Screening and predicting adolescent depressive symptoms in rural settings

A reliability generalization meta-analysis of coefficient alpha for the Reynolds Adolescent Depression Scale

The purpose of this study was to use a meta-analytic method known as reliability generalization to investigate the score reliability for a popular depression measure: The Reynolds Adolescent Depression Scale. We used the technique to provide an aggregate estimate of coefficient alpha across empirical studies that have employed the measure over time and across populations. Furthermore, we identified sample and demographic characteristics associated with variance in coefficient alpha. We discuss conditions associated with variability in coefficient alpha and alert researchers and practitioners to appropriate uses of the scale based on common reliability benchmarks.

Identification of suicide risk among rural youth: implications for the use of HEADSS

INTRODUCTION

Nurse practitioners have the power to assess psychosocial risk and detect and prevent suicide, a problem plaguing rural areas of the United States. Suicide risk assessment can be completed using the Home, Education, Activities, Drug use and abuse, Sexual behavior, and Suicidality and depression (HEADSS) interview instrument. The purpose of this study was to determine if HEADSS is appropriate for guiding suicide risk assessment of rural adolescents.

METHOD

High school students in Southwestern Pennsylvania completed qualitative questions from the Child Behavior Checklist and Coping Response Inventory as part of the Intervention to Promote Mental Health in Rural Youth. Qualitative content analysis was performed.

RESULTS

Prominent themes identified by participants included academic performance, relationships, dislikes about school, friends, death, mental health, and the future. Several minor themes concerned safety. Most known risk factors for suicide were concerns of participants.

DISCUSSION

The expansion of HEADSS to include death and safety should be considered. The modified version-HEADDSSS-can be used to guide suicide risk assessment of youth in rural Pennsylvania, ensuring both thoroughness of assessment and safety.

The state of nursing science--cultural and lifespan issues in depression: part II: focus on children and adolescents

The manifestation of depressive phenomena is a complex, dynamic biopsychosocial process across cultures and the lifespan. Without appropriate treatment, depression persists and can have significant negative effects on the lives of youth, including an increased risk of suicide. Psychiatric mental-health (PMH) nurses are uniquely positioned to address this health concern. This manuscript is Part II of a review of current nursing literature on culture and lifespan aspects of depression. The review presented in Part II focuses on children and adolescents. This information can be used to enhance PMH nurses' knowledge of current nursing research and their efforts in addressing prevention, early intervention, education, and treatment of youth who experience depression.

Adolescents coping with mood disorder: a grounded theory study

A grounded theory methodology was used to explore the phenomenon of coping as experienced by adolescents with a mood disorder. Mood disorders among children and adolescents are more persistent than previously thought and have numerous negative associated features, including further episodes of depression, impaired social, academic and vocational relationships, use of alcohol and other drugs, and an increased risk of suicide. Current literature offered little awareness of how adolescents cope with a mood disorder, as well as their perspective of how such an illness impacts their lives. A substantive theory regarding the process of coping for adolescents with a mood disorder was generated from the data collected from one male and eight female adolescents. Using grounded theory coding procedures, a four-phase coping theory identified by the categories feeling different, cutting off connections, facing the challenge/reconnecting, and learning from the experience was developed. The core category identified in this research was An Unplanned Journey: Coping Through Connections. Implications identified for nursing practice, research and education included greater attention on the prevention of adolescent mood disorder, and the education of adolescents about the development and enhancement of healthy coping skills.

Characteristics of adolescent depression

Depression is a common psychiatric disorder that is acknowledged to be increasing in disease burden. The rates of adolescent depression is particularly concerning as they continue to increase. The seriousness and pervasive effects of depression on young people's lives supports the view that research that extends the knowledge in this area is vital. This is a descriptive study of the characteristics of depression in a sample of 121 adolescents attending an outpatient specialist adolescent mental health service in New Zealand. The adolescents were required to complete two self-report measures to assess presence of depressive symptoms, severity of depression, and particular characteristics of the depression. The findings revealed that irritability was the most common characteristic along with other interpersonal and thought processing symptoms. It is important that mental health nurses are able to identify the specific characteristics of adolescent depression that may differ from adult depression in order to manage this patient population effectively.

Depressive Symptoms in Adolescents Living in Rural America

PURPOSE

The purposes of this pilot study were to examine prevalence of depressive symptoms among rural adolescents and identify related social and environmental variables.

METHODS

A convenience sample of 299 14- to 18-year-old agriculture class students at 5 rural high schools in Kentucky and Iowa completed a survey that included demographic information, family farm history, experience with suicide, perception of school environment, and indicators of farm injuries and risky behaviors. Participants also completed the Center for Epidemiologic Studies Depression Scale (CES-D) as well as scales to assess the number of major life events in the last year, active coping use, and family closeness.

FINDINGS

The prevalence of a high level of depressive symptoms (CES-D > or = 16) in this sample was 34%. Nine percent had seriously considered suicide in the last year. Unlike previous reports, boys reported as many depressive symptoms as girls. Although the literature reports that engaging in risky behavior is associated with depressive symptoms, the only risky behavior linked with depressive symptoms in this sample was operating a 4-wheel all-terrain vehicle. Other predictors of depressive symptoms included poor family relationships and poor active coping.

CONCLUSIONS

Interventions to identify and prevent depressive symptoms in rural adolescents are needed. Boosting active coping and improving family function may also prevent the development of clinical depression in rural adolescents.

Adolescent research recruitment issues and strategies: application in a rural school setting

This report discusses adolescent research recruitment strategies in general and specifically, those developed by a research team for a rural school setting. Recruitment of adolescent subjects involves the consideration of several complex issues. These issues include adolescent development, ethical and legal guidelines, and access to school settings. Specific strategies are discussed regarding access and culture of the rural setting, collaboration, and recruitment procedures in relation to their use to recruit adolescent subjects from rural schools.

Sex differences in indicators of well-being in adolescents

The 1999 Youth Risk Behavior Survey, administered to 964 females and 852 males in randomly selected high schools in a midwestern state, indicated significantly greater negative indicators of mental and physical well-being for adolescent girls than adolescent boys. Results of the 1997 survey finding that significantly more adolescent girls reported engaging in several high risk sexual and drug behaviors such as having their first drink of alcohol at an earlier age, driving a vehicle in the past 30 days when they had been drinking, smoking at an earlier age, smoking more cigarettes per day, and using over-the-counter drugs to get high more often, were supported and enlarged.