Jones Jason D, Long Erin E, Hankin Benjamin L, Gallop Robert, Davis Molly, Young Jami F
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia.
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine.
J Clin Child Adolesc Psychol. 2025 Jan-Feb;54(1):113-126. doi: 10.1080/15374416.2023.2188562. Epub 2023 Mar 20.
Depression and stressors both increase during adolescence. The stress generation model posits that depression symptoms and associated impairment contribute to the generation of dependent stressors. Adolescent depression prevention programs have been shown to reduce the risk of depression. Recently, risk-informed personalization approaches have been adopted to enhance the efficacy of depression prevention, and preliminary evidence supports the beneficial effects of personalized prevention on depression symptoms. Given the close association between depression and stress, we examined the hypothesis that personalized depression prevention programs would reduce adolescents' experience of dependent stressors (interpersonal and non-interpersonal) over longitudinal follow-up.
The present study included 204 adolescents (56% girls, 29% racial minority) who were randomized to receive either a cognitive-behavioral or an interpersonal prevention program. Youth were categorized as high or low on cognitive and interpersonal risk using a previously established risk classification system. Half of the adolescents received a prevention program that matched their risk profile (e.g., high cognitive risk randomized to cognitive-behavioral prevention); half received a mismatched program (e.g., high interpersonal risk randomized to cognitive-behavioral prevention). Exposure to dependent and independent stressors was assessed repeatedly over an 18-month follow-up period.
Matched adolescents reported fewer dependent stressors during the post-intervention follow-up period ( = .46, = .002) and from baseline through 18-months post-intervention ( = .35, = .02) compared to mismatched youth. As expected, there were no differences between matched and mismatched youth on the experience of independent stressors.
These findings further highlight the potential of personalized approaches to depression prevention and demonstrate benefits that go beyond depression symptom reduction.
抑郁和压力源在青少年时期都会增加。压力产生模型认为，抑郁症状及相关损害会导致依赖性压力源的产生。青少年抑郁预防项目已被证明可降低抑郁风险。最近，采用了基于风险的个性化方法来提高抑郁预防的效果，初步证据支持个性化预防对抑郁症状的有益影响。鉴于抑郁与压力之间的密切关联，我们检验了以下假设：在纵向随访中，个性化抑郁预防项目将减少青少年经历的依赖性压力源（人际和非人际压力源）。
本研究纳入了204名青少年（56%为女孩，29%为少数族裔），他们被随机分配接受认知行为或人际预防项目。使用先前建立的风险分类系统，将青少年分为认知和人际风险高或低两类。一半青少年接受与其风险特征相匹配的预防项目（例如，高认知风险者被随机分配到认知行为预防组）；另一半接受不匹配的项目（例如，高人际风险者被随机分配到认知行为预防组）。在18个月的随访期内，对依赖性和独立性压力源的暴露情况进行了多次评估。
与不匹配的青少年相比，匹配的青少年在干预后随访期（ = 0.46， = 0.002）以及从基线到干预后18个月（ = 0.35， = 0.02）报告的依赖性压力源较少。正如预期的那样，匹配和不匹配的青少年在独立性压力源的经历上没有差异。
这些发现进一步凸显了个性化抑郁预防方法的潜力，并证明了其益处不仅限于减少抑郁症状。
