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http://crossmark.crossref.org/dialog/?doi=10.1007/s10608-016-9780-2&domain=pdf
Web End = Cogn Ther Res (2016) 40:705716
DOI 10.1007/s10608-016-9780-2
http://crossmark.crossref.org/dialog/?doi=10.1007/s10608-016-9780-2&domain=pdf
Web End = ORIGINAL ARTICLE
Mediators and Moderators of a School-Based Cognitive-Behavioral Depression Prevention Program
Mylien T. Duong1 Brynn M. Kelly2 Wren L. Haaland3 Brandon Matsumiya3
Stanley J. Huey Jr4 Carolyn A. McCarty1,3
Published online: 28 April 2016 Springer Science+Business Media New York 2016
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 moderatorsethnic minority status, gender, and baseline depressive symptomsand three mediators representing functional outcomes targeted by PTAparentchild 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.
Keywords Depression Prevention Intervention
Mediator Moderator
Introduction
Recent meta-analyses suggest that prevention programs do indeed reduce or slow the escalation of depressive symptoms (Horowitz and Garber 2006; Merry and Stasiak 2012; Stice et al. 2009). In previous reports, we described the post-intervention and 12-month follow-up outcomes (McCarty et al. 2013; Duong et al. 2016) for Positive Thoughts and Actions (PTA), a manualized and developmentally tailored school-based depression prevention program for middle school students. PTA is designed to address key factors that inuence and perpetuate depressive symptoms, including diminished health behaviors, academic stress, and interpersonal problems (Brittian et al. 2013; de Bruyn and Cillessen 2006). Relative to a brief, individually administered supportive control group (Individual Support Program, or ISP), middle school students assigned...