Preventing Youth Depression: A Multimedia Internet-Based Parent Program

描述(申请人提供)：抑郁症是困扰青少年的最普遍的精神障碍之一。它严重影响角色功能，通常需要反复或慢性病程。也有越来越多的证据表明抑郁症是家族遗传的。由于大多数抑郁青年从未接受过治疗，因此迫切需要制定易于获得的预防方案。该项目将开发和测试一种交互式多媒体干预措施，旨在通过向父母传授干预子女的技能来预防青少年抑郁症。该计划整合了使用交互式多媒体技术干预青少年的两种经过经验验证的方法：认知行为技能培训和育儿技能培训技术。将采用经验性检验的框架，以便通过因特网或光盘进行自我管理。干预将包括六个以知识和技能为基础的干预课程：关于青少年抑郁的教育、情绪和活动监测、积极思考、愉快的活动参与、将情绪和活动联系起来以及规划未来。其他浏览器模块(即，不受限制的访问)将包括：抑郁自我筛查、增强人际关系、学习放松、改善沟通和解决问题、抑郁资源和育儿资源。基于能力的教学设计将使用基于自定进度的视频教程、家庭成员和同龄人推荐信以及行为建模小插曲，为多个课程构建结构。该计划将针对三个用户群体：单身母亲、单身父亲和夫妇。该计划的基本结构将为每个目标人群相同，但具体内容将为每个群体定制。第一阶段的原型，目标是11至14岁报告抑郁症状增加的单身母亲，提供有关理解抑郁、监测情绪和参与愉快活动的培训。受试者内部的岗位前设计测试了该项目的可行性，在该项目中，参与者接受了为期一周的跟踪调查。结果显示，在使用所教授的技能以及青少年抑郁症状、情绪和愉快的活动参与度方面，家长的知识和自我效能感在岗位前发生了显著的变化。受试者发现该程序易于使用，并给出了很高的用户满意度评分。第二阶段的产品将在一项大型随机试验中进行评估(N=320个亲子二人组)；参与者将接受为期三个月的跟踪调查。预计结果将显示，父母对使用所教授的认知-行为技能的知识和自我效能感增加，以及父母养育技能的改善；这些父母结果的变化有望在干预条件与青少年抑郁症状减少之间的联系中起到中介作用。第二阶段产品的潜在商业应用是员工援助计划、健康计划和疾病管理组织。公共卫生相关性：抑郁症是青少年中最普遍的精神障碍之一，但大多数都得不到治疗。父母在孩子的心理健康方面发挥着重要作用，但缺乏获得支持服务和培训计划的机会。有证据表明，认知行为疗法和育儿技能培训都是帮助预防青少年抑郁症的有效干预策略，因此迫切需要为父母制定一项培训计划，将这些方法结合起来，易于实施和广泛传播。

DESCRIPTION (provided by applicant): Depression is one of the most prevalent mental disorders to afflict adolescents. It seriously impacts role functioning and typically takes a recurrent or chronic course. There is also mounting evidence for familial transmission of depression. Because most depressed youth never receive treatment, there is a critical need to develop easily accessed prevention programs. This project will develop and test an interactive multimedia intervention aimed at preventing youth depression by teaching parents skills for intervening with their children. The program integrates two empirically validated approaches for intervening with youth using interactive multimedia technology: cognitive-behavioral skills training and parenting skills training techniques. An empirically tested framework will be adapted for self- administration via the Internet or CD-ROM. The intervention will consist of six knowledge- and skills-based intervention sessions: education about youth depression, mood and activity monitoring, positive thinking, pleasant activity engagement, linking mood and activities, and planning for the future. Additional browser (i.e., unrestricted access) modules will include: self-screening for depression, enhancing personal relationships, learning to relax, improving communication and problem-solving, depression resources, and parenting resources. The competency-based instructional design will be structured for multiple sessions using self-paced video-based tutorials, family member and peer testimonials, and behavior modeling vignettes. The program will be targeted to three user groups: single mothers, single fathers, and couples. The basic structure of the program will be the same for each target population, but specific content will be customized to each group. The Phase I prototype, targeted to single mothers of 11 to 14-year-olds reporting elevated depressive symptoms, provided training on understanding depression, monitoring mood, and engaging in pleasant activities. A within-subjects pre-post design tested the feasibility of the program in which participants were followed over a 1-week period. The results indicated significant pre-post change in parent knowledge and self- efficacy to use the skills taught as well as youth depressive symptomatology, mood, and pleasant activity engagement. Subjects found the program easy to use and gave it high user satisfaction ratings. The Phase II product will be evaluated in a large randomized trial (N = 320 parent-child dyads); participants will be followed over a three-month period. Results are expected to show increased parent knowledge of and self-efficacy for using the cognitive-behavioral skills taught as well as improvement in parenting skills; these changes in parent outcomes are expected to mediate the association between intervention condition and decreases in youth depressive symptomatology. The potential commercial applications of the Phase II product are to employee assistance programs, health plans, and disease management organizations. PUBLIC HEALTH RELEVANCE: Depression is one of the most prevalent mental disorders among adolescents, however most go untreated. Parents play a significant role in their child's mental health yet lack access to support services and training programs. Given the evidence that cognitive-behavioral therapy and parenting skills training are both effective intervention strategies to help prevent youth depression, there is a critical need to develop a training program for parents incorporating these approaches that can be easily implemented and widely disseminated.