Does the absence of a supportive family environment influence the outcome of a universal intervention for the prevention of depression?
To date, universal, school-based interventions have produced limited success in the long-term prevention of depression in young people. This paper examines whether family relationship support moderates the outcomes of a universal, school-based preventive intervention for depression in adolescents. It reports a secondary analysis of data from the beyondblue schools research initiative. Twenty-five matched pairs of secondary schools were randomly assigned to an intervention or control condition (N = 5633 Grade 8 students). The multi-component, school-based intervention was implemented over a 3-year period, with 2 years of follow-up in Grades 11 and 12. For those available at follow-up, small but significantly greater reductions in depressive and anxiety symptoms and improvements in emotional wellbeing were found over time for the intervention group compared to the control among those who experienced low family relationship support in Grade 8. For those who did not experience low family relationship support in Grade 8, no significant effects of the invention were found over the control condition. This pattern of results was also found for the intent-to-treat sample for measures of depression and anxiety. Previous research may have overlooked important moderating variables that influence the outcome of universal approaches to the prevention of depression. The findings raise issues of the relative costs and benefits of universal versus targeted approaches to the prevention of depression.
Griffith Health Institute, Griffith University, Nathan Campus, 170 Kessels Road, Nathan, QLD 4111, Australia. s.spence@griffith.edu.au.
Susan H
SH
Spence
Research and Evaluation Unit, Women's and Children's Hospital, and Discipline of Paediatrics, University of Adelaide, North Terrace Adelaide, SA 5005, Australia. michael.sawyer@adelaide.edu.au.
Michael G
MG
Sawyer
School of Psychology, University of Queensland, Sir Fred Schonell Dr., St. Lucia, QLD 4072, Australia. jeanie@psy.uq.edu.au.
Jeanie
J
Sheffield
Centre for Adolescent Health, Murdoch Children's Research Institute, University of Melbourne, 2 Gatehouse Street, Parkville, VIC 3052, Australia. gcpatton@unimelb.edu.au.
George
G
Patton
Centre of Excellence in Intervention and Prevention Science, 15-31 Pelham Street South Carlton, VIC 3053, Australia. lyndalbond@ceips.org.au.
Lyndal
L
Bond
beyondblue, P.O. Box 6100, Hawthorn West, Melbourne, VIC 3122, Australia. brian.graetz@beyondblue.org.au.
Brian
B
Graetz
International Centre for Allied Health Research, School of Health Sciences, University of South Australia, City East Campus, Cnr of North Terrace and Frome Rd., Adelaide, SA 5000, Australia. debra.kay@internode.on.net.
Debra
D
Kay
D000293:Adolescent; D002648:Child; D003863:Depression / Q000517:prevention & control*; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D011793:Queensland; D011897:Random Allocation; D012572:School Health Services / Q000592:standards*; D012944:Social Support; D013021:South Australia; D013334:Students; D014739:Victoria