Evaluation of a Group Cognitive-Behavioral Depression Prevention Program for Young Adolescents: A Randomized Effectiveness Trial

Abstract

Depression is a common psychological problem in adolescence. Recent research suggests that group cognitive-behavioral interventions can reduce and prevent symptoms of depression in youth. Few studies have tested the effectiveness of such interventions when delivered by school teachers and counselors (as opposed to research team staff). We evaluated the effectiveness of the Penn Resiliency Program for adolescents (PRP-A), a school-based group intervention that targets cognitive behavioral risk factors for depression. We randomly assigned 408 middle school students (ages 10–15) to one of three conditions: PRP-A, PRP-AP (in which adolescents participated in PRP-A and parents were invited to attend a parent intervention component), or a school-as-usual control. Adolescents completed measures of depression and anxiety symptoms, cognitive style, and coping at baseline, immediately after the intervention, and at 6-month follow-up. PRP-A reduced depression symptoms relative to the school as usual control. Baseline levels of hopelessness moderated intervention effects. Among participants with average and high levels of hopelessness, PRP (A and AP) significantly improved depression symptoms, anxiety symptoms, hopelessness, and active coping relative to control. Among participants with low baseline hopelessness, we found no intervention effects. PRP-AP was not more effective than PRP-A alone. We found no intervention effects on clinical levels of depression or anxiety. These findings suggest that cognitive-behavioral interventions can be beneficial when delivered by school teachers and counselors. These interventions may be most helpful to students with elevated hopelessness.

Acknowledgments

This project was supported by National Institute of Mental Health grant MH52270. Clinical trials registration #: NCT00360451. We thank the adolescents, parents, school counselors, and teachers who participated in this project.

The Penn Resiliency Program materials are available for use in research. Materials can be requested by e-mail to [email protected].

Disclosures: Drs. Gillham and Reivich are authors of the Penn Resiliency Program. The University of Pennsylvania has licensed the Penn Resiliency Program to Adaptiv Learning Systems. Drs. Reivich and Seligman own Adaptiv stock and could profit from the sale of this program. None of the other authors of this study has a financial relationship with Adaptiv.

Notes

Note: N = 408.

Note: All correlations significant at p < .001. CDI = Children's Depression Inventory; RADS = Reynolds Adolescent Depression Scale; RCMAS = Revised Children's Manifest Anxiety Scale; CASQ–N = Children's Attributional Style Questionnaire, Negative Events Scale; HSC = Hopelessness Scale for Children; CCSC = Children's Coping Strategies Checklist.

Note: PRP-A = Penn Resiliency Program for adolescents; PRP-AP = PRP for adolescents and parents; CDI = Children's Depression Inventory; ANCOVA = analysis of covariance; MM ANOVA = mixed-model analysis of variance; RADS = Reynolds Adolescent Depression Scale; RCMAS = Revised Children's Manifest Anxiety Scale; CASQ–N = Children's Attributional Style Questionnaire, Negative Events Scale; HSC = Hopelessness Scale for Children; CCSC = Children's Coping Strategies Checklist. The numbers in brackets in the Pairwise Comparison columns reflect 95% confidence intervals.

Note: There were no significant intervention effects on clinical levels of symptoms. PRP-A = Penn Resiliency Program for adolescents; PRP-AP = PRP for adolescents and parents.

Note: PRP-A = Penn Resiliency Program for adolescents; PRP-AP = PRP for adolescents and parents; CDI = Children's Depression Inventory; ANCOVA = analysis of covariance; MM ANOVA = mixed-model analysis of variance; RADS = Reynolds Adolescent Depression Scale; RCMAS = Revised Children's Manifest Anxiety Scale; CASQ–N = Children's Attributional Style Questionnaire, Negative Events Scale; HSC = Hopelessness Scale for Children; CCSC = Children's Coping Strategies Checklist. The numbers in brackets in the Pairwise Comparison columns reflect 95% confidence intervals.

Additional information

Notes on contributors

Steven M. Brunwasser

Steven M. Brunwasser is now at the Department of Psychology, University of Michigan;

Norma D. Chajon

Norma D. Chajon is now at Middlesex Middle School, Darien, CT;

V. Megan Kash-MacDonald

V. Megan Kash-MacDonald is now at the Institute of Psychiatry, Kings College, London;

Tara M. Chaplin

Tara M. Chaplin is now at the Department of Psychiatry, Yale University School of Medicine;

Rachel M. Abenavoli

Rachel M. Abenavoli is now at the Department of Human Development and Family Studies, Pennsylvania State University; and

Samantha L. Matlin

Samantha L. Matlin is now at the Department of Behavioral Health and Intellectual Disabilities, Philadelphia, PA.