ABSTRACT

Objective

The aim of this study was to investigate age group, gender, and baseline depressive symptom severity as possible effect moderators in (1) cognitive versus behavioral based CBT-modules and (2) sequences of modules that started either with cognitive or behavioral modules in indicated depression prevention in adolescents.

Method

We conducted a pragmatic cluster-randomized trial under four parallel conditions. Each condition consisted of four CBT-modules of three sessions (cognitive restructuring, problem solving, behavioral activation, relaxation), but the sequencing of modules differed. The CBT-modules and sequences were clustered into more cognitive versus more behavioral based approaches. The sample involved 282 Dutch adolescents with elevated depressive symptoms (Mage = 13.8; 55.7% girls, 92.9% Dutch). Assessments were conducted at baseline, after three sessions, at post-intervention and 6-month follow-up with self-reported depressive symptoms as the primary outcome.

Results

We found no evidence for substantial moderation effects. Age group, gender, and depressive symptom severity level at baseline did not moderate the effects of cognitive versus behavioral modules after three sessions. No evidence was also found that these characteristics moderated the effectiveness of sequences of modules that started either with cognitive or behavioral modules at post-intervention and 6-month follow-up.

Conclusion

Cognitive and behavioral based modules and sequences in the prevention of depression in adolescents might apply to a relatively wide range of adolescents in terms of age group, gender, and severity levels of depressive symptoms.

Abbreviation: CDI-2:F: Children’s Depression Inventory-2 Full-length version; CDI-2:S: Children’s Depression Inventory-2 Short version; STARr: Solve, Think, Act, Relax, and repeat

中文翻译：

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评估基于认知与行为的 CBT 模块和序列中预防青少年抑郁症的效果调节因素

摘要

客观的

本研究的目的是调查年龄组、性别和基线抑郁症状严重程度作为以下方面可能的影响调节因素：(1) 基于认知与行为的 CBT 模块和 (2) 以认知或行为模块开始的模块序列青少年抑郁症的预防。

方法

我们在四个平行条件下进行了务实的整群随机试验。每个条件由三个会话的四个 CBT 模块组成（认知重建、问题解决、行为激活、放松），但模块的顺序不同。CBT 模块和序列被分为更多基于认知的方法和更多基于行为的方法。该样本涉及 282 名患有严重抑郁症状的荷兰青少年（Mage = 13.8；55.7% 为女孩，92.9% 为荷兰人）。在基线、三个疗程后、干预后和 6 个月随访时进行评估，以自我报告的抑郁症状作为主要结果。

结果

我们没有发现任何证据表明存在显着的调节效应。基线时的年龄组、性别和抑郁症状严重程度在三个疗程后并没有调节认知模块与行为模块的影响。还没有发现证据表明这些特征会在干预后和 6 个月的随访中调节以认知或行为模块开始的模块序列的有效性。

结论

预防青少年抑郁症的基于认知和行为的模块和顺序可能适用于相对广泛的青少年，包括年龄组、性别和抑郁症状的严重程度。

缩写： CDI-2:F：儿童抑郁量表-2 完整版；CDI-2:S：儿童抑郁量表-2简版；STARr：解决、思考、行动、放松和重复