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Mediators and Moderators of a School-Based Cognitive-Behavioral Depression Prevention Program

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Abstract

This study tested potential moderators and mediators of an indicated depression prevention program for middle school students, Positive Thoughts and Actions (PTA). Participants were 120 students randomly assigned to PTA, or a brief, individually administered supportive intervention (Individual Support Program). Youths completed measures of depressive symptoms at baseline, post-intervention, and 12-month follow-up. Hierarchical regression was used to test three moderators—ethnic minority status, gender, and baseline depressive symptoms—and three mediators representing functional outcomes targeted by PTA—parent–child communication, attitude towards school, and health behavior. Ethnic minority status did not moderate PTA effects at post-intervention but did moderate PTA effects at 12-month follow-up. At 12 months, PTA appeared to be more effective for White participants than ethnic minority youth. Follow-up analyses suggested this moderation effect was due to the tendency of ethnic minority youth, especially those with fewer symptoms at baseline, to drop out by 12 months. Neither gender nor baseline depressive symptoms moderated the effects of PTA. Although PTA improved parent-child communication and attitudes toward school, there was no evidence that any of the three functional outcomes measured mediated the impact of PTA on depressive symptoms. Future directions are discussed.

This study is registered on ClinicalTrials.gov as NCT01220635.

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Acknowledgments

This research was supported by Grant R34 MH083076 from the National Institute of Mental Health (awarded to C. McCarty). The authors wish to thank the participating schools, parents, and students for their valuable contributions to science.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th St, Building 29, Suite 110, Seattle, WA, 98115, USA

    Mylien T. Duong & Carolyn A. McCarty

  2. IWK Health Centre, Halifax, Canada

    Brynn M. Kelly

  3. Seattle Children’s Research Institute, Seattle, WA, USA

    Wren L. Haaland, Brandon Matsumiya & Carolyn A. McCarty

  4. University of Southern California, Los Angeles, CA, USA

    Stanley J. Huey Jr

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Mylien T. Duong, Brynn M. Kelly, Wren L. Haaland, Brandon Matsumiya, Stanley J. Huey and Carolyn A. McCarty declare that they have no conflict of interest.

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Duong, M.T., Kelly, B.M., Haaland, W.L. et al. Mediators and Moderators of a School-Based Cognitive-Behavioral Depression Prevention Program. Cogn Ther Res 40, 705–716 (2016). https://doi.org/10.1007/s10608-016-9780-2

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