Reducing the Risk of Depressive Symptoms Among Vulnerable Youth: The Role of Adversity in Intervention Response

Introduction. Youth who experience chronic stress and adversity are at high risk of developing mental, emotional and behavioral health problems (MEB), including elevated depressive symptoms. Preventive interventions have the potential to play an important role in addressing these disparities by reducing risk factors and promoting protective factors. However, it is important to first determine whether evidence-based preventive interventions work similarly for youth experiencing adversity compared to other youth. Indeed, youth who experience different forms of adversity may have special prevention intervention needs.

Method. Using a combined dataset of 18 prevention intervention RCTs, this paper will utilize synthesis analyses to examine the differential efficacy of preventive interventions for youth experiencing different types of adverse experiences. Adversity variables analyzed will include: socioeconomic disadvantage (percentage of federal poverty level), parental unemployment, limited parental education, single parent households, and ethnic/ racial minority status. Multiple regression analysis will examine these different indicators of adversity as predictors of intervention effects on youth depressive symptoms, as well as test interactions between adversity variables in their effects on youth depressive symptoms. Additive effects among adversity measures will also be examined as predictors of depressive symptoms.  Finally, analyses will also explore whether certain types of preventive interventions (e.g., parenting/ family, cognitive-behavioral, interpersonal therapy; or depression-specific, multiple-target interventions) are most efficacious for youth experiencing adversity.

Results and Conclusions. Results of these synthesis analyses will be presented, together with implications regarding the potential utility of evidence-based preventive interventions as part of a comprehensive strategy to address disparities in youth depressive symptoms. The conclusions will also address the extent and quality of adversity measures in current prevention trials, as well as provide recommendations for how measures can be strengthened and made more consistent across trials to facilitate future synthesis analyses.