Longterm Treatment Effects on Juvenile Justice Girls' Depression and Suicide Risk

长期治疗对少年司法女孩抑郁和自杀风险的影响

• 批准号: 8104190
• 负责人: David C. R. Kerr
• 金额: $ 6.96万
• 依托单位: OREGON SOCIAL LEARNING CENTER, INC.
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-06 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8104190
• 关键词: Accounting; Address; Adolescence; Adolescent; Age; Child; Data; Data Collection; Depression and Suicide; Development; Developmental Process; Drug abuse; Effectiveness; Feeling suicidal; Female; Female Adolescents; Funding; Growth; High Risk Woman; Intercept; Intervention; Interview; Justice; Measurement; Measures; Mediating; Mediation; Mental Depression; Modeling; National Institute of Mental Health; Parents; Participant; Pathway interactions; Patient Self-Report; Persons; Phase; Population; Pregnancy; Pregnancy Rate; Pregnancy in Adolescence; Prevention; Probability; Psychopathology; Randomized; Randomized Controlled Trials; Recording of previous events; Recurrence; Relative (related person); Research Project Grants; Resources; Risk; Sampling; Schools; Specific qualifier value; Suicide attempt; Telephone; Testing; Time; To specify; United States National Institutes of Health; Woman; Youth; boys; community setting; depressive symptoms; deviant; effective therapy; emerging adult; evidence base; follow-up; foster care; girls; high risk; innovation; intervention effect; intervention program; juvenile justice system; peer; prevent; programs; psychosocial; public health relevance; suicidal behavior; suicidal risk; treatment as usual; treatment effect; young adult

DESCRIPTION (provided by applicant): The aims of the proposed project address gaps in the evidence base concerning interventions with girls in the juvenile justice system (JJS). All aims focus on the extent to which a delinquency-focused intervention disrupts depressive symptoms and suicide risk trajectories in young adulthood for these high-risk females. Participants are 164 women who were involved in the JJS as adolescents. The women initially participated at ages 13-17 in a randomized controlled trial to test the effectiveness of Multidimensional Treatment Foster Care (MTFC, Chamberlain, 2003) versus treatment as usual (TAU) at reducing delinquency and drug abuse. Delinquency, depressive symptoms, and suicidal thoughts were measured four times across the original 2-year follow-up period. A study is currently underway (R01 DA024672: February 2009-December 2012) in which in- person and telephone assessments of these women will be conducted across multiple 6-month intervals in young adulthood (18-28 years). The aims of this R01, however, do not address the course of depressive symptoms or suicide risk among these high-risk women. In the present application, we capitalize on rich existing longitudinal data and the active assessment phase in the R01 study to propose a new focus on the effects of MTFC on these problems. Specifically, we propose to 1) conduct a lifetime assessment of the number and timing of suicide attempts; and 2) augment R01 assessments planned at 6-month intervals to include self-reported suicidal thoughts and behaviors. Two of these assessments will occur prior to the proposed study, and will be supported with limited internal resources; we request funding for three additional measurement occasions (at 6-month intervals), for a total of five assessments in young adulthood. Using existing and proposed data collection, we will pursue three aims that estimate MTFC effects on depressive symptoms and suicide risk in young adulthood, and specify three key mechanisms of indirect effects. In Aim 1, we will use latent growth modeling to characterize the course of depressive symptoms across 9 time points in adolescence and young adulthood, and then to test intervention effects; girls randomly assigned to MTFC are expected to show decreases in depressive symptoms over time relative to girls assigned to TAU. Aim 2 tests whether changes in three domains already demonstrated to be impacted by MTFC (Chamberlain et al., 2007; Leve et al., 2007) mediate effects of the intervention on changes in depressive symptoms; specifically, MTFC is expected to reduce depressive symptoms through early adulthood via decreased delinquency and teenage pregnancy/child-bearing, and educational attainment. Aim 3 tests the effects of MTFC on suicide attempts and whether such effects are mediated by intervention-related reductions in delinquency and depressive symptoms. Findings will suggest directions for development and augmentation of interventions for JJS girls. Thus, the proposed study answers calls for innovative approaches to reaching high risk youth who do not benefit from existing depression prevention paradigms (Avenevoli et al., 2006). PUBLIC HEALTH RELEVANCE: Adolescent girls with serious conduct problems are at high risk for depression and suicide. Yet, effective treatments for these problems in this group are lacking. We examine whether a delinquency-focused intervention for girls in the juvenile justice system will reduce depressive symptoms and rates of suicide attempt into young adulthood via changes in delinquency, teen pregnancy rates, and educational attainment.

描述（由申请人提供）：拟议项目的目的解决了证据基础，涉及与少年司法系统（JJS）中女孩的干预措施。所有目的都集中在以犯罪性干预破坏这些高风险女性的年轻成年中的抑郁症状和自杀风险轨迹的程度。 参与者是164名作为青少年参与JJS的妇女。这些妇女最初以13-17岁的年龄参加了一项随机对照试验，以测试多维治疗寄养的有效性（MTFC，Chamberlain，2003年）与惯常治疗（TAU）在减少犯罪和药物滥用方面的有效性。在最初的2年随访期间，违法，抑郁症状和自杀思想是四次测量的。目前正在进行一项研究（R01 DA024672：2012年2月至12月），其中将在年轻的成年期（18-28岁）跨多个6个月的间隔进行对这些妇女的人力和电话评估。但是，这种R01的目的并不能解决这些高危妇女的抑郁症状或自杀风险的过程。在本应用中，我们利用R01研究中现有的现有纵向数据和主动评估阶段的资本，提出了对MTFC对这些问题的影响的新关注。具体而言，我们建议1）对自杀企图的数量和时机进行终身评估； 2）以6个月的间隔计划增加R01评估，以包括自杀的思想和行为。这些评估中的两项将在拟议的研究之前进行，并将以有限的内部资源提供支持；我们要求提供三个额外的测量场合（以6个月的间隔）进行资金，在成年期间总共进行了五次评估。 使用现有和拟议的数据收集，我们将追求三个目标，以估计MTFC对年轻成年的抑郁症状和自杀风险的影响，并指定间接影响的三种关键机制。在AIM 1中，我们将使用潜在的生长建模来表征青春期和成年期在9个时间点的抑郁症状的过程，然后测试干预效果。与分配给tau的女孩相比，随着时间的流逝，随机分配给MTFC的女孩在抑郁症状中显示出降低。 AIM 2测试是否已经证明已经被MTFC影响的三个领域的变化（Chamberlain等，2007; Leve等，2007）介导了干预对抑郁症状变化的影响；具体而言，预计MTFC会通过拖延和青少年怀孕/生育和教育成就来减少成年初期的抑郁症状。 AIM 3测试了MTFC对自杀尝试的影响，以及此类影响是否是通过与干预相关的拖延和抑郁症状的减少来介导的。调查结果将为JJS女孩开发和增强干预措施的发展指示。因此，拟议的研究回答呼吁采用创新的方法来达到没有从现有的抑郁症预防范式中受益的高风险青年（Avenevoli等，2006）。 公共卫生相关性：有严重行为问题的青少年女孩遭受抑郁和自杀的高风险。然而，缺乏对该组中这些问题的有效治疗方法。我们检查了针对少年司法系统中女孩的犯罪干预是否会通过犯罪，青少年怀孕率和教育程度的变化来减少抑郁症状和自杀率的抑郁症状和自杀率。