Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Apr;78(2):273-80.
doi: 10.1037/a0018396.

Testing mediators of intervention effects in randomized controlled trials: An evaluation of three depression prevention programs

Eric Stice  1 , Paul Rohde, John R Seeley, Jeff M Gau
Affiliations

Testing mediators of intervention effects in randomized controlled trials: An evaluation of three depression prevention programs

Eric Stice et al. J Consult Clin Psychol. 2010 Apr.

Abstract

Objective: Evaluate a new 5-step method for testing mediators hypothesized to account for the effects of depression prevention programs.

Method: In this indicated prevention trial, at-risk teens with elevated depressive symptoms were randomized to a group cognitive-behavioral (CB) intervention, group supportive expressive intervention, CB bibliotherapy, or assessment-only control condition.

Results: The group CB intervention reduced depressive symptoms and negative cognitions and increased pleasant activities. Change in these mediators predicted change in depression, and intervention effects became weaker controlling for change in the mediators; yet, change in depression appeared typically to occur before change in the mediators. The supportive expressive intervention reduced depressive symptoms but affected only 1 of 2 mediators (emotional expression but not loneliness). Change in emotional expression did not correlate with change in depression, and change in depression usually occurred before change in the mediators. Bibliotherapy did not significantly affect depressive symptoms or the ostensive mediators (negative cognitions and pleasant activities), and change in depression usually occurred before change in the mediators.

Conclusion: Results imply that this procedure provides a sensitive test of mediation but yielded limited support for the hypothesized mediators, suggesting that nonspecific factors may play an important mediational role.

PubMed Disclaimer

Comment in

References

    1. Beck AT, Steer RM, Garbin M. Psychometric properties of the Beck Depression Inventory: 25 years of evaluation. Clinical Psychology Review. 1988;8:77–100.
    1. Hollon SD, Kendall PC. Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research. 1980;4:383–395.
    1. Jaycox LH, Reivich KJ, Gillham J, Seligman MEP. Prevention of depressive symptoms in school children. Behavioral Research and Therapy. 1994;32:801–816. - PubMed
    1. Jolly JB, Wiesner DC. Psychometric properties of the Automatic Thoughts Questionnaire with inpatient adolescents. Cognitive Therapy and Research. 1996;20:481–498.
    1. Kazdin AE, Nock MK. Delineating mechanisms of change in child and adolescent therapy: Methodological issues and research recommendations. Journal of Child Psychology and Psychiatry. 2003;44:1116–1129. - PubMed

Publication types