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Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Study protocol

Evaluation of a Dutch school-based depression prevention program for youths in highrisk neighborhoods: study protocol of a two-armed randomized controlled trial

Authors: Karlijn CM Kindt, Rinka van Zundert, Rutger CME Engels

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

Research has indicated that depression prevention programs attenuate the development of symptoms of depression in adolescents. To implement these programs on a large scale, implementation in a school setting with teachers providing the programs is needed. In the present study, the effectiveness of the Dutch depression prevention program Op Volle Kracht (OVK) provided by school teachers during school hours with adolescents from high risk neighborhoods will be tested. The mediating effects of cognitive distortions and alexithymia will be evaluated as well. We hypothesize that the OVK program will prevent or decrease reported depressive symptoms, and that this association will be mediated by cognitive distortions and alexithymia.

Methods/Design

Schools with at least 30% of their pupils living in low income areas in the Netherlands are invited to participate in the study. Classes from vocational training up to pre-university level are eligible and 1324 adolescents (11-14 years) will be participating in the study. Randomisation will be done at class level, randomly assigning participants to an intervention group (OVK) and a control group (care as usual), stratifying by school level (high versus low). Trained school teachers will be delivering the program, which covers cognitive-behavioral and social problem-solving skills. Longitudinal data will be collected with self-report measurements administered in the school setting at baseline, post intervention and at two follow ups (at 6 and 12 months). Primary outcome is the level of depressive symptoms, and secondary outcomes include: cognitive errors, response style, attributional style, alexithymia, stressful life events, substance use, happiness, and school grades.

Discussion

If the OVK program proves to be effective when it is provided by school teachers, a structural implementation of the program in the school curriculum will enhance the quality of the lives of adolescents and their families and will reduce costs in health care. In addition, the results of the study advances current knowledge on the underlying mechanisms of the development of depression and may aid the improvement of depression prevention programs in general.

Trial registration

Dutch Trial Register NTR3110
Appendix
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Literature
2.
go back to reference Cuijpers P, van Straten A, Smit F, Mihalopoulos C, Beekman A: Preventing the onset of depressive disorders: a meta-analytic review of psychological interventions. Am J Psychiatry. 2008, 165: 1272-1280. 10.1176/appi.ajp.2008.07091422.CrossRefPubMed Cuijpers P, van Straten A, Smit F, Mihalopoulos C, Beekman A: Preventing the onset of depressive disorders: a meta-analytic review of psychological interventions. Am J Psychiatry. 2008, 165: 1272-1280. 10.1176/appi.ajp.2008.07091422.CrossRefPubMed
3.
go back to reference Stice E, Shaw H, Bohon C, Marti CN, Rohde P: A meta-analytic review of depression prevention programs for children and adolescents: factors that predict magnitude of intervention effects. J Consult Clin Psychol. 2009, 77: 486-503.CrossRefPubMedPubMedCentral Stice E, Shaw H, Bohon C, Marti CN, Rohde P: A meta-analytic review of depression prevention programs for children and adolescents: factors that predict magnitude of intervention effects. J Consult Clin Psychol. 2009, 77: 486-503.CrossRefPubMedPubMedCentral
4.
go back to reference Gillham JE, Reivich KJ, Freres DR, Chaplin TM, Shatte AJ, Samuels B, Elkon AGL, Litzinger S, Lascher M, Gallop R, Seligman MEP: School-based prevention of depressive symptoms: a randomized controlled study of the effectiveness and specificity of the Penn resiliency program. J Consult Clin Psychol. 2007, 75: 9-19.CrossRefPubMedPubMedCentral Gillham JE, Reivich KJ, Freres DR, Chaplin TM, Shatte AJ, Samuels B, Elkon AGL, Litzinger S, Lascher M, Gallop R, Seligman MEP: School-based prevention of depressive symptoms: a randomized controlled study of the effectiveness and specificity of the Penn resiliency program. J Consult Clin Psychol. 2007, 75: 9-19.CrossRefPubMedPubMedCentral
5.
go back to reference Tak YR, van Zundert RMP, Kuijpers RCWM, van Vlokhoven BS, Rensink HFW, Engels RCME: A randomized controlled trial testing the effectiveness of a universal school-based depression prevention program 'Op Volle Kracht' in the Netherlands. BMC Public Health. 2012, 12: 21-10.1186/1471-2458-12-21.CrossRefPubMedPubMedCentral Tak YR, van Zundert RMP, Kuijpers RCWM, van Vlokhoven BS, Rensink HFW, Engels RCME: A randomized controlled trial testing the effectiveness of a universal school-based depression prevention program 'Op Volle Kracht' in the Netherlands. BMC Public Health. 2012, 12: 21-10.1186/1471-2458-12-21.CrossRefPubMedPubMedCentral
6.
go back to reference Muñoz RF, Cuijpers P, Smit F, Barrera AZ, Leykin Y: Prevention of major depression. Ann Rev Clin Psychol. 2010, 6: 181-212. 10.1146/annurev-clinpsy-033109-132040.CrossRef Muñoz RF, Cuijpers P, Smit F, Barrera AZ, Leykin Y: Prevention of major depression. Ann Rev Clin Psychol. 2010, 6: 181-212. 10.1146/annurev-clinpsy-033109-132040.CrossRef
7.
go back to reference Horowitz JL, Garber J: The prevention of depressive symptoms in children and adolescents: a meta-analytic review. J Consult Clin Psychol. 2006, 74: 401-415.CrossRefPubMed Horowitz JL, Garber J: The prevention of depressive symptoms in children and adolescents: a meta-analytic review. J Consult Clin Psychol. 2006, 74: 401-415.CrossRefPubMed
8.
go back to reference Barreto S, McManus M: Casting the net for "depression" among ethnic minority children from the high-risk urban communities. Clin Psychol Rev. 1997, 8: 823-845.CrossRef Barreto S, McManus M: Casting the net for "depression" among ethnic minority children from the high-risk urban communities. Clin Psychol Rev. 1997, 8: 823-845.CrossRef
9.
go back to reference Bruce ML, Takeuchi DT, Leaf PJ: Poverty and psychiatric status: longitudinal evidence from the New Haven epidemiologic catchment area study. Arch Gen Psychiatry. 1991, 48: 470-474. 10.1001/archpsyc.1991.01810290082015.CrossRefPubMed Bruce ML, Takeuchi DT, Leaf PJ: Poverty and psychiatric status: longitudinal evidence from the New Haven epidemiologic catchment area study. Arch Gen Psychiatry. 1991, 48: 470-474. 10.1001/archpsyc.1991.01810290082015.CrossRefPubMed
10.
go back to reference Cardemil EV, Reivich KJ, Beevers CG, Seligman MEP, James J: The prevention of depressive symptoms in low-income, minority children: two-year follow-up. Behav Res Ther. 2007, 45: 313-327. 10.1016/j.brat.2006.03.010.CrossRefPubMed Cardemil EV, Reivich KJ, Beevers CG, Seligman MEP, James J: The prevention of depressive symptoms in low-income, minority children: two-year follow-up. Behav Res Ther. 2007, 45: 313-327. 10.1016/j.brat.2006.03.010.CrossRefPubMed
11.
go back to reference Gillham JE, Hamilton J, Freres DR, Patton K, Gallop R: Preventing depression among early adolescents in the primary care setting: a randomized controlled study of the Penn resiliency program. J Abnorm Child Psychol. 2006, 34: 203-219.CrossRefPubMed Gillham JE, Hamilton J, Freres DR, Patton K, Gallop R: Preventing depression among early adolescents in the primary care setting: a randomized controlled study of the Penn resiliency program. J Abnorm Child Psychol. 2006, 34: 203-219.CrossRefPubMed
12.
go back to reference Hankin BL, Abramson LY, Moffitt TE, McGee R, Silva PA, Angell KE: Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol. 1998, 107: 128-140.CrossRefPubMed Hankin BL, Abramson LY, Moffitt TE, McGee R, Silva PA, Angell KE: Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol. 1998, 107: 128-140.CrossRefPubMed
13.
go back to reference Beck AT, Rush AJ, Shaw BF, Emery G: Cognitive therapy of depression. 1979, New York: Guilford Press Beck AT, Rush AJ, Shaw BF, Emery G: Cognitive therapy of depression. 1979, New York: Guilford Press
14.
go back to reference Abramson LY, Metalsky GI, Alloy LB: Hopelessness depression: a theory-based subtype of depression. Psychol Rev. 1989, 96: 358-372.CrossRef Abramson LY, Metalsky GI, Alloy LB: Hopelessness depression: a theory-based subtype of depression. Psychol Rev. 1989, 96: 358-372.CrossRef
15.
go back to reference Nolen-Hoeksema S: Responses to depression and their effects on the duration of depressive episodes. J Abnorm Psychol. 1991, 100: 569-582.CrossRefPubMed Nolen-Hoeksema S: Responses to depression and their effects on the duration of depressive episodes. J Abnorm Psychol. 1991, 100: 569-582.CrossRefPubMed
16.
go back to reference Metalsky GI, Abramson LY, Seligman MEP, Semmel A, Peterson CR: Attributional styles and life events in the classroom: vulnerability and invulnerability to depressive mood reactions. J Pers Soc Psychol. 1982, 43: 612-617.CrossRefPubMed Metalsky GI, Abramson LY, Seligman MEP, Semmel A, Peterson CR: Attributional styles and life events in the classroom: vulnerability and invulnerability to depressive mood reactions. J Pers Soc Psychol. 1982, 43: 612-617.CrossRefPubMed
17.
go back to reference Abela JRZ, Hankin BL: Rumination as a vulnerability factor to depression during the transition from early to middle adolescence: a multiwave longitudinal study. J Abnorm Child Psychol. 2011, 120: 259-271.CrossRef Abela JRZ, Hankin BL: Rumination as a vulnerability factor to depression during the transition from early to middle adolescence: a multiwave longitudinal study. J Abnorm Child Psychol. 2011, 120: 259-271.CrossRef
18.
go back to reference Stice E, Rohde P, Seeley J, Gau J: Testing mediation of intervention effects in randomized trials: an evaluation of three depression prevention programs. J Consult Clin Psychol. 2010, 78: 273-280.CrossRefPubMedPubMedCentral Stice E, Rohde P, Seeley J, Gau J: Testing mediation of intervention effects in randomized trials: an evaluation of three depression prevention programs. J Consult Clin Psychol. 2010, 78: 273-280.CrossRefPubMedPubMedCentral
19.
go back to reference Lakdawalla Z, Hankin BL, Mermelstein R: Cognitive theories of depression in children and adolescents: a conceptual and quantitative review. Clin Child Fam Psychol Rev. 2007, 10: 1-24. 10.1007/s10567-006-0013-1.CrossRefPubMed Lakdawalla Z, Hankin BL, Mermelstein R: Cognitive theories of depression in children and adolescents: a conceptual and quantitative review. Clin Child Fam Psychol Rev. 2007, 10: 1-24. 10.1007/s10567-006-0013-1.CrossRefPubMed
20.
go back to reference Sifneos PE: Alexithymia: past and present. American J Psychiatry. 1996, 153: 137-142.CrossRef Sifneos PE: Alexithymia: past and present. American J Psychiatry. 1996, 153: 137-142.CrossRef
21.
go back to reference Rieffe C, Oosterveld P, Meerum Terwogt M, Novin S, Nasiri H, Latifian M: Relationship between alexithymia, mood and internalizing symptoms in children and young adolescents; Evidence from an Iranian sample. Personality Indiv Diff. 2010, 48: 425-430. 10.1016/j.paid.2009.11.010.CrossRef Rieffe C, Oosterveld P, Meerum Terwogt M, Novin S, Nasiri H, Latifian M: Relationship between alexithymia, mood and internalizing symptoms in children and young adolescents; Evidence from an Iranian sample. Personality Indiv Diff. 2010, 48: 425-430. 10.1016/j.paid.2009.11.010.CrossRef
22.
go back to reference Spek V, Nyklíček I, Cuijpers P, Pop V: Alexithymia and cognitive behaviour therapy outcome for subthreshold depression. Acta Psychiatr Scand. 2008, 118: 164-167. 10.1111/j.1600-0447.2008.01199.x.CrossRefPubMed Spek V, Nyklíček I, Cuijpers P, Pop V: Alexithymia and cognitive behaviour therapy outcome for subthreshold depression. Acta Psychiatr Scand. 2008, 118: 164-167. 10.1111/j.1600-0447.2008.01199.x.CrossRefPubMed
23.
go back to reference Kovacs M: The Children's Depression, Inventory (CDI). Psychopharmacology Bulletin. 1985, 21: 995-998.PubMed Kovacs M: The Children's Depression, Inventory (CDI). Psychopharmacology Bulletin. 1985, 21: 995-998.PubMed
24.
go back to reference Timbremont B, Braet C, Roelofs J: Children's Depression Inventory: Handleiding. 2008, Amsterdam: Pearson Timbremont B, Braet C, Roelofs J: Children's Depression Inventory: Handleiding. 2008, Amsterdam: Pearson
25.
go back to reference Maric M, Heyne DA, van Widenfelt BM, Westenberg PM: Distorted cognitive processing in youth: the structure of negative cognitive errors and their associations with anxiety. Cog Ther Res. 2011, 35: 11-20. 10.1007/s10608-009-9285-3.CrossRef Maric M, Heyne DA, van Widenfelt BM, Westenberg PM: Distorted cognitive processing in youth: the structure of negative cognitive errors and their associations with anxiety. Cog Ther Res. 2011, 35: 11-20. 10.1007/s10608-009-9285-3.CrossRef
26.
go back to reference Leitenberg H, Yost LW, Carroll-Wilson M: Negative cognitive errors in children: questionnaire development, normative data, and comparisons between children with and without self-reported symptoms of depression, low self-esteem, and evaluation anxiety. J Consult Clin Psychol. 1986, 54: 528-536.CrossRefPubMed Leitenberg H, Yost LW, Carroll-Wilson M: Negative cognitive errors in children: questionnaire development, normative data, and comparisons between children with and without self-reported symptoms of depression, low self-esteem, and evaluation anxiety. J Consult Clin Psychol. 1986, 54: 528-536.CrossRefPubMed
27.
go back to reference Abela JRZ, Brozina K, Haigh EP: An examination of the response styles theory of depression in third and seventh grade children: a short-term longitudinal study. J Abnorm Child Psychol. 2002, 30: 513-525. Abela JRZ, Brozina K, Haigh EP: An examination of the response styles theory of depression in third and seventh grade children: a short-term longitudinal study. J Abnorm Child Psychol. 2002, 30: 513-525.
28.
go back to reference Hankin BL, Abramson LY: Measuring cognitive vulnerability to depression in adolescence: reliability, validity, and gender differences. J Clin Child Adol Psychol. 2002, 31: 491-504.CrossRef Hankin BL, Abramson LY: Measuring cognitive vulnerability to depression in adolescence: reliability, validity, and gender differences. J Clin Child Adol Psychol. 2002, 31: 491-504.CrossRef
29.
go back to reference Bagby RM, Parker JDA, Taylor GJ: The twenty-item Toronto Alexithymia Scale: I. Item selection and cross-validation of the factor structure. J Psychosom Res. 1994, 38: 23-32. 10.1016/0022-3999(94)90005-1.CrossRefPubMed Bagby RM, Parker JDA, Taylor GJ: The twenty-item Toronto Alexithymia Scale: I. Item selection and cross-validation of the factor structure. J Psychosom Res. 1994, 38: 23-32. 10.1016/0022-3999(94)90005-1.CrossRefPubMed
30.
go back to reference Bagby RM, Parker JDA, Taylor GJ: The twenty-item Toronto Alexithymia Scale: II. Convergent, discriminant, and concurrent validity. J Psychosom Res. 1994, 38: 33-40. 10.1016/0022-3999(94)90006-X.CrossRefPubMed Bagby RM, Parker JDA, Taylor GJ: The twenty-item Toronto Alexithymia Scale: II. Convergent, discriminant, and concurrent validity. J Psychosom Res. 1994, 38: 33-40. 10.1016/0022-3999(94)90006-X.CrossRefPubMed
31.
go back to reference Auerbach RP, Bigda-Peyton JS, Eberhart NK, Webb CA, Ringo Ho M: Conceptualizing the prospective relationship between social support, stress, and depressive symptoms among adolescent. J Abnorm Child Psychol. 2011, 39: 475-487. 10.1007/s10802-010-9479-x.CrossRefPubMed Auerbach RP, Bigda-Peyton JS, Eberhart NK, Webb CA, Ringo Ho M: Conceptualizing the prospective relationship between social support, stress, and depressive symptoms among adolescent. J Abnorm Child Psychol. 2011, 39: 475-487. 10.1007/s10802-010-9479-x.CrossRefPubMed
32.
go back to reference Kalmijn W, Arends L, Veenhoven R: Happiness scale interval study. Methodological Considerations. Soc Indic Res. 2011, 102: 497-515. 10.1007/s11205-010-9688-2.CrossRefPubMed Kalmijn W, Arends L, Veenhoven R: Happiness scale interval study. Methodological Considerations. Soc Indic Res. 2011, 102: 497-515. 10.1007/s11205-010-9688-2.CrossRefPubMed
33.
go back to reference Engels RCME, Knibbe RA, Drop MJ: Why do late adolescents drink at home? A study on psychological well-being, social integration and drinking context. Addict Res. 1999, 7: 31-46. 10.3109/16066359909004373.CrossRef Engels RCME, Knibbe RA, Drop MJ: Why do late adolescents drink at home? A study on psychological well-being, social integration and drinking context. Addict Res. 1999, 7: 31-46. 10.3109/16066359909004373.CrossRef
34.
go back to reference Engels RCME, Knibbe RA: Alcohol use and intimate relationships in adolescence: when love comes to town. Addict Behav. 2000, 25: 435-439. 10.1016/S0306-4603(98)00123-3.CrossRefPubMed Engels RCME, Knibbe RA: Alcohol use and intimate relationships in adolescence: when love comes to town. Addict Behav. 2000, 25: 435-439. 10.1016/S0306-4603(98)00123-3.CrossRefPubMed
35.
go back to reference de Vries H, Engels R, Kremers S, Wetzels J, Mudde A: Parents' and friends' smoking status as predictors of smoking onset: findings from six European countries. Health Educ Res. 2003, 18: 627-636. 10.1093/her/cyg032.CrossRefPubMed de Vries H, Engels R, Kremers S, Wetzels J, Mudde A: Parents' and friends' smoking status as predictors of smoking onset: findings from six European countries. Health Educ Res. 2003, 18: 627-636. 10.1093/her/cyg032.CrossRefPubMed
36.
go back to reference Kremers SPJ, Mudde AN, de Vries H: "Kicking the initiation": do adolescent ex smokers differ from other groups within the initiation continuum?. Prev Med. 2001, 33: 392-401. 10.1006/pmed.2001.0904.CrossRefPubMed Kremers SPJ, Mudde AN, de Vries H: "Kicking the initiation": do adolescent ex smokers differ from other groups within the initiation continuum?. Prev Med. 2001, 33: 392-401. 10.1006/pmed.2001.0904.CrossRefPubMed
37.
go back to reference Muthén LK, Muthén BO: Mplus user's guide, version 4. 2006, Los Angeles, CA Muthén LK, Muthén BO: Mplus user's guide, version 4. 2006, Los Angeles, CA
38.
go back to reference Koning I, Vollebergh W, Verdurmen J, Smit F, van den Eijnden R, ter Bogt T, Stattin H, Engels RCME: Effect of PAS on delay in alcohol onset. Addiction. 2009, 104: 1669-1678. 10.1111/j.1360-0443.2009.02677.x.CrossRefPubMed Koning I, Vollebergh W, Verdurmen J, Smit F, van den Eijnden R, ter Bogt T, Stattin H, Engels RCME: Effect of PAS on delay in alcohol onset. Addiction. 2009, 104: 1669-1678. 10.1111/j.1360-0443.2009.02677.x.CrossRefPubMed
39.
go back to reference Moher D, Schulz KF, Altman DG: The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. Lancet. 2001, 357: 1191-1194. 10.1016/S0140-6736(00)04337-3.CrossRefPubMed Moher D, Schulz KF, Altman DG: The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. Lancet. 2001, 357: 1191-1194. 10.1016/S0140-6736(00)04337-3.CrossRefPubMed
40.
go back to reference MacKinnon DP, Fairchild AJ, Fritz MS: Mediation analysis. Ann Rev Psychol. 2007, 58: 593-614. 10.1146/annurev.psych.58.110405.085542.CrossRef MacKinnon DP, Fairchild AJ, Fritz MS: Mediation analysis. Ann Rev Psychol. 2007, 58: 593-614. 10.1146/annurev.psych.58.110405.085542.CrossRef
41.
go back to reference Kazdin AE: Mediators and mechanisms of change in psychotherapy research. Ann Rev Clin Psychol. 2007, 3: 1-27. 10.1146/annurev.clinpsy.3.022806.091432.CrossRef Kazdin AE: Mediators and mechanisms of change in psychotherapy research. Ann Rev Clin Psychol. 2007, 3: 1-27. 10.1146/annurev.clinpsy.3.022806.091432.CrossRef
42.
go back to reference DiBartolo PM, Grills AE: Who is best at predicting children's anxiety in response to a social evaluative task? A comparison of child, parent, and teacher reports. J Anxiety Disord. 2006, 20: 630-645. 10.1016/j.janxdis.2005.06.003.CrossRefPubMed DiBartolo PM, Grills AE: Who is best at predicting children's anxiety in response to a social evaluative task? A comparison of child, parent, and teacher reports. J Anxiety Disord. 2006, 20: 630-645. 10.1016/j.janxdis.2005.06.003.CrossRefPubMed
Metadata
Title
Evaluation of a Dutch school-based depression prevention program for youths in highrisk neighborhoods: study protocol of a two-armed randomized controlled trial
Authors
Karlijn CM Kindt
Rinka van Zundert
Rutger CME Engels
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-212

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