Despite consistent evidence that adolescent girls are at greater risk for developing depression than adolescent boys (Ge, Lorenz, Conger, & Elder, 1994; Nolen-Hoeksema, 1987, 1990; Weissman, Leaf, Holzer, Myers, & Tischler, 1984), and that women continue to predominate among depressed adults throughout the lifespan (Kessler, McGonagle, Swartz, Blazer & Nelson, 1993), few studies have examined the etiologic risk factors that predict depression for adolescent girls using a prospective design or examined differential processes of risk in a sample of adolescent girls and boys. Furthermore, although a number of variables have been implicated as risk factors for depressive symptoms or onset of depression among adolescents, some methodological limitations exist. The objective of this research was to examine a set of risk factors suspected to predict depression in adolescents, and to test whether gender moderates these relations. Secondly, this study examined a set of risk factors proposed by the gender additive model of depression (Stice et al., 2000; Stice & Bearman, 2001) that attempts to partially explain the increased prevalence of depressive symptoms in adolescent girls compared to boys. Finally, exploratory classification tree analyses tested for interactions between risk factors that might signal differential pathways to depression. This research provides insight into the etiology of adolescent depression as well as the disparate rate of depression among adolescent girls versus boys, and also provides direction for identifying high-risk individuals and developing effective prevention programs. / text

Depression is a significant mental health concern with a pivotal increase of incidence during adolescence, specifically for females. Currently, cognitive behavioral therapy (CBT) is the most widely tested treatment for depression. Yet, it is unclear how CBT functions to produce effective outcomes. Adult studies have shown that behavioral components of CBT are more effective than cognitive components in reducing depression at acute treatment. Both behavioral and cognitive components have been shown to be effective in preventing relapse of depressive symptoms at follow up. Yet less is understood about how treatment components work together to provide positive outcomes, particularly for depressed youth. The overall goal of this study was to examine which parts of treatment (cognitive and/or behavioral) aid in symptom reduction and to determine if treatment outcome is mediated by cognitive change. Forty two pre-adolescent girls, aged 9-14, participated in a 20-session manualized group CBT program. The first portion of treatment (session 1-9) focused the behavioral intervention and the second portion of treatment (sessions 11-19) focused on cognitive interventions while continuing to reinforce behavioral interventions when necessary. Self report measures and diagnostic interviews were completed at pre-treatment and post-treatment. Using multiple regression analyses, the findings of this study supported the role of behavioral and cognitive interventions in reducing depression. Behavioral interventions were found to significantly reduce depression at post-treatment. Additionally, cognitive interventions were found to play a small, but significant role in post-treatment outcome, with preliminary evidence that cognitive interventions could also be linked to treatment outcome one year later. Treatment specificity could not be tested, as the cognitive change of depressed girls was not directly influenced by the behavior and cognitive interventions. Exploratory analysis demonstrated the significant role of behavioral techniques such as behavior activation, positive reinforcement, homework review, and skills training in predicting outcome of treatment. Implications of the results, limitations, and recommendations for future research are provided. / text