A Randomized Placebo-Controlled Trial of a School-Based Depression Prevention Program

Merry, Sally; McDowell, Heather; Wild, C. J.; Bir, Julliet J; Cunliffe, Rachel

doi:10.1097/00004583-200405000-00007

Cited by 209 publications

(217 citation statements)

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“…In another study using RAP, Merry, McDowell, Wild, et al (2004) conducted a randomized "placebo-controlled" trial with 9 th and 10 th grade students (N = 392) in New Zealand. Whereas some students received the RAP-Kiwi program, other students engaged in an 11-week program including fun activities that were thought to be pleasurable but not actively prophylactic against depression.…”

Section: Universal Interventionsmentioning

confidence: 99%

“…Particularly in cases where follow-up assessments are spread far apart, interpretations of omnibus tests are problematic in the absence of planned or post-hoc crosssectional comparisons. For example, Merry, McDowell, Wild et al (2004) reported a significant difference favoring the intervention using area under the curve analyses over the post-intervention and 18 month follow-up periods. Based on their graphs however, it appears that at two if not all three follow-up assessments (6, 12, and 18 months) the error bars overlap between conditions.…”

Section: Concerns About Statistical Analyses and Outcome Measuresmentioning

confidence: 99%

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Prevention of depression in youth: A qualitative review and future suggestions

Sutton

2007

Clinical Psychology Review

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Since 1990, significant efforts have been made towards developing interventions to prevent depression in youth. Meta-analyses of preventive interventions have consistently yielded small but significant effect sizes in the short-term prevention of depression. However, the maintenance of intervention effects over extended follow-ups ranging from 6 months to 3 years has not been consistently demonstrated. In this qualitative review, significant methodological issues that continue to be of concern are discussed. Illustrative studies are described to highlight the accomplishments and limitations of interventions to date. Particular areas in need of attention include the implementation of booster sessions, use of appropriate statistical analyses, examination of multiple outcome variables, augmentation of protective factors, and exploration of mediators and moderators of intervention effects. Future directions for the field of depression prevention are outlined.

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Section: Universal Interventionsmentioning

confidence: 99%

Section: Concerns About Statistical Analyses and Outcome Measuresmentioning

confidence: 99%

Prevention of depression in youth: A qualitative review and future suggestions

Sutton

2007

Clinical Psychology Review

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“…To our knowledge, only one previous study compared a CBT depression prevention program to an active placebo control condition or alternative intervention. Merry, McDowell, Wild, Bir, and Cunliffe (2004) found that a universal CBT depression prevention program with an interpersonal focus produced significantly greater reductions in depressive symptoms from pre to post than an arts and crafts intervention, though effects faded over follow-up. It is vital to compare prevention programs to placebo or alternative intervention control groups because without such control conditions it is not possible to know whether improvements resulted because of the specific therapeutic procedures theorized to produce intervention effects, general nonspecific effects common to all psychosocial interventions (e.g., attention, therapist competence), or design artifacts (e.g., participant expectancies, demand characteristics).…”

mentioning

confidence: 92%

Randomized trial of a brief depression prevention program: An elusive search for a psychosocial placebo control condition

Stice

Burton

Bearman

et al. 2007

Behaviour Research and Therapy

126

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This trial compared a brief group cognitive-behavioral (CBT) depression prevention program to a waitlist control condition and four placebo or alternative interventions. High-risk adolescents with elevated depressive symptoms (N = 225, M age = 18, 70% female) were randomized to CBT, supportive-expressive group intervention, bibliotherapy, expressive writing, journaling, or waitlist conditions and completed assessments at baseline, termination, and 1-month and 6-month followup. All five active interventions showed significantly greater reductions in depressive symptoms at termination than waitlist controls; effects for CBT and bibliotherapy persisted into follow-up. CBT, supportive-expressive, and bibliotherapy participants also showed significantly greater decreases in depressive symptoms than expressive writing and journaling participants at certain follow-up points. Findings suggest there may be multiple ways to reduce depressive symptoms in high-risk adolescents, although expectancies, demand characteristics, and attention may have contributed to the observed effects. Keywordsdepression; prevention; high-risk; adolescent placebo; alternative interventions.Major depression is a common, recurrent, and impairing condition that predicts future suicide attempts, academic failure, interpersonal problems, unemployment, substance abuse, and delinquency (Gotlib, Lewinsohn, & Seeley, 1998;Newman et al., 1996;Reinherz, Giaconia, Hauf, Wasserman, & Silverman, 1999). Even subdiagnostic depressive symptoms persist over time and predict onset of psychiatric disorders, inpatient hospitalization, impaired social and academic functioning, and suicidal ideation (Capaldi & Stoolmiller, 1999;Nolen-Hoeksema, Girgus, & Seligman, 1992). Because less than one third of depressed youth receive treatment (Newman et al., 1996) and those who do often receive ineffective interventions (Weersing & Weisz, 2002), it is crucial to develop prevention programs for this common and debilitating condition.Several controlled trials have found that prevention programs based on cognitive behavioral therapy (CBT) principles produce significantly greater reductions in depressive symptoms than Correspondence should be addressed to Eric Stice, who is now at Oregon Research Institute, 1715 Franklin Blvd., Eugene, Oregon, 97403. Email: estice@ori.org.. Eric Stice, Emily Burton, and Sarah Kate Bearman, Department of Psychology, University of Texas at Austin. Paul Rohde, Oregon Research Institute.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptBehav Res Ther. Author manuscript...

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“…[4] Their benefits when applied universally are less certain. [4][5][6][7][8] For the most part, they are face-toface group programs delivered by mental health workers, or by the school's teachers specifically trained in the particular program. The need for staff training and support means the programs are often resource intense, costly, and difficult to sustain.…”

Section: Introductionmentioning

confidence: 99%

A controlled trial of a school-based Internet program for reducing depressive symptoms in adolescent girls

et al. 2009

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Background: This study evaluates the benefits of a self-directed Internet intervention for depression (MoodGYM) delivered as a part of the high school curriculum. Method: One hundred and fifty-seven girls, aged 15 and 16 years, were allocated to undertake either MoodGYM or their usual curriculum. MoodGYM's impact on depressive symptoms, risk of depression, attributional style, depression literacy and attitudes toward depression was examined using random effect regression. Results: MoodGYM produced a significantly faster rate of decline in depressive symptoms over the trial period than the control condition. The effect size for MoodGYM was not significant immediately after the intervention (Cohen's d 5 .19, 95% CI À.18-.56) but was moderate and significant 20 weeks after the intervention (d 5 .46, 95% CI .10-.82). Girls with high depression scores before intervention showed the strongest benefits on self-reported depression at follow-up (d 5 .92, 95% CI .10-1.38). There were no significant intervention effects on depression status, attributional style, depression literacy, and attitudes. Approximately 70% of girls in the MoodGYM group completed less than three of its modules and completion of fewer modules was related to high depression score before intervention. Conclusions: The findings suggest that there are benefits from MoodGYM on self-reported depressive symptoms but has low rates of completion highlight problems in ensuring adherence to Internet programs for depression. Depression and anxiety 26:65-72, 2009.

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A Randomized Placebo-Controlled Trial of a School-Based Depression Prevention Program

Cited by 209 publications

References 20 publications

Prevention of depression in youth: A qualitative review and future suggestions

Prevention of depression in youth: A qualitative review and future suggestions

Randomized trial of a brief depression prevention program: An elusive search for a psychosocial placebo control condition

A controlled trial of a school-based Internet program for reducing depressive symptoms in adolescent girls

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