The Effect of an Intervention Teaching Adolescents that People can Change on Depressive Symptoms, Cognitive Schemas, and Hypothalamic-Pituitary-Adrenal Axis Hormones

Abstract

Interest is increasing in developing universal interventions to prevent depression in adolescents that are brief enough to be scaled up. The aim of this study was to test the effects on depressive symptoms, cognitive schemas, and Hypothalamic-Pituitary-Adrenal Axis Hormones of an intervention focused on teaching an element of an incremental theory of personality, namely, the belief that people can change. We also examined whether grade level moderated the effects of the intervention. A double-blind, randomized, controlled trial was conducted with 867 Spanish adolescent participants (51.9% boys, Grades 8–10) randomly assigned to an incremental theory intervention (n = 456) or an educational control intervention (n = 411). The adolescents completed measures of depressive symptoms and negative cognitive schemas at pretest, at 6-month follow-up, and at 12-month follow-up. A subsample of 503 adolescents provided salivary samples for cortisol and DHEA-S testing. In 8th grade, adolescents who received the incremental theory intervention displayed a greater decrease in depressive symptoms and cognitive schemas and a lower increase in DHEA-S. Moreover, in adolescents who received the intervention, the rate of adolescents with high depression scores decreased by almost 18% whereas in the control group, the rate increased by 37%. Surprisingly, the effects of the intervention were in the opposite direction among adolescents in 9th grade. These data indicate that a brief universal intervention could prevent depressive symptoms under some conditions, but developmental characteristics can moderate the effectiveness of this approach.

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Notes

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    We tested models that included sex and the Sex x Time, Sex x Condition, and Sex x Condition x Time interaction terms. We also tested models that included initial risk status as moderator. However, as neither sex nor initial status moderated the effect of the intervention, we decided to report more parsimonious models without these variables. All models—with and without sex and risk status—obtained similar results for the effects of the condition and grade. Analyses with initial risk status are available as supplementary material.

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Acknowledgements

This research was supported by grants from the Ministry of Economy and Competitiveness (Spanish Government, Ref. PSI2015-68426-R), the Basque Country (Ref. IT982-16 and Ref. PI_2016_1_0023), and the Red PROEMA (PSI2017-90650-REDT) to the first author, and from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD084772-01) to the 9Th author.

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Calvete, E., Fernández-Gonzalez, L., Orue, I. et al. The Effect of an Intervention Teaching Adolescents that People can Change on Depressive Symptoms, Cognitive Schemas, and Hypothalamic-Pituitary-Adrenal Axis Hormones. J Abnorm Child Psychol 47, 1533–1546 (2019). https://doi.org/10.1007/s10802-019-00538-1

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Keywords

  • Incremental theory of personality intervention
  • Depressive symptoms
  • Cortisol
  • DHEA-S
  • Cognitive schemas
  • Adolescents