Gender differences in adolescent depression: do symptoms differ for boys and girls?

From classroom to life: Gender differences in the persistent effect of learning disabilities on adult depressive symptoms

Despite the well-established link between adolescent learning disabilities (LD) and mental health, little is known about its long-term consequences. This study examines the relationship between adolescent LD and adult depressive symptoms, with a focus on gender differences and underlying mechanisms. Using a sibling sample from the National Longitudinal Study of Adolescent to Adult Health (N = 3,414), this study estimated sibling fixed effects models to account for unobserved family-level characteristics such as genes and early childhood family and social context. Sobel mediation analyses were conducted to examine social-psychological mechanisms, including the student-teacher relationship, the student-student relationship, and a sense of school belonging. LD in adolescence was positively associated with depressive symptoms in adulthood (b = 0.823, p < 0.05). This association remained robust when controlling for unobserved family-level confounders as well as educational attainment in adulthood. Gender-stratified models showed that only the association for women is statistically significant (b = 1.935, p < 0.05), and its magnitude is nearly three times that of the association for men. Sobel mediation tests indicate that a decline in a sense of school belonging mediates approximately 17% of the association between adolescent LD and adult depressive symptoms. This study's findings suggest that LD in adolescence is associated with an increase in depressive symptoms in adulthood, particularly in women, and a low sense of school belonging may be a potential mediator. Implementing interventions to improve the school integration of girls with LD could be an effective means of improving their long-term mental health.

[Gender characteristics of depressive disorders: clinical, psychological, neurobiological and translational aspects]

Various studies have indicated that the prevalence of depression is almost twice as high among women as among men. A major factor associated with the development of depression and other affective disorders are adverse and psychologically traumatic life events that contribute to changes in the neuroendocrine system, altering the capacity to adapt to stress. These changes are involved in the pathogenesis of mental disorders, along with genetic and other factors, and are to a significant degree regulated by gender dependent mechanisms. While women have a high prevalence of depressive disorders, men show a higher rate of alcohol and substance abuse. These differences in the epidemiology are most likely explained by different predisposition to mental disorders in men and women and a diversity of biological consequences to adverse life events. Taking this into account, there is a need for a critical review of currently used approaches to modeling depressive disorders in preclinical studies, including the use of animals of both sexes. Adaptation of experimental models and protocols taking into account gender characteristics of neuroendocrine changes in response to stress, as well as structural-morphological, electrophysiological, molecular, genetic and epigenetic features, will significantly increase the translational validity of experimental work.

Sex-specific immune-inflammatory markers and lipoprotein profile in patients with anhedonia with unipolar and bipolar depression

BACKGROUND

Anhedonia is a core symptom in patients with unipolar and bipolar depression. However, sex-specific markers reflecting biological heterogeneity are lacking. Emerging evidence suggests that sex differences in immune-inflammatory markers and lipoprotein profiles are associated with anhedonia.

METHODS

The demographic and clinical data, immune-inflammatory markers (CD3, CD4, and CD8), and lipoprotein profiles [TC, TG, LDL-C, HDL-C, lipoprotein(a) Lp (a)] of 227 patients with unipolar and bipolar depression were collected. The Hamilton Depression Rating Scale (HAMD) and Snaith-Hamilton Pleasure Scale (SHAPS) were used to assess depression and anhedonia symptoms. Data were analyzed using ANOVA, logistic regression, and receiver operating characteristic curves.

RESULTS

Male patients in the anhedonia group had higher levels of CD3, CD4, and CD8, and lower levels of Lp (a) than the non-anhedonia group, while no significant difference was identified in female patients with and without anhedonia. Logistic regression analysis showed that CD3, CD4, CD8, and Lp (a) levels were associated with anhedonia in male patients. Furthermore, the combination of CD3, CD4, CD8, and Lp (a) had the strongest predictive value for distinguishing anhedonia in male patients than individual parameters.

CONCLUSIONS

We identified sex-specific associations between immune-inflammatory markers, lipoprotein profiles, and anhedonia in patients with unipolar and bipolar depression. The combination of CD3, CD4, CD8, and Lp (a) might be a possible biomarker for identifying anhedonia in male patients with unipolar and bipolar depression.

Diet and Depression during Peri- and Post-Menopause: A Scoping Review Protocol

The aim of the proposed scoping review is to describe and summarize studies assessing the associations between diet-related variables and depression in peri- and post-menopausal women. Studies examining the associations between diet-related variables and mental health indicators in women undergoing menopausal transition or in the post-menopausal period will be systematically retrieved via Medline, EMBASE, PsycINFO, Web of Science, and Scopus databases. All articles identified through the database searches will be imported into Covidence. Following the removal of duplicates, two authors will independently perform title and abstract screening, as well as full-text assessment against eligibility criteria. Data will be extracted using tables developed for observational and experimental studies. The methodological quality of randomized trials, cohort and cross-sectional studies, and case-control studies, will be assessed using the Cochrane risk-of-bias (RoB-2) tool, the NHLBI Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and the NHLBI Quality Assessment Tool for Case-Control studies, respectively. Data extraction tables will be used to produce two tables summarizing the main characteristics and findings of the studies included in the review. In the proposed review, we will systematically identify and summarize the currently available evidence on the association between diet-related variables and depression in peri- and post-menopausal women. To our knowledge, this is the first review focusing on this subgroup of the population. Protocol registration: osf.io/b89r6.

The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population

BACKGROUND

Subthreshold depression could be a significant precursor to and a risk factor for major depression. However, reliable estimates of the prevalence and its contribution to developing major depression under different terminologies depicting subthreshold depression have to be established.

METHODS

By searching PubMed and Web of Science using predefined inclusion criteria, we included 1 129 969 individuals from 113 studies conducted. The prevalence estimates were calculated using the random effect model. The incidence risk ratio (IRR) was estimated by measuring the ratio of individuals with subthreshold depression who developed major depression compared to that of non-depressed individuals from 19 studies (88, 882 individuals).

RESULTS

No significant difference in the prevalence among the different terminologies depicting subthreshold depression (Q = 1.96, p = 0.5801) was found. By pooling the prevalence estimates of subthreshold depression in 113 studies, we obtained a summary prevalence of 11.02% [95% confidence interval (CI) 9.78-12.33%]. The youth group had the highest prevalence (14.17%, 95% CI 8.82-20.55%), followed by the elderly group (12.95%, 95% CI 11.41-14.58%) and the adult group (8.92%, 95% CI 7.51-10.45%). Further analysis of 19 studies' incidence rates showed individuals with subthreshold depression had an increased risk of developing major depression (IRR = 2.95, 95% CI 2.33-3.73), and the term minor depression showed the highest IRR compared with other terms (IRR = 3.97, 95% CI 3.17-4.96).

CONCLUSIONS

Depression could be a spectrum disorder, with subthreshold depression being a significant precursor to and a risk factor for major depression. Proactive management of subthreshold depression could be effective for managing the increasing prevalence of major depression.

Depressive symptoms, alcohol use, and alcohol-related consequences: the moderating role of gender among American Indian adolescents

OBJECTIVES

Depression, alcohol use, and alcohol-related consequences are experienced disproportionately by American Indian (AI) adolescents. The co-occurrence of depression and alcohol use is clinically relevant, as it is associated with increased risk for suicide, among other negative consequences. Understanding how the association between depressive symptoms and alcohol use and related consequences is influenced by gender is important to understand for whom intervention efforts might be particularly relevant. Thus, the present study seeks to evaluate gender differences in these associations among AI adolescents.

METHODS

Participants were a representative sample of AI adolescents (N = 3,498, Mage=14.76, 47.8% female) residing on or near reservations who completed self-report questionnaires in school classrooms. Study activities were approved by IRB, school boards, and tribal authorities.

RESULTS

The interaction of depressive symptoms and gender was significant in predicting past-year alcohol use frequency (b=.02, p=.02) and, among youth reporting lifetime alcohol use, alcohol-related consequences (b=.03, p=.001). Analysis of simple slopes revealed that, for females, depressive symptoms were significantly associated with past-year alcohol use frequency (b=.02, p<.001) and alcohol-related consequences (b=.05, p<.001). For males, depressive symptoms were only significantly associated with alcohol-related consequences (b=.02, p=.04), and this effect was weaker than for females.

CONCLUSIONS

Results of the present study may inform the development of gender-sensitive recommendations for the assessment and treatment of alcohol use and alcohol-related consequences among AI adolescents. For instance, results suggest that treatments focusing on depressive symptoms may subsequently reduce alcohol use and related consequences for female AI adolescents.

Intraindividual phenotyping of depression in high-risk youth: An application of a multilevel hidden Markov model

BACKGROUND

Traditionally, depression phenotypes have been defined based on interindividual differences that distinguish between subgroups of individuals expressing distinct depressive symptoms often from cross-sectional data. Alternatively, depression phenotypes can be defined based on intraindividual differences, differentiating between transitory states of distinct symptoms profiles that a person transitions into or out of over time. Such within-person phenotypic states are less examined, despite their potential significance for understanding and treating depression.

METHODS

The current study used intensive longitudinal data of youths (N = 120) at risk for depression. Clinical interviews (at baseline, 4, 10, 16, and 22 months) yielded 90 weekly assessments. We applied a multilevel hidden Markov model to identify intraindividual phenotypes of weekly depressive symptoms for at-risk youth.

RESULTS

Three intraindividual phenotypes emerged: a low-depression state, an elevated-depression state, and a cognitive-physical-symptom state. Youth had a high probability of remaining in the same state over time. Furthermore, probabilities of transitioning from one state to another did not differ by age or ethnoracial minority status; girls were more likely than boys to transition from a low-depression state to either the elevated-depression state or the cognitive-physical symptom state. Finally, these intraindividual phenotypes and their dynamics were associated with comorbid externalizing symptoms.

CONCLUSION

Identifying these states as well as the transitions between them characterizes how symptoms of depression change over time and provide potential directions for intervention efforts.

Evaluating Effect Moderators in Cognitive Versus Behavioral Based CBT-Modules and Sequences Towards Preventing Adolescent Depression

OBJECTIVE

The aim of this study was to investigate age group, gender, and baseline depressive symptom severity as possible effect moderators in (1) cognitive versus behavioral based CBT-modules and (2) sequences of modules that started either with cognitive or behavioral modules in indicated depression prevention in adolescents.

METHOD

We conducted a pragmatic cluster-randomized trial under four parallel conditions. Each condition consisted of four CBT-modules of three sessions (cognitive restructuring, problem solving, behavioral activation, relaxation), but the sequencing of modules differed. The CBT-modules and sequences were clustered into more cognitive versus more behavioral based approaches. The sample involved 282 Dutch adolescents with elevated depressive symptoms (Mage = 13.8; 55.7% girls, 92.9% Dutch). Assessments were conducted at baseline, after three sessions, at post-intervention and 6-month follow-up with self-reported depressive symptoms as the primary outcome.

RESULTS

We found no evidence for substantial moderation effects. Age group, gender, and depressive symptom severity level at baseline did not moderate the effects of cognitive versus behavioral modules after three sessions. No evidence was also found that these characteristics moderated the effectiveness of sequences of modules that started either with cognitive or behavioral modules at post-intervention and 6-month follow-up.

CONCLUSION

Cognitive and behavioral based modules and sequences in the prevention of depression in adolescents might apply to a relatively wide range of adolescents in terms of age group, gender, and severity levels of depressive symptoms.Abbreviation: CDI-2:F: Children's Depression Inventory-2 Full-length version; CDI-2:S: Children's Depression Inventory-2 Short version; STARr: Solve, Think, Act, Relax, and repeat.

Prevalence and patterns of major depressive disorder and subthreshold depressive symptoms in south China

BACKGROUND

Information on major depressive disorder (MDD) and subthreshold depressive symptoms (SDS) is rarely reported in south China. This study examines the prevalence rates and patterns of MDD and SDS of a large representative sample of adult residents in south China.

METHODS

The Guangdong Mental Health Survey was conducted on adults (over 18 years) from September to December 2021. Multistage stratified cluster sampling was used and face-to-face interviews were done with a two-stage design by trained lay interviewers and psychiatrists. A total of 16,377 inhabitants were interviewed using standardized assessment tools. Data were weighted to adjust for differential probabilities of selection and differential response.

RESULTS

The weighted prevalence rates of MDD and SDS were 2.5 % (95%CI: 2.2 %-2.9 %) and 14.7 % (95%CI: 14.0 %-15.5 %), respectively. Multinomial logistic regression analysis revealed that female, younger age, living in urban area, higher education, unmarried, irregular meal pattern, lack of physical exercise, chronic diseases, irregular napping pattern and short sleep were positively associated with SDS. Besides, female, younger age, unmarried, irregular meal pattern, lack of physical exercise, chronic diseases, short sleep and poor mental health were positively associated with MDD.

LIMITATIONS

The cross-sectional nature of the study limited causal inferences.

CONCLUSIONS

The prevalence of MDD in Guangdong province in 2021 is higher than in mainland China in 2013. Given the higher prevalence of SDS, and high burden of depression, it also offers valuable opportunities for policymakers and health-care professionals to explore the factors affecting mental health in Guangdong province, especially during the COVID-19 epidemic.

Sleep Time and Depression Symptoms as Predictors of Cognitive Development Among Adolescents: A Cross-Lagged Study From China

Sleep time and depression symptoms are important factors affecting cognitive development in adolescents. Based on the China Education Panel Survey (CEPS) database, this study used a two-wave cross-lagged model to examine the bidirectional relationship between sleep time, depression symptoms, and cognitive development. Descriptive statistics showed that Chinese adolescents' cognitive development increased significantly from 7th to 8th grade in junior high school, but unfortunately, their depression level and average sleep time per night demonstrated a slightly deteriorating trend. Correlation analysis showed that there was a relatively stable negative correlation between cognitive development, sleep time, and depression symptoms. Moreover, the cross-lagged model revealed that there was a bidirectional relationship between cognitive development and sleep time, a bidirectional relationship between depression symptoms and sleep time, and a unidirectional relationship between depression symptoms and cognitive development. Male adolescents in the subgroup were consistent with the total sample. Among female adolescents, only cognitive development and sleep time have a bidirectional relationship, while depression symptoms and cognitive development, and depression symptoms and sleep time have a unidirectional relationship. Therefore, it is of significance to take targeted action to promote cognitive development and healthy growth in adolescents worldwide.

Depression and Substance Use as Consequences of Exposure to Family Violence: A Moderation Mediation and Self-Medication Hypothesis Study

Ample evidence exists suggesting that exposure to family violence leads to substance use and this relationship is moderated by gender; however, much is still unknown of the underlying mechanism of this relationship. Thus, the current study first examined whether exposure to family violence was associated with substance use. Then consistent with the self-medication hypothesis, we tested whether depressive symptoms mediated the relations between exposure to family violence and substance use. Finally, we examined the moderating effect of gender on the relationships among exposure to family violence and depressive symptoms/substance use (N = 1,850). Results suggest that exposure to family violence positively associated with substance use. Mediation results revealed that depressive symptoms explained the relationship between exposure to family violence and substance use. Moderation results indicated that males who were exposed to family violence were more likely to endorse depressive symptoms and more likely to use substances while controlling for sibling aggression victimization. This study provides new insight into the internalizing and externalizing symptoms of exposure to family violence, specifically for male adolescents. Implications are discussed.

Sex differences in subjective cognitive impairment and clinical correlates in Chinese patients with subthreshold depression

OBJECTIVE

Subthreshold depression (SD) is a global mental health problem given its high prevalence, comorbidity, functional impairment, and its association with increased service utilization. However, currently little is known about sex differences of SD in cognitive impairment with clinical correlates. This study aims to explore sex differences in subjective cognitive impairment and clinically associated risk factors in Chinese patients with subthreshold depression (SD).

METHODS

A total of 126 patients with SD, 40 males and 86 females, aged 18-45 years, were included in this cross-sectional observational study. Their general information, psychological assessments, and psychiatric symptom assessments were collected online. The Patient Health Questionnaire depression-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Deficits Questionnaire-Depression (PDQ-D), and Toronto Alexithymia Scale (TAS-20) with 3 subdomains were used. The obtained scores were analyzed with partial correlation and multiple linear regression analysis models.

RESULTS

Our results showed that females had significantly higher PDQ-D-20 total score than males. However, the differences in TAS-20 and subdomain score according to sex were not significant. Notably, TAS-20 and DDF (difficulty describing feelings) subdomain contributed to cognitive impairment in males, whereas both PHQ-9 total score and TAS-20 or DDF subdomain contributed to cognitive impairment in females.

CONCLUSION

These findings revealed significant sex differences in cognitive impairment and clinical correlates in SD, which should be further followed-up in the future.

Is it my fault? The role of the feeling of guilt in adolescent peer victimization

Introduction

The aim of this study was to analyze the relationships between feelings of guilt, peer victimization in school, and loneliness based on adolescents' gender.

Methods

A total of 671 Spanish students (50.7% boys), aged 10-16 years old (M = 13.04, SD = 1.80) from six public primary and secondary schools participated in the study. A Multivariate Analysis of Variance (3 × 2) was calculated.

Results

Adolescents with high levels of guilt presented greater physical, verbal, and relational victimization, as well as higher levels of loneliness. In addition, boys high in guilt had the highest scores in overt physical victimization, while girls high in guilt had the highest levels of loneliness.

Discussion

Results obtained suggest that adolescents with greater feelings of guilt feel responsible for being victims of peer aggression and for feeling lonely. These findings suggest the need to address the feeling of guilt, taking into account the gender perception.

Gender Differences in the Psychopathology of Mixed Depression in Adolescents with a Major Depressive Episode

BACKGROUND

Gender differences have been reported in the severity and psychopathological features of major depressive disorders among adults but are poorly reported in adolescent samples.

OBJECTIVE

This study aimed to examine gender differences in the psychopathology of mixed depression among adolescents.

METHODS

We analyzed 341 outpatients with the current major depressive episode (MDE) retrospectively to identify patients with DSM-5 MDE with mixed features. We compared examiner-rated depressive and (hypo)manic symptoms and self- and parent-reported symptoms between sexes.

RESULTS

We identified 76 patients with an MDE with mixed features (67.1% females, 32.9% with bipolar disorder). Depression severity was significantly greater in females versus males (CDRS-R total score 56.2 vs. 48.2, p = 0.014). Depressive symptoms were significantly and independently found to be more severe among females in a logistic regression model, including excessive fatigue (OR 1.68; p = 0.025), low self-esteem (OR 1.67; p = 0.04), excessive weeping (OR 1.62; p = 0.021), and CBCL AAA index (OR 1.04; p = 0.015). None of the depressive symptoms scored greater in males. Males had higher levels of motor activity (2.12 vs. 1.69; p = 0.048) and pressured speech (1.80 vs. 1.24; p = 0.004). Self-rated anxiety (69.3 vs. 56.8, p = 0.047) and CBCL AAA index (207 vs. 189; p = 0.007) were higher in females.

CONCLUSION

Adolescent depression with mixed features is more severe in women, with a higher expression of core affective symptoms and excessive fatigue. While in males, slightly higher levels of psychomotor activation are reported, in females, emotional dysregulation and excessive weeping may subtend a difference in a broader spectrum of mixed features.

The Longitudinal Effects of Depression on Academic Performance in Chinese Adolescents via Peer Relationships: The Moderating Effect of Gender and Physical Activity

This study aims to examine whether there is a difference in the sequential effect of depression on academic performance through peer relationships in Chinese adolescents based on gender and physical activity by using longitudinal data. Data from 7170 people from the China Education Panel Survey (CEPS) were used for analysis. The analysis showed that the indirect effect of depression on academic performance through peer relationships varied depending on gender and physical activity. Specifically, in male students experiencing depression, there was an indirect effect on academic performance through peer relationships in both high and low physical activity groups. In female students experiencing depression, the indirect effect on academic performance through peer relationships was offset if they participated more in physical activity. In other words, for female students participating in physical activity, improvement in peer relationships did not lead to higher academic performance, whereas for male students, improvement in academic performance could be anticipated by improving peer relationships regardless of participation in physical activity. Moreover, since peer relationships play a critical role in improving the academic performance of adolescents experiencing depression, it is important to develop a physical activity or sports program to strengthen peer relationships to improve academic performance.

Intersecting identities and adolescent depression: Patterns of depressed mood and anhedonia in the past decade

BACKGROUND

Research suggests adolescent depression is increasing and certain adolescents may be uniquely vulnerable. However, limited conceptualizations of identity and time, as well as the reliance on unitary conceptualizations of depression, inhibits a nuanced perspective on these trends. In response, we examined how adolescent depressive symptoms, depressed mood, and anhedonia, vary across intersecting identities over time.

METHODS

Secondary data analysis on the National Survey on Drug Use and Health between 2009 and 2017 was conducted. In total 145,499 nationally representative adolescents (ages 12-17) completed a diagnostic assessment for depression. Lifetime and past year reports of depressive symptoms, depressed mood, and anhedonia were treated as separate variables. A novel, mixed-level model in which participants were nested within identity (defined by one's age, gender, race/ethnicity, poverty level) and time was used to test our aims.

RESULTS

Overall, the relation between depression outcomes and identity did not vary over time (p > .01). Further, identity's impact on depression was approximately ten-fold that of temporal effects. Multiracial, late adolescent, female adolescents were at particular risk. Findings concerning depressed mood and anhedonia were similar across analyses.

LIMITATIONS

All facets of identity (e.g., sexual identity) were not included in the model and a unidimensional measure of poverty may have underestimated its depressogenic influence.

CONCLUSION

Adolescent depression outcomes are mostly consistent across criterial symptom subtypes and time, but vary as a function of identity. Prevention protocols that highlight mechanisms of risk tethered to social identity, and include salient experiences of females, late adolescents, and multiracial youth in particular, need to be prioritized in mental health initiatives.

Childhood experiences of threat and deprivation predict distinct depressive symptoms: A parallel latent growth curve model

BACKGROUND/AIM

There is growing awareness that specific childhood trauma (CT) may confer to the unique risk of depression, but little is known about this. The present study seeks to provide insight into how CT subtypes may impact distinct depressive symptoms over time based on the dimensional model of adversity (DMA).

METHODS

A total of 3535 college freshmen participated in a 2-year, four waves longitudinal tracking study. A conditional parallel latent growth curve model (LGCM) was constructed to examine the impacts of different types of CT (threat and deprivation) on the development of depressed mood and anhedonia, and whether these relationships vary across gender.

RESULTS

Our findings revealed that threat and deprivation could differentially relate to depressed mood and anhedonia. Both threat and deprivation predicted initial depressed mood levels (β = 0.309, p < 0.001; β = 0.175, p < 0.001, respectively) and its trajectory (β = -0.139, p = 0.068; β = -0.168, p < 0.05, respectively). Only deprivation predicted anhedonia levels (β = 0.318, p < 0.001) and trajectory (β = -0.218, p < 0.001). This pattern of relationships between CT and depressive symptoms varied across gender.

CONCLUSION

These findings highlight specific pathways and symptomatic manifestations of the impacts of different CT subtypes on depression and are consistent with the hypothesis of DMA. Threat and deprivation predicted more severe depressed mood, whereas deprivation uniquely conferred to the risk of depression via elevated anhedonia. Meanwhile, the deleterious effects of CT would persist during early adulthood. Gender differences were also discussed.

Nonproductive thoughts, somatic symptoms and well-being in adolescence: testing the moderator role of age and gender in a representative study

Background

Previous findings suggest a female preponderance in nonproductive thoughts -rumination and worry-, but studies on gender differences in the strength of the relationship between nonproductive thoughts, somatic symptoms and subjective well-being are scarce. Our aim was to test whether gender and age would moderate these associations.

Methods

1572 adolescents were involved in this representative cross-sectional study (770 boys; mean age = 15.39; SD = 2.26 years). Nonproductive thoughts were measured by Nonproductive Thoughts Questionnaire for Children (NPTQ-C), somatic symptoms were assessed by Somatic Complaint List (SCL), while Mental Health Continuum-Short Form (MHC-SF) was used to measure subjective well-being. To assess the moderation effects of age and gender on the relationship between nonproductive thoughts, somatic symptoms and well-being, four multiple indicator multiple causes (MIMIC) models were defined.

Results

Our results suggested that higher rates of nonproductive thoughts predicted a higher level of somatic symptoms and a lower level of subjective well-being. The analyses revealed that although nonproductive thoughts were strongly and equally associated with somatic symptoms among boys and girls, age was a significant moderator. Gender also moderated the relationship between nonproductive thoughts and subjective well-being.

Conclusions

Our results support the importance of nonproductive thoughts in somatic symptoms and highlight that the strength of the relationship is similar across both genders but could be dependent upon age. The findings also shed light on the decreased well-being of girls, especially with elevated level of nonproductive thoughts.

Examining the Gendered Impacts of Technology-Facilitated Sexual Violence: A Mixed Methods Approach

Technology-facilitated sexual violence (TFSV) is defined broadly as unwanted or unwelcome sexual behavior involving the use of technology, including online sexual harassment, online gender or sexuality-based harassment, online image-based abuse (colloquially known as "revenge porn"), and online sexual aggression/coercion (colloquially known as "sextortion"). The purpose of this study was to explore the victim impact of TFSV and to critically examine the positioning of TFSV as a gender-based harm; that is, a harm directed primarily towards women. This study employed a mixed methods approach, integrating quantitative online survey data (N = 333; M_age = 33.91 years; 63% women) with qualitative interview data (N = 10; Age_range = 24-46; 50% women) to gain a more comprehensive understanding of TFSV. We found that victims of TFSV experienced anxiety, stress, depression, loss of control, mistrust, multiple victimizations, poor academic/occupation functioning, problematic alcohol consumption, embarrassment, and online behavior changes (e.g., limiting personal information online) due to TFSV victimization. Individuals who experienced online image-based abuse reported greater distress on items of depression, anxiety, and occupational/academic functioning than did victims of other types of TFSV. The current study provides partial support for the gender similarities hypothesis that TFSV is not exclusively a gender-based harm; our findings suggest that women and men's TFSV experiences are similar for most TFSV types. Overall, the present study demonstrates the negative impact TFSV has for both women and men and highlights the need for greater awareness and increased support for all victims of this form of sexual violence.

Psychosocial factors associated with adolescent depressive and anxiety symptoms during the COVID-19 pandemic

The COVID-19 pandemic has created many challenges for adolescents across the world. The current study aimed to investigate the prevalence of depressive and anxiety symptoms and suicidal ideation in adolescents living in Melbourne, Australia, during the state of Victoria’s second lockdown. The study also sought to identify pre-existing and current psychosocial stressors associated with adolescent’s depressive and anxiety symptoms, and to identify the extent to which adolescents experiencing mental health difficulties sought professional help during the pandemic. A COVID-19 sub-study of the Mothers’ and Young People’s Study—an 18-year longitudinal cohort study—was conducted between July and September 2020, an online survey completed by 257 adolescents aged 14–17 years and their mothers, which asked about pandemic-related stressors, remote learning, family life, and mental health. Descriptive statistics and hierarchical multiple regression analysis were conducted. Mental health difficulties were common with 38% and 20% of adolescents reporting clinically significant depressive and anxiety symptoms, respectively, and 21% reporting frequent suicidal or self-harm ideation. Factors associated with depressive and anxiety symptoms included being female, exposure to current maternal depressive symptoms, lower levels of resilience, experiences of loneliness, stressful life events, and school- and family-related stressors. Two-thirds of adolescents who were experiencing clinically significant depressive or anxiety symptoms had not sought professional help. Our findings highlight the urgent mental health need among adolescents and the importance of reducing barriers to accessing support.

Peer Relationships and Depressive Symptoms Among Adolescents: Results From the German BELLA Study

Background: Poor mental health affects adolescent development and is associated with health and social outcomes in later life. The current study uses cross-sectional data to explore the understudied aspects of peer relationships as a predictor of depressive symptom severity of adolescents in Germany. Method: Data from the German BELLA study were analyzed. We focused on the most recent measurement point of the BELLA study and analyzed data of 446 adolescents (aged 14-17 years). Peer relationship was measured using four items from the internationally established Patient-Reported Outcome Measurement Information System (PROMIS). Depressive symptoms were assessed via seven items of the German version of the Centre for Epidemiological Studies Short Depression Scale (CES-D). Hierarchical linear regression models were computed to explore the association between depressive symptoms and peer relationships. Hierarchical linear regression models served to determine the added predictive effects of each aspect of peer relationships. Result: The regression model showed that 22% of the variance of the severity of depressive symptoms could be explained by the quality of adolescents' peer relationships (F(1,444) = 125.65, p < 0.001). Peer acceptance has the most substantial unique contribution to peer relationship as a predictor of depressive symptom severity (Change in R 2 = 0.05; Change in F = 27.01, p < 0.001). The gender-specific analysis shows different trends for boys and girls. Conclusion: The quality of peer relationships is a significant predictor of adolescents' depressive symptoms severity. Improved peer acceptance, dependability, and ease of making new friends are significantly associated with reduced depression symptoms for Germany's adolescent population.

Factor Structures of Patient Health Questionnaire-9 Instruments in Exploring Depressive Symptoms of Suburban Population

BACKGROUND

This study aims to examine the psychometric properties of the nine-item Patient Health Questionnaire (PHQ-9) and assess the relationship between the PHQ-9 domain and demographics and health behaviors in Vietnamese people.

MATERIALS AND METHODS

The PHQ9 was administered to 899 participants. Exploratory factor and reliability analyses were performed. Tobit regression and Ordered logistic regression were further performed to determine factors associated with the PHQ-9 score and characteristics of depression.

RESULTS

The 2-factor model of PHQ-9, including factor 1 "Somatic" and factor 2 "Cognitive/Affective," showed good psychometric properties. The Cronbach's alpha value showed high internal consistency in two factors (0.84 and 0.80, respectively). Gender, health behavior exercising, drinking, and health status had associations with both factors of the PHQ-9 model.

CONCLUSION

The PHQ-9 scale is a valid and reliable instrument to assess depression in the Vietnam population. This scale can be a useful screening tool for depression; however, further validation studies in other populations are required.

Cyberbullying victimization and depression among adolescents: A meta-analysis

Cyberbullying is a category of bullying that occurs in the digital realm/medium of electronic text. In this study, we used meta-analysis to explore the relation between cyberbullying victimization and depression. We investigated 57 empirical studies from 17 countries (74 effect sizes and 105, 440 participants). The results showed that there was a significant positive relation between cyberbullying victimization and depression (r = .291, 95% CI = [.246, .335]). Moreover, we found that gender, age and publication year significantly moderated the relation between cyberbullying victimization and depression.

Early Adolescent Social Media-Related Body Dissatisfaction: Associations with Depressive Symptoms, Social Anxiety, Peers, and Celebrities

OBJECTIVE

It is critical to examine the powerful socializing effects of networked media on early adolescents when social media use, body self-consciousness, and social comparisons are at their peak.

METHOD

Using 2 subsamples (N = 374 and N = 396) of those aged 11 to 14 years from a larger survey sample of 700 middle school participants in the Northeast United States, we conducted a cross-sectional pilot survey using brief, descriptive body dissatisfaction measures directly related to social media use.

RESULTS

Within our body dissatisfaction subsample, 19% reported dissatisfaction to body image issues. Participants' most common concerns around body image included not being thin enough, not attractive enough, and feeling dissatisfaction with body shape, hair, and face. The results from analysis of covariance analyses showed that those reporting social media-related body dissatisfaction checked their social media more frequently. When compared with those who did not feel negatively about their body image because of social media, those who did had higher rates of depressive symptoms, had online social anxiety, had found it harder to make new friends, and were more socially isolated. Those who followed celebrities checked social media more frequently and were more likely to have depressive symptoms and online social anxiety.

CONCLUSION

There may be negative socioemotional health consequences of early adolescent social media users with exposure to particular sources of social media content, such as photographs of celebrities.

Is the Effect of Body Dissatisfaction on Depressive Symptoms Dependent on Weight Status? A Study with Early-to-Middle Adolescents

Depression is a recognized mental health problem in adolescence and body dissatisfaction is an important risk factor. The main goal of this study is to examine the relationship between body dissatisfaction and depressive symptoms, and whether it depends on adolescents' weight status, an issue that remains understudied. Two hundred and fourteen adolescents (12-16 years) completed self-report measures of depressive symptoms, body dissatisfaction and weight status (i.e., current body weight and height, to compute body mass index z-scores, BMIz). Hierarchical multiple regression and moderation analyses were conducted, accounting for gender and age effects on depressive symptoms. Body dissatisfaction was found to be a predictor of depressive symptoms for the low and median BMIz adolescents, but not for those with high BMIz. In addition, this interaction of body dissatisfaction and BMIz improved the ability of the regression model to explain depressive symptoms´ variance beyond the effect of gender and age. The high-BMIz adolescents presented higher body dissatisfaction but similar levels of depressive symptoms, compared to the lower BMIz adolescents. These findings suggest the influence of body dissatisfaction in the emergence of depressive symptoms in the first half of adolescence, and the importance of weight status throughout this path.

B-vitamin supplementation ameliorates anxiety- and depression-like behavior induced by gestational urban PM2.5 exposure through suppressing neuroinflammation in mice offspring

PM_2.5 exposure is an emerging environmental concern and severe health insult closely related to psychological conditions such as anxiety and depression in adolescence. Adolescence is a critical period for neural system development characterized by continuous brain maturation, especially in the prefrontal cortex. The etiology of these adolescent conditions may derive from fetal origin, probably attributed to the adverse effects induced by intrauterine environmental exposure. Anxiety- and depression-like behavior can be induced by gestational exposure to PM_2.5 in mice offspring which act as a useful model system. Recent studies show that B-vitamin may alleviate PM_2.5-induced hippocampal neuroinflammation- and function-related spatial memory impairment in adolescent mice offspring. However, cortical damage and related neurobehavioral defects induced by gestational PM_2.5 exposure, as well as the potential reversibility by interventions in mice offspring require to be elucidated. Here, we aimed to investigate whether B-vitamin would protect mice offspring from the adverse effects derived from gestational exposure to urban PM_2.5 on cortical areas to which anxiety and depression are closely related. Pregnant mice were divided into three groups: control group (treated with PBS alone), model group (treated with both PM_2.5 and PBS), and intervention group (treated with both PM_2.5 and B-vitamin), respectively. The mice offspring were then applied to comprehensive neurobehavioral, ultrastructural, biochemical, and molecular biological analyses. Interestingly, we observed that gestational PM_2.5 exposure led to neurobehavioral defects including anxiety- and depression-like behavior. In addition, neuroinflammation, oxidative damage, increased apoptosis, and caspase-1-mediated inflammasome activation in the prefrontal cortex were observed. Notably, both behavioral and molecular changes could be significantly alleviated by B-vitamin treatment. In summary, our results suggest that the anxiety- and depression-like behavior induced by gestational PM_2.5 exposure in mice offspring can be ameliorated by B-vitamin supplementation, probably through the suppression of apoptosis, oxidative damage, neuroinflammation, and caspase-1-mediated inflammasome activation.

Demographic, Social, and Economic Factors of Internalizing Problems in Referred and Non-Referred Adolescents

Depressive symptoms and suicidal ideation are common internalizing problems during adolescence. Numerous studies have explored the role of certain demographic, social, and economic factors in their development in referred or non-referred adolescents, but not simultaneously in both groups. In this study, we examined the association between age, gender, parents’ educational level, and socioeconomic status (SES) and depressive symptoms and suicidal ideation in a referred group (n = 211) and a non-referred (n = 1401) group of adolescents. We also examined the moderating role that these factors play in the relationships between both internalizing problems. The results showed: higher levels of depressive symptoms and suicidal ideation in the referred group; an increase in both problems during early-to-middle adolescence in the non-referred group; an association between low SES and suicidal ideation in both groups; an association between low father’s education level and depressive symptoms in the non-referred group; and no gender differences in either of these two internalizing problems. The moderation analyses showed that age, in referred adolescents, and SES, in non-referred adolescents, moderated the relationship between depressive symptoms and suicidal ideation. This study contributes to the identification of groups of vulnerable adolescents that could constitute the target populations of preventive programs.

Pattern of inpatient care for depression: an analysis of 232,289 admissions

BACKGROUND

The prevalence of major depressive disorder (MDD) in women is up to 50% higher as compared to men. However, little is known about discrepancies in health care utilization between depressed female and male patients. Consequently, the aim of the present study was to elucidate gender differences regarding the frequency of hospital admissions and the length of inpatient treatment for MDD across the lifespan.

METHODS

This nationwide, registry-based study analyzed all inpatient admissions in psychiatric hospitals due to recurrent/non-recurrent MDD episodes according to ICD-10 (moderate (F32/33.1), severe (F32/33.2), severe with psychotic features (F32/33.3)) in Austria across 14 years. We calculated weekly admission rates per 100,000 patients by directly age-standardized rates.

RESULTS

Across 232,289 admissions (63.2% female) the population based admission rates in MDD were significantly higher in women (p < 0.001). Female to male ratios across subgroups were 1.65 (F32/33.1), 1.58 (F32/33.2), 1.73 (F32/33.3), and peaked around 65 years (ratio ≥ 2 for all subgroups). Length of hospital stay for women was significantly longer in all depression subtypes (p < 0.001).

CONCLUSIONS

Elevated rates of inpatient treatment in women cannot solely be explained by a higher MDD prevalence and are dependent on age and type of depressive episode. Irrespective of the type and severity of the mood episode, women exhibit longer hospitalisation times.

Subthreshold depression in adolescence: Gender differences in prevalence, clinical features, and associated factors

BACKGROUND

Subthreshold depression (SD) is an important mental health problem in adolescence given its high prevalence, comorbidity, and functional impairment. However, currently little is known about gender differences of SD in adolescence. The aim of this study was to examine gender differences in prevalence, clinical features, and associated factors in adolescents with subthreshold depressive episode (SDE).

METHODS

The participants were 2,022 adolescents between 9^th and 11^th grades (49.5% girls, 15.2 years average age) recruited from eight state-subsidized schools located in the northern part of Santiago, Chile. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms. Descriptive statistics, bivariate and multinomial logistic regression analyses were used.

RESULTS

The prevalence of SDE and major depressive episode were 16.5% (95% CI: 14.9-18.2) and 17.7% (95% CI: 16.1-19.4), respectively. Both mental health problems were more prevalent in females (p < 0.001). With regard to SDE, girls displayed a higher rate of depressive mood and sleep problems, while boys had greater anhedonia, problems related with concentration, and psychomotor retardation/agitation. High levels of dysfunctional thoughts and perceived social support were associated with SDE in females and males. Social problem solving and emotion regulation had a differentiated impact on SDE depending on gender.

CONCLUSION

Depressive symptoms and SDE were found to be common health problems among adolescents in Chile. SDE had major gender differences in terms of prevalence, clinical features, and associated factors. These differences should be considered in the development of preventive and early interventions.

Reciprocal associations between depression and screen-based sedentary behaviors in adolescents differ by depressive symptom dimension and screen-type

BACKGROUND

The heterogeneity of depression and sedentary behavior complicates understanding of mechanisms underlying and interventions addressing comorbid depression and sedentary behavior in adolescents. This study investigated reciprocal associations between four depressive symptom dimensions and two types of screen-based sedentary behaviors in adolescents, and tested whether these associations differed by sex.

METHODS

A school-based longitudinal cohort (N = =2,717, baseline Mage=14.57 years) completed questionnaires during two assessments one year apart. Participants reported on levels of four depressive symptom dimensions (continuous) and television viewing and computer/videogame use (≥2 h/day; yes vs. no).

RESULTS

Reciprocal associations between computer/videogame use and higher negative affect symptoms were observed (computer/video games predicting negative affect, β=0.06, 95%CI 0.01-0.11, p = =0.01; negative affect predicting computer/video games, OR 1.29, 95%CI 1.06-1.58, p = =0.01). The relationship between baseline computer/videogame use and subsequent negative affect differed by sex (p = =0.02), and was significant in girls (β=0.11, 95%CI 0.04-0.18, p = =0.002), but not boys (β=0.004, 95%CI -0.06-0.07, p = =0.90). Baseline computer/videogame use predicted somatic symptoms at follow-up (β=0.06, 95%CI 0.01-0.10, p = =0.02), but the reverse association was non-significant. Higher baseline positive affect predicted computer/videogame use at follow-up (OR 1.16, 95%CI 1.02-1.31, p = =0.02), but the reverse association was non-significant. Television viewing was unrelated to each depressive symptom dimension in either direction.

LIMITATIONS

Self-reports may be subject to recall errors and biases, and do not provide clinical diagnoses.

CONCLUSIONS

Associations are not uniform across screen-based sedentary behavior type, depressive symptom dimension, and sex. The association between computer/videogame use and negative affect symptoms may be reciprocal across time and particularly robust among girls.

Prevalence and correlates of maladaptive guilt in middle childhood

BACKGROUND

Maladaptive guilt can develop by age three and is associated with severe affective psychopathology in adolescents and adults. Yet, little is known about its prevalence prior to adolescence, or which children are at greatest risk of developing this symptom. This study examined the prevalence and correlates of maladaptive guilt in middle childhood.

METHODS

This study examined a large community sample of 9-to 10-year-old children (N = 4485) from the Adolescent Brain and Cognitive Development (ABCD) study. Maladaptive guilt was assessed through the Kiddie Schedule for Affective Disorders and Schizophrenia for DSM-5. Parental rejection, family conflict, and parental depression were assessed via questionnaires.

RESULTS

In depressed children, a 1-month prevalence of maladaptive guilt of 18.4% and a lifetime prevalence of 30.8% was found. Lifetime rates ranged from 1.8 to 4.1% in children with other psychiatric disorders. Cross-sectionally, maladaptive guilt was associated with lower family income-to-needs, greater family conflict, a history of maternal depression, and greater parental rejection. These findings held when controlling for children's depressive severity, indicating that these associations are specific to maladaptive guilt.

LIMITATIONS

Maladaptive guilt was assessed through one item, though many studies of maladaptive guilt measure the symptom in this manner.

CONCLUSIONS

Findings suggest that it may be beneficial for clinicians to assess for maladaptive guilt beyond the context of assessment for depression, particularly with children of low socioeconomic status and children of depressed mothers, whom this study suggests are at higher risk. Negative family climates and parenting might also be important targets of preventative interventions.

The Prevalence and Socio-Demographic Correlates of Depressive Symptoms in Early Adolescents in China: Differences in Only Child and Non-Only Child Groups

This study explores the prevalence and socio-demographic correlates of depressive symptoms in early adolescents in China, as well as the differences between an only child and non-only child group. A total of 2059 seventh-grade Chinese students were invited to complete a questionnaire, which included questions concerning socio-demographic factors, family function, and the Center for Epidemiological Studies Depression Scale (CES-D). The results revealed the following things. (1) thirty-four point seven percent of the participating Chinese early adolescents display symptoms of depression according to Radloff's criteria. Differences are significant across the four dimensions (i.e., positive affect, negative affect, somatic symptoms and retarded activity, and interpersonal difficulties), as well as across total scores between only children and children with sibling(s). (2) Academic achievement, having sibling(s) or not, migration, and family function can significantly predict depressive symptoms. (3) Two significant interactions were found, which were between sibling(s) and gender as well as sibling(s) and family function. Girls from the non-only child group and adolescents from the only child group with poor family function were more likely to have depressive symptoms. These findings suggest that a greater focus should be placed on girls from non-only child families, academic under-performers, migrants, and adolescents from poor family environments, and especially only children, to prevent or reduce the propensity for depressive symptoms.

Sex-Specific Differences in Severity of Depressive Symptoms, Heart Rate Variability, and Neurocognitive Profiles of Depressed Young Adults: Exploring Characteristics for Mild Depression

Mild depressive symptoms (MDS) reflect vulnerability to major depression that does not meet the criteria for a major depressive disorder (MDD). Previous research indicates that it is difficult to identify MDS in young adults, and they exhibit diverse aspects of depressive symptoms caused by clinical depression, which can lead to poor academic performance, relationship difficulties, and even suicide. Additionally, many young adults remain unaware of their depressive symptoms during the early stages of MDD. Thus, the present study investigated clinical, neurocognitive, and physiological characteristics of young adults with various symptoms of depression and explored sex-specific differences. A total of 113 students aged 18-35 (MDD: n = 32; MDS: n =37; control [CON]: n = 44) participated in the study. Self-report clinical measures, short-term cardiac activity measured by finger sensors, and neurocognitive data were collected. Pearson's correlations, two-way analysis of variance (ANOVA), principal component analysis, and exploratory structural equation modeling were conducted for the statistical analyses. Furthermore, the measurement invariance of the latent factor model was tested, and fit indices were compared according to sex. The results revealed that male students showed greater sympatho-vagal activity than female students. Additionally, male MDS students tended to exhibit decreased performance levels in neurocognitive function tasks compared with MDD and CON males, whereas female MDS students showed distinct characteristics compared to MDD and CON females on self-report measures of anxiety. Correlation analyses identified a positive association between the level of anger perception and latency in the executive function test among both males and females. Additionally, the use of a structured model revealed significant sex-specific differences in factor estimates. The present results suggest that recognizing the early signs of MDS that account for sex-specific differences in both subjective and objective measures may improve the diagnosis and monitoring of young adults with MDS.

Anhedonia, screen time, and substance use in early adolescents: A longitudinal mediation analysis

INTRODUCTION

Screen time is associated with substance use risk among adolescents; however, less is known about the underlying factors that explain this association.

METHODS

This research examined anhedonia, a facet of depression noted by the reduced capacity to experience pleasure, as a mediating factor in the relationship between screen time (hours spent watching television, using internet, and/or playing video games outside of school) and substance use (alcohol and/or cigarettes). We used a longitudinal survey design among a sample of students aged 9-11 years in the 4th to 6th grades in Southern California, United States of America [N = 709 (354 males)].

RESULTS

Structural equation modeling (SEM) findings revealed longitudinal mediation effects of anhedonia on the association between screen time and substance use, while controlling for baseline screen time, baseline individual and peer substance use, race/ethnicity, and gender. Moderation analysis based on a multiple-group approach revealed that gender was not a significant moderator of this mediation pathway.

CONCLUSIONS

Adolescents may become desensitized and exhibit a blunted response to hedonic effects from increased screen time. This may result in increased anhedonia and greater risk for substance use through the need to compensate for the reduced experience of rewards. These findings have implications for future school-based substance use prevention and intervention programs.

The association between excessive screen-time behaviors and insufficient sleep among adolescents: Findings from the 2017 youth risk behavior surveillance system

Although studies have examined the association between television viewing and poor sleep quality, few studies have considered the association between excessive screen-time behaviors and insufficient sleep among adolescents drawing on a large nationally representative sample. The objective of this study was to examine the association between excessive screen-time behaviors and insufficient sleep among adolescents. Data for this study came from the 2017 Youth Risk Behavior Survey. A sample of 14,603 adolescents aged 14-18 years (51.5% female) was analyzed using logistic regression with insufficient sleep as the outcome variable and excessive screen-time behaviors as the main explanatory variable. Of the 14,603 adolescents, almost three out of four (74.8%) had less than 8 h of sleep on an average school night, and about 43% engaged in excessive screen-time behaviors on an average school day. Controlling for all other predictors, odds were 1.34 times higher for adolescents who engaged in excessive screen-time behaviors to have insufficient sleep when compared to adolescents who did not engage in excessive screen-time behaviors (AOR = 1.34, p < .001, 95% CI = 1.22-1.48). School-based behavior interventions that focus on reduction in excessive screen-time and sedentary behaviors might be beneficial in reducing excessive screen-time behaviors and consequently improve sleep quality among adolescents.

The effects of internalized shame and self-blame on disordered eating and drive for muscularity in collegiate men

PURPOSE

The purpose of the present study was to explore the relative contributions of self-blame and internalized shame to variability in disordered eating and drive for muscularity scores in collegiate men.

METHOD

One hundred and sixty-eight male college students in the Rocky Mountain region of the USA completed valid and reliable self-report survey measures: the Drive for Muscularity Scale, the Internalized Shame Scale, the Shame and Guilt Eating Scale to assess self-blame, and the Eating Attitudes Test. Cross-sectional data were analyzed through descriptive, correlation, and regression statistics.

RESULTS

Men who reported higher levels of self-blame, r = 0.39, p < 0.001, and internalized shame, r = 0.38, p < 0.001, also reported higher levels of eating disorder symptomology. Similarly, men who scored higher on internalized shame, r = 0.20, p < 0.01, reported higher scores on drive for muscularity. Regression analyses revealed that internalized shame was the sole contributor to variability in drive for muscularity scores, β = 0.20, p < 0.01, whereas both self-blame, β = 0.27, p < 0.001, and internalized shame, β = 0.24, p < 0.001, contributed to scores on disordered eating attitudes and behaviors in men.

CONCLUSIONS

Our study was the first to examine how internalized shame and self-blame relate to drive for muscularity and disordered eating in collegiate men. Our results suggest that both self-blame and internalized shame may contribute to disordered eating in men. Additionally, internalized shame appears to relate to drive for muscularity in men. Clinicians may wish to consider how they approach treatment given the potential contributions of internalized shame and self-blame to disordered eating in their male clients.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Characteristics of adolescents who visit the emergency department following suicide attempts: comparison study between adolescents and adults

BACKGROUND

The purpose of this study was to identify the demographic and clinical characteristics of suicide attempts in adolescents who visit the emergency department compared to those of adults.

METHODS

This study included 149 children under the age of 18, and 1427 people in the age of 19-65 who came to the emergency department with suicide attempt from 2009 to 2015. We compare sociodemographic, clinical, and suicide attempt-related characteristics through Chi-square test and logistic regression analysis to evaluate the difference between two groups.

RESULTS

In adolescents, suicide attempters had more number of previous suicide attempt history than adults. Adolescents used more non-lethal method such as poisoning of over the counter drugs and had about 5 times higher odds ratio in suicide attempts with analgesics. The motivation of suicide attempt among adolescents was more related with interpersonal problems but less with financial or illness-related problems. The intention of suicide attempt in adolescents was less serious and lethal compared to adults.

CONCLUSION

Suicide attempts among adolescents had showed different from adults in method, motivation and intention. Considering the characteristics of suicide attempt among adolescent, it is necessary to keep close attention to adolescent's suicide attempters and develop the customized intervention program to prevent the suicide attempt in this groups.

Depressive symptoms, sexual activity, and substance use among adolescents in Kampala, Uganda

BACKGROUND

Adolescents experience high rates of depression, initiation of sexual activity, and substance use.

OBJECTIVES

To better understand the demographics of adolescents presenting to an adolescent clinic in Uganda, and to elucidate which factors are associated with depressive symptoms, sexual initiation, and substance use.

METHODS

A retrospective review was performed on intake forms obtained during interviews with adolescents presenting to the Makerere/Mulago Columbia Adolescent Health Clinic (MMCAH) in Kampala, Uganda.

RESULTS

Depressive symptoms in adolescents were correlated with having a chronic illness (p=.026), and reported poor quality of home life (p<.001). Initiation of sexual activity was also correlated with chronic illness (p=.008) and poor quality of home life (p=.006). Substance use was correlated with maternal death (p=.041), chronic illness (p=.038), and substance use among family members (p<.001) and friends (p<.001).

CONCLUSIONS

Knowing the aforementioned risk factors can help us better understand the needs of adolescents presenting to MMCAH, and allows us to develop targeted interventions aimed at decreasing health risks in Kampala's adolescent population.

Measuring depressive symptoms during adolescence: what is the role of gender?

AIMS

The higher prevalence of depressive symptoms among females is well recognised but the reasons for this gender difference are not fully understood. There is growing evidence that current diagnostic criteria and instruments used to assess depression are less sensitive to depression in men, but studies about this issue among adolescents are scarce, especially in Latin countries. Our aim was to assess sex differences in the intensity of depressive symptoms, measured using the Beck Depression Inventory second edition (BDI-II), among Portuguese adolescents, at 13 and 17 years of age.

METHODS

Urban adolescents born in 1990 and enrolled in schools of Porto, Portugal, in 2003-2004 (EPITeen study) completed the BDI-II at 13 and 17 years of age. The final sample included 1988 (52.2% girls) and 2131 (53.0% girls) adolescents at 13 and 17 years, respectively. Sex differences in the frequency of endorsing the statements on the 21 items of the BDI-II were examined using the χ2 test and effect sizes were estimated (Cohen's w). To examine whether responses were linked systematically to sex, we used a differential item functioning (DIF), based on the logistic regression approach. Option characteristic curves were estimated for items with differential endorsement and a new BDI-II score was computed excluding those items.

RESULTS

Girls and boys at the same level of depression expressed similar severity ratings for most of the depressive symptoms. We had four items with DIF at 13 and 17 years of age. At 13 years, two items provided lower scores (sadness and crying items) and two higher scores (punishment feelings and loss of interest in sex items) among boys, comparing with equally depressed girls. At 17 years, the four items with DIF provided lower scores among boys (sadness, crying, self-dislike and tiredness or fatigue items). After excluding these items the prevalence of depression remained higher among girls but at 17 years the difference between sexes was attenuated.

CONCLUSIONS

Sex differences were found in the functioning of the BDI-II, more relevant at 17 years of age, which may lead to an overestimation of symptoms among girls as well as to lower reported rates of depression among boys. For a higher diagnostic accuracy it is important that the criteria and instruments used to assess depression adequately reflect female and male common symptoms and experiences of depression.

Maltreatment subtypes, depressed mood, and anhedonia: A longitudinal study with adolescents

OBJECTIVE

Maltreatment exposure is a robust predictor of adolescent depression. Yet despite this well-documented association, few studies have simultaneously examined how maltreatment subtypes relate to qualitatively distinct depressive symptoms. The present multiwave longitudinal study addressed this gap in the literature by examining how different maltreatment subtypes independently impact depressed mood and anhedonia over time in a diverse adolescent sample.

METHOD

Adolescents (N = 673, M_age = 14.83, SD_age = 0.66, 57.1% female, 32.8% Hispanic, 30.4% Caucasian, 25.0% African American) completed self-report inventories for child-maltreatment and annual self-report measures of depressed mood and anhedonia over the course of 6 years. We used latent-growth-curve modeling to test how maltreatment exposure predicted anhedonia and depressed mood, and whether these relations differed as a function of sex and/or race/ethnicity.

RESULTS

Overall, both emotional abuse (p < .001) and neglect (p = .002) predicted levels of depressed mood over time, whereas only emotional neglect predicted levels (p < .001) and trajectories (p = .001) of anhedonia. Physical and sexual abuse did not predict depressive symptoms after accounting for emotional abuse and neglect (ns). These findings were largely invariant across sex and race.

CONCLUSION

Findings suggest that the consequences of emotional neglect may be especially problematic in adolescence because of its impact on both depressed mood and anhedonia, and that emotional abuse's association with depression is best explained via symptoms of depressed mood. These findings are congruent with recent findings that more "silent types" of maltreatment uniquely predict depression, and that abuse and neglect experiences confer distinct profiles of risk for psychological distress. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Depression in a sample of Tunisian adolescents: prevalence, associated factors and comorbidity with anxiety disorders

BACKGROUND

Adolescent depression is a significant health problem which can lead to detrimental consequences. This study aimed to determine the prevalence of the depression in a sample of secondary school students, to identify its associated factors and to explore the co-occurrence with symptoms of anxiety disorders.

MATERIALS AND METHODS

We conducted, in March 2017, a cross-sectional study that included, using a cluster sampling technique, 386 students from five public secondary schools in El Kef (Tunisia). Data were collected using a socio-demographic questionnaire and the Arabic versions of the Beck Depression Inventory (13 items) and the Screen for Child Anxiety Related Disorders. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20.

RESULTS

The prevalence of depression among participants was 75.9%. Of depressed students, 30.4% had mild depression, 48.8% had moderate depression and 20.8% had severe depression. The logistic regression analysis showed an association between the depression and the female gender [odds ratio (OR) = 2.59, 95% confidence interval (CI): 1.52-4.17], the 1st and 4th school grades (OR = 1.79, 95% CI: 1.09-2.94), the low and medium socioeconomic status (SES) (OR = 1.91, 95% CI: 1.14-3.18), the school dissatisfaction (OR = 2.77, 95% CI: 1.41-5.44) and the anxiety disorders (OR = 5.86, 95% CI: 3.54-9.70). The comorbidity "depression and anxiety" was found in 86.1% of students.

CONCLUSION

This high prevalence of depressive symptoms reported in the present study seems to have many implications especially for school health-care services.

The presentation of depression symptoms in attention-deficit/hyperactivity disorder: comparing child and parent reports

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with depression, and outcomes are poor when both are present. Little is known about whether depression symptoms present differently in ADHD compared to the general population, or how reliable young people with ADHD are at reporting these symptoms. This study aimed to describe depression symptoms in a clinical ADHD sample compared to a population sample, and compare self-reports of depression symptoms with parent-reports.

METHODS

Two hundred and forty-nine children with ADHD and their parents completed follow-up questionnaires around 5 years after taking part in a Cardiff University ADHD study. Child depression symptoms were measured using parent- and child-reported Mood and Feelings Questionnaires (MFQ) and compared to a population sample with MFQ data (n = 1460). Within both samples, child- and parent-reported depression symptoms were compared.

RESULTS

Although the profile of depression symptoms was similar between young people with ADHD and those in the general population, depression symptoms were much more common in the ADHD sample (parent-rated MFQ score = 24.52 vs. 9.39; child-rated = 21.02 vs. 11.86). The most common symptoms in both samples included irritability, restlessness and concentration difficulties, with core depression symptoms such as feeling miserable/unhappy also prominent. Within the ADHD sample, but not the population sample, children reported depression symptoms less frequently than their parents.

CONCLUSIONS

Young people with ADHD are at high risk of experiencing symptoms of depression but may under-report the severity of their symptoms. Obtaining parent reports of depression symptoms in this group may be important to avoid missing key indicators of risk.