Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, Michigan 48109, USA.
J Consult Clin Psychol. 2009 Dec;77(6):1042-54. doi: 10.1037/a0017671.
The purpose of this review was to evaluate whether the Penn Resiliency Program (PRP), a group cognitive-behavioral intervention, is effective in targeting depressive symptoms in youths. We identified 17 controlled evaluations of PRP (N = 2,498) in which depressive symptoms had been measured via an online search of PsycINFO, Medline, ERIC, and ProQuest Dissertations and Theses and by requesting data from PRP researchers. We combined effect sizes (ESs; Glass's d), using random effects models at postintervention and two follow-up assessments (6-8 and 12 months postintervention). PRP participants reported fewer depressive symptoms at postintervention and both follow-up assessments compared with youths receiving no intervention, with ESs ranging from 0.11 to 0.21. Subgroup analyses showed that PRP's effects were significant at 1 or more follow-up assessments among studies with both targeted and universal approaches, when group leaders were research team members and community providers, among participants with both low and elevated baseline symptoms, and among boys and girls. Limited data showed no evidence that PRP is superior to active control conditions. Preliminary analyses suggested that PRP's effects on depressive disorders may be smaller than those reported in a larger meta-analysis of depression prevention programs for older adolescents and adults. We found evidence that PRP significantly reduces depressive symptoms through at least 1-year postintervention. Future PRP research should examine whether PRP's effects on depressive symptoms lead to clinically meaningful benefits for its participants, whether the program is cost-effective, whether CB skills mediate program effects, and whether PRP is effective when delivered under real-world conditions.
本综述旨在评估宾夕法尼亚韧性计划（PRP），一种团体认知行为干预，是否能有效针对青少年的抑郁症状。我们通过在 PsycINFO、Medline、ERIC 和 ProQuest Dissertations and Theses 上进行在线搜索，并通过向 PRP 研究人员请求数据，确定了 17 项针对 PRP 的对照评估（N=2498），其中通过在线搜索和请求数据评估了抑郁症状。我们采用随机效应模型，在干预后和两次随访评估（干预后 6-8 个月和 12 个月）时对效应大小（ES；Glass 的 d）进行了合并。与未接受干预的青少年相比，PRP 参与者在干预后和两次随访评估中报告的抑郁症状更少，ES 范围为 0.11 至 0.21。亚组分析表明，在针对目标人群和普遍人群的研究中，在由研究团队成员和社区提供者担任团体领导者的研究中，在基线症状较低和较高的参与者中，以及在男孩和女孩中，PRP 的效果在一次或多次随访评估中均具有统计学意义。有限的数据表明，PRP 并不优于积极对照条件。初步分析表明，PRP 对抑郁障碍的影响可能小于对年龄较大青少年和成年人的抑郁预防计划的更大荟萃分析中报告的影响。我们有证据表明，PRP 通过至少 1 年的干预后显著降低抑郁症状。未来的 PRP 研究应检验 PRP 对抑郁症状的影响是否会给参与者带来临床意义上的益处，该计划是否具有成本效益，CB 技能是否介导计划效果，以及 PRP 在现实条件下是否有效。
