Effectiveness of depression and anxiety prevention in adolescents with high familial risk: study protocol for a randomized controlled trial

BMC Psychiatry

Ron HJ Scholte²  Jan MAM Janssens²  Daan HM Creemers¹  Sanne PA Rasing¹ 

[1]GGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, Netherlands

[2]Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, Netherlands

关键词: High risk;    Adolescents;    Anxiety;    Depression;    Selective;    Indicated;    Prevention;   

Others  :  1123880
DOI  :  10.1186/1471-244X-13-316

 received in 2013-11-18, accepted in 2013-11-20,  发布年份 2013

【 摘 要 】

Background

Depression and anxiety disorders during adolescence can have detrimental consequences. Both disorders are related to negative outcome in various areas during adolescence and are also predictive of depression and anxiety disorders later in life. Especially parental psychopathology and being female are risk factors that increase the probability of developing one of these disorders during adolescence. Research has shown that prevention programs have promising results, especially for adolescents who have these risk factors. Therefore, in this study, we will focus on the effectiveness of a prevention program ‘A jump forward’ that has been developed for adolescent girls with a familial risk of depression and/or anxiety.

Methods/Design

We designed a randomized controlled trial to test the effectiveness of an indicated and selective prevention program aimed at depression and anxiety in adolescent girls. Adolescents aged between 11 and 15 years old with depressive and/or anxiety symptoms and with parents who show indicators of parental psychopathology will be randomly assigned to the experimental (N = 80) or control groups (N = 80). Participants in the experimental group will follow a preventive intervention, consisting of six sessions of 90 minutes each. All participants will complete baseline, intervention phase 1 (after session 2), intervention phase 2 (after session 4), post-intervention, 6 month follow-up, and 12 month follow-up assessments. Furthermore, parents will be asked to complete assessments at baseline, post-intervention, and 12-month follow-up. Primary outcome will be depressive symptoms. Secondary outcomes will be anxiety symptoms, suicidal ideation, response style, negative cognitive errors, parental emotional support and parental control, parental psychopathology, parenting stress and adolescents’ depression and anxiety symptoms according to the parents.

Discussion

This paper described the study designed to evaluate a program for preventing depression and/or anxiety in high-risk adolescents over a 12-month follow-up period. If the program showed to be effective in reducing symptoms of depression and anxiety and preventing adolescents from developing clinical levels of these disorders, our results would be relevant to practice. Thus, the intervention could be used on a large scale. Moreover, this study aims to contribute to the evidence-based prevention of depression and anxiety of adolescents.

Trial registration

Dutch Trial Register NTR3720

【 授权许可】

   
2013 Rasing et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Costello EJ, Erkanli A, Angold A: Is there an epidemic of child or adolescent depression? J Child Psychol Psychiatry 2006, 47(12):1263-1271.
• [2]Albano AM, Chorpita BF, Barlow DH: Childhood anxiety disorders. In Child Psychopathology. 2nd edition. Edited by Mash EJ, Barkley RA. New York: Guilford; 2003:279-329.
• [3]Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE: Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 2005, 62(6):593-602.
• [4]Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, Perel J, Nelson B: Childhood and adolescent depression: a review of the past 10 years, Part I. J Am Acad Child Adolesc Psychiatry 1996, 35(11):1427-1439.
• [5]Strauss CC, Frame CL, Forehand R: Psychosocial impairment associated with anxiety in children. J Clin Child Psychol 1987, 16(3):235-239.
• [6]Fergusson DM, Woodward LJ: Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry 2002, 59(3):225-231.
• [7]Beesdo K, Knappe S, Pine DS: Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatr Clin North Am 2009, 32(3):483-524.
• [8]Lewinsohn PM, Solomon A, Seeley JR, Zeiss A: Clinical implications of “subthreshold” depressive symptoms. J Abnorm Psychol 2000, 109:345-351.
• [9]Aalto-Setala T, Marttunen M, Tuulio-Henriksson A, Poikolainen K, Lonnqvist J: Depressive symptoms in adolescence as predictors of early adulthood depressive disorders and maladjustment. Am J Psychiatr 2002, 159:1235-1237.
• [10]Lieb R, Isensee B, Hofler M, Pfister H, Wittchen HU: Parental major depression and the risk of depression and other mental disorders in offspring: a prospective-longitudinal community study. Arch Gen Psychiatry 2002, 59(4):365-374.
• [11]Bijl RV, Cuijpers P, Smit F: Psychiatric disorders in adult children of parents with a history of psychopathology. Soc Psychiatry Psychiatr Epidemiol 2002, 37(1):7-12.
• [12]Capps L, Sigman M, Sena R, Henker B, Whalen C: Fear, anxiety and perceived control in children of agoraphobic parents. J Child Psychol Psychiatry Allied Discip 1996, 37(4):445-452.
• [13]Van Dorsselaer S, De Graaf R, Verdurmen J, Van’t Land H, Ten Have M, Vollebergh W: Trimbos kerncijfers psychische stoornissen: resultaten van Nemesis [Trimbos key figures mental disorders: results of NEMESIS] (Netherlands Mental Health Survey and Incidence Study). Utrecht: Trimbos Institute; 2006.
• [14]Beidel DC, Turner SM: At risk for anxiety: I Psychopathology in the offspring of anxious parents. J Am Acad Child Adolesc Psychiatry 1997, 36(7):918-924.
• [15]Kashani JH, Vaidya AF, Soltys SM, Dandoy AC, Katz LM, Reid JC: Correlates of anxiety in psychiatrically hospitalized children and their parents. Am J Psychiatr 1990, 147(3):319-323.
• [16]Micco JA, Henin A, Mick E, Kim S, Hopkins CA, Biederman J, Hirshfeld-Becker DR: Anxiety and depressive disorders in offspring at high risk for anxiety: a meta-analysis. J Anxiety Disord 2009, 23(8):1158-1164.
• [17]Merikangas KR, Dierker LC, Szatmari P: Psychopathology among offspring of parents with substance abuse and/or anxiety disorders: a high-risk study. J Child Psychol Psychiatry Allied Discip 1998, 39(5):711-720.
• [18]Rice F: The genetics of depression in childhood and adolescence. Curr Psychiatry Rep 2009, 11(2):167-173.
• [19]Merikangas KR, Lieb R, Wittchen HU, Avenevoli S: Family and high-risk studies of social anxiety disorder. Acta Psychiatr Scand Suppl 2003, 417(417):28-37.
• [20]Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ: Generalized anxiety disorder in women. A population-based twin study. Arch Gen Psychiatry 1992, 49(4):267-272.
• [21]Ogliari A, Spatolaa CA, Pesenti-Gritti P, Meddac E, Pennac L, Stazi MA, Battagliaa M, Fagnanic C: The role of genes and environment in shaping co-occurence of DSM-IV defined anxiety dimensions among Italian twins aged 8-17. J Anxiety Disord 2010, 24:433-439.
• [22]Sullivan PF, Neale MC, Kendler KS: Genetic epidemiology of major depression: review and meta-analysis. Am J Psychiatr 2000, 157(10):1552-1562.
• [23]Eley TC: Contributions of behavioral genetics research: quantifying genetic, shared environmental and nonshared environmental influences. In The Developmental Psychopathology of Anxiety. Edited by Vasey MW, Dadds MR. New York: Oxford University Press; 2001:45-59.
• [24]Chaplin TM, Gillham J, Seligman MEP: Gender, anxiety, and depressive symptoms: a longitudinal study of early adolescents. J Early Adolesc 2009, 29(2):307-327.
• [25]De Graaf R, Ten Have M, Van Dorsselaer S: NEMESIS-2: De psychische gezondheid van de Nederlandse bevolking. Opzet en eerste resultaten. [The mental health of the Dutch population. NEMESIS-2: Design and the first results]. Trimbos Institute: Utrecht; 2010.
• [26]Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS: Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the national comorbidity survey. Arch Gen Psychiatry 1994, 51(1):8-19.
• [27]Nolen-Hoeksema S, Girgus JS: The emergence of gender differences in depression during adolescence. Psychol Bull 1994, 115:424-443.
• [28]Angold A, Erkanli A, Silberg J, Eaves L, Costello EJ: Depression scale scores in 8-17-year-olds: effects of age and gender. J Child Psychol Psychiatry Allied Discip 2002, 43(8):1052-1063.
• [29]Essau CA: Primary prevention of depression. In The Prevention of Anxiety and Depression: Theory, Research and Practice. Edited by Dozois DJA, Dobson KS. Washington, DC: American Psychological Association; 2004:185-204.
• [30]Cartwright-Hatton S, Roberts C, Chitsabesan P, Fothergill C, Harrington R: Systematic review of the efficacy of cognitive behaviour therapies for childhood and adolescent anxiety disorders. Br J Clin Psychol 2004, 43(4):421-436.
• [31]Wijnhoven LAMW, Creemers DHM, Vermulst AA, Scholte RHJ, Engels RCME: Randomized controlled trial testing the effectiveness of a depression prevention program (‘Op Volle Kracht’) among adolescent girls with elevated depressive symptoms. J Abnorm Child Psychol 2013, 1-12.
• [32]David-Ferdon C, Kaslow N: Evidence-based psychosocial treatments for child and adolescent depression. J Clin Child Adolesc Psychol 2008, 37(1):62-104.
• [33]Ishikawa S-i, Okajima I, Matsuoka H, Sakano Y: Cognitive behavioural therapy for anxiety disorders in children and adolescents: a meta-analysis. Child Adolesc Mental Health 2007, 12(4):164-172.
• [34]Sander JB, McCarty CA: Youth depression in the family context: familial risk factors and models of treatment. Clin Child Fam Psychol Rev 2005, 8(3):203-219.
• [35]Beardslee WR, Gladstone TR, Wright EJ, Cooper AB: A family-based approach to the prevention of depressive symptoms in children at risk: evidence of parental and child change. Pediatrics 2003, 112(2):e119-e131.
• [36]Clarke GN, Hornbrook M, Lynch F, Polen M, Gale J, Beardslee W, O’Connor E, Seeley J: A randomized trial of a group cognitive intervention for preventing depression in adolescent offspring of depressed parents. Arch Gen Psychiatry 2001, 58(12):1127-1134.
• [37]Garber J, Clarke GN, Weersing VR, Beardslee WR, Brent DA, Gladstone TR, DeBar LL, Lynch FL, D’Angelo E, Hollon SD, et al.: Prevention of depression in at-risk adolescents: a randomized controlled trial. JAMA 2009, 301(21):2215-2224.
• [38]Ginsburg GS: The child anxiety prevention study: intervention model and primary outcomes. J Consult Clin Psychol 2009, 77(3):580-587.
• [39]Axelson DA, Birmaher B: Relation between anxiety and depressive disorders in childhood and adolescence. Depress Anxiety 2001, 14:67-78.
• [40]Cole DA, Peeke LG, Martin JM, Truglio R, Seroczynski AD: A longitudinal look at the relation between depression and anxiety in children and adolescents. J Consult Clin Psychol 1998, 66:451-460.
• [41]Reardon JM, Williams NL: The specificity of cognitive vulnerabilities to emotional disorders: anxiety sensitivity, looming vulnerability and explanatory style. J Anxiety Disord 2007, 21(5):625-643.
• [42]Hoek W: Subclinical Depression and Anxiety in Adolescence: Developmental Trajectories and Online Intervention (Doctoral Dissertation). Amsterdam: Faculty of Psychology and Education, Vrije Universiteit; 2012.
• [43]Dozois DJA, Seeds PM, Collins KA: Transdiagnostic approaches to the prevention of depression and anxiety. J Cognitive Psychother 2009, 23:44-59.
• [44]Mrazek PJ, Haggerty RJ: Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. Washington: National Academy Press; 1994.
• [45]Schulz KF, Altman DG, Moher D, Group C: CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. Trials 2010, 11(32):32.
• [46]Horowitz JL, Garber J: The prevention of depressive symptoms in children and adolescents. A meta analytic review. J Consult Clin Psy 2006, 74:401-415.
• [47]Kovacs M: Children’s Depression Inventory 2 (CDI 2). Multi-Health Systems: North Tonawanda, NY; 2012.
• [48]Bae Y: Test Review: Children’s Depression Inventory 2 (CDI 2). J Psychoeduc Assess 2012, 30(4):304-308.
• [49]Spence SH: Structure of anxiety symptoms among children: a confirmatory factor-analytic study. J Abnorm Psychol 1997, 106(2):280-297.
• [50]Spence SH: A measure of anxiety symptoms among children. Behav Res Ther 1998, 36(5):545-566.
• [51]Spence SH, Barrett PM, Turner CM: Psychometric properties of the spence children’s anxiety scale with young adolescents. J Anxiety Disord 2003, 17(6):605-625.
• [52]Abela JR, Brozina K, Haigh EP: An examination of the response styles theory of depression in third- and seventh-grade children: a short-term longitudinal study. J Abnorm Child Psychol 2002, 30(5):515-527.
• [53]Maric M, Heyne DA, van Widenfelt BM, Westenberg P: Distorted cognitive processing in youth: the structure of negative cognitive errors and their associations with anxiety. Cogn Ther Res 2011, 35(1):11-20.
• [54]Leitenberg H, Yost LW, Carroll-Wilson M: Negative errors in children: quenstionnaire development, normative data, and comparisons between children with and without self-reported symptoms of depression, low self-esteem, and evaluation anxiety. J Consult Clin Psychol 1986, 54:528-536.
• [55]Scholte RHJ, Van Lieshout CFM, Van Aken MAG: Perceived relational support in adolescence: dimensions, configurations, and adolescent adjustment. J Res Adolesc 2001, 11:71-94.
• [56]Derogatis LR: The Brief Symptom Inventory. Clinical Psychometric Research: Baltimore (MD); 1975.
• [57]Derogatis LR: The Symptom Checklist-90-R. Clinical Psychometric Research: Baltimore (MD); 1975.
• [58]Derogatis LR, Melisaratos N: The brief symptom inventory: an introductory report. Psychol Med 1983, 13(3):595-605.
• [59]De Beurs E, Zitman F: De Brief Symptom Inventory (BSI). De betrouwbaarheid en validiteit van een handzaam alternatief voor de SCL-90 [The Brief Symptom Inventory. The reliability and validity of a practical alternative to SCL-90 ]. Maandblad Geestelijke Volksge 2005, 61(2):120.
• [60]Vermulst AAKG, De Meyer RE, Nguyen L, Veerman JW: OOHNP: Opvoedingsbelastingvragenlijst (OBVL) [Parenting stress questionnaire]. Nijmegen: Praktikon; 2012.
• [61]Nauta MH, Scholing A, Rapee RM, Abbott M, Spence SH, Waters A: A parent-report measure of children’s anxiety: psychometric properties and comparison with child-report in a clinic and normal sample. Behav Res Ther 2004, 42(7):813-839.