CBT vs, CBT + Parent Training for Girls with Depression

儿童期抑郁症是一种毒性特别强、持续时间特别长的疾病，是未来发展为抑郁症发作和其他精神障碍的危险因素。抑郁症的发展有多种途径。一个可能的途径是不正常的家庭环境。研究表明，缺乏支持、冲突的环境、沟通不良、低水平的愉快活动和不适应的养育行为与抑郁症有关。这些干扰可能对儿童的情绪调节有直接影响，也可能通过影响儿童的自我意识、世界意识和未来意识产生间接影响。家庭环境是青春期前女孩发展的一个特别突出的背景。在儿童期，不同性别的抑郁症患病率是相似的。在13岁到15岁之间，患抑郁症的女孩数量相对于男孩增加，直到达到2比1的比例。在女孩和男孩之间的抑郁表达以及与抑郁相关的变量中发现了性别差异。女孩可能不会像男孩那样从标准的认知行为治疗中受益，因为治疗可能没有针对对青春期前女孩至关重要的障碍和技能。迄今为止，对儿童时期抑郁症的治疗进行的研究很少。虽然家庭在儿童适应中的重要性已得到普遍认可，但现有的抑郁症儿童治疗结果研究值得注意的是，研究者未能对家庭环境进行干预。这似乎会把年轻人重新置于压力环境中，而压力环境可能会导致这种疾病的发展和维持。本研究的主要目的是评估CBT和CBT加家长训练（PT）与最小接触控制（MCC）治疗青春期前女孩抑郁症的疗效。在学校通过多门筛选和评估程序诊断为抑郁症的儿童将被随机分配到CBT， CBT+PT或MCC。以学校为基础的治疗是针对性别和年龄而设计的。在长达四年的时间里，多个评分者将在测试前、测试后和年度随访中完成多项测量。每个学期提供三次助推器，以进行程序维护。在13-15岁的高风险时期，干预措施预防未来抑郁症发作的能力将被评估。我们会评估这些干预措施对青少年在学校表现和家庭环境的实际影响。评估干预措施对家长适应的影响。将系统地评估可能影响治疗结果的变量。

Depressive disorders during childhood are especially virulent, long-lasting disorders that are a risk factor for the development of future depressive episodes and other psychiatric difficulties. There are multiple pathways to the development of depression. One possible pathway is a dysfunctional family environment. Consistencies are emerging from research suggesting that an unsupportive, conflictual environment, poor communication, low levels of pleasant activities, and maladaptive parenting behaviors are related to depressive disorders. These disturbances may have both direct effects on the child's emotional adjustment and an indirect effect through their impact on the child's developing sense of self, world, and future. The family environment is an especially salient context for the development of preadolescent girls. During childhood, the prevalence of depressive disorders across genders is similar. Between the ages of 13 to 15 y.o. the number of girls who become depressed increases relative to boys until it reaches a 2-to-1 ratio. Gender differences have been found in the expression of depression between girls and boys and in the variables that are associated with depression. Girls may not benefit as much as boys from standard CBT because the treatments may not target disturbances and skills that are critical for preadolescent girls. To date a paucity of research has been conducted into the treatment of depressive disorders during childhood. While the importance of the family in the adjustment of children is generally recognized, the existing treatment outcome research for depressed children is noteworthy for the failure of investigators to intervene in the family environment. This would appear to place the youngsters back into the stressful environment that may have contributed to the development and maintenance of the disorder. The primary objectives of this investigation are to evaluate the efficacy of CBT and CBT plus Parent Training (PT) vs. minimal contact control (MCC) condition for the treatment of depressive disorders among preadolescent girls. Children who have been diagnosed with a depressive disorder through a multiple-gate screening and assessment procedure in their schools will be randomly assigned to CBT, CBT+PT, or MCC. The school- based treatment is designed to be gender and age sensitive. Multiple measures will be completed by multiple raters at pre, post, and annual follow-ups for up to four years. Three booster sessions are provided each school semester to program for maintenance. The ability of the interventions to prevent future episodes of depression through the high-risk 13-15 y.o. period will be evaluated. The practical impact of the interventions on the youngsters' school performance and home environments will be evaluated. The impact of the interventions on the parent's adjustment be evaluated. Variables that may mediate treatment outcome will be systematically evaluated.