Washington — A depression prevention program that has helped white youth wasn’t effective for Black youth, raising concerns about the need for more research to help racially diverse groups, according to new research published by the American Psychological Association.
“I was very surprised that we couldn’t help Black youth as much as white youth, and we don’t know why there was such a profound difference in the outcomes,” said lead researcher Patrick Pössel, Dr. rer. soc., a professor of counseling psychology at the University of Louisville.
Pössel and some colleagues in Germany developed the LARS&LISA depression prevention program about 25 years ago, which was implemented successfully in schools in Germany and later in Tennessee.
The current study, published online in the Journal of Consulting and Clinical Psychology, included 425 freshman students (57% Black, 43% white) in a Louisville, Kentucky, high school serving primarily low-income students. Half of the students were in a control group while the other half participated in the 10-week LARS&LISA program.
The LARS&LISA program, which includes vignettes with two characters named Lars and Lisa, uses group sessions designed to build motivation through personal goal setting followed by aspects of cognitive behavioral therapy. Students are encouraged to recognize unhelpful thoughts and replace them with more helpful thoughts. In addition, they learn about the pros and cons of assertive, aggressive, passive-aggressive and withdrawing behaviors. They also practice the skills needed to form new social networks.
The students completed questionnaires about depressive symptoms before and after the LARS&LISA program and in a follow-up survey four months later. White youth who participated in the program reported significantly fewer depressive symptoms after completing the program and at the follow-up period. However, Black youth in the program didn’t differ from the control group, with no significant benefits found after completing the program or at the follow-up period.
The study couldn’t determine why the program was unsuccessful for Black youth so more research is needed, not only on that issue but to identify whether other depression treatment programs or models may experience the same shortcomings, Pössel said.
“Psychological theories and treatment programs are largely developed based on white, middle-class, female American clients or college students in psychology courses,” Pössel said. “We need to take a step back and examine the consequences of these limitations. It’s essential to be attentive to cultural and racial differences and not assume there’s a one-size-fits-all approach.”
Other researchers found similar concerns with another youth depression prevention program that is based on cognitive behavioral therapy techniques. That study found the Penn Resiliency Program helped white and Latino youth but showed no significant effects on the depressive symptoms for Black youth. Other studies have found that Black youth’s experiences with racism may put them at higher risk of depression, anxiety and suicide.
In the current study, the participants were from one high school in Louisville, Kentucky, who participated in the LARS&LISA program so the findings may not be generalizable across the United States or to other youth depression prevention programs. Only students who identified as white or Black were included in the analysis so there were no findings for other racial groups.
Article: “Equity and Inclusion in Prevention: Depression Prevention in Black and White American Youth,” Patrick Pössel, Dr. rer. soc., and Hayley D. Seely, PhD, University of Louisville, Journal of Consulting and Clinical Psychology, published online March 24, 2025.
Patrick Pössel, Dr. rer. soc., may be contacted via email.
一些抑郁症预防计划可能对黑人青少年没有帮助
华盛顿——美国心理学会（American Psychological Association）发表的一项新研究显示，一项帮助白人青年的抑郁症预防计划对黑人青年无效，这引发了人们对需要更多研究来帮助种族多元化群体的担忧。
“我非常惊讶，我们不能像白人青年那样帮助黑人青年，我们不知道为什么结果会有如此深远的差异，”首席研究员 Patrick Pössel 博士说。soc.，路易斯维尔大学咨询心理学教授。
Pössel 和德国的一些同事在大约 25 年前开发了 LARS&LISA 抑郁症预防计划，该计划在德国的学校和后来的田纳西州成功实施。
目前的研究在线发表在《咨询与临床心理学杂志》上，包括肯塔基州路易斯维尔一所主要为低收入学生服务的高中 425 名新生（57% 黑人，43% 白人）。一半的学生在对照组，而另一半参加了为期 10 周的 LARS&LISA 计划。
LARS&LISA 计划包括两个名为 Lars 和 Lisa 的角色的小插曲，使用小组会议旨在通过个人目标设定来建立动力，然后是认知行为疗法的各个方面。鼓励学生识别无用的想法，并用更有用的想法代替它们。此外，他们还了解自信、攻击性、被动攻击性和退缩行为的利弊。他们还练习形成新社交网络所需的技能。
学生们在 LARS&LISA 计划之前和之后以及四个月后的后续调查中完成了关于抑郁症状的问卷调查。参加该计划的白人青年在完成该计划后和随访期间报告的抑郁症状明显减少。然而，该计划中的黑人青年与对照组没有差异，在完成该计划后或随访期间没有发现显着的好处。
Pössel 说，该研究无法确定为什么该计划对黑人青年不成功，因此需要更多的研究，不仅在这个问题上，而且要确定其他抑郁症治疗计划或模式是否可能会遇到同样的缺点。
“心理学理论和治疗计划主要是根据白人、中产阶级、美国女性客户或心理学课程的大学生开发的，”Pössel 说。“我们需要退后一步，审视这些限制的后果。必须注意文化和种族差异，而不是假设存在一种放之四海而皆准的方法。
其他研究人员对另一个基于认知行为疗法技术的青少年抑郁症预防计划也发现了类似的担忧。该研究发现，宾夕法尼亚大学复原计划帮助了白人和拉丁裔青年，但对黑人青年的抑郁症状没有显着影响。其他研究发现，黑人青年的种族主义经历可能会使他们面临更高的抑郁、焦虑和自杀风险。
在目前的研究中，参与者来自肯塔基州路易斯维尔的一所高中，他们参加了 LARS&LISA 计划，因此这些发现可能无法推广到美国或其他青年抑郁症预防计划。只有被认定为白人或黑人的学生被纳入分析，因此没有其他种族群体的发现。
品：“预防中的公平和包容：美国黑人和白人青年的抑郁症预防”，Patrick Pössel，rer 博士。和 Hayley D. Seely 博士，路易斯维尔大学，咨询与临床心理学杂志，2025 年 3 月 24 日在线发布。