Prevention of Depression in Maltreated and Nonmaltreated Adolescents

预防虐待和非虐待青少年的抑郁症

• 批准号: 8678997
• 负责人: DANTE CICCHETTI CICCHETTI
• 金额: $ 71.03万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-13 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8678997
• 关键词: Address; Adolescence; Adolescent; Aftercare; Alleles; Behavioral; Biological; Caring; Child; Child Abuse and Neglect; Cognitive; Depressed mood; Depressive disorder; Development; Distress; Evaluation; Female Adolescents; Functional disorder; Future; Genetic; Interpersonal Relations; Intervention; Intervention Studies; Investigation; Knowledge; Literature; Low income; Major Depressive Disorder; Mediating; Mediator of activation protein; Mental Depression; Neurobiology; Neurosecretory Systems; Outcome; Pathway interactions; Prevention; Prevention strategy; Preventive Intervention; Process; Psychopathology; Psychotherapy; Public Health; Randomized; Recording of previous events; Regulation; Research; Risk; Sampling; Symptoms; Time; Youth; abuse neglect; base; boys; child depression; depression prevention; depressive symptoms; design; evidence base; experience; follow-up; girls; innovation; intervention effect; maltreatment; prevent; psychologic; response; suicidal adolescent

DESCRIPTION (provided by applicant): Research has consistently demonstrated that child maltreatment places children at heightened risk for the emergence of psychopathology, including major depressive disorders (MDD; Cicchetti & Valentino, 2006; Thompson, 2005; Widom et al., 2007). Adolescents with maltreatment histories have been found to be three times more likely to become depressed or suicidal than adolescents without histories of maltreatment (Brown et al., 1999). Because adolescence represents a peak time for the emergence of depressive disorders, as well as a developmental period during which rates of depression for girls begin to exceed those of boys, the provision of preventive intervention for adolescent girls with elevated depressive symptoms is particularly important. Moreover, because studies examining processes underlying depression have begun to elucidate differential pathways based on the presence of maltreatment (Heim et al., 2008), the evaluation of a preventive intervention for subsyndromal depressed adolescent girls with or without histories of maltreatment addresses a critical gap in the prevention literature. As increased knowledge on the biological consequences of child abuse and neglect has emerged (Watts-English et al., 2006), it is increasingly important to incorporate a multiple- levels-of-analysis perspective into the design and evaluation of preventive interventions. The proposed research seeks to extend knowledge on an efficacious preventive intervention for depression in adolescent girls with and without histories of maltreatment. The investigation will utilize a developmental psychopathology framework with 350 low-income ethnically and culturally diverse adolescent girls to evaluate the efficacy of Interpersonal Psychotherapy for Adolescents (IPT-A) for preventing depression. 140 of these adolescents with depressive symptoms will have histories of child maltreatment and 140 will be demographically comparable but without maltreatment history. Within each group, half will be randomly assigned to IPT-A and half to enhanced care with comparable duration. An additional group of 70 nonmaltreated nonsymptomatic girls will serve as a comparison for to determining how psychological and neurobiological functioning in the depressive groups may approximate that seen in a nonsymptomatic group of adolescents. The investigation will apply a multiple- levels-of-analysis approach to evaluate IPT-A efficacy in decreasing depressive symptoms and preventing MDD in maltreated and nonmaltreated adolescent girls through examining genetic, neuroendocrine, cognitive, and interpersonal domains at baseline, mid-treatment, post-treatment, and at one-year follow-ups. Group differences in the network of causative processes in depression for maltreated and nonmaltreated adolescents will be examined in relation to outcomes. Additionally, potential mechanisms involved in the intervention process will be examined, including changes in neuroendocrine regulation, cognitive processes, and interpersonal relations. Additionally, analyses will determine whether genetic differences moderate the efficacy of IPT-A in reducing depressive symptomatology in maltreated and in nonmaltreated girls.

描述（由申请人提供）：研究一直证明，儿童虐待使儿童处于精神病学的出现风险上，包括重度抑郁症（MDD； Cicchetti＆Valentino，2006; Thompson，2005; Widom等，2007，2007）。发现虐待历史的青少年比没有虐待病史的青少年沮丧或自杀的可能性要高三倍（Brown等，1999）。因为青春期是抑郁症出现的高峰时间，以及在此期间开始超过男孩的抑郁症率，因此为患有抑郁症状升高的青少年女孩提供预防性干预尤为重要。此外，由于研究抑郁症基础过程的研究已经开始根据虐待的存在来阐明差异途径（Heim等，2008），因此评估对抑郁症的青少年抑郁症的预防干预措施，对具有或没有恶意病史的次肿瘤抑郁症的青少年女孩解决了预防文献中的关键差距。随着对虐待和忽视儿童的生物学后果的知识的越来越多（Watts-English等，2006），将多重分析的观点纳入预防干预措施的设计和评估越来越重要。拟议的研究旨在扩展有关有或没有虐待病史的青少年女孩的有效预防性干预的知识。该调查将利用发展性心理病理学框架，具有350个低收入和文化多样的青少年女孩，以评估人际心理治疗对青少年（IPT-A）预防抑郁症的疗效。这些患有抑郁症状的青少年中有140名将有儿童虐待的历史，而140的历史在人口统计学上是可比的，但没有虐待病史。在每个组中，一半将被随机分配给IPT-A，一半将以可比的持续时间增强护理。另外一组70个未杀伤的非症状女孩将与确定抑郁症组中心理和神经生物学功能的比较，可以近似于无症状的青少年组中看到的。该调查将采用多重分析方法来评估IPT-A抑郁症状的功效，并通过检查遗传，神经内分泌，认知和人际际交往域，在基线，中期，中期，培养和一年的遗传域，并在遗传，神经内分泌，认知和人际际际群体中检查遗传，神经内分泌，认知和人际交往，以防止MDD的MDD。将研究与结局有关的虐待和未经虐待青少年的抑郁过程中的因果抑郁症网络的群体差异。另外，将检查干预过程中涉及的潜在机制，包括神经内分泌调节，认知过程和人际关系的变化。此外，分析将确定遗传差异是否适应IPT-A在降低虐待和未熟食的女孩中降低抑郁症状的功效。