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首页> 外文期刊>Prevention science: the official journal of the Society for Prevention Research >Prevention of Depression in At-Risk Adolescents: Moderators of Long-term Response
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Prevention of Depression in At-Risk Adolescents: Moderators of Long-term Response

机译：预防风险青少年的抑郁症：长期反应的主持人

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Abstract In a randomized controlled trial, we found that a cognitive behavioral program (CBP) was significantly more effective than usual care (UC) in preventing the onset of depressive episodes, although not everyone benefitted from the CBP intervention. The present paper explored this heterogeneity of response. Participants were 316 adolescents ( M age ?=?14.8, SD?=?1.4) at risk for depression due to having had a prior depressive episode or having current subsyndromal depressive symptoms and having a parent with a history of depression. Using a recursive partitioning approach to baseline characteristics, we (Weersing et al. 2016) previously had identified distinct risk clusters within conditions that predicted depressive episodes through the end of the continuation phase (month 9). The present study used the same risk clusters that had been derived in the CBP group through month 9 to reclassify the UC group and then to examine group differences in depression through month 33. We found that in this overall very high-risk sample, the CBP program was superior to UC among youth in the low-risk cluster ( n ?=?33), characterized by higher functioning, lower anxiety, and parents not depressed at baseline, but not in the middle ( n ?=?95) and high-risk ( n ?=?25) clusters. Across conditions, significantly more depression-free days were found for youth in the low-risk cluster ( M ?=?951.9, SD?=?138.8) as compared to youth in the high-risk cluster ( M ?=?800.5, SD?=?226.7). Identification of moderators, based on purely prognostic indices, allows for more efficient use of resources and suggests possible prevention targets so as to increase the power of the intervention.
机译：摘要在一个随机对照试验中，我们发现认知行为程序（CBP）比通常的护理（UC）在预防抑郁症发作时明显更有效，尽管并非所有人都受益于CBP干预。本文探讨了这种反应的异质性。参与者是316名青少年（M年龄？=？14.8，SD？=？1.4）由于具有先前的抑郁发作或具有目前的Superyndromal抑郁症状并且具有患有抑郁历史的父母，因此具有抑郁症的风险。利用递归分区方法进行基线特征，我们（Weersing等，2016）以前在延续阶段结束时预测了抑郁发作的条件下已经确定了明显的风险群集（第9个月）。目前的研究使用了通过月9日衍生的CBP集团的相同风险簇，以重新分类UC组，然后通过月33日检查抑郁症的群体差异。我们发现在这一整体非常高风险的样本中，CBP程序在低风险群体中优于UC（n？=？33），其特征在于功能较高，焦虑率较高，父母在基线不抑郁，但不在中间（n？= 95）和高-RISK（n？=？25）簇。在低风险群体中为青少年发现无抑郁天数（M？= 951.9，SD？= 138.8），比高风险集群（M？= 800.5，SD相比？=？226.7）。基于纯粹预后指数的主持人识别，允许更有效地利用资源，并提出可能的预防目标，以增加干预的力量。

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