Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA.
University of Minnesota, Minneapolis, MN, USA.
J Abnorm Child Psychol. 2020 Oct;48(10):1351-1365. doi: 10.1007/s10802-020-00682-z.
Adolescent girls are at heightened risk of depression, and because adolescent depression may initiate a negative developmental cascade, intervention early in adolescence has potential for altering a negative developmental trajectory. Identifying risk factors that impact response to intervention may inform decisions about the type of treatment to provide for adolescent girls with depression. Understanding moderators of outcomes in evidence-based treatment is critical to the delivery of timely and effective interventions. Matching patients effectively with optimal intervention will not only expedite the alleviation of patients' distress, but will also reduce unnecessary time and resources spent on less advantageous interventions. The current investigation examines the efficacy of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) in a racially and ethnically diverse sample of 120 low-income adolescent girls age 13-15 with and without histories of child maltreatment. Adolescent and parent report of depressive symptoms were assessed at the beginning and end of treatment and a diagnosis of subsyndromal symptoms of depression or depression were required for purposes of inclusion. Results indicated that among adolescent girls who had experienced two or more subtypes of maltreatment, IPT-A was found to be more efficacious than Enhanced Community Standard (ECS) treatment. Importantly, when the subtype of maltreatment experienced was further probed, among girls with a history of sexual abuse, we found preliminary evidence that IPT-A was significantly more effective than ECS in reducing depressive symptoms, and the effect size was large. Thus, if a history of maltreatment is present, especially including sexual abuse, specifically addressing the interpersonal context associated with depressive symptoms may be necessary.
青春期女孩患抑郁症的风险较高，而且由于青春期抑郁症可能引发负面的发展轨迹，因此在青春期早期进行干预有可能改变这种负面的发展轨迹。确定影响干预反应的风险因素可能有助于决定为患有抑郁症的青春期女孩提供哪种治疗方法。了解基于证据的治疗结果的调节因素对于及时有效的干预措施的提供至关重要。有效地将患者与最佳干预措施相匹配不仅可以加快患者痛苦的缓解，而且还可以减少在效果较差的干预措施上不必要的时间和资源浪费。目前的研究调查了人际心理治疗对抑郁青少年（IPT-A）在一个种族和民族多样化的 120 名低收入 13-15 岁青少年女孩样本中的疗效，这些女孩有或没有儿童虐待史。在治疗开始和结束时，对青少年和家长报告的抑郁症状进行评估，并要求出现亚综合征症状性抑郁或抑郁的诊断，以作为纳入标准。结果表明，在经历了两种或多种虐待亚型的青春期女孩中，IPT-A 比增强社区标准（ECS）治疗更有效。重要的是，当进一步探究所经历的虐待亚型时，对于有性虐待史的女孩，我们发现初步证据表明，IPT-A 在降低抑郁症状方面比 ECS 更有效，且效果显著。因此，如果存在虐待史，特别是包括性虐待史，则特别需要解决与抑郁症状相关的人际环境。
