Longitudinal Outcomes of a Randomized Controlled Trial Testing the Effectiveness of a Universal Resiliency Training ‘Op Volle Kracht' in Reducing Depression and Promoting Positive Adolescent Development

Introduction: Depressive symptoms are known to increase the risk for future depression and adverse life outcomes. Also, depressive symptoms increase the risk for anxiety and hopelessness, and are associated with less adaptive coping skills. Therefore, the effectiveness of a universal school-based prevention program ‘Op Volle Kracht/On Full Power’ (OVK) was evaluated on its ability to prevent depressive symptoms, whether adolescents who followed OVK were less anxious, more hopeful, more optimistic, more satisfied with their life, and had better coping skills, and it was tested whether the effects sustained over time.

Method:  The effectiveness of OVK was evaluated in a randomized controlled trial with two conditions, intervention (OVK) and care as usual, in a sample of 1341 adolescents (Mage = 13.91, SD = .55, boys 52.2%). The questionnaires were administered prior to prevention, post, six, 12, 18 and 24 months follow-up. We included over the follow-up moments respectively 96%, 89%, 89%, 84%, 77% and 84% of the participants. The OVK program is a Cognitive Behavioral Therapy program targeting thinking styles, social skills training, problem solving and decision making. The program consists of 16 lessons of 50 minutes and was provided by trained psychologists during school hours in the school setting. The effectiveness of OVK was analyzed with latent growth curve modeling. Missing data was imputed, and the completer-only and intention-to-treat analyses will be presented. (Trial registration number: NTR2879).

Results: The completer-only analyses showed that condition did not predict the intercept or slope of depression, anxiety, hopelessness, optimism, happiness, life satisfaction, active coping, cognitive coping, distraction coping, avoidance coping,  and support seeking. Gender did predict the intercept (β0 = -.12, p < .001) and slope of depression (β1 = .16, p = .004), indicating that boys report less depressive symptoms at baseline but show a larger increase over time. Gender also predicted the intercept of anxiety (β0 = -.29, p < .001), life satisfaction (β0 = .11, p < .001), active coping (β0 = -.07, p < .001), and seeking support (β0 = -.30, p < .001), and predicted the slope of hopelessness (β1 = .28, p < .001), optimism (β1 = -.17, p < .001), and cognitive coping (β1 = -.15, p = .003).

Conclusion: OVK is not effective in preventing depression, anxiety and promoting positive psychological functioning during adolescence when implemented as a universal prevention program. Implications for universal prevention will be discussed.