A randomized trial of online single-session interventions for adolescent depression during COVID-19

Jessica L Schleider, Michael C Mullarkey, Kathryn R Fox, Mallory L Dobias, Akash Shroff, Erica A Hart, Chantelle A Roulston, Jessica L Schleider, Michael C Mullarkey, Kathryn R Fox, Mallory L Dobias, Akash Shroff, Erica A Hart, Chantelle A Roulston

Abstract

The COVID-19 pandemic has potentially increased the risk for adolescent depression. Even pre-pandemic, <50% of youth with depression accessed care, highlighting needs for accessible interventions. Accordingly, this randomized controlled trial (ClinicalTrials.gov: NCT04634903 ) tested online single-session interventions (SSIs) during COVID-19 in adolescents with elevated depression symptoms (N = 2,452, ages 13-16). Adolescents from all 50 US states, recruited via social media, were randomized to one of three SSIs: a behavioural activation SSI, an SSI teaching that traits are malleable and a supportive control. We tested each SSI's effects on post-intervention outcomes (hopelessness and agency) and three-month outcomes (depression, hopelessness, agency, generalized anxiety, COVID-19-related trauma and restrictive eating). Compared with the control, both active SSIs reduced three-month depressive symptoms (Cohen's d = 0.18), decreased post-intervention and three-month hopelessness (d = 0.16-0.28), increased post-intervention agency (d = 0.15-0.31) and reduced three-month restrictive eating (d = 0.12-17). Several differences between active SSIs emerged. These results confirm the utility of free-of-charge, online SSIs for high-symptom adolescents, even in the high-stress COVID-19 context.

© 2021. The Author(s), under exclusive licence to Springer Nature Limited.

Figures

Figure 1.
Figure 1.
Depression symptom severity at baseline and three-month follow-up for adolescents in each intervention condition (Project ABC/BA-SSI, N=818; Project Personality/GM-SSI, N=821; and the Sharing Feelings Project/Placebo Control, N=818). Adolescents randomized to the BA-SSI reported significantly decreases in depression symptom severity from pre-intervention to 3-month follow-up than did adolescents in the Placebo Control, padj<0.001, as did adolescents randomized to the GM-SSI relative to control-group adolescents, padj<0.001. Adolescents assigned to the BA- and GM-SSIs did not significantly differ in their depression symptom reductions, padj=0.845.
Figure 2.
Figure 2.
CONSORT Diagram.

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