University of New South Wales, Sydney, NSW, Australia.
The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia.
Psychol Med. 2023 Aug;53(11):5042-5051. doi: 10.1017/S0033291722002033. Epub 2022 Jul 15.
Lifetime trajectories of mental ill-health are often established during adolescence. Effective interventions to prevent the emergence of mental health problems are needed. In the current study we assessed the efficacy of the cognitive behavioural therapy (CBT)-informed universal eHealth preventive mental health programme, relative to a control. We also explored whether the intervention had differential effects on students with varying degrees of social connectedness.
We evaluated the efficacy of the mental health programme (19 participating schools; average age at baseline was 13.6) a control group (18 participating schools; average age at baseline was 13.5) which formed part of a large cluster randomised controlled trial in Australian schools. Measures of internalising problems, depression and anxiety were collected at baseline, immediately following the intervention and at 6-, 12- and 18-months post intervention. Immediately following the intervention, 2539 students provided data on at least one outcome of interest (2065 students at 18 months post intervention).
Compared to controls, we found evidence that the standalone mental health intervention improved knowledge of mental health, however there was no evidence that the intervention improved other mental health outcomes, relative to a control. Student's social connectedness did not influence intervention outcomes.
These results are consistent with recent findings that universal school-based, CBT-informed, preventive interventions for mental health have limited efficacy in improving symptoms of anxiety and depression when delivered alone. We highlight the potential for combined intervention approaches, and more targeted interventions, to better improve mental health outcomes.
精神健康问题的终身轨迹通常在青少年时期形成。需要有效的干预措施来预防心理健康问题的出现。在当前的研究中,我们评估了基于认知行为疗法(CBT)的通用电子心理健康预防计划相对于对照组的效果。我们还探讨了该干预措施对社交联系程度不同的学生是否具有不同的效果。
我们评估了心理健康计划(19 所参与学校;基线平均年龄为 13.6 岁)的效果,该计划是澳大利亚学校一项大型集群随机对照试验的一部分,对照组(18 所参与学校;基线平均年龄为 13.5 岁)。在基线、干预后立即以及干预后 6、12 和 18 个月收集了内化问题、抑郁和焦虑的测量结果。在干预后立即,有 2539 名学生提供了至少一项感兴趣的结果的数据(2065 名学生在干预后 18 个月)。
与对照组相比,我们有证据表明,独立的心理健康干预提高了对心理健康的认识,但没有证据表明该干预相对于对照组改善了其他心理健康结果。学生的社交联系程度并没有影响干预结果。
这些结果与最近的发现一致,即单独提供的基于学校的、基于 CBT 的通用心理健康预防干预措施,在改善焦虑和抑郁症状方面效果有限。我们强调了联合干预方法和更有针对性的干预措施的潜力,以更好地改善心理健康结果。