Objective: To evaluate whether evidence-based depression prevention programs can be optimized by matching youths to interventions that address their psychosocial vulnerabilities. Method: This randomized controlled trial included 204 adolescents (mean [SD] age ¼ 14.26 [1.65] years; 56.4% female). Youths were categorized as high or low on cognitive and interpersonal risks for depression and randomly assigned to Coping With Stress (CWS), a cognitive-behavioral program, or Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST), an interpersonal program. Some participants received a match between risk and prevention (eg, high cognitive–low interpersonal risk teen in CWS, low cognitive–high interpersonal risk teen in IPT-AST), others received a mismatch (eg, low cognitive-high interpersonal risk teen in CWS). Outcomes were depression diagnoses and symptoms through 18 months postintervention (21 months total). Results: Matched adolescents showed significantly greater decreases in depressive symptoms than mismatched adolescents from postintervention through 18-month follow-up and across the entire 21-month study period (effect size [d] ¼ 0.44, 95% CI ¼ 0.02, 0.86). There was no significant difference in rates of depressive disorders among matched adolescents compared with mismatched adolescents (12.0% versus 18.3%, t193 ¼ .78, p ¼ .44). Conclusion: This study illustrates one approach to personalizing depression prevention as a form of precision mental health. Findings suggest that risk-informed personalization may enhance effects beyond a one-size-fits-all approach. Clinical trial registration information: Bending Adolescent Depression Trajectories Through Personalized Prevention; https://www.clinicaltrials. gov/; NCT01948167.
Journal of the American Academy of Child & Adolescent Psychiatry
Elsevier Science Inc.
Young, J. F., Jones, J. D., Gallop, R., Benas, J. S., Schueler, C. M., Garber, J., & Hankin, B. L. (2021). Personalized Depression Prevention: A Randomized Controlled Trial to Optimize Effects Through Risk-Informed Personalization. Journal of the American Academy of Child & Adolescent Psychiatry, 60(9), 1116-1126. http://dx.doi.org/10.1016/j.jaac.2020.11.004