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Negative life events and substance use moderate cognitive behavioral adolescent depression prevention intervention.

ABSTRACT: Investigate factors that amplify or mitigate the effects of an indicated cognitive behavioral (CB) depression prevention program for adolescents with elevated depressive symptoms. Using data from a randomized trial (Registration No. NCT00183417; n = 173) in which adolescents (M age=15.5, SD=1.2) were assigned to a brief cognitive behavioral prevention program or an educational brochure control condition, we tested whether elevated motivation to reduce depression and initial depressive symptom severity amplified intervention effects and whether negative life events, social support deficits, and substance use attenuated intervention effects. Hierarchical linear modeling (HLM) indicated differential intervention effects for two of the five examined variables: negative life events and substance use. For adolescents at low and medium levels of substance use or negative life events, the CB intervention produced declines in depressive symptoms relative to controls. However, at high levels of substance use or negative life events, the CB intervention did not significantly reduce depressive symptoms in comparison to controls. Results imply that high-risk adolescents with either high rates of major life stress or initial substance use may require specialized depression prevention efforts.

SUBMITTER: Gau JM

PROVIDER: S-EPMC3577375 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Negative life events and substance use moderate cognitive behavioral adolescent depression prevention intervention.

Gau Jeff M JM Stice Eric E Stice Eric E Rohde Paul P Seeley John R JR

Cognitive behaviour therapy 20120313 3

Investigate factors that amplify or mitigate the effects of an indicated cognitive behavioral (CB) depression prevention program for adolescents with elevated depressive symptoms. Using data from a randomized trial (Registration No. NCT00183417; n = 173) in which adolescents (M age=15.5, SD=1.2) were assigned to a brief cognitive behavioral prevention program or an educational brochure control condition, we tested whether elevated motivation to reduce depression and initial depressive symptom se ...[more]

PMID: 22414236

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Project description:Previous studies have demonstrated an association between negative life events (NLEs) in childhood and resilience/posttraumatic growth (PTG) with regard to the pathogenesis of major depressive disorder. We hypothesized that the type and timing of NLEs interact to influence mental health in the general youth population. Therefore, the present study aimed to examine the effects of NLE timing and intensity on current depressive symptoms, and to determine the direct and indirect effects of NLEs/resilience on PTG and depression among non-clinical adolescents. Data were collected from 1,038 high-school students across seven high schools in Fukui, Japan, during their freshman and sophomore years (648 boys and 390 girls, mean age = 15.71, SD = 0.524). Respondents completed a set of questionnaires designed to evaluate the type and timing of NLEs, depressive and traumatic symptoms, and PTG. Cluster analysis was used to divide participants into three groups based on outcomes: "cluster 1" (n = 631), for whom depressive scores were significantly lower than other two subgroups (p < 0.05, for both); "cluster 2" (n = 52), for whom levels of current and past perceived stress associated with NLEs were significantly higher than those of the other two subgroups (p < 0.05, for both); "cluster 3" (n = 374), for whom perceived stress at the time of NLE was significantly higher than that of participants in the cluster 1 (p < 0.05) group, but not the cluster 2 group. Our findings indicated that exposure to NLEs at a younger age resulted in stronger negative outcomes and that NLE timing and intensity were associated with PTG and current symptoms of depression. Furthermore, path analysis demonstrated that associations between perceived stress at the time of NLEs were direct and indirect predictors of current depression via PTG and that posttraumatic stress symptom and PTG mediate the association between NLEs/trait-resiliency and current depression. In conclusion, our findings suggest that event intensity, NLE timing, and gender may play a role in emotional vulnerability during adolescence.

Dataset Information

Negative life events and substance use moderate cognitive behavioral adolescent depression prevention intervention.

Publications

Negative life events and substance use moderate cognitive behavioral adolescent depression prevention intervention.

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