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: 8507807
• 负责人: DANTE CICCHETTI CICCHETTI
• 金额: $ 66.97万
• 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/8507807
• 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; 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）：研究一致表明，虐待儿童会使儿童面临更高的精神病理学风险，包括重度抑郁症（MDD；Cicchetti & Valentino，2006；Thompson，2005；Widom 等，2007）。研究发现，有虐待史的青少年变得抑郁或自杀的可能性是没有虐待史的青少年的三倍（Brown 等，1999）。由于青春期是抑郁症出现的高峰期，也是女孩抑郁症发病率开始超过男孩的发育时期，因此对抑郁症状加重的青春期女孩提供预防干预尤为重要。此外，由于研究抑郁症的潜在过程已开始阐明基于是否存在虐待的不同途径（Heim 等，2008），因此对有或没有虐待史的亚综合征抑郁少女的预防性干预措施的评估弥补了一个关键差距在预防文献中。随着对儿童虐待和忽视的生物学后果的认识不断增加（Watts-English 等，2006），将多层次分析视角纳入预防性干预措施的设计和评估中变得越来越重要。拟议的研究旨在扩展对有或没有虐待史的青春期女孩抑郁症的有效预防干预的知识。该调查将利用发展精神病理学框架，对 350 名低收入、种族和文化多样化的少女进行调查，以评估青少年人际心理治疗 (IPT-A) 预防抑郁症的功效。这些患有抑郁症状的青少年中，有 140 名有虐待儿童史，另外 140 名在人口统计上具有可比性，但没有虐待史。在每组中，一半将被随机分配至 IPT-A，另一半将被分配至具有相当持续时间的强化护理。另外一组由 70 名未受虐待、无症状的女孩组成，将作为比较，以确定抑郁症组的心理和神经生物学功能与无症状青少年组的心理和神经生物学功能是否相似。该调查将采用多层次分析方法，通过检查基线、治疗中期、治疗后和一年随访时。将检查受虐待和未受虐待青少年抑郁症因果过程网络的群体差异与结果的关系。此外，还将研究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会调节 IPT-A 在减少受虐待和未受虐待女孩的抑郁症状方面的功效。