ABSTRACT

Objective

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.

Method

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.

Results

Matched adolescents reported fewer dependent stressors during the post-intervention follow-up period (d = .46, p = .002) and from baseline through 18-months post-intervention (d = .35, p = .02) compared to mismatched youth. As expected, there were no differences between matched and mismatched youth on the experience of independent stressors.

Conclusions

These findings further highlight the potential of personalized approaches to depression prevention and demonstrate benefits that go beyond depression symptom reduction.

中文翻译：

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个性化抑郁症预防可减少青少年的依赖性压力源：随机对照试验的结果

 抽象的

 客观的

抑郁和压力源在青春期都会增加。压力产生模型假设抑郁症状和相关的损伤会导致依赖性压力源的产生。青少年抑郁症预防计划已被证明可以降低抑郁症的风险。最近，已采用风险告知的个性化方法来提高抑郁症预防的功效，初步证据支持个性化预防对抑郁症症状的有益作用。鉴于抑郁症和压力之间的密切联系，我们检验了这样的假设：个性化抑郁症预防计划将减少青少年在纵向随访中经历的依赖性压力源（人际和非人际）。

 方法

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预防计划或人际预防计划。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的类别。一半的青少年接受了与其风险状况相匹配的预防计划（例如，将高认知风险随机分配到认知行为预防）；一半接受了不匹配的计划（例如，将高人际风险随机分配到认知行为预防）。在 18 个月的随访期内，对依赖和独立压力源的暴露情况进行了反复评估。

 结果

与不匹配的青少年相比，匹配的青少年在干预后随访期间 ( d = .46， p = .002) 以及从基线到干预后 18 个月 ( d = .35， p = .02) 报告的依赖性压力源较少青年。正如预期的那样，匹配和不匹配的年轻人在独立压力源的体验上没有差异。

 结论

这些发现进一步强调了个性化方法预防抑郁症的潜力，并证明其益处不仅仅限于减轻抑郁症状。