Prevention of depressive symptoms in adolescents: a trial of two school-based programs.
Horowitz JL, Garber J, Ciesla JA, Young JF, Mufson L.
The Issue
Depression is common in teenagers. It can interfere with enjoyment of life and school achievement. Depression can become a life-long burden in many cases. Preventing or treating depression in teens can reduce the likelihood that the condition will impair functioning and continue into adulthood.
The Research
This study compared the ability of cognitive behavioural therapy (CBT) and interpersonal psychotherapy/adolescent skills training (IPT-AST) to prevent depression in teenagers. Of the 600 students taking part in wellness classes in three high schools, consent for participation was given by 380 students and their parents. They were randomly assigned to CBT (112 students), IPT-AST (99 students), and 169 served as the control group. It was assumed at the beginning that both treatments would prevent depression and that the effect would last at least six months. The researchers wanted to understand whether or not the initial level of depression and the sex of the student affected how well the interventions worked. They also looked at whether the two interventions worked in different ways depending upon certain personality traits. If cognitive behavioural therapy works because it is based on learning new things and involves challenges it should benefit students who are achievement oriented. If IPT-AST improves the way students interact with other people, it should benefit those students whose sense of self is strongly involved in friendships and social interactions.
The Outcome
Both interventions worked to reduce the symptoms of depression but did not prevent new episodes of depression in those free of depression at the outset. Those with the highest level of symptoms at the beginning of the study had the best improvement. The kind of intervention made no difference. IPT-AST seemed to work to reduce depression in students who are most concerned about social interactions. Contrary to what the researchers predicted, CBT was not more effective with those who are achievement oriented. It may be that its effectiveness is actually based on its ability to change negative thinking. Gender did not influence the findings. The improvements in depression symptoms did not persist at six-month follow up.
Conclusions
Both CBT and IP-AST were effective in the short-term in reducing symptoms of depression but they did not prevent depression in the participants. The students’ personality characteristics did not influence the effectiveness of each of the interventions.
The preceding is a summary of:
The preceding is a summary of: Horowitz JL, Garber J, Ciesla JA, Young JF, Mufson L. Journal of Consulting and Clinical Psychology. 2007; 75(5): 693-706.
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