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Kodzo LD, Danso NAA, Budu JT, Akriti KB, Hussain A, Zhang R. Experience of psychosocial rehabilitation; perspectives of depressed adolescents. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02473-z. [PMID: 38809300 DOI: 10.1007/s00787-024-02473-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/18/2024] [Indexed: 05/30/2024]
Abstract
Given the multifaceted character of depression and its related symptoms, an adolescent living with it is at increased risk for a wide range of adverse events. This research aimed to understand and characterize the psychosocial rehabilitation experiences of depressed teenage participants in the Greater Accra Region of Ghana. A cross-sectional semi-structured interview design influenced by an interpretive phenomenological analysis (IPA) technique was adopted. We employed a nonprobability, purposeful sampling approach to recruit twenty-one adolescents (6 males, 15 females) diagnosed with depression from the community after one month of discharge from admission and undergoing psychosocial rehabilitation. Using separate interviews, we gathered and analyzed data using interpretive phenomenological analysis to produce themes and sub-themes. These were presented with the participants' direct quotations. We discovered that the perspectives of adolescents' psychosocial rehabilitation experience include hopelessness and suicide ideation, coping difficulties, undesirable attitudes from support networks, challenges related to school, and isolation. Participants suggested appropriate therapeutic environments, encouraging support systems, and the media's role in preventing and treating depression among young people as rehabilitation approaches that could assist adolescents to remain lucid for longer intervals. These results shed light on the tragic realities faced by depressed adolescents. There is an urgent need to put well-defined structures in place to aid their rehabilitation and develop coping strategies for a better life.
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Affiliation(s)
- Lalit Dzifa Kodzo
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
- Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
- School of International Education, Southern Medical University, Guangzhou, China
- Organization of African Academic Doctors (OAAD), Off Kamiti Road, Nairobi, Kenya
| | | | | | | | - Abid Hussain
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Ruixing Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China.
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Dubois AC, Roberti-Lintermans M, Mallien Z, François A, Lahaye M, De Mol J, Aujoulat I. How do exhausted parents experience their interactions with their children? A qualitative and participative study. Front Public Health 2024; 12:1340748. [PMID: 38751584 PMCID: PMC11094333 DOI: 10.3389/fpubh.2024.1340748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/29/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Parental burnout, known as a state of physical and psychological exhaustion, results in an imbalance between the parent's perceived stressors in relation to parenting, and the resources available to the parent to cope with such stressors. The causes and consequences of parental burnout for the parents themselves have been studied from the parents' point of view, but the perception of parents regarding the impact of parental burnout on the parent-child relationship has not yet been documented. Methods We conducted a qualitative study through semi-structured interviews with exhausted parents (n=21). We aimed to better understand their general interactions with their children, as well as the way they communicate with them about their state of exhaustion, knowing that dealing with parental suffering can have a long-term impact on the child. Results Our results reveal that exhausted parents experience a widespread loss of control in all areas of their lives, particularly in their interaction with their children, which generates feelings of guilt and shame. Communicating their experience to their children can create various difficulties for both parents and children. This may complicate the process of seeking help and reinforce the feeling of isolation. Discussion An emerging result from our analysis leads us to identify a need for the parents to be heard and validated in their suffering who took part in this research.
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Affiliation(s)
- Anne-Catherine Dubois
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Margaux Roberti-Lintermans
- Institute for the Analysis of Change in History and Contemporary Societies, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Zoé Mallien
- Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Aurore François
- Institute for the Analysis of Change in History and Contemporary Societies, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Magali Lahaye
- Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Jan De Mol
- Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Isabelle Aujoulat
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
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Ekbäck E, Rådmark L, Molin J, Strömbäck M, Midgley N, Henje E. The Power Threat Meaning Framework: a qualitative study of depression in adolescents and young adults. Front Psychiatry 2024; 15:1393066. [PMID: 38757135 PMCID: PMC11097657 DOI: 10.3389/fpsyt.2024.1393066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Depression constitutes one of our largest global health concerns and current treatment strategies lack convincing evidence of effectiveness in youth. We suggest that this is partly due to inherent limitations of the present diagnostic paradigm that may group fundamentally different conditions together without sufficient consideration of etiology, developmental aspects, or context. Alternatives that complement the diagnostic system are available yet understudied. The Power Threat and Meaning Framework (PTMF) is one option, developed for explanatory and practical purposes. While based on scientific evidence, empirical research on the framework itself is still lacking. This qualitative study was performed to explore the experiences of adolescents and young adults with depression from the perspective of the PTMF. Methods We conducted semi-structured interviews with 11 Swedish individuals aged 15- 22 years, mainly female, currently enrolled in a clinical trial for major depressive disorder. Interviews were transcribed verbatim and analyzed with framework analysis informed by the PTMF. Results A complex multitude of adversities preceding the onset of depression was described, with a rich variety of effects, interpretations, and reactions. In total, 17 themes were identified in the four dimensions of the PTMF, highlighting the explanatory power of the framework in this context. Not all participants were able to formulate coherent narratives. Discussion The PTMF provides a framework for understanding the complexities, common themes, and lived experiences of young individuals with depression. This may be essential for the development of new interventions with increased precision and effectiveness in the young.
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Affiliation(s)
- Erik Ekbäck
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Lina Rådmark
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Jenny Molin
- Department of Clinical Science, Umeå University, Umeå, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Maria Strömbäck
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Nick Midgley
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Eva Henje
- Department of Clinical Science, Umeå University, Umeå, Sweden
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Prizeman K, McCabe C, Weinstein N. Stigma and its impact on disclosure and mental health secrecy in young people with clinical depression symptoms: A qualitative analysis. PLoS One 2024; 19:e0296221. [PMID: 38180968 PMCID: PMC10769096 DOI: 10.1371/journal.pone.0296221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Clinical depression ranks as a leading cause of disease and disability in young people worldwide, but it is widely stigmatized. The aim of this qualitative research was to gather young people's experiences of depression stigma and its impact on loneliness, social isolation, and mental health disclosure and secrecy. This novel information can then be used to guide psychosocial interventions for young people with depression. METHODS This qualitative study included N = 28 young people aged 18-25 years (Mage = 21.30). Participants were recruited from the community who had high symptoms of depression (assessed through a pre-screen using the Mood and Feelings Questionnaire (MFQ) with a benchmark score > 27) or had been recently diagnosed with depression by a medical professional. Semi-structured interviews were based on conceptual model drawings created by participants and analyzed using thematic analysis. RESULTS Four main themes emerged: 1) Depression secrecy: positive and negative aspects; 2) Depression disclosure: positive and negative aspects; 3) The solution is selective disclosure; and 4) Participants' recommendations do not align with personal preferences. In particular, the young people described non-disclosure as a way to be in control, but that secrecy prevented authentic engagement with others. Young people also described disclosure as eliciting more stigma but as necessary to gain help. Finally, the young people described struggling with knowing how much to disclose in relation to their mental health and with whom they could disclose. CONCLUSIONS This study provides new evidence of how young people with depression experience stigma and its effects on disclosure and mental health secrecy. Knowing how young people struggle with these issues can allow us to develop interventions to encourage them to come forward and discuss their mental health in order to receive appropriate support and treatment. We recommend young people be signposted and have access to mental health champions or nominated teachers in their schools or universities.
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Affiliation(s)
- Katie Prizeman
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Ciara McCabe
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Netta Weinstein
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
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Twivy E, Kirkham M, Cooper M. The lived experience of adolescent depression: A systematic review and meta-aggregation. Clin Psychol Psychother 2023; 30:754-766. [PMID: 36700415 DOI: 10.1002/cpp.2834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND The under-detection of depression in adolescents suggests that a better understanding of its presentation may be needed. Conceptualizations of adolescent depression are largely the same as adult depression, with minimal consideration of developmental stage. Exploration of first-hand accounts could help to identify any unique features of adolescent depression. Therefore, this systematic review aimed to understand the lived experience of adolescents with depression to inform clinical practice. METHODS The review was registered with PROSPERO (CRD42020198141). Databases (PsychINFO, CINAL, MEDLINE and EMBASE) were searched in March 2022 to identify peer-reviewed qualitative studies on first-hand experiences of adolescent depression. The Joanna Briggs Institute's qualitative data extraction tool and checklist for qualitative research were used to obtain study data and assess methodological quality of included papers. Meta-aggregation was the method of synthesis, whereby extracted themes from the papers were grouped according to shared meanings. RESULTS Fifteen papers of mixed methodological quality were identified for inclusion from screening a total of 1,983 references. Studies were published between 2002 and 2021, spanned seven countries and included participants aged 11 to 22 years old. Aggregation of 56 themes resulted in 16 categories and 3 synthesized findings encompassing key aspects of adolescent depression: causes, symptoms and coping. Variability in adolescents' perspectives across these domains was evident. Some symptoms described, such as social disconnection and anger, are not listed in existing diagnostic criteria. CONCLUSIONS Subjective experiences of depression among adolescents vary and may not entirely match diagnostic criteria. Awareness of this when assessing for depression may improve detection and help to ensure adolescents feel understood.
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Affiliation(s)
- Eve Twivy
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Miriam Kirkham
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Myra Cooper
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
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Orphanidou M, Kadianaki I, O'Connor C. Depression as an Embodied Experience: Identifying the Central Role of the Body in Meaning-Making and Identity Processes. QUALITATIVE HEALTH RESEARCH 2023; 33:509-520. [PMID: 36922708 DOI: 10.1177/10497323231154210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Α significant part of the psychological research on mental health and illness is interested in how the body can impact one's mental health. This impact is primarily explored using a biomedical framework, in studies that examine the body's role in the emergence of a mental illness, the ways it can signify the presence of an illness (i.e. physical symptoms) and, finally, its role in the treatment process. Within this literature, the body is conceptualised as an object that can be diagnosed and treated. The current study approaches the body as a subject in the experience of depression. Specifically, it demonstrates that the experience of depression is embodied and that the body mediates meaning-making and identity processes. Using qualitative findings from eight interviews with Greek-Cypriot adults diagnosed with depression, we demonstrate that participants make sense of depression through their bodies, as a painful, uncomfortable and agonising experience. Further, we discuss how the struggle to regain control over the body, experienced as hijacked by depression, leads to a disrupted relation with the self and the world that expands beyond the idea of the loss of self, as described in the literature. Theoretical and clinical implications are examined.
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Affiliation(s)
| | - Irini Kadianaki
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
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Beckers W, Jakob P, Schreiter ML. Mattering and parental presence in systemic therapy using nonviolent resistance: The utilization of imaginary methods. FAMILY PROCESS 2022; 61:507-519. [PMID: 34240414 DOI: 10.1111/famp.12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 06/13/2023]
Abstract
An empowered sense of "self" is crucial for emotional well-being and positive relationships. Certain family interaction patterns can disrupt the adult's sense of "mattering" to the child, eroding their perceived self-efficacy. Mattering can be understood as a felt sense of relational agency which is necessary for experiencing one's interactions as meaningful, effective, and self-determined. When parents generate more positive future narratives in co-creation with their therapist, their sense of relevance to a child can be restored. In this way, more constructive forms of interaction can emerge with their child which has hitherto eschewed their care. This article aims to provide a conceptual basis for addressing an absence of reciprocity, where children demonstrate harmful or self-destructive behavior and refuse to cooperate in therapy. In such instances, one-sided parental action, utilizing nonviolent resistance methods, can influence relational dynamics. Imaginary methods can then facilitate shifts to psychological states in which the parent internally experiences efficacy and mattering more often without requiring validation from the "physical child" in the here and now. We introduce examples of specific imaginary techniques, which in our clinical practice have shown to facilitate such shifts in parents. We discuss neuroscientific theories that may account for their powerful impact we witness in our clinical experience.
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Affiliation(s)
- Willem Beckers
- PartnershipProjects UK Ltd, Seaford, UK
- Interactie-Academie VZW, Antwerpen, Belgium
| | | | - Marie Luise Schreiter
- PartnershipProjects UK Ltd, Seaford, UK
- Department of Psychology, Faculty of Science, Eberhard Karls University, Tübingen, Germany
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Chukwuere PC, Sehularo LA, Manyedi ME. Experiences of adolescents and parents on the mental health management of depression in adolescents, North West province, South Africa. Curationis 2022; 45:e1-e9. [PMID: 35261252 PMCID: PMC8905408 DOI: 10.4102/curationis.v45i1.2178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 12/29/2021] [Accepted: 11/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background Living with or managing an adolescent suffering from depression predisposes the adolescent and parents to various experiences, considering the multifactorial nature of depression and associated symptoms. Objective This study explored and described the experiences of adolescents and their parents on the mental health management of depression in the North West province (NWP), South Africa. Method A qualitative, exploratory, descriptive, contextual research design was adopted. Data was collect from two mental health care institutions and two mental health care units attached to two general hospitals in the NWP, SA. Thirty-two participants (18 adolescents and 14 parents) were purposefully selected for the study. Data were collected through individual interviews and analysed using Tesch’s open-coding method to generate themes and categories which were presented with the concurrent support of participants direct quotations. Results The study revealed that the experiences of adolescents with depression and their parents taking care of them at homes include the following: emotional distress, poor coping mechanisms, financial burden, repeated suicidal attempts, negative attitudes from support systems and withdrawal behaviours. Appropriate therapeutic environments, ongoing monitoring by mental healthcare practitioners and adequate support systems were suggested by participants as management approaches that could enhance the recovery of adolescents from depression. Conclusion The findings revealed the devastating experiences of adolescents with depression and their parents taking care of them in their various homes which confirms the dire need for attention on the plights of these groups in order to facilitate adolescents’ recovery and strengthen the adolescents’ and parents’ coping mechanisms for a healthier family.
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Affiliation(s)
- Precious C Chukwuere
- Department of Nursing Science, Faculty of Health Science, North-West University, Mahikeng.
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Anderson NW, Markowitz AJ, Eisenberg D, Halfon N, Moore KA, Zimmerman FJ. The Child and Adolescent Thriving Index 1.0: Developing a Measure of the Outcome Indicators of Well-Being for Population Health Assessment. CHILD INDICATORS RESEARCH 2022; 15:2015-2042. [PMID: 35966033 PMCID: PMC9362709 DOI: 10.1007/s12187-022-09962-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 05/13/2023]
Abstract
UNLABELLED The well-being of children and adolescents is emerging as an area of interest for population health measurement. Previous approaches assessing national and state trends in well-being have relied on composite indices. However, these methodologies suffer from several weaknesses. This paper develops an improved index for the United States that is measurable with existing population-data resources. It derives the appropriate weights for items in this index using a longitudinal panel of 2,942 children in the Panel Study of Income Dynamics. Candidate component measures are selected for the index based on their demonstrated association with several subjective scales assessed during young adulthood. The final index demonstrates that a broad range of measures indicate higher levels of population-level well-being. The predictive validity of the index for outcomes during young adulthood is also assessed: a one-standard-deviation increase in the index score is associated with a 7.9-percentage-point decrease [95% CI: 5.9 - 9.8] in ever reporting fair or poor health, a 6.3-percentage-point decrease [95% CI: 4.6 - 8.0] in ever reporting depression, and a 17.2% [95% CI: 13.7% - 20.5%] increase in peak earnings. These values for predictive validity are slightly higher than those of existing methodologies. We also find that incorporating contextual indicators from childhood and adolescence does not substantively improve predictive validity. Policy-makers and government agencies interested in population-level well-being of children and adolescents can continue to use existing indices as reasonable proxies, but should also commit to upgrading data systems to make them more child-centric in the future. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12187-022-09962-0.
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Affiliation(s)
| | | | - Daniel Eisenberg
- Department of Health Policy and Management, UCLA, Los Angeles, CA USA
| | - Neal Halfon
- Department of Health Policy and Management, Department of Pediatrics, UCLA, Los Angeles, CA USA
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Moscibrodzki P, Enane LA, Hoddinott G, Brooks MB, Byron V, Furin J, Seddon JA, Meyersohn L, Chiang SS. The Impact of Tuberculosis on the Well-Being of Adolescents and Young Adults. Pathogens 2021; 10:1591. [PMID: 34959546 PMCID: PMC8706072 DOI: 10.3390/pathogens10121591] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/25/2021] [Accepted: 11/27/2021] [Indexed: 01/26/2023] Open
Abstract
The health needs of adolescents and young adults (AYAs) have been neglected in tuberculosis (TB) care, control, and research. AYAs, who are distinct from younger children and older adults, undergo dynamic physical, psychological, emotional, cognitive, and social development. Five domains of adolescent well-being are crucial to a successful transition between childhood and adulthood: (1) Good health; (2) connectedness and contribution to society; (3) safety and a supportive environment; (4) learning, competence, education, skills, and employability; and (5) agency and resilience. This review summarizes the evidence of the impact of TB disease and treatment on these five domains of AYA well-being.
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Affiliation(s)
- Patricia Moscibrodzki
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Leslie A. Enane
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 8000, South Africa; (G.H.); (J.A.S.)
| | - Meredith B. Brooks
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA; (M.B.B.); (V.B.); (J.F.)
| | - Virginia Byron
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA; (M.B.B.); (V.B.); (J.F.)
| | - Jennifer Furin
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA; (M.B.B.); (V.B.); (J.F.)
- Sentinel Project on Pediatric Drug-Resistant Tuberculosis, Boston, MA 02115, USA
| | - James A. Seddon
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 8000, South Africa; (G.H.); (J.A.S.)
- Department of Infectious Diseases, Imperial College London, London W2 1NY, UK
| | - Lily Meyersohn
- Center for International Health Research, Rhode Island Hospital, Providence, RI 02903, USA; (L.M.); (S.S.C.)
| | - Silvia S. Chiang
- Center for International Health Research, Rhode Island Hospital, Providence, RI 02903, USA; (L.M.); (S.S.C.)
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI 02903, USA
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Adolescents' Experiences of Facilitators for and Barriers to Maintaining Exercise 12 Months after a Group-Based Intervention for Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105427. [PMID: 34069571 PMCID: PMC8161306 DOI: 10.3390/ijerph18105427] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 01/10/2023]
Abstract
Exercise can improve health among adolescents with depression. Understanding facilitators for and barriers to maintaining exercise among adolescents with depression may increase adherence to exercise and consequently improve health. The aim was to explore adolescents’ experiences of facilitators for and barriers to maintaining exercise after a group-based exercise intervention for depression. Interviews (n = 14) were conducted 12 months after the exercise intervention. A qualitative content analysis was used to extract facilitators and barriers. Facilitators for maintaining exercise among adolescents with depression were (1) greater self-esteem by having companionship while exercising and by achieving exercise results and (2) having a supportive environment in terms of accessibility and coaching. Barriers to maintaining exercise were (1) disease burden due to fatigue, social anxiety, and a lack of drive, and (2) lack of a supportive environment including a lack of social support, as well as structural support. In conclusion, facilitating enhanced self-esteem and continuous support for exercising are important for adolescents with depression to maintain exercise. The disease burden of depression is a substantial barrier that needs to be considered to maintain exercise. The findings can contribute to the development of services that promote and coordinate exercise as a treatment among adolescents with depression.
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Achterbergh L, Pitman A, Birken M, Pearce E, Sno H, Johnson S. The experience of loneliness among young people with depression: a qualitative meta-synthesis of the literature. BMC Psychiatry 2020; 20:415. [PMID: 32831064 PMCID: PMC7444250 DOI: 10.1186/s12888-020-02818-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/12/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Young people have a higher prevalence of loneliness than other age groups, and they are also at risk of depression. Quantitative studies describe a bidirectional association between loneliness and depression, but there is limited understanding of how these influence each other. Little is known about the experience of loneliness among young people with depression. Qualitative approaches may help understand the relationship between loneliness and depression among young people, and how to intervene to improve outcomes. We aimed to conduct a meta-synthesis to understand the complex inter-relationship between loneliness and depression among young depressed people by synthesising evidence from a systematic review of qualitative studies. METHODS We conducted a meta-synthesis of qualitative studies capturing experiences of loneliness among young people with depression. We systematically searched six electronic databases for selected search terms, critically appraised eligible studies, and analysed the data from included studies using the approach of thematic synthesis. We used feedback from an inter-disciplinary research workshop to improve reflexivity. RESULTS Our inclusion criteria identified fourteen studies. Our analysis identified four themes: (1) social withdrawal due to poor mental health, (2) non-disclosure of depression contributing to social distance, (3) the desire to connect, and (4) paradoxes of loneliness and depression. These themes illustrated a range of pathways between depression and loneliness, and a sense of how these might be mutually reinforcing. Our findings suggest that where depressed individuals engage in certain behaviours (withdrawing; not confiding) for a range of reasons, this can lead to feelings of loneliness, an awareness of which worsens their mood, thus perpetuating their depression. CONCLUSIONS Young people with depression experience loneliness as an insurmountable distance between themselves and others. Our findings identified non-disclosure of depression, and the debilitating nature of the depressive symptomatology, as factors perpetuating a vicious cycle of loneliness and depression. They suggest that approaches to tackling the problem might include helping young people communicate about their depression to trusted friends and educating their social networks in how to support them. The wider research literature suggests that cognitive interventions may have a role in shifting maladaptive cognitions about their social world.
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Affiliation(s)
- Louis Achterbergh
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. .,Amsterdam UMC, location AMC (University of Amsterdam), Meibergdreef 9, 1105, Amsterdam, AZ, Netherlands.
| | - Alexandra Pitman
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK ,grid.439468.4Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE UK
| | - Mary Birken
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Eiluned Pearce
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Herman Sno
- grid.7177.60000000084992262Amsterdam UMC, location AMC (University of Amsterdam), Meibergdreef 9, 1105 Amsterdam, AZ Netherlands
| | - Sonia Johnson
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK ,grid.439468.4Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE UK
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Sorbring E, Kuczynski L. Children's agency in the family, in school and in society: implications for health and well-being. Int J Qual Stud Health Well-being 2019; 13:1634414. [PMID: 31608827 PMCID: PMC7011967 DOI: 10.1080/17482631.2019.1634414] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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