Cognitive and Interpersonal Moderators of Two Evidence-Based Depression Prevention Programs

• Published in: Journal of consulting and clinical psychology 2024-07, Vol.92 (7), p.432-444
• Main Authors: Jones, Jason D., Schwartz, Karen T. G., Davis, Molly, Gallop, Robert, Hankin, Benjamin L., Young, Jami F.
• Format: Article
• Language: English
• Subjects: Adolescent Psychology; Adolescents; Change agents; Cognition; Cognitive Style; Cognitive-behavioral factors; Conflict; Coping style; Evidence Based Practice; Fathers; Female; Friendship; Hopelessness; Human; Interpersonal psychotherapy; Major Depression; Male; Mental depression; Moderators; Negative interactions; Prevention; Prevention programs; Psychotherapy; Risk Factors; Rumination; Skill development; Social support; Symptoms; Youth
• ISSN: 0022-006X; 1939-2117; 1939-2117
• DOI: 10.1037/ccp0000886

Objective: To test potential cognitive and interpersonal moderators of two evidence-based youth depression prevention programs. Method: Two hundred four adolescents (Mage = 14.62 years, SD = 1.65; 56% female; 71% White, 11% Black, 11% multiracial, 5% Asian, 2% other races, 18% Hispanic/Latinx) were randomized to either a cognitive-behavioral (Coping With Stress [CWS]) or interpersonal (Interpersonal Psychotherapy-Adolescent Skills Training [IPT-AST]) prevention program. Potential moderators, selected based on theory and research, included rumination, negative cognitive style, dysfunctional attitudes, hopelessness, parent-adolescent conflict, negative interactions with parents and friends, and social support from parents and friends. Depression symptoms were assessed repeatedly through 18 months postintervention. Results: After adjusting for multiple comparisons, rumination (B = −2.02, SE = .61, p = .001, d = .47), hopelessness (B = −2.03, SE = .72, p = .005, d = .41), and conflict with father (B = 1.68, SE = .74, p = .02, d = .32) moderated intervention effects on change in depression symptoms from postintervention through 18-month follow-up. For example, at high levels of conflict with father, youth in IPT-AST reported a significant decrease in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. At low levels of conflict with father, youth in IPT-AST reported a significant increase in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. Conclusions: These exploratory secondary analyses of Personalized Depression Prevention study data highlight specific cognitive and interpersonal risk factors that could be considered when determining which prevention program may be most effective for a given adolescent. What is the public health significance of this article? Adolescent depression is a major public health concern, and improving prevention efforts is critical. Study results suggest specific cognitive and interpersonal risk factors that may impact the effects of interventions for youth.