1/2-Two-Site Evaluation of Family Focused Treatment for Childhood Depression

以家庭为中心的儿童抑郁症治疗的 1/2-两点评估

基本信息

批准号：
7740489
负责人：
MARTHA C. TOMPSON
金额：
$ 36.56万
依托单位：
BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-01 至 2014-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7740489
关键词：
Accident and Emergency department Acquired Immunodeficiency Syndrome Address Adherence Adolescent Adopted Adverse event Aftercare Age Anxiety Area As-A 2 Authorship Beck depression inventory Behavioral Biometry Boston Caring Characteristics Child Child Behavior Checklist Childhood Client Clinical Clinical Services Cognitive Collaborations Communities Comorbidity Complex Consult Control Groups Country Data Data Collection Dependence Depressive disorder Development Diagnosis Disease Dysthymic Disorder Enrollment Ensure Environment Equilibrium Evaluation Evidence based practice Expressed Emotion Faculty Family Family member Goals Grant Guidelines Health Insurance Portability and Accountability Act Health Services Health Services Research Individual Informed Consent Institutes Intervention Knowledge Lead Link Literature Los Angeles Maintenance Major Depressive Disorder Manuals Measures Mediating Mediator of activation protein Mental Health Mental disorders Modeling Monitor Morbidity - disease rate National Institute of Mental Health Operative Surgical Procedures Outcome Paper Parents Participant Patient Care Patient Self-Report Personal Communication Population Privacy Procedures Process Protocols documentation Psychiatry Psychotherapy Public Health Publications Quality Control Randomized Randomized Controlled Trials Recording of previous events Recovery Recurrence Relaxation Reporting Research Research Design Research Personnel Resistance Resources Running Safety Safety Management Sampling Sampling Studies School-Age Population Severities Site Social Adjustment Stress Structure Study Section Subgroup Supervision Supportive care Symptoms Syndrome Testing Time Training Training Programs Treatment Efficacy Universities Work Youth aged alcohol use disorder base blind childhood onset depression children&apos s depression rating scale clinically relevant cognitive behavior therapy community setting cost data management depressed depression depressive symptoms design early onset economic cost evidence base experience follow up assessment follow-up health care service organization improved instrument interest intervention effect journal article meetings member post intervention primary outcome psychosocial public health relevance public health research quality assurance research clinical testing resilience response secondary outcome skills social staff intervention statistics suicidal adolescent symposium therapy development treatment adherence treatment as usual treatment effect treatment site treatment strategy week trial

项目摘要

DESCRIPTION (provided by applicant): Childhood-onset depression is an impairing and often recurrent and persistent disorder that impacts current and later development resulting in high personal, social, and economic costs. Despite the costs of early-onset depression, the emphasis in current practice parameters on an initial course of psychosocial treatment, and extensive research on adolescent depression, we currently lack randomized controlled trials evaluating psychosocial treatments for children with depressive disorders. The present application aims to address this gap in knowledge regarding optimal psychosocial treatment strategies for children suffering from depressive disorders. We propose a 2-site randomized controlled trial to evaluate the efficacy of Family Focused Treatment (FFT), as compared to an individual client-centered psychotherapy (IP) modeled after "usual" community care. This application builds on and extends work conducted through our initial NIMH treatment development grant in which we developed and manualized the FFT and carried out a preliminary trial demonstrating that the FFT resulted in significant improvements in depression outcomes, global functioning, and reductions in parent reported internalizing, externalizing, and total problems, with gains persisting and strengthening by the 9-month post-treatment follow-up. FFT adopts an interpersonal model for understanding how depressive symptoms are maintained, emphasizes developing family skills/strategies for altering interpersonal processes, and works on building a family environment that supports recovery and enhances stress resistance and resilience. This approach may be particularly appropriate to the developmental needs of depressed children, given their dependence on parents, the potential of FFT to address the needs of multiple family members, and our data supporting benefits on depression, functioning, and other co-occurring symptoms. The proposed project will enroll 140 children (ages 8-12) with depressive disorders (major depression and/or dysthymic disorder). Children will be randomly assigned to receive a 14-week trial of either FFT or IP. At study entry, immediately post-treatment, and at a 9-month post-treatment follow-up all participants will undergo intensive evaluation of clinical state and psychosocial and family functioning. We hypothesize that FFT will be associated with quicker recovery from depression, greater improvement in symptoms and psychosocial functioning, and reduction in associated symptoms/syndromes (anxiety and oppositional disorders). Follow-up evaluations will examine maintenance of treatment gains. Potential moderating (Expressed Emotion, presence of comorbid externalizing disorder) and mediating (family functioning, parental depression) variables will be evaluated. To enhance external validity and facilitate recruitment of a large, diverse sample, the study will be conducted at two sites -- Boston University and UCLA. Childhood-onset depression is an impairing and often recurrent and persistent disorder that impacts current and later development resulting in high social and economic costs, and development of efficacious treatments is of critical importance. Family-Focused Treatment (FFT), developed to specifically target depressed pre- adolescents and their families, presents an interpersonal model for understanding how depressive symptoms are maintained, emphasizes developing family skills/strategies for altering interpersonal processes, and works on building a family environment that supports recovery and enhances stress resistance and resilience. The goal of the current application is to conduct a randomized controlled trial of FFT for the treatment of depressed school-aged youth. PUBLIC HEALTH RELEVANCE: Childhood-onset depression is an impairing and often recurrent and persistent disorder that impacts current and later development resulting in high social and economic costs, and development of efficacious treatments is of critical importance. Family-Focused Treatment (FFT), developed to specifically target depressed pre- adolescents and their families, presents an interpersonal model for understanding how depressive symptoms are maintained, emphasizes developing family skills/strategies for altering interpersonal processes, and works on building a family environment that supports recovery and enhances stress resistance and resilience. The goal of the current application is to conduct a randomized controlled trial of FFT for the treatment of depressed school-aged youth.

描述（由申请人提供）：儿童期抑郁症是一种损害，经常发生的且持续性的疾病，会影响当前和后来的发展，从而导致个人，社会和经济成本高。尽管有早发性抑郁症的成本，但当前实践参数的重点是最初的社会心理治疗过程，以及对青少年抑郁症的广泛研究，我们目前缺乏评估抑郁症儿童心理社会治疗的随机对照试验。本申请旨在解决有关患有抑郁症患者的最佳社会心理治疗策略的知识差距。与以“通常”社区护理为基础的个别以客户为中心的心理治疗（IP）相比，我们提出了一项2个站点的随机对照试验，以评估以客户为中心的心理治疗（IP）的功效。 This application builds on and extends work conducted through our initial NIMH treatment development grant in which we developed and manualized the FFT and carried out a preliminary trial demonstrating that the FFT resulted in significant improvements in depression outcomes, global functioning, and reductions in parent reported internalizing, externalizing, and total problems, with gains persisting and strengthening by the 9-month post-treatment follow-up. FFT采用了人际模型来了解如何保持抑郁症状，强调开发家庭技能/策略来改变人际交往过程，并致力于建立支持恢复并增强压力抵抗力和韧性的家庭环境。鉴于他们对父母的依赖，解决多个家庭成员需求的潜力以及我们支持抑郁症，功能和其他同时发生的症状，这种方法可能特别适合抑郁症儿童的发育需求。拟议的项目将招募140名患有抑郁症（严重抑郁症和/或心律失常）的儿童（8-12岁）。儿童将被随机分配接受FFT或IP的14周试验。在研究条目中，治疗后立即进行，在治疗后9个月后，所有参与者将对临床状态以及社会心理和家庭功能进行深入评估。我们假设FFT将与抑郁症的恢复更快，症状和社会心理功能的改善以及相关症状/综合征（焦虑和对立疾病）的减轻有关。后续评估将检查治疗收益的维持。将评估潜在的调节（表达的情绪，合并外在化障碍的存在）和中介（家庭功能，父母抑郁）变量。为了提高外部有效性并促进了大量不同样本的招募，该研究将在波士顿大学和加州大学洛杉矶分校的两个地点进行。儿童期抑郁症是一种损害，经常发生的且持续性的疾病，会影响当前和后来的发展，导致社会和经济成本较高，而有效治疗的发展至关重要。以家庭为中心的治疗（FFT）专门针对抑郁症的前青少年及其家人，为了解如何保持抑郁症状的方式介绍了一个人际模型，强调开发家庭技能/策略以改变人际关系过程，并致力于建立家庭环境，以支持康复和增强压力和抵抗力和抵抗力，并增强压力和抗复原力。当前申请的目的是进行FFT的随机对照试验，以治疗沮丧的学龄青年。公共卫生相关性：儿童期抑郁症是一种损害，经常经常发生的持续性疾病，会影响当前和后来的发展，导致社会和经济成本较高，而有效治疗的发展至关重要。以家庭为中心的治疗（FFT）专门针对抑郁症的前青少年及其家人，为了解如何保持抑郁症状的方式介绍了一个人际模型，强调开发家庭技能/策略以改变人际关系过程，并致力于建立家庭环境，以支持康复和增强压力和抵抗力和抵抗力，并增强压力和抗复原力。当前申请的目的是进行FFT的随机对照试验，以治疗沮丧的学龄青年。