C. Hendricks Brown, PhD, Professor, Northwestern University, Chicago, IL
George W. Howe, PhD, Professor, George Washington University, Washington, DC
Tatiana Perrino, PsyD, Research Assistant Professor, University of Miami Miller School of Medicine, Miami, FL
Juned Siddique, PhD, Assistant Professor, Northwestern University, Chicago, IL
Shi Huang, PhD, Assistant Scientist, University of Miami, Miller School of Medicine, Miami, FL
Ahnalee Brincks, PhD, Lead Research Analyst, University of Miami, Miami, FL
Peter John De Chavez, MS, Biostatistician, Northwestern University, Chicago, IL
Hilda Maria Pantin, PhD, Professor, University of Miami, Miami, FL
Jami Finkelson Young, PhD, Associate Professor of Clinical Psychology, Rutgers University, Piscataway, NJ
Gracelyn Cruden, MA, Research Project Coordinator, Northwestern University, Chicago, IL
William Rigby Beardslee, MD, Senior Research Scientist, Children's Hospital Boston, Boston, MA
Irwin N. Sandler, PhD, Regents' Professor, Arizona State University, Tempe, AZ
Robert D. Gibbons, PhD, Professor, University of Chicago, Chicago, IL
Introduction. A number of approaches have been taken to prevent depressive episodes, or prevent the rise in depressive symptoms, that often occurs in adolescence. One approach is to target at-risk youth and deliver a preventive intervention involving cognitive behavioral therapy (CBT) or interpersonal therapy (IPT) either individually or in a group setting. A second approach is to focus on parents as change agents in their children’s lives, regardless of the child’s current symptomatology. A third approach is to use a family-focused intervention where an interventionist works with the parent and adolescent together. We use participant-level data across 19 adolescent prevention trials to examine variation in impact on adolescent depressive symptoms across this wide range of preventive interventions. Our objectives are to: contribute to an understanding of who benefits from preventive interventions, who is potentially harmed, identify which interventions are most beneficial for discrete subgroups, and uncover gaps in existing programs that can be addressed through combining strengths of these different interventions.
Method. This paper presents the initial findings from an integrative data analysis of individual-level data involving 19 adolescent prevention trials (n=5292) and 9 distinct preventive interventions. Specifically, we examine the shared and unique effects of these interventions on adolescent depressive symptoms by level of baseline depressive symptoms in the youth, socio-demographic characteristics of the youth (age and sex), intervention type, and by delivery to the youth, parent, or both. Our methods include harmonization across 7 depression measures and the use of latent growth models to summarize and compare intervention impact over two years post-randomization.
Results & Conclusions. We found a significant overall effect of these interventions in improving the depression symptom trajectory, with stronger improvement among interventions that target depression, and those that are delivered to directly to the adolescent. We also found evidence of variation in impact by baseline level of symptoms, with a stronger impact on those with higher elevated symptoms, and a weaker but still significant impact among those with lower baseline symptom levels. Implications for improving population-level impact will be discussed.
Irwin N. Sandler
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