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行抑郁和物质使用预防(DSUP)计划，这是一种父母培训预防干预措施，改编自两种先前存在的循证干预措施：一种针对青少年抑郁症(希望、意义和连续性)，另一种针对青少年物质使用(家庭问题)。研究表明，母亲或父亲的抑郁导致的育儿技能缺陷可能不仅会使青少年面临抑郁的风险，还会使他们面临物质使用的风险。改善抑郁的照顾者的育儿能力可能有助于防止抑郁和药物使用，以及这些结果在青年中共同发生。考虑到研究表明，与抑郁症或单独使用药物相比，未来发展问题的风险更高，减少问题的重复发生尤为重要。这一探索性/发展性(R21)项目将制定儿童抑郁症干预方案(目标1)，并评估将该方案提供给12-15岁青少年抑郁父母的可行性，这一发展阶段的特点是抑郁症易感性增加和药物使用(目标2)。此外，将对改善育儿和减少青少年抑郁和药物使用方案的短期效果进行初步测试(目标3)。为了实现这些目标，60个家庭(60个父母/照顾者和60个目标青少年)将通过在整个诊所宣传一个大型医疗保健系统来招募，该系统服务于西雅图、华盛顿州大都市区的不同人群。每个家庭将被分配到干预条件或最小接触者对照条件下。将针对不同但相关结果的兼容的、预先存在的预防计划结合起来，可能会提供一种有效且具有成本效益的方式，以增强对目标结果的影响，并潜在地减少青少年中经常共同发生的问题的共病，如抑郁和药物使用。本申请是针对PA-06-530《青少年的育儿能力和健康结果》提出的。这项研究的结果将有助于评估联合的DSUP计划的可行性和短期疗效，并将为未来R01提案的发展提供信息，以进行更大规模的干预随机试验。公共卫生意义拟议的探索性/发展项目将评估抑郁症和药物使用预防(DSUP)计划的可行性和有效性，这是一种父母培训预防性干预措施，由两种预先存在的循证干预措施改编而成。研究结果将提供有关DSUP计划在多大程度上改善育儿能力、减少青少年抑郁和药物使用以及这些情绪和行为问题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.