TY - JOUR
T1 - Personalized Depression Prevention
T2 - A Randomized Controlled Trial to Optimize Effects Through Risk-Informed Personalization
AU - Young, Jami F.
AU - Jones, Jason D.
AU - Gallop, Robert
AU - Benas, Jessica S.
AU - Schueler, Christie M.
AU - Garber, Judy
AU - Hankin, Benjamin L.
N1 - Funding Information:
The research reported in this article was supported by grants from the National Institute of Mental Health (NIMH) to Jami F. Young (R01MH077178) and to Benjamin L. Hankin (R01MH077195).Disclosure: Dr. Young has developed Interpersonal Psychotherapy?Adolescent Skills Training (IPT-AST) and has received royalties from sales of the book she co-authored that describes the program. She has also received funding from the Institute of Education Sciences (R305A190088) and NIMH to support her research (1R01 MH087481). Dr. Garber has received funding from the NIMH (1R61MH115125, 1R61MH119270) to support her research. Dr. Hankin has received funding from NIMH (1R01MH109662, 1R01MH105501, 1R21MH102210) to support his research. Drs. Jones, Gallop, Benas, and Schueler have reported no biomedical financial interests or potential conflicts of interest. Conceptualization: Young, Benas, Schueler, Garber, Hankin Data curation: Jones, Gallop Formal analysis: Young, Jones, Gallop, Hankin Funding acquisition: Young, Hankin Investigation: Young, Hankin Methodology: Young, Gallop, Garber, Hankin Project administration: Young, Benas, Schueler, Hankin Supervision: Young, Benas, Schueler, Garber, Hankin Writing ? original draft: Young, Jones, Gallop, Benas, Schueler, Garber, Hankin Writing ? review and editing: Young, Jones, Gallop, Benas, Schueler, Garber, Hankin
Publisher Copyright:
© 2021 American Academy of Child and Adolescent Psychiatry
PY - 2021/9
Y1 - 2021/9
N2 - Objective: To evaluate whether evidence-based depression prevention programs can be optimized by matching youths to interventions that address their psychosocial vulnerabilities. Method: This randomized controlled trial included 204 adolescents (mean [SD] age = 14.26 [1.65] years; 56.4% female). Youths were categorized as high or low on cognitive and interpersonal risks for depression and randomly assigned to Coping With Stress (CWS), a cognitive-behavioral program, or Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST), an interpersonal program. Some participants received a match between risk and prevention (eg, high cognitive–low interpersonal risk teen in CWS, low cognitive–high interpersonal risk teen in IPT-AST), others received a mismatch (eg, low cognitive-high interpersonal risk teen in CWS). Outcomes were depression diagnoses and symptoms through 18 months postintervention (21 months total). Results: Matched adolescents showed significantly greater decreases in depressive symptoms than mismatched adolescents from postintervention through 18-month follow-up and across the entire 21-month study period (effect size [d] = 0.44, 95% CI = 0.02, 0.86). There was no significant difference in rates of depressive disorders among matched adolescents compared with mismatched adolescents (12.0% versus 18.3%, t
193 = .78, p = .44). Conclusion: This study illustrates one approach to personalizing depression prevention as a form of precision mental health. Findings suggest that risk-informed personalization may enhance effects beyond a one-size-fits-all approach. Clinical trial registration information: Bending Adolescent Depression Trajectories Through Personalized Prevention; https://www.clinicaltrials.gov/; NCT01948167.
AB - Objective: To evaluate whether evidence-based depression prevention programs can be optimized by matching youths to interventions that address their psychosocial vulnerabilities. Method: This randomized controlled trial included 204 adolescents (mean [SD] age = 14.26 [1.65] years; 56.4% female). Youths were categorized as high or low on cognitive and interpersonal risks for depression and randomly assigned to Coping With Stress (CWS), a cognitive-behavioral program, or Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST), an interpersonal program. Some participants received a match between risk and prevention (eg, high cognitive–low interpersonal risk teen in CWS, low cognitive–high interpersonal risk teen in IPT-AST), others received a mismatch (eg, low cognitive-high interpersonal risk teen in CWS). Outcomes were depression diagnoses and symptoms through 18 months postintervention (21 months total). Results: Matched adolescents showed significantly greater decreases in depressive symptoms than mismatched adolescents from postintervention through 18-month follow-up and across the entire 21-month study period (effect size [d] = 0.44, 95% CI = 0.02, 0.86). There was no significant difference in rates of depressive disorders among matched adolescents compared with mismatched adolescents (12.0% versus 18.3%, t
193 = .78, p = .44). Conclusion: This study illustrates one approach to personalizing depression prevention as a form of precision mental health. Findings suggest that risk-informed personalization may enhance effects beyond a one-size-fits-all approach. Clinical trial registration information: Bending Adolescent Depression Trajectories Through Personalized Prevention; https://www.clinicaltrials.gov/; NCT01948167.
KW - depression
KW - personalization
KW - precision
KW - prevention
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U2 - 10.1016/j.jaac.2020.11.004
DO - 10.1016/j.jaac.2020.11.004
M3 - Article
C2 - 33189876
AN - SCOPUS:85102288956
SN - 0890-8567
VL - 60
SP - 1116-1126.e1
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 9
ER -