A randomized controlled trial comparing two cognitive-behavioral programs for adolescent girls with subclinical depression: A school-based program (Op Volle Kracht) and a computerized program (SPARX).

Limited research has indicated the effectiveness of the school-based Cognitive Behavioral Therapy (CBT) prevention program 'Op Volle Kracht (OVK)' and the computerized CBT program 'SPARX' in decreasing depressive symptoms. Therefore, a randomized controlled trial of the effectiveness of OVK and SPARX was conducted among Dutch female adolescents (n = 208, mean age = 13.35) with elevated depressive symptoms. Participants were randomly assigned to one of four conditions: OVK only (n = 50), SPARX only (n = 51), OVK and SPARX combined (n = 56) and a monitoring control condition (n = 51). Participants in the first three conditions received OVK lessons and/or the SPARX game. Depressive symptoms were assessed before interventions started, weekly during the interventions, and immediately after the interventions ended, with follow-up assessments at 3, 6 and 12 months. Intention to treat results showed that depressive symptoms decreased in all conditions (F(12, 1853.03) = 14.62, p < .001), with no difference in depressive symptoms between conditions. Thus, all conditions, including the monitoring control condition, were equally effective in reducing depressive symptoms. Possible explanations for the decrease of depressive symptoms in all conditions are discussed and suggestions for future research are provided. Dutch Trial Register: NTR3737.

[1]  S. Nolen-Hoeksema,et al.  The emergence of gender differences in depression during adolescence. , 1994, Psychological bulletin.

[2]  Theresa Fleming,et al.  A pragmatic randomized controlled trial of computerized CBT (SPARX) for symptoms of depression among adolescents excluded from mainstream education. , 2012, Behavioural and cognitive psychotherapy.

[3]  I. Gotlib,et al.  Symptoms versus a diagnosis of depression: differences in psychosocial functioning. , 1995, Journal of consulting and clinical psychology.

[4]  Jason L. Horowitz,et al.  The prevention of depressive symptoms in children and adolescents: A meta-analytic review. , 2006, Journal of consulting and clinical psychology.

[5]  S. Spence,et al.  Long-term outcome of a school-based, universal approach to prevention of depression in adolescents. , 2005, Journal of consulting and clinical psychology.

[6]  Tom Baranowski,et al.  Lying (or Maybe Just Misleading) With (or Without) Statistics. , 2014, Games for health journal.

[7]  H. Christensen,et al.  Review of internet‐based prevention and treatment programs for anxiety and depression in children and adolescents , 2010, The Medical journal of Australia.

[8]  C. Fitzpatrick,et al.  Depression in adolescence. , 1995, Irish medical journal.

[9]  Elisa S. Shernoff,et al.  School-based interventions. , 2004, Child and adolescent psychiatric clinics of North America.

[10]  Eric S. Kim,et al.  A meta-analytic review of the Penn Resiliency Program's effect on depressive symptoms. , 2009, Journal of consulting and clinical psychology.

[11]  M. Stemmler,et al.  Depression in adolescence. , 1993, The American psychologist.

[12]  A. Sanabria,et al.  Randomized controlled trial. , 2005, World journal of surgery.

[13]  Matthew P. Mychailyszyn.  School-based interventions for anxious and depressed youth: A meta-analysis of outcomes , 2012 .

[14]  M. Nock,et al.  Delineating mechanisms of change in child and adolescent therapy: methodological issues and research recommendations. , 2003, Journal of child psychology and psychiatry, and allied disciplines.

[15]  Schubert Foo,et al.  Game-Based Digital Interventions for Depression Therapy: A Systematic Review and Meta-Analysis , 2014, Cyberpsychology Behav. Soc. Netw..

[16]  P. Stallard.  School-based interventions for depression and anxiety in children and adolescents , 2013, Evidence-Based Mental Health.

[17]  Mathijs F. G. Lucassen,et al.  The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial , 2012, BMJ : British Medical Journal.

[18]  Derek Richards,et al.  Computer-based psychological treatments for depression: a systematic review and meta-analysis. , 2012, Clinical psychology review.

[19]  H. Christensen,et al.  Effects of a Cognitive‐Behavioural Internet Program on Depression, Vulnerability to Depression and Stigma in Adolescent Males: A School‐Based Controlled Trial , 2006, Cognitive behaviour therapy.

[20]  J. Cairney,et al.  Emergence of gender differences in depression during adolescence: national panel results from three countries. , 2002, Journal of the American Academy of Child and Adolescent Psychiatry.

[21]  J. Graham,et al.  Missing data analysis: making it work in the real world. , 2009, Annual review of psychology.

[22]  Bernadette A. Thomas,et al.  Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[23]  K. Manassis,et al.  The feelings club: randomized controlled evaluation of school‐based CBT for anxious or depressive symptoms , 2010, Depression and anxiety.

[24]  S. Spence,et al.  Preventing adolescent depression: an evaluation of the problem solving for life program. , 2003, Journal of consulting and clinical psychology.

[25]  W. Arrindell.  Changes in waiting-list patients over time: data on some commonly-used measures. Beware! , 2001, Behaviour research and therapy.

[26]  Joost R van Ginkel,et al.  Analysis of Variance of Multiply Imputed Data , 2014, Multivariate Behavioral Research.

[27]  H. Christensen,et al.  The YouthMood Project: a cluster randomized controlled trial of an online cognitive behavioral program with adolescents. , 2009, Journal of consulting and clinical psychology.

[28]  T. Richardson,et al.  Computerised Cognitive Behavioural Therapy for the Prevention and Treatment of Depression and Anxiety in Children and Adolescents: A Systematic Review , 2010, Clinical child and family psychology review.

[29]  P. Cuijpers,et al.  Prevention of major depression. , 2010, Annual review of clinical psychology.

[30]  Lena Sanci,et al.  Self-monitoring Using Mobile Phones in the Early Stages of Adolescent Depression: Randomized Controlled Trial , 2012, Journal of medical Internet research.

[31]  R. Millsap,et al.  Evaluating Latent Growth Curve Models Using Individual Fit Statistics , 2006 .

[32]  R. Engels,et al.  A randomized controlled trial testing the effectiveness of a universal school-based depression prevention program 'Op Volle Kracht' in the Netherlands , 2012, BMC Public Health.

[33]  H. Christensen,et al.  A controlled trial of a school‐based Internet program for reducing depressive symptoms in adolescent girls , 2009, Depression and anxiety.

[34]  R. Kessler,et al.  Mood disorders in children and adolescents: an epidemiologic perspective , 2001, Biological Psychiatry.

[35]  S. Nolen-Hoeksema,et al.  Age, gender, race, socioeconomic status, and birth cohort differences on the children's depression inventory: a meta-analysis. , 2002, Journal of abnormal psychology.

[36]  R. Engels,et al.  The benefits of playing video games. , 2014, The American psychologist.

[37]  David C. Atkins,et al.  Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. , 2006, Journal of consulting and clinical psychology.

[38]  S. Merry,et al.  Psychological and educational interventions for preventing depression in children and adolescents. , 2011, The Cochrane database of systematic reviews.

[39]  L. Rehm,et al.  A self-control behavior therapy program for depression. , 1977, Journal of consulting and clinical psychology.

[40]  S. Nolen-Hoeksema,et al.  Age, gender, race, socioeconomic status, and birth cohort difference on the children's depression inventory: A meta-analysis. , 2002 .

[41]  O. Moghraby,et al.  Depression in children and young people: identification and management in primary, community and secondary care (NICE guideline CG28) , 2015, Archives of Disease in Childhood: Education & Practice Edition.

[42]  I. Hickie,et al.  Young men’s attitudes and behaviour in relation to mental health and technology: implications for the development of online mental health services , 2013, BMC Psychiatry.

[43]  J. Romano,et al.  An Evaluation of Major Components in a Self-Control Therapy Program for Depression , 1981 .

[44]  R. Engels,et al.  Randomized Controlled Trial Testing the Effectiveness of a Depression Prevention Program (‘Op Volle Kracht’) Among Adolescent Girls with Elevated Depressive Symptoms , 2013, Journal of Abnormal Child Psychology.

[45]  K. Stark,et al.  Treatment of Childhood Depression: The ACTION Treatment Program. , 2006 .

[46]  C. Mathers,et al.  Global burden of disease in young people aged 10–24 years: a systematic analysis , 2011, The Lancet.

[47]  Alan E. Kazdin,et al.  Understanding how and why psychotherapy leads to change , 2009, Psychotherapy research : journal of the Society for Psychotherapy Research.

[48]  Michelle G. Craske,et al.  Computer Therapy for the Anxiety and Depressive Disorders Is Effective, Acceptable and Practical Health Care: A Meta-Analysis , 2010, PloS one.

[49]  I. Hickie,et al.  Young Men, Mental Health, and Technology: Implications for Service Design and Delivery in the Digital Age , 2012, Journal of medical Internet research.

[50]  R. Scholte,et al.  Evaluation of a School-Based Depression Prevention Program among Adolescents from Low-Income Areas: A Randomized Controlled Effectiveness Trial , 2014, International journal of environmental research and public health.

[51]  R. Engels,et al.  Universal School-Based Depression Prevention ‘Op Volle Kracht’: a Longitudinal Cluster Randomized Controlled Trial , 2015, Journal of abnormal child psychology.

[52]  R. Rapee,et al.  Evaluation of universal, indicated, and combined cognitive-behavioral approaches to the prevention of depression among adolescents. , 2006, Journal of consulting and clinical psychology.

[53]  J. Os,et al.  A therapeutic application of the experience sampling method in the treatment of depression: a randomized controlled trial , 2014, World psychiatry : official journal of the World Psychiatric Association.

[54]  M. Kovács.  Cognitive therapy in depression. , 1980, The Journal of the American Academy of Psychoanalysis.

[55]  E. Heiervang,et al.  Subthreshold depression in children and adolescents - a systematic review. , 2013, Journal of affective disorders.

[56]  P. Cuijpers,et al.  Preventing the onset of major depressive disorder: a meta-analytic review of psychological interventions. , 2014, International journal of epidemiology.

[57]  G. Patton,et al.  School-based prevention of depression: a randomised controlled study of the beyondblue schools research initiative. , 2010, Journal of child psychology and psychiatry, and allied disciplines.

[58]  N. Ryan,et al.  Cognitive-behavioral therapy of depression and depressive symptoms during adolescence: a review and meta-analysis. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[59]  C. Hammen,et al.  Depression, activity, and evaluation of reinforcement. , 1975, Journal of abnormal psychology.

[60]  Alan D. Lopez,et al.  Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study , 1997, The Lancet.

[61]  Y. Park,et al.  Psychometric Properties of the Children’s Depression Inventory , 2012 .

[62]  G. Clum,et al.  Validity and reactivity of a system of self-monitoring suicide ideation , 1993 .

[63]  K. Dobson,et al.  Cognitive therapy of depression: pretreatment patient predictors of outcome. , 2002, Clinical psychology review.