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Identifying Moderators of Response to the Penn Resiliency Program: A Synthesis Study

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Abstract

To identify moderators of a cognitive-behavioral depression prevention program’s effect on depressive symptoms among youth in early adolescence, data from three randomized controlled trials of the Penn Resiliency Program (PRP) were aggregated to maximize statistical power and sample diversity (N = 1145). Depressive symptoms, measured with the Children’s Depression Inventory (CDI; Kovacs 1992), were assessed at six common time points over two-years of follow-up. Latent growth curve models evaluated whether PRP and control conditions differed in the rate of change in CDI and whether youth- and family-level characteristics moderated intervention effects. Model-based recursive partitioning was used as a supplementary analysis for identifying moderators. There was a three-way interaction of PRP, initial symptom severity, and intervention site on growth in depressive symptoms. There was considerable variability in PRP’s effects, with the nature of the interaction between PRP and initial symptom levels differing considerably across sites. PRP reduced depressive symptoms among youth with unmarried parents, but not among those with married parents. Finally, PRP’s effects differed across school grade levels. Although initial symptom severity moderated PRP’s effect on depressive symptoms, it was not a reliable indicator of how well the intervention performed, limiting its utility as a prescriptive variable. Our primary analyses suggest that PRP’s effects are limited to youth whose parents are unmarried. The small number of fifth grade students (n = 25; 2 %) showed a delayed and sustained intervention response. Our findings underscore the importance of evaluating site, family, and contextual characteristics as moderators in future studies.

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Acknowledgments

We would like to thank Martin Seligman, Karen Reivich, John Hamilton, and Derek Freres for their essential contributions to these projects. We would also like to acknowledge George Howe, Hilda Pantin, Tatiana Perrino, and anonymous reviewers for providing helpful comments on earlier drafts of this manuscript. Finally, above all, we thank the adolescents and families who participated in these research trials.

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Authors and Affiliations

  1. Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, T-1218 Medical Center North,1161 21st Ave. S., Nashville, TN, 37232-2650, USA

    Steven M. Brunwasser

  2. Department of Psychology, Swarthmore College, Swarthmore, PA, USA

    Jane E. Gillham

  3. Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA

    Jane E. Gillham

  4. Department of Psychology and Human Development, Vanderbilt University, 552 Peabody, 230 Appleton Pl, Nashville, TN, 37203-5721, USA

    Steven M. Brunwasser

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  1. Steven M. Brunwasser
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Correspondence to Steven M. Brunwasser.

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Conflict of Interest

The authors declare that they have no competing interests.

Funding

This study involved aggregating data from three existing randomized controlled trials. Data from the first trial were obtained from a study funded by the Kaiser Foundation Research Institute. Data from the second and third trials were obtained from studies funded by the National Institute of Mental Health Grant MH52270. Steven Brunwasser was supported in part from an NIMH training grant (T32-MH18921) during completion of this work.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from parents of all youth participating in all three randomized controlled trials from which data were drawn for this study. Voluntary assent was obtained from all youth participating in these trials.

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Brunwasser, S.M., Gillham, J.E. Identifying Moderators of Response to the Penn Resiliency Program: A Synthesis Study. Prev Sci 19 (Suppl 1), 38–48 (2018). https://doi.org/10.1007/s11121-015-0627-y

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