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Prevention bends adolescent internalizing trajectories: Within-person changes from pre- to post-prevention.
Benjamin L Hankin1, Jason D Jones2, Molly Davis2
1University of Illinois at Urbana-Champaign, Champaign, IL, United States of America.
Journal of Affective Disorders
|December 21, 2025
Summary
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.
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.
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