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Indicated Prevention for Depression at the Transition to High School: Outcomes for Depression and Anxiety

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Abstract

This study examined the impact of a school-based indicated prevention program on depression and anxiety symptoms for youth during the transition from middle to high school. The High School Transition Program (HSTP) was designed to build social and academic problem-solving skills and engagement during this period of particular vulnerability for adolescents. Students (N = 2664) at six middle schools in the Pacific Northwest completed a universal emotional health screening during the second half of the 8th grade year, and those with elevated depression scores and low conduct problem scores were invited to participate in the trial. Eligible students (N = 497) were randomized to either the HSTP (N = 241) or control (N = 256) conditions. Depression and anxiety symptoms were measured at five time points over an 18-month period using validated self-report measures. Hierarchical linear modeling was used to assess prevention effects and moderators such as baseline symptoms, race, and sex. Results suggested that students randomized to the HSTP group had accelerated rate of reduction in depressive symptoms over time (d = .23) relative to the control group. Students randomized to the HSTP group also had significantly faster rates of change of anxiety scores (d = 0.25). Baseline anxiety severity, race, and sex did not differentially impact the trajectories of symptom outcomes between conditions. Implications for prevention efforts during this normative but stressful period of transition for youth are discussed.

ClinicalTrials.gov registration number is NCT00071513.

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Funding

National Institute of Health grant R01 MH61984.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th St., Ste. 110, Seattle, WA, 98115, USA

    Heather Makover, Molly Adrian, Chelsey Wilks, Kendra Read, Ann Vander Stoep & Elizabeth McCauley

  2. Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, 98101, USA

    Elizabeth McCauley

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  1. Heather Makover
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  2. Molly Adrian
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  4. Kendra Read
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  5. Ann Vander Stoep
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Correspondence to Heather Makover.

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Makover, H., Adrian, M., Wilks, C. et al. Indicated Prevention for Depression at the Transition to High School: Outcomes for Depression and Anxiety. Prev Sci 20, 499–509 (2019). https://doi.org/10.1007/s11121-019-01005-5

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