Dahlqvist Heléne Zetterström, Landstedt Evelina, Gådin Katja Gillander
Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden;
Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
Int J Circumpolar Health. 2015 Nov 3;74:29805. doi: 10.3402/ijch.v74.29805. eCollection 2015.
Adolescents are a vulnerable group when it comes to the risk of developing depression. Preventing the onset of depressive episodes in this group is therefore a major public health priority. In the last decades, school-based cognitive-behavioural interventions have been a common primary prevention approach. However, evidence on what girls actually are allocated to such interventions when no researchers are involved is scarce.
To explore how a selective cognitive-behavioural program (Depression In Swedish Adolescents) developed to prevent depression in adolescents, was implemented in a naturalistic setting in schools in northern part of Sweden. The focus was on characteristics of participants allocated to the intervention.
Cross-sectional baseline data on depressive symptoms, school environment and socio-economic factors were collected in 2011 by means of questionnaires in schools in a municipality in the northern part of Sweden. Intervention participants were identified in a follow-up questionnaire in 2012. Students (n=288) included in the analyses were in the ages of 14-15.
Sixty-six girls and no boys were identified as intervention participants. They reported higher levels of depressive symptoms, lower personal relative affluence, more sexual harassment victimization and less peer support compared to female non-participants (n=222). Intervention participants were more likely to attend schools with a higher proportion of low parental education levels and a lower proportion of students graduating with a diploma.
The developers of the intervention originally intended the program to be universal or selective, but it was implemented as targeted in these schools. It is important for school administrations to adhere to program fidelity when it comes to what students it is aimed for. Implications for effectivenss trials of cognitive-behavioural interventions in the school setting is discussed.
青少年是患抑郁症风险的弱势群体。因此，预防该群体抑郁发作是一项重大公共卫生优先事项。在过去几十年中，基于学校的认知行为干预一直是常见的一级预防方法。然而，关于在没有研究人员参与的情况下女孩实际被分配到此类干预措施的证据很少。
探讨为预防青少年抑郁症而制定的选择性认知行为项目（瑞典青少年抑郁症项目）如何在瑞典北部学校的自然环境中实施。重点是分配到干预措施的参与者的特征。
2011年，通过瑞典北部一个市镇学校的问卷调查收集了关于抑郁症状、学校环境和社会经济因素的横断面基线数据。2012年通过后续问卷调查确定了干预参与者。纳入分析的学生（n = 288）年龄在14 - 15岁之间。
确定66名女孩为干预参与者，没有男孩。与未参与干预的女性（n = 222）相比，她们报告的抑郁症状水平更高、个人相对富裕程度更低、遭受性骚扰更多且同伴支持更少。干预参与者更有可能就读于父母低教育水平比例较高且毕业获得文凭的学生比例较低的学校。
干预措施的开发者最初打算该项目具有普遍性或选择性，但在这些学校中实施时却成为了针对性的。学校管理部门在针对哪些学生实施项目时坚持项目保真度很重要。讨论了对学校环境中认知行为干预有效性试验的影响。
