Longitudinal Outcomes of Depression Prevention and Resiliency Training for Dutch Adolescents: An Efficacy Trial

Introduction

Preventing symptoms of depression and anxiety and fostering positive development during adolescence is highly relevant, since symptoms of depression and anxiety are prevalent and increase during adolescence (Chavira, Stein, Bailey, & Stein, 2004; Saluja et al., 2004). Also, experiencing elevated levels of depressive symptoms or anxiety increases the risk for psychiatric disorders in adulthood (Costello, Copeland, & Angold, 2011; Pine, Cohen, Cohen, & Brook, 1999). Universal social emotional programs resulted in reductions of internalizing and conduct problems and adolescents showed improvements in academic performance, in social and emotional skills (Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011). In the Netherlands, a universal school-based resiliency training Op Volle Kracht (OVK) was developed, based on the Penn Resiliency Program (Brunwasser, Gillham, & Kim, 2009). In this study the effectiveness of OVK in preventing the increase in depressive and anxiety symptoms and promoting positive development during adolescence will be reported.

Method:

The efficacy of OVK was tested in a sample of 1.370 Dutch adolescents, by means of a randomized controlled trial with intervention and control condition (care as usual). OVK consists of 16 lessons of 50 min, given by trained psychologists to groups of 11–15 students. OVK contains Cognitive Behavioral Therapy, social skills training, problem solving and decision making. The effect of OVK on depressive symptoms (primary outcome), anxiety, hopelessness, life satisfaction, coping, self-efficacy, optimism and happiness (secondary outcomes) will be presented at post-intervention, 6 and 12 months follow up. At this moment, the 12 month follow up is being collected (trial registration number: NTR2879).

Data will be analyzed in accordance with the intent-to-treat principle and for the completers only. Multiple imputations will be used for missing observations at follow-ups (Graham, 2009). The hypotheses will be tested with regression analyses in MPLUS (Muthén & Muthén, 1998–2006) controlled for possible confounders. Possible baseline differences between the conditions in demographic variables (e.g. age, gender, school level, and ethnic background) and depressive symptoms will be checked. Cluster effects at group-level will be taken into account. Also, possible moderating effects of gender, educational level, adolescent baseline depressive symptoms, and parental depressive symptoms will be tested by means of multivariate regression analyses in MPLUS.

Discussion

The results of our RCT will be discussed and implications for research and practice will be given in relation to the promotion of positive development and the prevention of internalizing problems during adolescence.