This application is one of four interlocking R01's to assess the impact of a group cognitive behavioral program (CBP) on the prevention of depression in adolescents at risk for depression. Eligible teens must have a parent with active depression; teens themselves must have either a past depressive episode or current subsyndromal depressive symptoms. In this 5-year study, 320 at-risk adolescents (80 at each site) drawn from managed care organizations will be randomized to either CBP or usual care (UC) and followed for 32 months post intake to determine the impact of CBP vs. UC on onset of depressive disorders and symptoms, level of functioning, and medical and mental health care utilization. We hypothesize that participants in the CBP intervention will have a significantly lower prospective incidence of first and repeated episodes of depressive disorders and symptoms compared to adolescents in the usual care group. In addition, we will explore whether participants in CBP have a reduced prospective incidence of non-affective symptoms and disorders, and will show improved global functioning relative to the comparison group. Analyses also will focus on the incremental cost-effectiveness of providing the CBP over usual care from the health care perspective. This study builds on previous work by the Portland site (Clarke et al., 2001) showing a nearly six-fold reduction in the incidence of depression in CBP vs. UC, and extends this work in two ways - first, by testing whether the program can be replicated at several different sites, thereby greatly increasing the generalizability of the original findings; and second, by changing the timing and spacing of the intervention to provide continuation sessions to prolong the duration of the effect of CBP. This program of research is significant for several reasons: (1) depression is a chronic, prevalent, and impairing condition in adolescence that is often undetected, and which is more difficult to treat as chronicity increases; (2) there have been no large-scale studies of the prevention of depression in adolescence; and (3) by basing this study in managed care organizations, it will be possible to ascertain the costs and benefits of incorporating this intervention into """"""""best practice"""""""" in real world settings. This application is based in Nashville (Judy Garber, PI), and interlocks with applications from Boston (William Beardslee, PI), Pittsburgh (David Brent, PI), and Portland (Greg Clarke, PI).

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Special Emphasis Panel (ZMH1-ITV-D (01))
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Vitiello, Benedetto
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Vanderbilt University Medical Center
Schools of Education
United States
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Siddique, Juned; de Chavez, Peter J; Howe, George et al. (2018) Limitations in Using Multiple Imputation to Harmonize Individual Participant Data for Meta-Analysis. Prev Sci 19:95-108
Garber, J; Weersing, V R; Hollon, S D et al. (2018) Prevention of Depression in At-Risk Adolescents: Moderators of Long-term Response. Prev Sci 19:6-15
Brown, C Hendricks; Brincks, Ahnalee; Huang, Shi et al. (2018) Two-Year Impact of Prevention Programs on Adolescent Depression: an Integrative Data Analysis Approach. Prev Sci 19:74-94
Brincks, Ahnalee; Montag, Samantha; Howe, George W et al. (2018) Addressing Methodologic Challenges and Minimizing Threats to Validity in Synthesizing Findings from Individual-Level Data Across Longitudinal Randomized Trials. Prev Sci 19:60-73
Goodman, Sherryl H; Garber, Judy (2017) Evidence-Based Interventions for Depressed Mothers and Their Young Children. Child Dev 88:368-377
Weersing, V Robin; Shamseddeen, Wael; Garber, Judy et al. (2016) Prevention of Depression in At-Risk Adolescents: Predictors and Moderators of Acute Effects. J Am Acad Child Adolesc Psychiatry 55:219-26
Brunwasser, Steven M; Garber, Judy (2016) Programs for the Prevention of Youth Depression: Evaluation of Efficacy, Effectiveness, and Readiness for Dissemination. J Clin Child Adolesc Psychol 45:763-783
Garber, Judy; Frankel, Sarah A; Herrington, Catherine G (2016) Developmental Demands of Cognitive Behavioral Therapy for Depression in Children and Adolescents: Cognitive, Social, and Emotional Processes. Annu Rev Clin Psychol 12:181-216
Evans, Lindsay D; Kouros, Chrystyna D; Samanez-Larkin, Silvia et al. (2016) Concurrent and Short-Term Prospective Relations among Neurocognitive Functioning, Coping, and Depressive Symptoms in Youth. J Clin Child Adolesc Psychol 45:6-20
Garber, Judy; Brunwasser, Steven M; Zerr, Argero A et al. (2016) Treatment and Prevention of Depression and Anxiety in Youth: Test of Cross-Over Effects. Depress Anxiety 33:939-959

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