Parent Intervention in CBT for Depressed Latino Youth

描述（由申请人提供）：尽管在治疗青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次心理教育干预（PPI）来提高有效干预的影响。这种PPI将被纳入12期CBT，这是一种认知行为治疗方法，已被证明对治疗青少年抑郁症有效。本研究将140名患有重度抑郁症的拉丁裔青少年随机分组接受CBT治疗，分组时给予或不给予PPI。将通过结构化诊断访谈（儿童诊断访谈计划-青少年DISC和父母复合国际诊断访谈-CIDI）获得摄入诊断。这项研究将侧重于波多黎各青少年及其父母。主要目的是解决干预和治疗的功效和有效性。疗效问题重点关注比较有和无PPI的活性治疗在治疗12周后减少抑郁症状和诊断（DISC）以及在治疗后一年内预防复发（DISC）。有效性问题的重点是有或没有PPI的治疗对更广泛的功能结局的影响。患者功能结局包括一般功能状态、家庭功能、上学率和自然减员率。CBT的相对价值与和不连续的父母干预改善父母功能的精神痛苦和症状，病人的疾病负担，和出勤率将进行检查。我们假设，在治疗后减少抑郁症方面，使用PPI的积极治疗将优于不使用PPI的积极治疗上级。由于PPI旨在让父母参与，从而影响家庭系统的其他方面，因此这种治疗预计将在几个功能领域产生更好的结果。为了测试干预的理论假设，我们还旨在研究假设的治疗特异性变化机制对介导短期结局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色人群之间健康和精神卫生保健差距的倡议，并将有助于我们的知识基础。

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.