Stice Eric, Shaw Heather, Bohon Cara, Marti C Nathan, Rohde Paul
Oregon Research Institute, Eugene, Oregon 97403, USA.
J Consult Clin Psychol. 2009 Jun;77(3):486-503. doi: 10.1037/a0015168.
In this meta-analytic review, the authors summarized the effects of depression prevention programs for youth as well as investigated participant, intervention, provider, and research design features associated with larger effects. They identified 47 trials that evaluated 32 prevention programs, producing 60 intervention effect sizes. The average effect for depressive symptoms from pre-to-posttreatment (r = .15) and pretreatment to-follow-up (r = .11) were small, but 13 (41%) prevention programs produced significant reductions in depressive symptoms and 4 (13%) produced significant reductions in risk for future depressive disorder onset relative to control groups. Larger effects emerged for programs targeting high-risk individuals, samples with more females, samples with older adolescents, programs with a shorter duration and with homework assignments, and programs delivered by professional interventionists. Intervention content (e.g., a focus on problem-solving training or reducing negative cognitions) and design features (e.g., use of random assignment and structured interviews) were unrelated to effect sizes. Results suggest that depression prevention efforts produce a higher yield if they incorporate factors associated with larger intervention effects (e.g., selective programs with a shorter duration that include homework).
在这项荟萃分析综述中,作者总结了青少年抑郁症预防项目的效果,并调查了与较大效果相关的参与者、干预措施、提供者和研究设计特征。他们确定了47项评估32个预防项目的试验,得出了60个干预效应量。从治疗前到治疗后抑郁症状的平均效应(r = 0.15)以及从治疗前到随访的平均效应(r = 0.11)较小,但13个(41%)预防项目使抑郁症状显著减轻,4个(13%)项目相对于对照组使未来抑郁症发作风险显著降低。针对高危个体、女性比例更高的样本、年龄较大青少年的样本、持续时间较短且有家庭作业的项目以及由专业干预人员实施的项目,出现了更大的效果。干预内容(例如,侧重于问题解决训练或减少消极认知)和设计特征(例如,使用随机分配和结构化访谈)与效应量无关。结果表明,如果抑郁症预防工作纳入与较大干预效果相关的因素(例如,持续时间较短且包括家庭作业的选择性项目),则会产生更高的成效。