Prevention of Depressive Symptoms in Schoolchildren: A Research Update

Abstract

Recent research suggests that cognitive vulnerabilities implicated in adult depression are relevant to depression in children, at least by middle childhood. For example, a pessimistic explanatory style is associated with depressive symptoms in children and has been found to predict depressive symptoms in some studies (for reviews, see Gladstone & Kaslow, 1995; Joiner & Wagner, 1995). Intervention programs that target these cognitive vulnerabilities are effective in treating and preventing depression symptoms and episodes (Clarke et al., 1995; Gillham, Reivich, Jaycox, & Seligman, 1995; Lewinsohn, Clarke, & Rohde, 1994). Clarke and colleagues found a prevention effect that lasted through 12 months of follow-up. Little is known about the even longer-term benefits of such programs. Do children who participate in these programs continue to benefit throughout their school years, or do the effects dissolve with time? In 1995, we reported long-term follow-up results of a school-based program designed to prevent depressive symptoms (Gillham et al., 1995). In this study, 69 fifth and sixth graders who participated in the prevention group were compared with a control group of 49 children. The children completed an assessment battery that included the Children’s Depression Inventory (CDI; Kovacs, 1985) and the Children’s Attributional Style Questionnaire (CASQ; Kaslow, Tannenbaum, & Seligman, 1978) before the program, following the program, and every 6 months thereafter for 2 years. The prevention group reported significantly fewer depressive symptoms throughout the 2-year follow-up period. Children in the prevention group were also less likely to report moderate to severe symptoms. Explanatory-style scores became more optimistic in the prevention group, and there was evidence that improvements in explanatory style, in part, mediated the program’s effect on depressive symptoms. We have since completed our final follow-up. Sixty-nine of these children (37 from the prevention group and 32 from the control group) completed questionnaires 2 1/2 years after the program, and 67 children (40 from the prevention group and 27 from the control group) completed questionnaires at the 3-year follow-up. To examine the possibility of differential attrition, we ran a series of analyses comparing prevention- and control-group children who left the study on demographic variables and questionnaire scores obtained at baseline. No significant differences were found. Our results indicate the prevention program’s effect on explanatory