Evaluating the efficacy of a school-based prevention program for depression and anxiety, and the moderating role of friendship network characteristics
Creators: name: Andrews, Jack
Publisher: name: Open Science Framework
Year: 2021
Subjects: subject: Mental Disorders
subject: Maternal and Child Health
subject: Psychiatry and Psychology
subject: Public Health
subject: Medicine and Health Sciences
subject: Developmental Psychology
subject: Community Health and Preventive Medicine
subject: Social and Behavioral Sciences
subject: Psychology
subject: FOS: Psychology

description: Adolescence is a period of marked vulnerability to the onset of many mental health problems, and depression and anxiety are some of the most commonly experienced mental health problems among this age group (Merikangas et al., 2010). Importantly, depression represents the fourth highest burden of all diseases globally, and the third in Australia given the most recent data, rendering it an important candidate for prevention and intervention (Australian institute of Health and Welfare, 2014; GBD 2019 Diseases and Injuries Collaborators). Schools are ideal places in which to deliver preventative interventions and existing school-based interventions have been shown to elicit small to moderate improvements in depression and anxiety among young people (Werner-Seidler et al., 2017). The current study makes use of data collected from the Climate Schools Combined (CSC) trial – a multicenter, cluster-randomized controlled trial in Australian secondary schools. This study aimed to compare the effectiveness of a combined substance use and mental health intervention with a mental health only intervention, a substance use only intervention, and an active control (Teesson et al., 2014). Compared with controls, the combined intervention reduced odds of drinking and reduced increases in anxiety symptoms. No differences in depressive symptoms were observed. The combined intervention also showed greater improvements in alcohol use outcomes compared with the substance use only and mental health only interventions. Further, the combined intervention showed improvements in anxiety outcomes, relative to the mental health only intervention (Teesson et al., 2020). However, comparisons between the efficacy of the mental health-only intervention versus the control group have not yet been examined. This will form the focus of the present study. In addition, follow up analyses will be conducted to examine whether social network characteristics moderate the mental health intervention effects. Previous studies have shown that individuals with high, relative to low, centrality (a proxy measure for popularity) demonstrate higher levels of prosocial behaviour, and among school classrooms with high social cohesion there are reduced levels of antisocial behaviour towards peers and increased trust (van den Bos et al., 2018). This is an important consideration for the health and wellbeing of students as antisocial behaviours such as bullying are negatively associated with mental health outcomes, including depression and suicidal ideation (Ford et al., 2017). In another study of over 10 thousand high school students, less peer network integration (i.e. low social cohesion) was related to an increased likelihood of suicide ideation and suicide attempts among students (Wyman et al., 2019). These findings, among others, highlight the potential role that one’s respective position within the social environment of the school, may influence intervention efficacy. Research questions: 1. Is a school-based mental health intervention effective at improving mental health outcomes among young people, relative to a control? 2. To what extent does the individual position of students within their school’s social network moderate intervention effects?