title: Reduced substance use as a secondary benefit of an indicated cognitive-behavioral adolescent depression prevention program.
abstract: Our first aim was to test whether a group cognitive-behavioral (CB) depression prevention program reduces substance use escalation over 2-year follow-up relative to two active comparison interventions and a brochure assessment control. Our second aim examined whether reductions in depressive symptoms mediate intervention effects, as posited by the affect-regulation model of substance use. In this indicated prevention trial, 341 high school adolescents at risk for depression because of the presence of elevated depressive symptoms were randomized to a Group CB intervention, group supportive-expressive group intervention, CB bibliotherapy, or educational brochure control condition. Participants in Group CB had significantly lower rates of substance use compared with brochure control participants at both 1- and 2-year follow-up and lower substance use at 2-year follow-up relative to bibliotherapy participants; no other condition differences were significant. Mediational analyses suggested that reductions in depressive symptoms from baseline to posttest accounted for changes in substance use over 2 years for participants in Group CB relative to brochure control participants but did not mediate effects relative to those receiving bibliotherapy. Results suggest that a secondary benefit of this CB group indicated depression prevention program is lower rates of long-term substance use. Findings supported the hypothesis that, relative to a nonactive comparison condition, reductions in depressive symptoms mediated the effects of Group CB prevention on substance use escalation.
authors.affiliation: Oregon Research Institute, Eugene, OR 97403, USA. paulr@ori.org
authors.forename: Paul
authors.initials: P
authors.lastname: Rohde
authors.forename: Eric
authors.initials: E
authors.lastname: Stice
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Gau
authors.forename: C Nathan
authors.initials: CN
authors.lastname: Marti
mesh_terms: D000293:Adolescent; D000339:Affect; D000428:Alcohol Drinking / Q000517:prevention & control / Q000523:psychology; D001638:Bibliotherapy; D015928:Cognitive Behavioral Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology; D010174:Pamphlets; D011615:Psychotherapy, Group; D012307:Risk Factors; D012944:Social Support; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology
chemical_list: D013287:Illicit Drugs