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Two-Year Impact of Prevention Programs on Adolescent Depression: an Integrative Data Analysis Approach

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Abstract

This paper presents the first findings of an integrative data analysis of individual-level data from 19 adolescent depression prevention trials (n = 5210) involving nine distinct interventions across 2 years post-randomization. In separate papers, several interventions have been found to decrease the risk of depressive disorders or elevated depressive/internalizing symptoms among youth. One type of intervention specifically targets youth without a depressive disorder who are at risk due to elevated depressive symptoms and/or having a parent with a depressive disorder. A second type of intervention targets two broad domains: prevention of problem behaviors, which we define as drug use/abuse, sexual risk behaviors, conduct disorder, or other externalizing problems, and general mental health. Most of these latter interventions improve parenting or family factors. We examined the shared and unique effects of these interventions by level of baseline youth depressive symptoms, sociodemographic characteristics of the youth (age, sex, parent education, and family income), type of intervention, and mode of intervention delivery to the youth, parent(s), or both. We harmonized eight different measures of depression utilized across these trials and used growth models to evaluate intervention impact over 2 years. We found a significant overall effect of these interventions on reducing depressive symptoms over 2 years and a stronger impact among those interventions that targeted depression specifically rather than problem behaviors or general mental health, especially when baseline symptoms were high. Implications for improving population-level impact are discussed.

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Acknowledgments

We gratefully acknowledge the National Institute of Mental Health Collaborative Synthesis for Adolescent Depression Trials Study Team, comprising our many colleagues who generously provided their data to be used in this study, obtained access to key datasets, reviewed coding decisions, provided substantive or methodologic recommendations, and reviewed this manuscript. We also thank NIMH for their support through grant number R01MH040859 (Collaborative Synthesis for Adolescent Depression Trials, Brown PI), and the following grants: Garber, Brent, Beardslee, Clarke et al.—NIMH MH064735, MH064503, MH064717; Gillham et al.—NIMH MH52270; Garber et al.—William T. Grant Foundation 961730; Dishion et al.—NIDA DA07031 and DA13773; Szapocznik et al.—NIMH MH61143; Pantin et al.—NIDA DA017462; Prado et al.—NIDA DA025894; Prado et al.—CDC U01PS000671; Stormshak et al.—NIDA DA018374; Sandler et al.—NIMH MH49155; Wolchik et al.—NIMH MH068685; Young et al.—NARSAD; Spoth et al.—NIDA DA 007029; Clarke et al.—NIMH MH 48118; Young et al.—NIMH MH071320; Beardslee et al.—NIMH MH48696; VanVoorhees et al.—NIMH MH072918; and Gonzales et al.—NIMH MH64707. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies or that of our collaborators who provided access to their data.

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Authors and Affiliations

  1. Departments of Psychiatry and Behavioral Sciences, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    C. Hendricks Brown, Gracelyn Cruden & Samantha Montag

  2. Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA

    Ahnalee Brincks

  3. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    Ahnalee Brincks, Tatiana Perrino & Hilda Pantin

  4. Department of Biostatistics, Vanderbilt University, Nashville, TN, USA

    Shi Huang

  5. Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Gracelyn Cruden

  6. Departments of Psychology and Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA

    George Howe

  7. Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ, USA

    Jami F. Young

  8. Boston Children’s Hospital, Harvard University, Cambridge, MA, USA

    William Beardslee

  9. Department of Psychology, Arizona State University, Tempe, AZ, USA

    Irwin Sandler

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  1. C. Hendricks Brown
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  3. Shi Huang
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  7. George Howe
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  8. Jami F. Young
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  11. Irwin Sandler
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Corresponding author

Correspondence to C. Hendricks Brown.

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Funding

Funding for this project was by NIMH R01MH040859 (Collaborative Synthesis for Adolescent Depression Trials, Brown PI) and the following grants for the specific trials: Garber, Brent, Beardslee, Clarke et al.—NIMH MH064735, MH064503, MH064717; Gillham et al.—NIMH MH52270; Garber et al.—William T. Grant Foundation 961730; Dishion et al.—NIDA DA07031 and DA13773; Szapocznik et al.—NIMH MH61143; Pantin et al.—NIDA DA017462; Prado et al.—NIDA DA025894; Prado et al.—CDC U01PS000671; Stormshak et al.—NIDA DA018374; Sandler et al.—NIMH MH49155; Wolchik et al.—NIMH MH068685; Young et al.—NARSAD; Spoth et al.—NIDA DA 007029; Clarke et al.—NIMH MH 48118; Young et al.—NIMH MH071320; Beardslee et al.—NIMH MH48696; VanVoorhees et al.—NIMH MH072918; and Gonzales et al.—NIMH MH64707.

Conflict of Interest

CHB was supported as a consultant on one of these projects (New Beginnings) and received funding support on the Familias Unidas trials, as did Huang. Young, Sandler, Pantin, and Beardslee directed their own trials that are included in this synthesis. Brincks, Perrino, and Cruden were colleagues of Pantin. All the trial directors were consulted on codings for their trials and were offered an opportunity to provide comments before this paper was submitted.

Ethics Approval

This article does not contain any studies with animals performed by any of the authors. This project involving sharing of data was reviewed by two IRBs. Use of deidentified data in this synthesis project was approved by the University of Miami and Northwestern University IRBs, and all institutions signed data use agreements with Northwestern.

Informed Consent

All trials included in this synthesis were approved by their respective institutional review boards. Informed consent was obtained from all individual participants included in these respective studies.

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Brown, C.H., Brincks, A., Huang, S. et al. Two-Year Impact of Prevention Programs on Adolescent Depression: an Integrative Data Analysis Approach. Prev Sci 19 (Suppl 1), 74–94 (2018). https://doi.org/10.1007/s11121-016-0737-1

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