Prevention of Depression in Adolescents

描述(由申请人提供)：建议的以患者为导向的导师研究职业发展奖(K23)是一个五年计划，旨在将候选人发展为一名独立的抑郁症预防干预研究人员。应聘者概述了一项应用程序，该应用程序整合了正规课程、与成熟的抑郁症和预防研究人员的咨询以及独立研究计划，使应聘者能够：(1)发展预防科学的全面知识，特别是预防干预；(2)加深她对青少年抑郁症和与抑郁障碍相关的风险的理解；(3)获得针对儿童和青少年进行随机预防试验的培训；以及(4)提高与分析预防试验数据以及调解和缓和问题相关的技能。候选人建议通过研究人际心理疗法-青少年技能训练(IPT-AST)来扩展之前在抑郁预防方面的工作，这是她对抑郁青少年人际心理疗法(IPT-A)的修改。IPT-AST是一种以学校为基础的团体预防干预措施，针对抑郁症状升高的青少年，侧重于心理教育和人际交往技能培养。核心项目将是一项对照临床试验，比较IPT-AST、IPT-AST加3次额外的亲子会话(增强型IPT-AST)，以及对患有阈值下抑郁症的青少年的常规护理。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和增强的IPT-AST是否与缓解和预防抑郁症状有关；(2)与常规护理相比，增强的IPT-AST对青少年的抑郁症状和功能有额外的影响；(3)初步证据表明，人际功能在干预效果中起调节作用，且年龄和性别适中。拟议计划的最终目标是准备候选人提交一份成功的申请，以在一项更大规模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.