Long-term results from the empowering a multimodal pathway toward healthy youth program, a multimodal school-based approach, show marked reductions in suicidality, depression, and anxiety in 6,227 students in grades 6-12 (aged 11-18)

Frontiers in Psychiatry

Volumn 8, Issue MAY, 2017, Pages

  Silverstone, Peter H ^a,b,c   Bercov, Marni ^b   Suen, Victoria Y M ^b   Allen, Andrea ^b   Cribben, Ivor ^c   Goodrick, Jodi ^d   Henry, Stu ^d   Pryce, Catherine ^b   Langstraat, Pieter ^d   Rittenbach, Katherine ^b   Chakraborty, Samprita ^e   Engles, Rutger C ^f   McCabe, Christopher ^e  

^a UNIVERSITY OF ALBERTA   (Canada)

^b ALBERTA HEALTH SERVICES   (Canada)

^c UNIVERSITY OF ALBERTA   (Canada)

^d Red Deer Public Schools   (Canada)

^e Trimbos Institute ^*  (Canada)

^f NETHERLANDS INSTITUTE OF MENTAL HEALTH AND ADDICTION   (Netherlands)

Author keywords

Anxiety; Depression; Mental health; Prevention; School; Self esteem; Suicide; Youth

Indexed keywords

ADULT; ANXIETY DISORDER; ARTICLE; CHILD; COGNITIVE BEHAVIORAL THERAPY; DEPRESSION; FEMALE; FOLLOW UP; HEALTH PROGRAM; HIGH RISK POPULATION; HUMAN; LONGITUDINAL STUDY; MAJOR CLINICAL STUDY; MALE; MENTAL HEALTH; OUTCOME ASSESSMENT; POPULATION RESEARCH; SCHOOL CHILD; SCORING SYSTEM; SELF ESTEEM; STUDENT; SUICIDAL IDEATION;

EID: 85032578992     PISSN: None     EISSN: 16640640     Source Type: Journal    
DOI: 10.3389/fpsyt.2017.00081     Document Type: Article

References (74)

1. Perou R, Bitsko RH, Blumberg SJ, Pastor P, Ghandour RM, Gfroerer JC, et al. Mental health surveillance among children-United States, 2005-2011. MMWR Surveill Summ (2013) 62(Suppl 2):1-35.
2. Nardi B, Francesconi G, Catena-Dell'osso M, Bellantuono C. Adolescent depression: clinical features and therapeutic strategies. Eur Rev Med Pharmacol Sci (2013) 17:1546-51.
3. Bor W, Dean AJ, Najman J, Hayatbakhsh R. Are child and adolescent mental health problems increasing in the 21st century? A systematic review. Aust N Z J Psychiatry (2014) 48:606-16. doi:10.1177/0004867414533834
4. Fichter MM, Kohlboeck G, Quadflieg N, Wyschkon A, Esser G. From childhood to adult age: 18-year longitudinal results and prediction of the course of mental disorders in the community. Soc Psychiatry Psychiatr Epidemiol (2009) 44:792-803. doi:10.1007/s00127-009-0501-y
5. Hawton K, Saunders KE, O'Connor RC. Self-harm and suicide in adolescents. Lancet (2012) 379:2373-82. doi:10.1016/S0140-6736(12)60322-5
6. Clifford AC, Doran CM, Tsey K. A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand. BMC Public Health (2013) 13:463. doi:10.1186/1471-2458-13-463
7. Eaton DK, Kann L, Kinchen S, Shanklin S, Flint K, Hawkins J, et al. Youth Risk Behavior Surveillance-United States, 2011 (Vol. 61). Centers for Disease Control and Prevention MMWR, Surveillance Summaries (2012). p. SS-4. Available: http://www.cdc.gov/mmwr/pdf/ss/ss6104.pdf
8. Carli V, Hoven CW, Wasserman C, Chiesa F, Guffanti G, Sarchiapone M, et al. A newly identified group of adolescents at "invisible" risk for psychopathology and suicidal behavior: findings from the SEYLE study. World Psychiatry (2014) 13:78-86. doi:10.1002/wps.20088
9. Beghi M, Rosenbaum JF. Risk factors for fatal and nonfatal repetition of suicide attempt: a critical appraisal. Curr Opin Psychiatry (2010) 23:349-55. doi:10.1097/YCO.0b013e32833ad783
10. Weisz JR, Kuppens S, Ng MY, Eckshtain D, Ugueto AM, Vaughn-Coaxum R, et al. What five decades of research tells us about the effects of youth psychological therapy: a multilevel meta-analysis and implications for science and practice. Am Psychol (2017) 72:79-117. doi:10.1037/a0040360
11. Devenish B, Berk L, Lewis AJ. The treatment of suicidality in adolescents by psychosocial interventions for depression: a systematic literature review. Aust N Z J Psychiatry (2016) 50:726-40. doi:10.1177/0004867415627374
12. Takagaki K, Okamoto Y, Jinnin R, Mori A, Nishiyama Y, Yamamura T, et al. Behavioral activation for late adolescents with subthreshold depression: a randomized controlled trial. Eur Child Adolesc Psychiatry (2016) 25:1171-82. doi:10.1007/s00787-016-0842-5
13. Henje-Blom E, Tymofiyeva O, Chesney MA, Ho TC, Moran P, Connolly CG, et al. Feasibility and Preliminary Efficacy of a Novel RDoC-Based Treatment Program for adolescent depression: "Training for Awareness Resilience and Action" (TARA)-A Pilot Study. Front Psychiatry (2017) 7:208. doi:10.3389/fpsyt.2016.00208
14. Ahlen J, Lenhard F, Ghaderi A. Universal prevention for anxiety and depressive symptoms in children: a meta-analysis of randomized and cluster-randomized trials. J Prim Prev (2015) 36:387-403. doi:10.1007/s10935-015-0405-4
15. Merry SN, Hetrick SE, Cox GR, Brudevold-Iversen T, Bir JJ, McDowell H. Psychological and educational interventions for preventing depression in children and adolescents. Cochrane Database Syst Rev (2011) (12):CD003380. doi:10.1002/14651858.CD003380.pub3
16. van Zoonen K, Buntrock C, Ebert DD, Smit F, Reynolds CF III, Beekman AT, et al. Preventing the onset of major depressive disorder: a meta-analytic review of psychological interventions. Int J Epidemiol (2014) 43:318-29. doi:10.1093/ije/dyt175
17. Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students' social and emotional learning: a meta-analysis of school-based universal interventions. Child Dev (2011) 82:405-32. doi:10.1111/j.1467-8624.2010.01564.x
18. O'Leary-Barrett M, Topper L, Al-Khudhairy N, Pihl RO, Castellanos-Ryan N, Mackie CJ, et al. Two-year impact of personality-targeted, teacher-delivered interventions on youth internalizing and externalizing problems: a cluster-randomized trial. J Am Acad Child Adolesc Psychiatry (2013) 52:911-20. doi:10.1016/j.jaac.2013.05.020
19. Bond L, Butler H, Thomas L, Carlin J, Glover S, Bowes G, et al. Social and school connectedness in early secondary school as predictors of late teenage substance use, mental health, and academic outcomes. J Adolesc Health (2007) 40(357):e9-18. doi:10.1016/j.jadohealth.2006.10.013
20. Wei Y, Kutcher S. International school mental health: global approaches, global challenges, and global opportunities. Child Adolesc Psychiatr Clin N Am (2012) 21:11-27. doi:10.1016/j.chc.2011.09.005
21. Dever BV, Kamphaus RW, Dowdy E, Raines TC, Distefano C. Surveillance of middle and high school mental health risk by student self-report screener. West J Emerg Med (2013) 14:384-90. doi:10.5811/westjem.2013.2.15349
22. Garber J, Brunwasser SM, Zerr AA, Schwartz KT, Sova K, Weersing VR. Treatment and prevention of depression and anxiety in youth: test of cross-over effects. Depress Anxiety (2016) 33:939-59. doi:10.1002/da.22519
23. Pirkis J, Too LS, Spittal MJ, Krysinska K, Robinson J, Cheung YT. Interventions to reduce suicides at suicide hotspots: a systematic review and meta-analysis. Lancet Psychiatry (2015) 2:994-1001. doi:10.1016/S2215-0366(15)00266-7
24. Di Napoli WA, Della Rosa A. Suicide and attempted suicide: epidemiological surveillance as a crucial means of a local suicide prevention project in Trento's Province. Psychiatr Danub (2015) 27(Suppl 1):S279-84.
25. Calear AL, Christensen H, Freeman A, Fenton K, Busby Grant J, van Spijker B, et al. A systematic review of psychosocial suicide prevention interventions for youth. Eur Child Adolesc Psychiatry (2016) 25:467-82. doi:10.1007/s00787-015-0783-4
26. Wilcox HC, Wyman PA. Suicide prevention strategies for improving population health. Child Adolesc Psychiatr Clin N Am (2016) 25:219-33. doi:10.1016/j. chc.2015.12.003
27. Strunk CM, King KA, Vidourek RA, Sorter MT. Effectiveness of the surviving the teens suicide prevention and depression awareness program: an impact evaluation utilizing a comparison group. Health Educ Behav (2014) 41:605-13. doi:10.1177/1090198114531774
28. Werner-Seidler A, Perry Y, Calear AL, Newby JM, Christensen H. School-based depression and anxiety prevention programs for young people: a systematic review and meta-analysis. Clin Psychol Rev (2017) 51:30-47. doi:10.1016/j.cpr.2016.10.005
29. Weare K, Nind M. Mental health promotion and problem prevention in schools: what does the evidence say? Health Promot Int (2011) 26(Suppl 1): i29-69. doi:10.1093/heapro/dar075
30. Robinson J, Pirkis J. Research priorities in suicide prevention: an examination of Australian-based research 2007-11. Aust Health Rev (2014) 38:18-24. doi:10.1071/AH13058
31. Teesson M, Newton NC, Slade T, Chapman C, Allsop S, Hides L, et al. The CLIMATE schools combined study: a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety. BMC Psychiatry (2014) 14:32. doi:10.1186/1471-244X-14-32
32. Gould MD, Greenberg T, Velting DD, Shaffer DD. Youth suicide risk and preventive interventions: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry (2003) 42:386-405. doi:10.1097/01.CHI.0000046821. 95464.CF
33. Robinson J, Hetrick SE, Martin C. Preventing suicide in young people: systematic review. Aust N Z J Psychiatry (2011) 45:3-26. doi:10.3109/00048 674.2010.511147
34. Sheffield JK, Spence SH, Rapee RM, Kowalenko N, Wignall A, Davis A, et al. Evaluation of universal, indicated, and combined cognitive-behavioral approaches to the prevention of depression among adolescents. J Consult Clin Psychol (2006) 74:66-79. doi:10.1037/0022-006X.74.1.66
35. Sawyer MG, Pfeiffer S, Spence SH, Bond L, Graetz B, Kay D, et al. School-based prevention of depression: a randomised controlled study of the Beyond Blue Schools research initiative. J Child Psychol Psychiatry (2010) 51:199-209. doi:10.1111/j.1469-7610.2009.02136.x
36. Calear AL, Christensen H. Systematic review of school-based prevention and early intervention programs for depression. J Adolesc (2010) 33:429-38. doi:10.1016/j.adolescence.2009.07.004
37. Duong MT, Kelly BM, Haaland WL, Matsumiya B, Huey SJ Jr, McCarty CA. Mediators and moderators of a School-Based Cognitive-Behavioral Depression Prevention Program. Cognit Ther Res (2016t) 40:705-16. doi:10.1007/s10608-016-9780-2
38. Dahlqvist HZ, Landstedt E, Gådin KG. What students do schools allocate to a cognitive-behavioural intervention? Characteristics of adolescent participants in Northern Sweden. Int J Circumpolar Health (2015) 74:29805. doi:10.3402/ijch.v74.29805
39. Brière FN, Rohde P, Shaw H, Stice E. Moderators of two indicated cognitive-behavioral depression prevention approaches for adolescents in a school-based effectiveness trial. Behav Res Ther (2014) 53:55-62. doi:10.1016/j. brat.2013.12.005
40. Anaby D, Lal S, Huszczynski J, Maich J, Rogers J, Law M. Interrupted time series design: a useful approach for studying interventions targeting participation. Phys Occup Ther Pediatr (2014) 34:457-70. doi:10.3109/01942638.2 013.866612
41. Silverstone PH, Bercov M, Suen VYM, Allen A, Goodrick J, Cribben I, et al. Initial findings from a novel school-based program, EMPATHY, which may help reduce depression and suicidality in youth. PLoS One (2015) 10:e0125527. doi:10.1371/journal.pone.0125527
42. Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of the PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA (1999) 282:1737-44. doi:10.1001/jama.282.18.1737
43. Ganguly S, Samanta M, Roy P, Chatterjee S, Kaplan DW, Basu B. Patient health questionnaire-9 as an effective tool for screening of depression among Indian adolescents. J Adolesc Health (2013) 52:546-51. doi:10.1016/j. jadohealth.2012.09.012
44. Richardson LP, McCauley E, McCarty CA, Grossman DC, Myaing M, Zhou C, et al. Predictors of persistence after a positive depression screen among adolescents. Pediatrics (2012) 130:e1541-8. doi:10.1542/peds.2012-0450
45. Richardson LP, McCauley E, Grossman DC, McCarty CA, Richards J, Russo JE, et al. Evaluation of the patient health questionnaire-9 item for detecting major depression among adolescents. Pediatrics (2010) 126:1117-23. doi:10.1542/peds.2010-0852
46. Spirito A, Esposito-Smythers C. Attempted and completed suicide in adolescence. Annu Rev Clin Psychol (2006) 2:237-66. doi:10.1146/annurev. clinpsy.2.022305.095323
47. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand (1983) 67:361-70. doi:10.1111/j.1600-0447.1983.tb09716.x
48. Wiklund M, Malmgren-Olsson EB, Ohman A, Bergström E, Fjellman-Wiklund A. Subjective health complaints in older adolescents are related to perceived stress, anxiety and gender -a cross-sectional school study in Northern Sweden. BMC Public Health (2012) 12:993. doi:10.1186/1471-2458-12-993
49. van der Geest IM, van Dorp W, Hop WC, Neggers SJ, de Vries AC, Pieters R, et al. Emotional distress in 652 Dutch very long-term survivors of childhood cancer, using the hospital anxiety and depression scale (HADS). J Pediatr Hematol Oncol (2013) 35:525-9. doi:10.1097/MPH.0b013e31829f2799
50. Wen L, Jiang G, Zhang X, Lai R, Wen X. Relationship between acne and psychological burden evaluated by ASLEC and HADS Surveys in high school and college students from central China. Cell Biochem Biophys (2014) 71:1083-8. doi:10.1007/s12013-014-0312-y
51. Elison S, Ward J, Davies G, Moody M. Implementation of computer-assisted therapy for substance misuse: a qualitative study of Breaking Free Online using Roger's diffusion of innovation theory. Drugs Alcohol Today (2014) 14:207-18. doi:10.1108/DAT-05-2014-0025
52. Andersson G. Using the Internet to provide cognitive behavioural therapy. Behav Res Ther (2009) 47:175-80. doi:10.1016/j.brat.2009.01.010
53. Carrard I, Crépin C, Rouget P, Lam T, Golay A, Van der Linden M. Randomised controlled trial of a guided self-help treatment on the Internet for binge eating disorder. Behav Res Ther (2011) 49:482-91. doi:10.1016/j.brat.2011.05.004
54. Titov N, Andrews G, Davies M, McIntyre K, Robinson E, Solley K. Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance. PLoS One (2010) 5:e10939. doi:10.1371/journal. pone.0010939
55. Jaycox LH, Reivich KJ, Gillham J, Seligman ME. Prevention of depressive symptoms in school children. Behav Res Ther (1994) 32:801-16. doi:10.1016/0005-7967(94)90160-0
56. Gillham JE, Reivich KJ. Prevention of depressive symptoms in school children: a research update. Psychol Sci (1999) 10:461-2. doi:10.1111/1467-9280.00188
57. Gillham JE, Reivich KJ, Freres DR, Chaplin TM, Shatté AJ, Samuels B, et al. 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. doi:10.1037/0022-006X.75.1.9
58. Gillham JE, Reivich KJ, Brunwasser SM, Freres DR, Chajon ND, Kash-Macdonald VM, et al. Evaluation of a group cognitive-behavioral depression prevention program for young adolescents: a randomized effectiveness trial. J Clin Child Adolesc Psychol (2012) 41:621-39. doi:10.1080/15 374416.2012.706517
59. Tak YR, Van Zundert RM, Kuijpers RC, Van Vlokhoven BS, Rensink HF, Engels RC. 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. doi:10.1186/1471-2458-12-21
60. Wijnhoven LA, Creemers DH, Vermulst AA, Scholte RH, Engels RC. Randomized controlled trial testing the effectiveness of a depression prevention program ('Op Volle Kracht') among adolescent girls with elevated depressive symptoms. J Abnorm Child Psychol (2014) 42:217-28. doi:10.1007/s10802-013-9773-5
61. Kindt KCM, van Zundert RMP, Engels RC. Evaluation of a Dutch school-based depression prevention program for youths in high-risk neighborhoods: study protocol of a two-armed randomized controlled trial. BMC Public Health (2012) 12:212. doi:10.1186/1471-2458-12-212
62. Kindt KCM, Kleinjan M, Janssens JMAM, Scholte RHJ. Evaluation of a School-Based Depression Prevention Program among adolescents from low-income areas: a randomized controlled effectiveness trial. Int J Environ Res Public Health (2014) 11:5273-93. doi:10.3390/ijerph110505273
63. Shochet I, Montague R, Smith C, Dadds M. A qualitative investigation of adolescents' perceived mechanisms of change from a universal school-based depression prevention program. Int J Environ Res Public Health (2014) 11: 5541-54. doi:10.3390/ijerph110505541
64. Cutuli JJ, Gillham JE, Chaplin TM, Reivich KJ, Seligman ME, Gallop RJ, et al. Preventing adolescents' externalizing and internalizing symptoms: effects of the Penn Resiliency Program. Int J Emot Educ (2013) 5:67-79.
65. Sander JB, McCarty CA. Youth depression in the family context: familial risk factors and models of treatment. Clin Child Fam Psychol Rev (2005) 8:203-19. doi:10.1007/s10567-005-6666-3
66. Kutcher S, Wei Y. Mental health and the school environment: secondary schools, promotion and pathways to care. Curr Opin Psychiatry (2012) 25:311-6. doi:10.1097/YCO.0b013e3283543976
67. Lima-Serrano M, Lima-Rodríguez JS. Impact of school-based health promotion interventions aimed at different behavioral domains: a systematic review. Gac Sanit (2014) 28:411-7. doi:10.1016/j.gaceta.2014.05.003
68. Everett BG. Changes in neighborhood characteristics and depression among sexual minority young adults. J Am Psychiatr Nurses Assoc (2014) 20:42-52. doi:10.1177/1078390313510319
69. Rose K, Hawes DJ, Hunt CJ. Randomized controlled trial of a friendship skills intervention on adolescent depressive symptoms. J Consult Clin Psychol (2014) 82:510-20. doi:10.1037/a0035827
70. Wahl MS, Adelson JL, Patak MA, Pössel P, Hautzinger M. Teachers or psychologists: who should facilitate depression prevention programs in schools? Int J Environ Res Public Health (2014) 11:5294-316. doi:10.3390/ijerph110505294
71. Balázs J, Miklósi M, Keresztény A, Hoven CW, Carli V, Wasserman C, et al. Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk. J Child Psychol Psychiatry (2013) 54:670-7. doi:10.1111/jcpp.12016
72. Bertha EA, Balázs J. Subthreshold depression in adolescence: a systematic review. Eur Child Adolesc Psychiatry (2013) 22:589-603. doi:10.1007/s00787-013-0411-0 73.
73. Saunders K, Brand F, Lascelles K, Hawton K. The sad truth about the SADPERSONS Scale: an evaluation of its clinical utility in self-harm patients. Emerg Med J (2014) 31:796-8. doi:10.1136/emermed-2013-202781
74. Simon GE, Rutter CM, Peterson D, Oliver M, Whiteside U, Operskalski B, et al. Does response on the PHQ-9 depression questionnaire predict subsequent suicide attempt or suicide death? Psychiatr Serv (2013) 64:1195-202. doi:10.1176/appi.ps.201200587