Explaining the Female Preponderance in Adolescent Depression-A Four-Wave Cohort Study

Associations of health literacy and sleep quality with depressive symptoms in Turkish adolescents: A descriptive cross-sectional study

PURPOSE

The purpose of this study was to determine the associations of health literacy and sleep quality with depressive symptoms in adolescents.

DESIGN AND METHODS

This descriptive cross-sectional study was conducted with 1081 high school students in Turkey. The data were collected online using the Health Literacy for School-Aged Children Scale, Pittsburg Sleep Quality Index, and the Center for Epidemiological Studies Depression Scale for Children. The chi-square test and binary logistic regression analysis were used to analyze the data obtained from the scales.

RESULTS

The prevalence of depressive symptoms, sleep problems, and low health literacy was 78.4%, 70.6%, and 11.3%, respectively. Sleep problems were significantly positively correlated with depressive symptoms (OR = 4.187, 95% CI: 2.998 -5.848). The students who were experiencing sleep problems and had low health literacy were at risk of the most severe depressive symptoms (OR = 12.696, 95% CI: 5.122-31.474).

CONCLUSIONS

Overall, depressive symptoms and sleep problems were common among the adolescents in the study sample. The students who had sleep problems and low health literacy were at an increased risk for depressive symptoms.

PRACTICAL IMPLICATIONS

To prevent mental health problems in adolescents, intervention programs focused on increasing the health literacy levels and improving sleep quality in this population are recommended.

Sport practice and depression during adolescence: Special emphasis on performance level and sport discipline

OBJECTIVES

Depression is one of the most prevalent diseases worldwide, with almost half of the adolescent population affected according to latest research. Given this serious burden of disease, research points toward interventions that could effectively fight this disease in this population subset. One of these pivotal interventions is physical activity, although the effects of different sport types and sport performance level on depression have not yet been studied in adolescent populations. Accordingly, the objective of the current study was to assess the relationship between depressive symptoms, sport type and performance level in a large adolescent population.

DESIGN

Cross-sectional study assessing a large cohort of adolescents through self-reported data.

METHODS

10,248 participants aged 11-19 years old answered questionnaires regarding depressive symptoms and sporting habits and were classified according to their sport performance level: from physically inactive to internationally competitive.

RESULTS

Girls reported higher incidence of depressive symptoms than boys, difference that further increased during late adolescence. Performance level was related to depressive symptoms: inactive participants reported the highest depressive scores while internationally competitive athletes reported the lowest. However, there were no differences between competitive athletes of different performance levels. Further, sport type had a small influence on depressive symptoms.

CONCLUSIONS

All these findings result in a potential guideline for future research and community health recommendations: as long as sufficient physical activity levels are met and the adolescent engages in sporting activities, the protection against depressive symptoms remains largely unrelated to the sport type and the level at which he or she performs.

The relationship of depressive symptoms with pain and analgesic use in Turkish adolescents

PROBLEM

This study aimed to determine the prevalence of depressive symptoms, pain (headache, abdominal pain, back pain) and analgesic use among Turkish adolescents. Additionally, it aimed to examine the association between depressive symptoms and pain and analgesic use in adolescents.

METHODS

This cross-sectional, correlational study was conducted in Izmir, Turkey with 954 adolescents aged 11-19 years. Data were collected with the "socio-demographic questionnaires" and the "Center for Epidemiologic Studies Depression Scale for Children". Analyzes were performed using descriptive statistics and multiple logistic regression analysis.

FINDINGS

Of the adolescents, 632 (66.2%) showed depressive symptoms. Of the adolescents, 424 (44.4%) experienced headache, 256 (26.8%) experienced abdominal pain, and 343 (36.0%) experienced back pain. A total of 309 (32.4%) adolescents used analgesics for headaches, 132 (13.8%) abdominal pain, and 47 (4.9%) for back pain. Female gender, high level maternal education, bad economic status, poor health perception, bad school success, pain and analgesic use were the correlated variables with adolescent depression.

CONCLUSIONS

The depressive symptoms, headache and back pain, and use of analgesics especially for headaches were common among adolescents. The results showed depression in adolescent correlated with pain (headache, abdominal pain, and back pain) and analgesic use. Regular screening is needed to assure early intervention of depression among adolescents.

Are social pressure, bullying and low social support associated with depressive symptoms, self-harm and self-directed violence among adolescents? A cross-sectional study using a structural equation modeling approach

BACKGROUND

More in-depth evidence about the complex relationships between different risk factors and mental health among adolescents has been warranted. Thus, the aim of the study was to examine the direct and indirect effects of experiencing social pressure, bullying, and low social support on mental health problems in adolescence.

METHODS

A school-based cross-sectional study was conducted in 2022 among 15 823 Norwegian adolescents, aged 13-19 years. Structural Equation Modelling was used to assess the relationships between socioeconomic status, social pressure, bullying, social support, depressive symptoms, self-harm and suicide thoughts.

RESULTS

Poor family economy and low parental education were associated with high pressure, low parental support and depressive symptoms in males and females. Moreover, poor family economy was associated with bullying perpetration and bullying victimization among males and females, and cyberbullying victimization among females, but not males. Low parental education was associated with bullying victimization among males, but not females. Further, high social pressure was associated with depressive symptoms among males and females, whereas high social pressure was linked to self-harm and suicide thoughts among females, but not males. Bullying victimization and cyberbullying victimization were associated with depressive symptoms, self-harm, and suicide thoughts among males and females. Bullying victimization was associated with depressive symptoms among males, but not females, whereas bullying perpetration was linked to self-harm and suicide thoughts among females, but not males. Low parental support was associated with bullying perpetration, bullying victimization, depressive symptoms, self-harm and suicide thoughts among males and females, whereas low parental support was associated with high social pressure among females, but not males. Low teacher support was associated with high social pressure and depressive symptoms. Low support from friends was associated with bullying victimization, depressive symptoms and suicide thoughts among males and females, whereas low support from friends was linked to self-harm among males, but not females. Finally, results showed that depressive symptoms were associated with self-harm and suicide thoughts among males and females.

CONCLUSION

Low socioeconomic status, social pressure, bullying and low social support were directly and indirectly associated with depressive symptoms and self-directed violence among Norwegian adolescents.

The Relationship of Rejection Sensitivity to Depressive Symptoms in Adolescence: The Indirect Effect of Perceived Social Acceptance by Peers

Rejection sensitivity (RS), the tendency to expect, perceive and overreact to rejection from others, has been linked to children's and adolescents' increased vulnerability to depressive symptoms, negatively affecting their perceptions of the quality of their relationship with their peers. The aim of this study is to examine (a) the indirect effect of perceived peer social acceptance in the relationship between RS and depressive symptoms in a sample of Greek adolescents, (b) the differential effect of the different components of rejection sensitivity (angry and anxious RS) on the model, and (c) possible gender differences. The sample of the study consists of 295 adolescents (139 boys, 156 girls, Mage = 14.20, SD = 1.60) residing in the greater Heraklion Prefecture area. Data collection was carried out using self-report questionnaires that measured demographic characteristics, self-perceptions about their peer relationships (self-perception profile for adolescents/SPPA), susceptibility to rejection (children's rejection sensitivity questionnaire/CRSQ), and depressive symptoms (children's depression inventory/CDI). Results showed that (a) RS was positively related to depressive symptoms and negatively related to adolescents' perceptions of their relationships, (b) relationship perceptions were negatively related to depressive symptoms, and gender differences were also found, (c) perceived social acceptance by peers was found to have an indirect effect in the relationship between RS and depressive symptoms, with girls showing a greater effect, and (d) differences were observed in the mediating model between the components of RS, with the mediating effect of perceptions being higher in the model with anxious RS, which appears to confirm previous theoretical postulations. The results of this study highlight the importance of adolescents' perceptions of their peer relationships in the occurrence of depressive symptoms during this developmental period, especially in youths with anxious rejection sensitivity.

Discordance Indices of Stress Sensitivity and Trajectories of Internalizing Symptoms in Adolescence

Psychiatric illness in adolescence is associated with long-term impairments, making it critical to identify predictors of adolescent psychiatric distress. Individual differences in stress sensitivity could be associated with longitudinal trajectories of internalizing symptoms. Historically, researchers have operationalized stress sensitivity by assessing either objective or subjective responses to stress. However, we posit that the relative discordance between subjective and objective responses to stress is a critical metric of stress sensitivity. We examined whether two discordance-based indices of stress sensitivity were related to one another and to trajectories of internalizing psychopathology among a sample of 101 adolescent youths (Mage = 12.80 at baseline; 55% males) across two successive stressors: the high school transition and the COVID-19 pandemic. Using latent growth curve modeling, we found that greater discordance between subjective (i.e., affective) and objective (i.e., cortisol) responses to a social-evaluative stressor was associated with higher internalizing symptoms at baseline and an accelerated symptom growth trajectory across the first year of the pandemic. In contrast, early life stress sensitivity was not associated with internalizing symptoms. Findings suggest that the discordance between objective and subjective experiences of social-evaluative stress predicts a pernicious growth trajectory of internalizing symptoms during adolescence. This work advances current methodologies, contributes to theoretical models of internalizing psychopathology, and with replication could have implications for policy and practice by identifying a key vulnerability factor that increases adolescents' psychiatric distress over time.