Testing the Effectiveness of Adolescent Depression Prevention Programs (The OregonBlues Study)

Major depression is one of the most common psychiatric disorders experienced by adolescents.
Even adolescents with depressive symptoms below the level of diagnosis are at increased risk
of a range of future problems, such as psychiatric disorders, impaired social functioning,
and substance abuse.

Depression prevention therapies have had mixed results. Those that are implemented
universally have shown little efficacy, although those that specifically target adolescents
at risk of depression have shown greater efficacy. A large scale effectiveness trial—one
that applies treatments outside of a lab in "real world" settings—of a targeted depression
prevention therapy has not been conducted. This study will test the effectiveness of two
therapies for preventing depression in adolescents. The first is a brief, group
cognitive-behavioral depression prevention program, and the second is bibliotherapy, which
involves giving participants a self-help book for depression. Bibliotherapy has shown
efficacy in previous research but has not been examined in an effectiveness trial.

Participation in this study will last 24 months. Participants will be randomly assigned to
one of three conditions: a six-session, cognitive-behavioral depression prevention group; a
bibliotherapy group; and an assessment only group. Participants in the cognitive-behavioral
group will meet with a study therapist and other group members to learn strategies for
preventing depression. Participants in the bibliotherapy group will be given a self-help
book titled "Feeling Good" with information on preventing depression. Participants in the
assessment only group will receive a pamphlet on depression symptoms and treatment. All
participants will complete assessments at baseline; after the cognitive-behavioral group has
been completed; and at 6-, 12-, 18-, and 24-month follow-ups. These assessments will include
an interview about depression symptoms and a survey about thoughts, feelings, actions,
depression, and substance abuse.

Inclusion Criteria:

- High school student

- Subthreshold depressive symptoms

Exclusion Criteria:

- Meets criteria for major depression or dysthymia