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Preventing Depression in Final Year Secondary Students: School-Based Randomized Controlled Trial

Perry, Yael; Werner-Seidler, Aliza; Calear, Alison; Mackinnon, Andrew; King, Catherine; Scott, Jan; Merry, Sally; Fleming, Theresa; Stasiak, Karolina; Christensen, Helen; Batterham, Philip

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BACKGROUND: Depression often emerges for the first time during adolescence. There is accumulating evidence that universal depression prevention programs may have the capacity to reduce the impact of depression when delivered in the school environment. OBJECTIVE: This trial investigated the effectiveness of SPARX-R, a gamified online cognitive behavior therapy intervention for the prevention of depression relative to an attention-matched control intervention delivered to students prior to...[Show more]

dc.contributor.authorPerry, Yael
dc.contributor.authorWerner-Seidler, Aliza
dc.contributor.authorCalear, Alison
dc.contributor.authorMackinnon, Andrew
dc.contributor.authorKing, Catherine
dc.contributor.authorScott, Jan
dc.contributor.authorMerry, Sally
dc.contributor.authorFleming, Theresa
dc.contributor.authorStasiak, Karolina
dc.contributor.authorChristensen, Helen
dc.contributor.authorBatterham, Philip
dc.date.accessioned2021-09-07T01:30:56Z
dc.date.available2021-09-07T01:30:56Z
dc.identifier.issn1438-8871
dc.identifier.urihttp://hdl.handle.net/1885/247394
dc.description.abstractBACKGROUND: Depression often emerges for the first time during adolescence. There is accumulating evidence that universal depression prevention programs may have the capacity to reduce the impact of depression when delivered in the school environment. OBJECTIVE: This trial investigated the effectiveness of SPARX-R, a gamified online cognitive behavior therapy intervention for the prevention of depression relative to an attention-matched control intervention delivered to students prior to facing a significant stressor-final secondary school exams. It was hypothesized that delivering a prevention intervention in advance of a stressor would reduce depressive symptoms relative to the control group. METHODS: A cluster randomized controlled trial was conducted in 10 government schools in Sydney, Australia. Participants were 540 final year secondary students (mean 16.7 [SD 0.51] years), and clusters at the school level were randomly allocated to SPARX-R or the control intervention. Interventions were delivered weekly in 7 modules, each taking approximately 20 to 30 minutes to complete. The primary outcome was symptoms of depression as measured by the Major Depression Inventory. Intention-to-treat analyses were performed. RESULTS: Compared to controls, participants in the SPARX-R condition (n=242) showed significantly reduced depression symptoms relative to the control (n=298) at post-intervention (Cohen d=0.29) and 6 months post-baseline (d=0.21) but not at 18 months post-baseline (d=0.33). CONCLUSIONS: This is the first trial to demonstrate a preventive effect on depressive symptoms prior to a significant and universal stressor in adolescents. It demonstrates that an online intervention delivered in advance of a stressful experience can reduce the impact of such an event on the potential development or exacerbation of depression.
dc.description.sponsorshipThis project was supported by an Australian National Health and Medical Research Council (NHMRC) project grant 1061072 to HC. HC is supported by an NHMRC John Cade fellowship (1056964). ALC and PJB are supported by NHMRC fellowships 1013199 and 1083311
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherJournal of medical Internet Research
dc.rights©Yael Perry, Aliza Werner-Seidler, Alison Calear, Andrew Mackinnon, Catherine King, Jan Scott, Sally Merry, Theresa Fleming, Karolina Stasiak, Helen Christensen, Philip J Batterham. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.11.2017.
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceJournal of Medical Internet Research
dc.subjectprevention
dc.subjectdepression
dc.subjectadolescent
dc.subjectdigital cognitive behavior therapy
dc.titlePreventing Depression in Final Year Secondary Students: School-Based Randomized Controlled Trial
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume19
dc.date.issued2017
local.identifier.absfor111714 - Mental Health
local.identifier.ariespublicationu5684624xPUB231
local.publisher.urlhttps://www.jmir.org/
local.type.statusPublished Version
local.contributor.affiliationPerry, Yael, Black Dog Institute
local.contributor.affiliationWerner-Seidler, Aliza, Black Dog Institute
local.contributor.affiliationCalear, Alison, College of Health and Medicine, ANU
local.contributor.affiliationMackinnon, Andrew, Black Dog Institute (UNSW)
local.contributor.affiliationKing, Catherine, Black Dog Institute
local.contributor.affiliationScott, Jan, Newcastle University
local.contributor.affiliationMerry, Sally, University of Auckland
local.contributor.affiliationFleming, Theresa, University of Auckland
local.contributor.affiliationStasiak, Karolina, University of Auckland
local.contributor.affiliationChristensen, Helen, Black Dog Institute
local.contributor.affiliationBatterham, Philip, College of Health and Medicine, ANU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1061072
dc.relationhttp://purl.org/au-research/grants/nhmrc/1056964
dc.relationhttp://purl.org/au-research/grants/nhmrc/1013199
dc.relationhttp://purl.org/au-research/grants/nhmrc/1083311
local.bibliographicCitation.issue11
local.bibliographicCitation.startpage1
local.bibliographicCitation.lastpage10
local.identifier.doi10.2196/jmir.8241
dc.date.updated2020-11-23T10:58:44Z
local.identifier.scopusID2-s2.0-85034834326
dcterms.accessRightsOpen Access
dc.provenanceThis is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
dc.rights.licenseCreative Commons Attribution License
CollectionsANU Research Publications

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