Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, and PolicyLab Children's Hospital of Philadelphia.
Department of Mathematics, West Chester University.
J Clin Child Adolesc Psychol. 2021 Mar-Apr;50(2):202-214. doi: 10.1080/15374416.2019.1644648. Epub 2019 Aug 20.
Several adolescent depression prevention programs have demonstrated effects on depressive symptoms and overall functioning. Yet, despite an increasing emphasis on elucidating mechanisms of change in interventions, few studies have identified mediators of these preventive interventions. In this study, we examined interpersonal mediators of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), an evidence-based depression prevention program. The Depression Prevention Initiative is a school-based randomized controlled trial in which 186 adolescents ( age = 14.01, = 1.22; 66.7% female; 32.2% racial minority) were assigned to receive either IPT-AST ( = 95) or Group Counseling (GC) ( = 91). We examined whether change in interpersonal conflict, social support, or social functioning from baseline to midintervention mediated the effects of IPT-AST on depressive symptoms and overall functioning at postintervention. At postintervention, youth in IPT-AST had lower depressive symptoms ( = -.31) and higher overall functioning scores ( = .32) than youth in GC. Improvements in adolescent romantic functioning, reductions in peer conflict, and improvements in a factor score reflecting mother-adolescent conflict and difficulties in family functioning emerged as significant mediators. However, the effects of the intervention on change in the mediators were not statistically significant. These findings add to the sparse literature on mediators of psychosocial interventions, provide partial support for the theoretical mechanisms underlying change in IPT-AST, and highlight important directions for future prevention and intervention research.
几项青少年抑郁预防计划已证明对抑郁症状和整体功能有影响。然而,尽管越来越强调阐明干预措施变化的机制,但很少有研究确定这些预防干预措施的中介因素。在这项研究中,我们检查了人际心理治疗-青少年技能培训(IPT-AST)的人际中介因素,IPT-AST 是一种基于证据的预防抑郁的方案。抑郁预防计划是一项基于学校的随机对照试验,其中 186 名青少年(年龄 = 14.01, = 1.22;66.7%为女性;32.2%为少数族裔)被分配接受IPT-AST( = 95)或团体咨询(GC)( = 91)。我们研究了从基线到中期干预期间人际冲突、社会支持或社会功能的变化是否中介了 IPT-AST 对干预后抑郁症状和整体功能的影响。在干预后,IPT-AST 组的青少年抑郁症状( = -.31)和整体功能评分( =.32)均低于 GC 组。青少年浪漫关系功能的改善、同伴冲突的减少以及反映母子冲突和家庭功能障碍的因素得分的提高,成为重要的中介因素。然而,干预对中介变化的影响在统计学上并不显著。这些发现增加了关于心理社会干预中介因素的文献,为 IPT-AST 变化背后的理论机制提供了部分支持,并突出了未来预防和干预研究的重要方向。