Depressive Symptom Trajectories Among Girls in the Juvenile Justice System: 24-month Outcomes of an RCT of Multidimensional Treatment Foster Care
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Youth depression is a significant and growing international public health problem. Youth who engage in high levels of delinquency are at particularly high risk for developing problems with depression. The present study examined the impact of a behavioral intervention designed to reduce delinquency (Multidimensional Treatment Foster Care; MTFC) compared to a group care intervention (GC; i.e., services as usual) on trajectories of depressive symptoms among adolescent girls in the juvenile justice system. MTFC has documented effects on preventing girls’ recidivism, but its effects on preventing the normative rise in girls’ depressive symptoms across adolescence have not been examined. This indicated prevention sample included 166 girls (13–17 years at T1) who had at least one criminal referral in the past 12 months and who were mandated to out-of-home care; girls were randomized to MTFC or GC. Intent-to-treat analyses examined the main effects of MTFC on depression symptoms and clinical cut-offs, and whether benefits were greatest for girls most at risk. Depressive symptom trajectories were specified in hierarchical linear growth models over a 2 year period using five waves of data at 6 month intervals. Depression clinical cut-off scores were specified as nonlinear probability growth models. Results showed significantly greater rates of deceleration for girls in MTFC versus GC for depressive symptoms and for clinical cut-off scores. The MTFC intervention also showed greater benefits for girls with higher levels of initial depressive symptoms. Possible mechanisms of effect are discussed, given MTFC’s effectiveness on targeted and nontargeted outcomes.
KeywordsMTFC Randomized controlled trial Depression Girls Juvenile justice Maltreatment
This study was supported primarily by the following grants: R01 DA024672 and R01 DA015208, NIDA, U.S. PHS; and R01 MH054257, NIMH, U.S. PHS. Additional support was provided by the following grants: R03 MH091611, NIMH, U.S. PHS; and P30 DA023920, NIDA, U.S. PHS. We thank Patricia Chamberlain for directing the original MTFC studies, Brandon Gibson for data management assistance, and Matthew Rabel and Michelle Baumann for editorial assistance. No author has a conflict of interest with the current study.
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