PDF(Pubmed)
Abstract：
This paper summarizes many findings about depression among children and adolescents. Depression is prevalent, highly distressing, and exerts considerable burden worldwide. Rates surge from childhood through young adulthood and have increased over the last decade. Many risk factors have been identified, and evidence-based interventions exist targeting mostly individual-level changes via psychological or pharmacological means. At the same time, the field appears stuck and has not achieved considerable progress in advancing scientific understanding of depression\'s features or delivering interventions to meet the challenge of youth depression\'s high and growing prevalence. This paper adopts several positions to address these challenges and move the field forward. First, we emphasize reinvigoration of construct validation approaches that may better characterize youth depression\'s phenomenological features and inform more valid and reliable assessments that can enhance scientific understanding and improve interventions for youth depression. To this end, history and philosophical principles affecting depression\'s conceptualization and measurement are considered. Second, we suggest expanding the range and targets of treatments and prevention efforts beyond current practice guidelines for evidence-based interventions. This broader suite of interventions includes structural- and system-level change focused at community and societal levels (e.g., evidence-based economic anti-poverty interventions) and personalized interventions with sufficient evidence base. We propose that by focusing on the FORCE (Fundamentals, Openness, Relationships, Constructs, Evidence), youth depression research can provide new hope.
摘要：
本文总结了许多关于儿童和青少年抑郁症的发现。抑郁症很普遍,非常痛苦，并在世界范围内施加相当大的负担。从童年到成年的比率激增，并且在过去十年中有所上升。已经确定了许多风险因素，并且存在基于证据的干预措施，主要是通过心理或药理手段针对个体水平的变化。同时,在推进对抑郁症特征的科学理解或提供干预措施以应对青年抑郁症高发和不断增长的挑战方面，该领域似乎停滞不前，并没有取得相当大的进展。本文采取了几个立场来应对这些挑战，并推动该领域向前发展。首先,我们强调了构建验证方法的再激活,这些方法可以更好地表征青年抑郁症的现象学特征,并提供更有效和可靠的评估,以增强科学理解并改善青年抑郁症的干预措施.为此,考虑了影响抑郁症概念化和测量的历史和哲学原理。第二,我们建议将治疗和预防工作的范围和目标扩大到目前的循证干预实践指南之外.这套更广泛的干预措施包括集中在社区和社会层面的结构和系统层面的变化(例如，基于证据的经济反贫困干预措施)和具有足够证据基础的个性化干预措施。我们建议通过关注FORCE(基础知识，开放,关系,Constructs,证据)，青少年抑郁症的研究可以提供新的希望。
