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Prevention bends adolescent internalizing trajectories: Within-person changes from pre- to post-prevention.

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Depression prevention programs significantly reduced depression and anxiety symptoms in adolescents over 21 months. These evidence-based interventions effectively lowered internalizing symptom trajectories during a critical developmental period.

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Area of Science:

  • Adolescent mental health
  • Preventive psychiatry
  • Clinical psychology

Background:

  • Adolescence is a critical period for the onset of internalizing disorders.
  • Understanding the trajectory of depression and anxiety symptoms during adolescence is crucial for developing effective interventions.
  • Previous research has not fully evaluated the long-term impact of depression prevention programs on within-person symptom changes.

Purpose of the Study:

  • To assess the efficacy of depression prevention programs in reducing adolescents' within-person depression and anxiety symptoms.
  • To determine if these programs can alter symptom trajectories from pre-intervention levels to sustained lower levels post-intervention.
  • To evaluate symptom changes over a 21-month follow-up period.

Main Methods:

  • A randomized controlled trial involving 204 adolescents (mean age 14.26 years).
  • Naturalistic repeated assessments of depression and anxiety symptoms every 3 months for 1 year prior to intervention.
  • Participants received either a cognitive-behavioral or interpersonal skills training program, with outcomes measured up to 21 months post-intervention.

Main Results:

  • Adolescents' depression and anxiety symptoms naturally decreased in the year before the intervention.
  • Preventive interventions significantly reduced within-person symptoms of depression (d=0.67 at 3 months, d=0.45 at 21 months) and anxiety (d=0.88 at 3 months, d=0.74 at 21 months) compared to pre-intervention levels.
  • Symptom reductions were maintained throughout the 21-month follow-up period.

Conclusions:

  • Evidence-based depression prevention programs are effective in modifying adolescent internalizing symptom trajectories.
  • These programs can lower symptom levels from those normatively rising during adolescence to sustained lower levels.
  • The study design highlights the utility of pre-intervention naturalistic data for evaluating prevention effectiveness.