Depression in Children and Adolescents. Linking Risk Research and Prevention

Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee 37203-5721, USA.
American Journal of Preventive Medicine (Impact Factor: 4.53). 01/2007; 31(6 Suppl 1):S104-25. DOI: 10.1016/j.amepre.2006.07.007
Source: PubMed


The National Institute of Mental Health has called for translational research linking basic knowledge about vulnerabilities that underlie mood disorders to the development of effective preventive interventions. This paper highlights research about risk factors for depression in children and adolescents and links it to current knowledge about interventions aimed at preventing depression in youth. Basic epidemiologic and clinical research indicates that increased risk for depression is associated with being female; a family history of depression, particularly in a parent; subclinical depressive symptoms; anxiety; stressful life events; neurobiological dysregulation; temperament/personality (e.g., neuroticism); negative cognitions; problems in self-regulation and coping; and interpersonal dysfunction. These vulnerabilities both increase individuals' chances of encountering stress and decrease their ability to deal with the stress once it occurs. Although several existing depression-prevention studies have targeted one or more of these risk factors, the efficacy of these various prevention programs for youth with different combinations of these risk factors needs to be investigated further. Most existing depression-prevention programs in youth have used cognitive-behavioral techniques, with some success. Other depression-prevention strategies have included training in coping, social problem solving, social skills, communication skills, and parenting. A comprehensive prevention program is recommended that includes multiple intervention components, each of which addresses risk and protective factors across different domains and levels of analysis.

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    • "IPT-AST is based on interpersonal theories of depression which posit that certain individuals possess interpersonal risk factors, such as maladaptive interpersonal behaviors and/or chronic impairment in interpersonal relationships, which make them particularly susceptible to the deleterious impact of interpersonal stressors on depression (e.g., Rudolph et al. 2008). The relation between interpersonal vulnerability factors and depression is reciprocal and transactional , with interpersonal difficulties preceding depressive symptoms which further contribute to these interpersonal problems (Garber 2006; Rudolph et al. 2008; Stice et al. 2004). IPT-AST aims to decrease interpersonal conflict and increase social support, two interpersonal factors which have been linked prospectively to adolescent depression (e.g., Allen et al. 2006; Brendgen et al. 2005; Sheeber et al. 2007; Stice et al. 2004). "
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    ABSTRACT: Given the rise in depression disorders in adolescence, it is important to develop and study depression prevention programs for this age group. The current study examined the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a group prevention program for adolescent depression, in comparison to group programs that are typically delivered in school settings. In this indicated prevention trial, 186 adolescents with elevated depression symptoms were randomized to receive IPT-AST delivered by research staff or group counseling (GC) delivered by school counselors. Hierarchical linear modeling examined differences in rates of change in depressive symptoms and overall functioning from baseline to the 6-month follow-up assessment. Cox regression compared rates of depression diagnoses. Adolescents in IPT-AST showed significantly greater improvements in self-reported depressive symptoms and evaluator-rated overall functioning than GC adolescents from baseline to the 6-month follow-up. However, there were no significant differences between the two conditions in onset of depression diagnoses. Although both intervention conditions demonstrated significant improvements in depressive symptoms and overall functioning, results indicate that IPT-AST has modest benefits over groups run by school counselors which were matched on frequency and duration of sessions. In particular, IPT-AST outperformed GC in reduction of depressive symptoms and improvements in overall functioning. These findings point to the clinical utility of this depression prevention program, at least in the short-term. Additional follow-up is needed to determine the long-term effects of IPT-AST, relative to GC, particularly in preventing depression onset.
    Full-text · Article · Dec 2015 · Prevention Science
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    • "Another severe consequence of adolescent depression is suicide (Wild et al. 2004), with more than half of adolescent suicide victims having a depressive disorder at the time of death (Thapar et al. 2012), and subthreshold-depressed adolescents being three times more likely to have suicidal thoughts/ideations than their non-depressed counterparts (Balazs et al. 2013). Given these data on the prevalence and consequences of adolescent depression, identifying its etiological mechanisms is critical for developing empiricallybased prevention and intervention programs (Garber 2006). Many now appreciate that both genetic and environmental factor, as well as the gene–environment interactions (G 9 E), contribute to the development of depression (Caspi et al. 2003; Rice 2014; Rutter et al. 2009). "
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    ABSTRACT: Although depressive symptoms are common during adolescence, little research has examined gene-environment interaction on youth depression. This study chose the brain-derived neurotrophic factor (BDNF) gene, tested the interaction between a functional polymorphism resulting amino acid substitution of valine (Val) to methionine (Met) in the proBDNF protein at codon 66 (Val66Met), and maternal parenting on youth depressive symptoms in a sample of 780 community adolescents of Chinese Han ethnicity (aged 11-17, M = 13.6, 51.3 % females). Participants reported their depressive symptoms and perceived maternal parenting. Results indicated the BDNF Val66Met polymorphism significantly moderated the influence of maternal warmth-reasoning, but not harshness-hostility, on youth depressive symptoms. Confirmatory model evaluation indicated that the interaction effect involving warmth-reasoning conformed to the differential-susceptibility rather than diathesis-stress model of person-X-environment interaction. Thus, Val carriers experienced less depressive symptoms than Met homozygotes when mothering was more positive but more symptoms when mothering was less positive. The findings provided evidence in support of the differential susceptibility hypothesis of youth depressive symptoms and shed light on the importance of examining the gene-environment interaction from a developmental perspective.
    Full-text · Article · Oct 2015 · Journal of Youth and Adolescence
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    • "As a result, research has sought to identify early family risk factors and child characteristics that can predict adolescent depressive symptoms, to enable early identification and mobilize preventative intervention measures that focus on early risk factors (e.g. Garber, 2006). "
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    ABSTRACT: The authors tested three possible pathways linking prenatal maternal depressive symptoms to adolescent depressive symptoms. These pathways went through childhood Irritability Symptoms, Anxiety/Depressive Symptoms or Conduct Problems. Data were collected from 3,963 mother-child pairs participating in the Avon Longitudinal Study of Parents and Children. Measures include maternal depressive symptoms (pre- and postnatal); toddler temperament (2 years); childhood (7-13 years) irritability symptoms, anxiety/depressive symptoms, conduct problems, and adolescent depressive symptoms (16 years). Irritability Symptoms: This pathway linked sequentially - prenatal maternal depressive symptoms, toddler temperament (high perceived intensity and low perceived adaptability), childhood irritability symptoms, and adolescent depressive symptoms. Anxiety/Depressive symptoms: This pathway linked sequentially - prenatal maternal depressive symptoms, toddler temperament (negative perceived mood), childhood anxiety/depressive symptoms, and adolescent depressive symptoms. Childhood conduct problems were not associated with adolescent depressive symptoms, above and beyond irritability symptoms and anxiety/depressive symptoms. Results suggest evidence for two distinct developmental pathways to adolescent depressive symptoms that involve specific early and midchildhood features. © 2015 Association for Child and Adolescent Mental Health.
    Full-text · Article · Feb 2015 · Journal of Child Psychology and Psychiatry
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