调解与调节问题相关的技能。候选人建议通过研究人际心理治疗-青少年技能训练（IPT-AST），即她对抑郁症青少年人际心理治疗（IPT-A）的修改，来扩展先前在抑郁症预防方面的工作。IPT-AST是一种以学校为基础的针对抑郁症状升高的青少年的团体预防性干预，侧重于心理教育和人际关系技能的培养。核心项目将是一项对照临床试验，比较IPT-AST、IPT-AST加3次额外的父母-青少年会议（增强型IPT-AST）和常规护理对阈下抑郁症青少年的影响。建议对抑郁症状、抑郁障碍和人际功能进行即时和长期评估，以确定：(1)与常规护理相比，IPT-AST和强化IPT-AST是否与抑郁症状的缓解和抑郁障碍的预防相关；(2)强化IPT-AST家长-青少年会话对青少年抑郁症状和功能有额外影响；(3)有初步证据表明，人际功能在干预效果中起中介作用，年龄和性别起调节作用。该计划的最终目标是准备候选人提交一份成功的申请，以在更大的随机对照试验中测试最佳IPT-AST干预的有效性。

DESCRIPTION (provided by applicant): The proposed Mentored Patient-Oriented Research Career Development Award (K23) is a five-year plan to develop the candidate into an independent depression prevention intervention researcher. The candidate outlines a application integrating formal coursework, consultation with established depression and prevention investigators, and an independent research program that will enable the candidate to: (1) develop comprehensive knowledge of prevention science, particularly prevention interventions; (2) increase her understanding of adolescent depression and the risks associated with developing a depressive disorder; (3) acquire training in conducting randomized prevention trials for children and adolescents; and (4) enhance skills related to the analysis of data from prevention trials and issues of mediation and moderation. The candidate proposes to extend previous work in depression prevention by studying Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), her modification of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A). IPT-AST is a school-based group preventive intervention for adolescents with elevated depressive symptoms focusing on psychoeducation and interpersonal skill-building. The core project will be a controlled clinical trial comparing IPT-AST, IPT-AST plus 3 additional parent-adolescent sessions (enhanced IPT-AST), and usual care in adolescents with subthreshold depression. Immediate and long-term assessments of depression symptoms, depressive disorders, and interpersonal functioning are proposed to determine whether: (1) IPT-AST and enhanced IPT-AST are associated with relief of depressive symptoms and prevention of depressive disorders as compared to usual care; (2) the parent-adolescent sessions in enhanced IPT-AST have an additional impact on adolescents' depressive symptoms and functioning; (3) there is preliminary evidence that interpersonal functioning mediates, and age and gender moderate, the effects of the intervention. The ultimate goal of the proposed program is to prepare the candidate to submit a successful application to test the efficacy of the optimal IPT-AST intervention in a larger, randomized controlled trial.