Influence of general self-efficacy on the effects of a school-based universal primary prevention program of depressive symptoms in adolescents: A randomized and controlled follow-up study

University of Tuebingen at Tuebingen, Germany.
Journal of Child Psychology and Psychiatry (Impact Factor: 5.67). 10/2005; 46(9):982-94. DOI: 10.1111/j.1469-7610.2004.00395.x
Source: PubMed

ABSTRACT Depressive disorders in adolescents are a widespread and increasing problem. Prevention seems a promising and feasible approach.
We designed a cognitive-behavioral school-based universal primary prevention program and followed 347 eighth-grade students participating in a randomized controlled trial for three months.
In line with our hypothesis, participants in the prevention program remained on a low level of depressive symptoms, having strong social networks. The control group showed increasing depressive symptoms and a reduced social network. Contrary to our expectations, students low in self-efficacy benefited more from the program than high self-efficient students. Social network did not mediate the relationship between participation in the prevention program and changes in depressive symptoms.
Our results show that the prevention program had favorable effects. Further research is needed to explore the impact of self-efficacy on the effects of prevention programs.

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    • "Other common interventions reported were building social networks and skills for help-seeking (Aseltine & DeMartino, 2004; Eggert et al., 2002; Thompson et al., 2001) and developing life skills (Eggert et al., 2002; Thompson et al., 2001). A few studies reported interventions based on Interpersonal Therapy (Horowitz et al., 2007), physical activity (Bonhauser et al., 2005), and information processing (Pössel et al., 2005). All of the interventions reviewed were conducted with students in groups and ranged in duration from 1 to 2 hours per week over a period of 8 to 12 weeks. "
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    ABSTRACT: Background Symptoms of anxiety and depression are common in childhood, as are risk factors that undermine wellbeing: low self-esteem and limited participation in daily occupations. Current treatments focus primarily on modifying internal cognitions with insufficient effect on functional outcomes. Occupational therapists have a role in measuring and enabling children’s functional abilities to promote health and wellbeing. To-date there is no evidence for the use of occupational therapy as an intervention to promote mental health or increase self-esteem, participation and wellbeing in a preventative context. The aim of this cluster-randomised controlled study is to investigate the effectiveness of an 8-week occupational therapy group intervention (Kia Piki te Hauora) at reducing symptoms of anxiety and depression and improving self-esteem, participation and wellbeing in children aged 11–13 years. Methods/design In this two-arm, pragmatic, cluster-randomised controlled trial, 154 children will be recruited from 14 schools. All mainstream schools in the region will be eligible and a convenience sample of 14 schools, stratified by decile ranking (i.e. low, medium, and high) will be recruited. Eight to twelve students aged 11–13 years from each school will be recruited by senior school personnel. Following consent, schools will be randomised to either the intervention or waitlist control arm of the trial. The study will employ a parallel and one-way waitlist-to-intervention crossover design. Each cluster’s involvement will last up to 19 or 31 weeks depending on allocation to the intervention or waitlist respectively. The primary outcome is symptoms of anxiety and secondary outcomes are symptoms of depression, self-esteem, participation in daily occupations and wellbeing. Outcome measurement will be repeated at baseline, post-intervention and again at 8–9 weeks follow-up. Planned statistical analyses will utilise repeated measures analysis of covariance. The primary analysis will be based on an intention-to-treat analysis set and include only parallel data. The crossover data will only be used in secondary analyses. Discussion This is the first cluster-randomised controlled trial to investigate an occupational therapy intervention promoting emotional wellbeing in a non-clinical sample of children. Results will contribute to the limited evidence base for occupational therapists in this field and potentially support investment in these services. Trial registration Australia/New Zealand Clinical Trials Register: ACTRN12614000453684.
    06/2014; 2:16. DOI:10.1186/2050-7283-2-16
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    • "Nonetheless, it might represent a factor promoting help-seeking behavior and affecting the intervention outcome in mental health prevention programs. Contrary to their hypothesis, Pössel et al. [52] found students low on self-efficacy to benefit more from a depression prevention program. The current study will investigate whether selfefficacy can predict self-directed use of MoodGYM when presented to students in a school-based setting. "
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    ABSTRACT: Background. Focus upon depression and prevention of its occurrence among adolescents is increasing. Novel ways of dealing with this serious problem have become available especially by means of internet-based prevention and treatment programs of depression and anxiety. The use of Internet-based intervention programs among adolescents has revealed some difficulties in implementation that need to be further elucidated. The aim of this study is to investigate the association between personality and adolescent depression and the characteristics of users of an Internet-based intervention program. Method. The Junior Temperament and Character Inventory (JTCI), the General Self-Efficacy scale (GSE) and the Centre for Epidemiological Studies-Depression scale (CES-D) have been administered to a sample (n = 1234) of Norwegian senior high-school students. Results. Multiple regression analysis revealed associations between depression and gender, and several JTCI domains and facets. In line with previous findings in adults, high Harm Avoidance and low Self-Directedness emerged as the strongest predictors of adolescent depressive symptoms. Further, in logistic regression analysis with the covariates JTCI, GSE and CES-D, the only significant variables predicting use/non-use were the CES-D and the temperament domain Reward Dependence. Conclusion. The results in this study revealed level of depressive symptoms as the strongest predictor of the use of the Internet based intervention and that personality might provide useful information about the users.
    Depression research and treatment 08/2012; 2012:593068. DOI:10.1155/2012/593068
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    • "Those randomly allocated to CBT showed improvement on the Beck Depression Inventory (BDI) and the Self-Efficacy Scale (Hyun et al., 2005). Pössel et al. (2005) conducted a 10-week CBT school-based depression prevention program , finding that those students with low self-efficacy on the General Self-Efficacy Scale had greater improvement on the Center for Epidemiological Studies Depression Scale scores following CBT than those with initially higher self-efficacy scores. Of the existing self-efficacy measures only the SEQ-DA has been developed for clinical use in depressed adolescent subjects. "
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    ABSTRACT: Self-efficacy can be conceptualised as a person's perception of their own ability to produce a desired outcome. Low self-efficacy has been reported to be a mediating variable in developing depression. The Self-Efficacy Questionnaire for Depressed Adolescents (SEQ-DA) is a 12-item inventory, designed to measure self-perceived ability of the young person to cope with depressive symptoms. This paper presents further information on the psychometric properties of the SEQ-DA in a clinical sample of depressed adolescents. The SEQ-DA was administered to a clinical sample of 130 adolescents with a depressive disorder at baseline, at the end of 3 months of therapy and 6 months following therapy. A diagnosis of depression was made using the Schedule for Affective Disorders and Schizophrenia for School Aged Children. The ability of the SEQ-DA to identify those adolescents who had a diagnosis of major depressive disorder at baseline, following treatment and at 6-month follow-up was evaluated. Receiver operating characteristic (ROC) analysis of the SEQ-DA in this clinical sample of depressed adolescents was undertaken to establish cut-off scores of the SEQ-DA. The SEQ-DA score at baseline of < 36 and following treatment of < 43 were predictive of a depressive disorder. The SEQ-DA is a very simple self-report measure that can be used to predict which adolescents treated for depression are likely to remain depressed, thus prompting more intensive treatment and follow-up.
    Australian and New Zealand Journal of Psychiatry 01/2012; 46(1):47-54. DOI:10.1177/0004867411428390 · 3.77 Impact Factor
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