Understanding Depression

Developmental Pathways Project 

Study Aims

The Developmental Pathways Project is an epidemiological study designed to learn about the development of depression and disruptive behavior during the middle school years.  Funded by the National Institute of Mental Health, the specific aims of DPP are to:

  1. Identify developmental precursors (temperament and cognitive style) for the emergence of co-occurring and non-co-occurring depression and disruptive behavior.
  2. Understand the expression (signs and symptoms) and longitudinal course of emerging depression and disruptive behavior in children.
  3. Identify how stressful life events, family and peer support, and the onset of puberty affect the onset and resolution of depression and disruptive behavior.  Understand how these factors affect the occurrence of depression and disruptive behavior differently in girls and boys and in students who come from different ethnic backgrounds.
  4. Document outcomes (school performance, social skills, substance use, adaptive functioning) for children who have depression and disruptive behavior problems, compared to other children from their community.
Study Design

Part 1 of the Developmental Pathways Project began with 6th grade students in the Seattle public schools. During the fall of the year from 2001-2005, 6th graders in four middle schools were invited to participate in a voluntary school-based screening activity.  Teams of UW screeners visited classrooms and administered two brief standardized questionnaires used to assess depression and disruptive behavior problems in young adolescents.

A total of 521 students who represented the entire spectrum of screening scores were randomly selected and recruited with a parent/guardian to participate in Part 2 of the Developmental Pathways Project, the longitudinal study. Interviewers visited homes to conduct lengthy interviews with both the student and a parent/guardian five times during the middle school years.  Students and their parent/guardian receive monetary compensation for their time.  School information was also obtained from teachers and school records.

The Developmental Pathways Project was funded for five years beginning in 2001.  In 2005 we obtained funding from the American Society for Suicide Prevention and in 2006 from Children’s Hospital and the UW Provost’s Office to conduct 9th grade interviews with DPP families.

Data analysis and writing continues. We are writing on topics such as differences in symptomatology, functional impairment, suicidal behavior, ethnic/racial background, negative cognitive style between adolescents with comorbid problems and those with depression or conduct problems alone.  We have also written papers on related topics such as implementing a school-based screening program, accuracy of adolescents’ self-reported weight and height, neighborhood poverty and symptoms of depression and anxiety, associations between adolescent depression and obesity, and optimal methods for early identification of depressed adolescents.

In April 2008 we received funding from the National Institute of Mental Health to continue to study the original Developmental Pathways Project cohort.  For this study we are conducting one lengthy interview about the emotional, cognitive, and social development of DPP participants in late adolescence.  The youth are 17-18 years of age at the time of the interview and are beginning to plan for or engage in life as young adults.  We ask them about their mental health status, high school performance, social relationships, and vocational experiences and will determine what stresses and supports they encountered during the high school years.  This cohort was well characterized during early adolescence, which will provide us with a firm foundation for understanding developmental pathways into late adolescent depression and conduct problems.

We are currently awaiting a funding decision from the National Institute of Alcohol Abuse and Alcoholism for a continuation of DPP into young adulthood.  We have proposed to investigate gender differences in developmental pathways from depression and conduct problems in adolescence to problem use and substance use disorders in young adulthood.

 

Understanding in Action:

DPP Ancillary Studies

The first ancillary study conducted with the DPP cohort was the Daily Study.  Dr. Cynthia Flynn, PhD, Principal Investigator on this study, was funded by Seattle Children’s Hospital to recruit 250 DPP participants in their 9th grade school year to complete daily diaries of both the stresses and the emotional highs and lows they experienced.

Three ancillary studies were funded in 2010, a secondary analysis R-01 from the National Institute of Alcohol Abuse and Alcoholism (Cari McCarty, PhD, PI) to study associations between depression and alcohol use trajectories over the course of adolescence and a Klingenstein Young Investigator Award (Gretchen Gudmundsen, PhD, PI) to conduct physiological assessments of an informative subset of the DPP cohort. We have also received a Royalty Research Fund award (Ann Vander Stoep, PhD, PI) and a Seattle Children’s Hospital CTTR Award (Ann Vander Stoep & Elizabeth McCauley, Co-PIs) to genotype members of the DPP cohort to study genetic polymorphisms associated with depression and conduct problems.

In 2011 we obtained pilot funds from the University of Washington Alcohol and Drug Abuse Institute (Ann Vander Stoep & Elizabeth McCauley, Co-PI’s) to implement the methods proposed in the NIAAA project studying persistent heavy alcohol use during the transition to young adulthood with the first DPP cohort of young adults.  We have implemented the pilot study, interviewing 42 DPP participants at age 21-22 years.

In fall 2012 we obtained funding from the Loeb Family Foundation to conduct young adult interviews with another 100 DPP participants.  The young adult study combines online and in-person data collection.