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.
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