Psychotherapy for youth depression is only modestly efficacious. Investigating treatment mediators may guide improvement. Among 46 randomized trials of cognitive behavioral therapy and interpersonal psychotherapy with depressed youths, 74% measured candidate mediators (CMs), but only 17% analyzed CMs as mediators. Although four significant CMs emerged, findings were sparse, conflicting, and clouded by methodological issues. We see enormous untapped opportunity in the ample data collected but not yet analyzed using recommended methods. We propose exploiting existing data using mediation meta-analysis, broadening the range of CMs and the rigor of assessments, making measurement longitudinal and idiographic to clarify temporal precedence of CMs over outcomes and detect individual differences, and markedly altering journal and funder policies to promote change process and mechanism research.

中文翻译：

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30 年的随机试验告诉我们心理治疗如何改善青少年抑郁症？对候选调解员的系统评价

对青少年抑郁症的心理治疗只是适度有效。调查治疗介质可能会指导改善。在 46 项针对抑郁青少年的认知行为治疗和人际心理治疗的随机试验中，74% 测量了候选调解员 (CMs)，但只有 17% 将 CMs 分析为调解员。尽管出现了四个重要的 CM，但研究结果稀少、相互矛盾，并且被方法问题所笼罩。我们在收集的大量数据中看到了巨大的未开发机会，但尚未使用推荐的方法进行分析。我们建议使用中介元分析来利用现有数据，扩大 CM 的范围和评估的严谨性，使测量纵向和具体，以澄清 CM 相对于结果的时间优先级并检测个体差异，