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Adolescent Depression Prevention

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (15 February 2014) | Viewed by 75649

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Special Issue Editors

Dr. Jane E. Gillham

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Guest Editor

Psychology Department Swarthmore College 500 College Ave, Swarthmore, PA 19081, USA
Interests: intersection of clinical psychology; developmental psychology and education

Dr. Patrick Pössel

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Guest Editor

College of Education and Human Development University of Louisville Louisville, KY 40292, USA
Interests: prevention of depression in adolescents; relationship between cognitive risk factors of depression, depressive symptoms, and physical health

Special Issue Information

Dear Colleagues,

Depressive disorders in adolescents are an increasing and prevalent problem with extensive psychosocial consequences and high costs for society. A large body of epidemiological studies has shown prevalence rates up to 20% as well as high persistence rates into adulthood. Even sub-threshold depressive symptoms in young people are strongly associated with an increased risk of developing depressive disorders in adulthood. Thus, the World Health Organization considers prevention as one of the most effective strategies to reduce the burden associated with psychological diseases. Consistent with the WHO’s consideration, multiple prevention programs have been developed world-wide. However, many questions regarding the prevention of depression in adolescents are still unanswered.

While the specific research area within the special edition “Adolescent Depression Prevention” is not limited to contributions answering these questions, we are particularly interested in manuscripts that focus on the following questions:

- Are the effects of prevention programs influenced by the cultural setting in which they are implemented?

- What is the status of prevention (research) of adolescent depression in middle- or low-income countries?

- Which type of prevention program (universal, selective, indicated) is most beneficial for whom and under what conditions?

- What are the “active ingredients” of prevention programs?

- What are the additional benefits of depression prevention programs? (What other outcomes do they affect?)

- Do adolescent depression prevention programs have iatrogenic effects?

- What forms of delivery (e.g., online) and/or settings (e.g., school-based) are most beneficial?

- How can effective prevention programs be disseminated without losing their impact?

- What is the cost-benefit of adolescent depression prevention?

Both empirical and review papers on any topic relevant to the prevention of depression in adolescents are welcome. We hope to create an issue that represents a truly global and state-of-the art perspective on adolescent depression prevention.

Dr. Patrick Pössel
Dr. Jane E. Gillham
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

adolescents
children
cost-benefit
culture
depression
dissemination
effectiveness
efficiency
minority populations
prevention
youth

Published Papers (9 papers)

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209 KiB

Open AccessArticle

A Qualitative Process Evaluation of Classroom-Based Cognitive Behaviour Therapy to Reduce Adolescent Depression

by John A. Taylor, Rhiannon Phillips, Ellen Cook, Lucy Georgiou, Paul Stallard and Kapil Sayal

Int. J. Environ. Res. Public Health 2014, 11(6), 5951-5969; https://doi.org/10.3390/ijerph110605951 - 05 Jun 2014

Cited by 18 | Viewed by 10052

Abstract

Small scale trials indicate that classroom-based Cognitive Behaviour Therapy (CBT) for adolescents has good reach and can help prevent depression. However, under more diverse everyday conditions, such programmes tend not to show such positive effects. This study examined the process of implementing a classroom-based CBT depression prevention programme as part of a large (n = 5,030) randomised controlled trial across eight UK secondary schools which was not found to be effective (PROMISE, ISRCTN19083628). The views of young people (n = 42), teachers (n = 12) and facilitators (n = 16) involved in the Resourceful Adolescent Programme (RAP) were obtained via focus groups and interviews which were thematically analysed. The programme was considered to be well structured and contain useful content, particularly for younger pupils. However, challenges associated with implementation were its age appropriateness for all year groups, its perceived lack of flexibility, the consistency of quality of delivery, the competing demands for teacher time and a culture where academic targets were prioritised over personal, social and health education. Whilst schools are convenient locations for introducing such programmes and allow good reach, the culture around improving well-being of young people in schools, increasing engagement with teachers and young people and sustaining such programmes are issues that need addressing. Full article

(This article belongs to the Special Issue Adolescent Depression Prevention)

243 KiB

Open AccessArticle

A Qualitative Investigation of Adolescents’ Perceived Mechanisms of Change from a Universal School-Based Depression Prevention Program

by Ian Shochet, Roslyn Montague, Coral Smith and Mark Dadds

Int. J. Environ. Res. Public Health 2014, 11(5), 5541-5554; https://doi.org/10.3390/ijerph110505541 - 22 May 2014

Cited by 17 | Viewed by 7788

Abstract

A recent meta-analysis provides evidence supporting the universal application of school-based prevention programs for adolescent depression. The mechanisms underlying such successful interventions, however, are largely unknown. We report on a qualitative analysis of 109 Grade 9 students’ beliefs about what they gained from an evidence-based depression prevention intervention, the Resourceful Adolescent Program (RAP-A). Fifty-four percent of interviewees articulated at least one specific example of program benefit. A thematic analysis of responses revealed two major themes, improved interpersonal relationships and improved self-regulation, both stronger than originally assumed. A more minor theme also emerged—more helpful cognitions. It is postulated that both improved interpersonal relationships and improved self-regulation are likely to enhance one another, and more helpful cognitions may express its contribution through enhanced self-regulation. These findings broaden our understanding of the impact of depression prevention programs, beginning to illuminate how such programs benefit participants. Full article

(This article belongs to the Special Issue Adolescent Depression Prevention)

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Open AccessArticle

Teachers or Psychologists: Who Should Facilitate Depression Prevention Programs in Schools?

by Melanie S. Wahl, Jill L. Adelson, Margarete A. Patak, Patrick Pössel and Martin Hautzinger

Int. J. Environ. Res. Public Health 2014, 11(5), 5294-5316; https://doi.org/10.3390/ijerph110505294 - 15 May 2014

Cited by 24 | Viewed by 7962

Abstract

The current study evaluates a depression prevention program for adolescents led by psychologists vs. teachers in comparison to a control. The universal school-based prevention program has shown its efficacy in several studies when implemented by psychologists. The current study compares the effects of the program as implemented by teachers versus that implemented by psychologists under real-life conditions. A total of 646 vocational track 8th grade students from Germany participated either in a universal prevention program, led by teachers (n = 207) or psychologists (n = 213), or a teaching-as-usual control condition (n = 226). The design includes baseline, post-intervention, and follow-up (at 6 and 12 months post-intervention). The cognitive-behavioral program includes 10 sessions held in a regular school setting in same-gender groups and is based on the social information-processing model of social competence. Positive intervention effects were found on the change in girls’ depressive symptoms up to 12 months after program delivery when the program was implemented by psychologists. No such effects were found on boys or when program was delivered by teachers. The prevention program can successfully be implemented for girls by psychologists. Further research is needed for explanations of these effects. Full article

(This article belongs to the Special Issue Adolescent Depression Prevention)

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Open AccessArticle

Evaluation of a School-Based Depression Prevention Program among Adolescents from Low-Income Areas: A Randomized Controlled Effectiveness Trial

by Karlijn C. M. Kindt, Marloes Kleinjan, Jan M. A. M. Janssens and Ron H. J. Scholte

Int. J. Environ. Res. Public Health 2014, 11(5), 5273-5293; https://doi.org/10.3390/ijerph110505273 - 15 May 2014

Cited by 45 | Viewed by 9817

Abstract

A randomized controlled trial was conducted among a potential high-risk group of 1,343 adolescents from low-income areas in The Netherlands to test the effectiveness of the depression prevention program Op Volle Kracht (OVK) as provided by teachers in a school setting. The results showed no main effect of the program on depressive symptoms at one-year follow-up. A moderation effect was found for parental psychopathology; adolescents who had parents with psychopathology and received the OVK program had less depressive symptoms compared to adolescents with parents with psychopathology in the control condition. No moderating effects on depressive symptoms were found for gender, ethnical background, and level of baseline depressive symptoms. An iatrogenic effect of the intervention was found on the secondary outcome of clinical depressive symptoms. Based on the low level of reported depressive symptoms at baseline, it seems that our sample might not meet the characteristics of a high-risk selective group for depressive symptoms. Therefore, no firm conclusions can be drawn about the selective potential of the OVK depression prevention program. In its current form, the OVK program should not be implemented on a large scale in the natural setting for non-high-risk adolescents. Future research should focus on high-risk participants, such as children of parents with psychopathology. Full article

(This article belongs to the Special Issue Adolescent Depression Prevention)

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Does the Absence of a Supportive Family Environment Influence the Outcome of a Universal Intervention for the Prevention of Depression?

by Susan H. Spence, Michael G. Sawyer, Jeanie Sheffield, George Patton, Lyndal Bond, Brian Graetz and Debra Kay

Int. J. Environ. Res. Public Health 2014, 11(5), 5113-5132; https://doi.org/10.3390/ijerph110505113 - 13 May 2014

Cited by 31 | Viewed by 8494

Abstract

To date, universal, school-based interventions have produced limited success in the long-term prevention of depression in young people. This paper examines whether family relationship support moderates the outcomes of a universal, school-based preventive intervention for depression in adolescents. It reports a secondary analysis of data from the beyondblue schools research initiative. Twenty-five matched pairs of secondary schools were randomly assigned to an intervention or control condition (N = 5633 Grade 8 students). The multi-component, school-based intervention was implemented over a 3-year period, with 2 years of follow-up in Grades 11 and 12. For those available at follow-up, small but significantly greater reductions in depressive and anxiety symptoms and improvements in emotional wellbeing were found over time for the intervention group compared to the control among those who experienced low family relationship support in Grade 8. For those who did not experience low family relationship support in Grade 8, no significant effects of the invention were found over the control condition. This pattern of results was also found for the intent-to-treat sample for measures of depression and anxiety. Previous research may have overlooked important moderating variables that influence the outcome of universal approaches to the prevention of depression. The findings raise issues of the relative costs and benefits of universal versus targeted approaches to the prevention of depression. Full article

(This article belongs to the Special Issue Adolescent Depression Prevention)

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224 KiB

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Resiliency Training in Indian Children: A Pilot Investigation of the Penn Resiliency Program

by Aruna Sankaranarayanan and Chandrika Cycil

Int. J. Environ. Res. Public Health 2014, 11(4), 4125-4139; https://doi.org/10.3390/ijerph110404125 - 15 Apr 2014

Cited by 9 | Viewed by 7088

Abstract

This paper examines the effectiveness of the Penn Resiliency Program (PRP) in an urban Indian setting. The PRP is a program to prevent depression in early adolescence and has proved successful in changing children’s attributional style of life events. While the program has been successful in preventing symptoms of depression in Western populations, the current study explored whether this program could be effective with an Indian sample. The aim of the current study was twofold; first, to study the attributional style of early adolescents in India and identify negative effects (if any) and second, to gain insights in using the PRP as a tool to change explanatory styles in Indian children. A total of 58 children participated in the study (Intervention group n = 29 and Control group n = 29). An Analysis of Covariance comparing post-test scores on Children’s Attributional Style Questionnaire (CASQ) while controlling for baseline scores indicated that children in the intervention group exhibited a significant reduction in pessimistic explanatory style and an increase in optimistic orientation compared to children in the control group. This indicates that the program was effective in changing negative attribution styles among upper-class Indian school children. Future work may look into the longer impact of the program as well as further considerations into adapting the program for a middle class population. Full article

(This article belongs to the Special Issue Adolescent Depression Prevention)

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386 KiB

Open AccessArticle

Predictors of Prevention Failure in College Students Participating in Two Indicated Depression Prevention Programs

by Vanessa Blanco, Paul Rohde, Fernando L. Vázquez and Patricia Otero

Int. J. Environ. Res. Public Health 2014, 11(4), 3803-3821; https://doi.org/10.3390/ijerph110403803 - 04 Apr 2014

Cited by 8 | Viewed by 7097

Abstract

The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force. Full article

(This article belongs to the Special Issue Adolescent Depression Prevention)

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Review

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Where to Go from Here? An Exploratory Meta-Analysis of the Most Promising Approaches to Depression Prevention Programs for Children and Adolescents

by Sarah E. Hetrick, Georgina R. Cox and Sally N. Merry

Int. J. Environ. Res. Public Health 2015, 12(5), 4758-4795; https://doi.org/10.3390/ijerph120504758 - 30 Apr 2015

Cited by 43 | Viewed by 10923

Abstract

Objective: To examine the overall effect of individual depression prevention programs on future likelihood of depressive disorder and reduction in depressive symptoms. In addition, we have investigated whether Cognitive Behavioural Therapy (CBT), Interpersonal Therapy (IPT) and other therapeutic techniques may modify this effectiveness. Methods: This study is based on and includes the trial data from meta-analyses conducted in the Cochrane systematic review of depression prevention programs for children and adolescents by Merry et al. (2011). All trials were published or unpublished English language randomized controlled trials (RCTs) or cluster RCTs of any psychological or educational intervention compared to no intervention to prevent depression in children and adolescents aged 5–19 years. Results: There is some evidence that the therapeutic approach used in prevention programs modifies the overall effect. CBT is the most studied type of intervention for depression prevention, and there is some evidence of its effectiveness in reducing the risk of developing a depressive disorder, particularly in targeted populations. Fewer studies employed IPT, however this approach appears promising. To our knowledge, this is the first study to have explored how differences in the approach taken in the prevention programs modify the overall treatment effects of prevention programs for children and adolescents. Conclusions: More research is needed to identify the specific components of CBT that are most effective or indeed if there are other approaches that are more effective in reducing the risk of future depressive episodes. It is imperative that prevention programs are suitable for large scale roll-out, and that emerging popular modes of delivery, such as online dissemination continue to be rigorously tested. Full article

(This article belongs to the Special Issue Adolescent Depression Prevention)

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Prevention of Adolescent Depression in the Spanish-Speaking World

by Andrea B. Horn, Catalina Cañizares and Yvonne Gómez

Int. J. Environ. Res. Public Health 2014, 11(6), 5665-5683; https://doi.org/10.3390/ijerph110605665 - 27 May 2014

Cited by 2 | Viewed by 5741

Abstract

This paper aims at presenting programs targeted at the prevention of adolescent depression applied with Spanish-speaking populations that have been developed in Spanish-speaking countries and are mostly published in Spanish. These programs have been developed under different cultural contexts in Spain and Latin-America. The main goal of this paper is to make the studies and movements of the Spanish-speaking literature in this field accessible to the non-Spanish-speaking part of the research community. Therefore, after an introduction referring to possible cultural differences regarding depression in general and epidemiological basics, several programs are introduced. In total 11 programs will be shortly presented and discussed. After revising the programs it can be concluded that in the Spanish-speaking world many programs have been developed and conducted following current state of the art-approaches for adolescent depression prevention. Further research is needed especially targeting possible cultural and contextual aspects of prevention measures and their efficacy and efficiency. Full article

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