Parent-Training Intervention to Prevent Adolescent Depression and Substance Use

描述（由申请人提供）：拟议的项目将开发和试点测试抑郁症和药物使用预防（DSUP）计划，这是一项父母培训预防性干预措施，改编自两个已有的基于证据的干预措施：一个针对青少年抑郁症（希望，意义和连续性），另一个针对青少年药物使用（家庭问题）。研究表明，父母抑郁导致的育儿技能缺陷不仅会使青少年面临抑郁的风险，还会使他们吸毒。提高抑郁照顾者的养育能力可能有助于预防青少年的抑郁和药物使用，以及这些结果的共同发生。减少问题的同时发生尤其重要，因为研究表明，与抑郁症或单独使用药物相比，未来发展问题的风险增加。这个探索性/发展性（R21）项目将开发DSUP干预（目标1），并评估将该计划提供给12-15岁青少年的抑郁父母的可行性，12-15岁的青少年是一个以抑郁和物质使用易感性增加为特征的发展时期（目标2）。此外，还将对该项目在改善父母教养、减少青少年抑郁和药物使用方面的短期效果进行初步测试（目标3）。为了实现这些目标，将通过广告招募60个家庭（60名父母/照顾者和60名目标青少年），这些家庭将在西雅图，华盛顿大都会地区的一个大型医疗保健系统的诊所中为不同人群提供服务。每个家庭将被分配到干预条件或最小接触比较条件。将针对不同但相关结果的相容的、预先存在的预防方案结合起来，可能提供一种有效且具有成本效益的方法，以增强对目标结果的影响，并有可能减少问题的共病性，如抑郁症和药物使用，这些问题经常在青少年中同时发生。该申请是根据PA-06-530青年和青少年的养育能力和健康结果提交的。这项研究的结果将有助于评估联合DSUP项目的可行性和短期疗效，并将为未来R01提案的发展提供信息，以开展更大规模的干预随机试验。拟议的探索性/开发项目将评估抑郁症和物质使用预防（DSUP）计划的可行性和有效性，该计划是一项由两项已有的循证干预措施改编而成的家长培训预防干预措施。研究结果将提供关于DSUP项目在多大程度上提高了养育能力，减少了青少年抑郁和物质使用，以及这些情绪和行为问题的共同发生的初步信息。

DESCRIPTION (provided by applicant): The proposed project will develop and pilot test the Depression and Substance Use Prevention (DSUP) program, a parent-training preventive intervention adapted from two pre-existing, evidence-based interventions: one that targets adolescent depression (Hope, Meaning, and Continuity) and another that targets adolescent substance use (Family Matters). Research suggests that parenting skills deficits that result from maternal or paternal depression may place adolescents at risk not only for depression but also for substance use. Improving the parenting capacities of depressed caregivers may help prevent depression and substance use, as well as the co-occurrence of these outcomes, among youth. Reducing problem co- occurrence is particularly important given research showing increased risk for future developmental problems compared with either depression or substance use alone. This exploratory/developmental (R21) project will develop the DSUP intervention (Aim 1) and evaluate the feasibility of delivering the program to depressed parents of teenagers between the ages of 12-15 years, a period of development characterized by increased susceptibility for depression and substance use (Aim 2). In addition, a preliminary test of the short-term efficacy of the program for improving parenting and reducing adolescent depression and substance use will be conducted (Aim 3). To accomplish these aims, 60 families (60 parents/caregivers and 60 target adolescents) will be recruited via advertising throughout clinics of a large health care system serving a diverse population of individuals in the Seattle, Washington metropolitan area. Thirty families each will be assigned to either the intervention condition or the minimal-contact comparison condition. Combining compatible, pre-existing prevention programs that target different but related outcomes may provide an efficient and cost-effective way to enhance effects on targeted outcomes and potentially reduce the comorbidity of problems, such as depression and substance use, that often co-occur among teens. This application is submitted in response to PA-06-530 Parenting Capacities and Health Outcomes in Youths and Adolescents. Findings from this study will be useful for evaluating the feasibility and short-term efficacy of the combined DSUP program, and will inform the development of a future R01 proposal to conduct a larger randomized trial of the intervention. PUBLIC HEALTH SIGNIFICANCE The proposed exploratory/development project will evaluate the feasibility and efficacy of the Depression and Substance Use Prevention (DSUP) program, a parent-training preventive intervention adapted from two pre-existing, evidence-based interventions. Findings will provide preliminary information about the degree to which the DSUP program improves parenting capacities and reduces adolescent depression and substance use, as well as the co-occurrence of these emotional and behavioral problems.