Strategies for Universal Prevention of Depression in Adolescents

Background: The occurrence of depressive disorders in adolescence is of high individual and social importance because of their prevalence and persistence into adulthood and their co-morbidity with other psychological disorders and psychosocial problems. International researchers have recognized the seriousness of depressive disorders in adolescence and thus have been involved in the development and evaluation of prevention programs. Methods: This article will present the difficulties encountered in prevention research with adolescents and in the determination of prevention program efficacy. The main focus will be an overview of current prevention programs and their efficacy with special attention paid to programs featured in the German language literature. Finally, this article will highlight future directions for prevention research. Conclusions: In spite of some critical points, there appears to be a positive outlook for depression prevention programs for adolescents. There is currently support for universal depression prevention programs that may be incorporated into school settings and on which future research may build. It is expected that the methodological problems highlighted in this article may be corrected in the next few years, which may result in more effective, easily integrated programs and a more thorough understanding of adolescent depression

Dysthymia and major depression : distinct conditions or different stages along a one-dimensional continuum?

Until recently researchers have discussed whether dysthymia and major depression represent distinct conditions or rather different stages along a one-dimensional continuum. This study addresses this question by examining the belief systems of normal, dysthymic, and depressed participants. We explored participants‘ beliefs and differentiated between positive and negative as well as between core and peripheral beliefs. Normal participants showed fewer negative beliefs and negative peripheral beliefs than the dysthymic group, whereas normal participants had more positive beliefs and positive core beliefs as well as fewer negative core beliefs than the depressed group. The hypothesized one-dimensional continuum could not be demonstrated for the belief systems. Instead, the data point to the conclusion that our idea of a one-dimensional continuum reaching from normal to dysthymic to depressed was too simple. Apparently, the differences in the belief systems reported here are related to the chronic character and severity of the mood disorder

Comparing different sequential mediational interpretations of Beck’s depression model in adolescents.

Depression is a developmental phenomenon with significantly increasing rates during adolescence. As Beck’s cognitive model of depression has been commonly accepted to explain the development and maintenance of depression, it is crucial to understand how and when cognitive vulnerabilities predicted in this model begin to interact. Three sequential interpretations of this model were compared. The causal mediational interpretation identifies dysfunctional attitudes as most distal to depressive symptoms, followed by cognitive errors, cognitive triad, and negative automatic thoughts, with each construct successively more proximal to depressive symptoms. In the symptom model the causal chain is reversed, with depressive symptoms as the most distal construct, followed by negative automatic thoughts, the cognitive triad, cognitive errors, and then dysfunctional attitudes. The bidirectional model merges both interpretations in which the activation of cognitive constructs causes the development of depressive symptoms which in turn trigger and reinforce already existing dysfunctional attitudes. Further, while Beck’s model of depression proposes full mediation, empirical studies identified repeatedly partial mediations. Thus, the causal meditational, the symptoms, and the bidirectional model were each tested as full and partial mediation models. Finally, sex differences in the associations between variables were studied. In the 3-wave longitudinal study, 518 high school students (62.7 % female, average age: 15.09 years) completed questionnaires measuring all mentioned elements of Beck’s model. The bidirectional model with partial mediation fits the data best. Cognitive errors emerged as the main mediator in the bidirectional model with partial mediation and significant sex differences in the strengths of associations were identified. The findings demonstrate the relevance of adolescence as developmental period during which the examined associations develop into the network they form in adulthood. Further, psychological interventions focusing on cognitive errors promise to be most effective

Cognitive Error Questionnaire (CEQ) : psychometric properties and factor structure of the German translation.

A central component of Beck et al.’s (1979) cognitive theory of depression is faulty information processing reflected by so-called cognitive errors. These cognitive errors are the reason why depressed individuals systematically misinterpret the significance of events in a negative way. They are usually assessed with the application of the Cognitive Error Questionnaire (CEQ). This study examines the psychometric properties and factor structure of the German version of the CEQ in a sample of 796 volunteers at a German university. Results confirmed that the German CEQ has satisfactory to very good psychometric properties, like the American original. Confirmatory factor analyses demonstrated that a hierarchical four-factor model with four subscales and 1 s order factor fits the data best. Therefore, besides using the German CEQ in studies with German-speaking samples, the similarities in psychometric properties of the American and German CEQ allow for cross-cultural studies