Parent Intervention in CBT for Depressed Latino Youth

描述(申请人提供)：尽管在治疗青少年精神障碍方面取得了进展，但人们对拉美裔人的干预知之甚少，他们现在是美国最大的少数群体。这项研究通过父母参与心理教育干预(PPI)的8次会议来检验加强有效干预的影响。这一PPI将被纳入12个疗程的CBT，这是一种认知行为治疗方法，已被证明对青少年抑郁症的治疗有效。这项研究将140名患有严重抑郁症的拉丁裔青少年随机分成两组，分别接受CBT和PPI治疗。录取诊断将通过结构化诊断面谈(儿童诊断面谈时间表-青少年DISC和综合国际诊断面谈-CIDI家长)获得。这项研究将重点关注波多黎各青少年及其父母。主要目标是解决干预和治疗的有效性和有效性。疗效问题集中在比较有无PPI的积极治疗在治疗12周后减少抑郁症状和诊断(DISC)以及在治疗后一年的过程中防止复发(DISC)。有效性问题集中在使用或不使用PPI的治疗对更广泛的功能结果的影响。患者的功能结果包括一般功能状态、家庭功能、学校出勤率和流失率。在父母辅助干预的情况下，CBT在改善父母在精神困扰和症状、患者疾病负担和工作出勤方面的功能方面的相对价值将被审查。我们推测，在减少治疗后的抑郁方面，使用PPI的积极治疗将优于不使用PPI的治疗。由于PPI旨在让父母参与，从而影响家庭系统的其他方面，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，我们还旨在检验假想的针对特定治疗的改变机制对调节短期结果和预测一年以上长期复发的贡献。这项研究响应了NIH和NIMH关于缩小少数族裔和白人之间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.