Department of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th St., Ste. 110, Seattle, WA, 98115, USA.
Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, 98101, USA.
Prev Sci. 2019 May;20(4):499-509. doi: 10.1007/s11121-019-01005-5.
This study examined the impact of a school-based indicated prevention program on depression and anxiety symptoms for youth during the transition from middle to high school. The High School Transition Program (HSTP) was designed to build social and academic problem-solving skills and engagement during this period of particular vulnerability for adolescents. Students (N = 2664) at six middle schools in the Pacific Northwest completed a universal emotional health screening during the second half of the 8th grade year, and those with elevated depression scores and low conduct problem scores were invited to participate in the trial. Eligible students (N = 497) were randomized to either the HSTP (N = 241) or control (N = 256) conditions. Depression and anxiety symptoms were measured at five time points over an 18-month period using validated self-report measures. Hierarchical linear modeling was used to assess prevention effects and moderators such as baseline symptoms, race, and sex. Results suggested that students randomized to the HSTP group had accelerated rate of reduction in depressive symptoms over time (d = .23) relative to the control group. Students randomized to the HSTP group also had significantly faster rates of change of anxiety scores (d = 0.25). Baseline anxiety severity, race, and sex did not differentially impact the trajectories of symptom outcomes between conditions. Implications for prevention efforts during this normative but stressful period of transition for youth are discussed. ClinicalTrials.gov registration number is NCT00071513.
本研究考察了一项基于学校的有针对性预防计划对青少年从初中过渡到高中期间抑郁和焦虑症状的影响。高中过渡计划（HSTP）旨在培养社交和学术问题解决技能，并在青少年特别脆弱的这段时间提高参与度。太平洋西北地区的六所中学的学生（N=2664）在八年级下半年完成了一次普遍的情绪健康筛查，那些抑郁分数升高且品行问题分数较低的学生被邀请参加试验。符合条件的学生（N=497）被随机分配到 HSTP（N=241）或对照组（N=256）。在 18 个月的时间里，使用经过验证的自我报告措施，在五个时间点测量抑郁和焦虑症状。分层线性模型用于评估预防效果和调节因素，如基线症状、种族和性别。结果表明，与对照组相比，随机分配到 HSTP 组的学生随着时间的推移，抑郁症状的缓解速度更快（d=0.23）。随机分配到 HSTP 组的学生焦虑评分的变化速度也明显更快（d=0.25）。基线焦虑严重程度、种族和性别并没有对不同条件下症状结果的轨迹产生差异影响。讨论了在这个对青年来说正常但压力大的过渡时期进行预防工作的意义。临床试验注册号为 NCT00071513。
