Examining Non-Responders to School-Based Depression Prevention Programs: IPT-AST and School Counseling

Background: In recognition of the considerable risk and impairment associated with elevated depressive symptoms in adolescence, there has been a call for an increase in indicated preventive intervention research. Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST; Young & Mufson, 2003) is a promising school-based indicated preventive intervention. We have conducted two small-scale randomized controlled trials comparing IPT-AST to usual school counseling (SC). Both studies found significant effects on depression symptoms, depression diagnoses, and overall functioning (Young, Mufson, & Davies, 2006; Young, Mufson, & Gallop, 2010).  While these results are encouraging, it is also important to examine the subset of adolescents who did not respond favorably to IPT-AST, as well as non-responders to SC.

Methods/Results: This poster will present analyses that examine predictors of non-response using data from both studies. In the first study, 41 adolescents were randomized to IPT-AST or SC and were followed for 12-months following the intervention. In the second study, 57 adolescents were randomized to IPT-AST and SC and were followed for 18-months following the intervention. First, we will identify adolescents who did not respond to the interventions, as defined by an increase in depressive symptoms from pre-intervention through follow-up or the diagnosis of a depressive episode during the follow-up period. Next, we will identify the pre-intervention characteristics (e.g., demographic variables, baseline measures) and intervention variables (e.g., session attendance, intervention satisfaction) that predict non-response. Finally, we will conduct a qualitative case review of non-responders to understand other variables in combination with the predicted demographic and baseline clinical measures that may explain intervention non-response.

Conclusions: These investigations can improve our understanding of adolescents for whom school-based depression prevention programs may not work and can highlight important avenues for program development.