Youth Cognitive-Behavioral Depression Prevention: Testing Theory in a Randomized Controlled Trial

Abstract

This study tested the plausibility of a theoretical model of change for the Penn Resiliency Program (PRP), a cognitive-behavioral (CB) depression prevention program for adolescents. Middle school students (N = 697) were randomized to PRP, an assessment-only control condition (CON), or a placebo-control condition (PLA). Explanatory style and depressive symptoms were evaluated over 24 months of follow-up. Relative to both CON and PLA, there were significant indirect effects of PRP on 12-month levels of depressive symptoms through improvements in explanatory style in two of three participating schools. Within a third school, where PRP was not effective in targeting depressive symptoms (Gillham et al., 2007), there was no evidence of group differences in growth in explanatory style or indirect effects. When effective, PRP's CB training provides incremental value over non-specific components and there are indirect effects on depressive symptoms through improvements in explanatory style.