Risk and Protective Factors for Depression in Youth

Multivariate association between psychosocial environment, behaviors, and brain functional networks in adolescent depression

BACKGROUND

Adolescent depression shows high clinical heterogeneity. Brain functional networks serve as a powerful tool for investigating neural mechanisms underlying depression profiles. A key challenge is to characterize how variation in brain functional organization links to behavioral features and psychosocial environmental influences.

METHODS

We recruited 80 adolescents with major depressive disorder (MDD) and 42 healthy controls (HCs). First, we estimated the differences in functional connectivity of resting-state networks (RSN) between the two groups. Then, we used sparse canonical correlation analysis to characterize patterns of associations between RSN connectivity and symptoms, cognition, and psychosocial environmental factors in MDD adolescents. Clustering analysis was applied to stratify patients into homogenous subtypes according to these brain-behavior-environment associations.

RESULTS

MDD adolescents showed significantly hyperconnectivity between the ventral attention and cingulo-opercular networks compared with HCs. We identified one reliable pattern of covariation between RSN connectivity and clinical/environmental features in MDD adolescents. In this pattern, psychosocial factors, especially the interpersonal and family relationships, were major contributors to variation in connectivity of salience, cingulo-opercular, ventral attention, subcortical and somatosensory-motor networks. Based on this association, we categorized patients into two subgroups which showed different environment and symptoms characteristics, and distinct connectivity alterations. These differences were covered up when the patients were taken as a whole group.

CONCLUSION

This study identified the environmental exposures associated with specific functional networks in MDD youths. Our findings emphasize the importance of the psychosocial context in assessing brain function alterations in adolescent depression and have the potential to promote targeted treatment and precise prevention.

Mental toughness in adolescents: bridging family relationships and depression across personality traits

BACKGROUND

Adolescence is a pivotal stage vulnerable to mental health issues like anxiety and depression. While family relationships, mental toughness, and personality traits are known to impact adolescent mental health, their interactive and moderating roles are not fully understood.

AIM

This study aims to investigate the mediating role of mental toughness in the relationship between family relationships and depression among high school students, and to examine the varying impacts of personality traits on this mediation.

METHOD

A cross-sectional study was conducted on a sample of 734 adolescents. Participants completed measures assessing family relationships, mental toughness, personality traits, and mental health outcomes (depression). Latent Profile Analysis, Multiple Regression Analysis, and Structural Equation Modeling, to investigate these relationships.

RESULTS

The study found that mental toughness significantly mediates the relationship between family relationships and depression. Notably, this mediating effect varied between personality type; it was more pronounced in the moderate-reserved type compared to the proactive-engaged type. LPA identified two distinct personality types of students based on their personality traits, with differential patterns of family relationships, mental toughness, and depression. Multiple regression analysis indicated that character and adaptability, components of mental toughness, were significant negative predictors of depression.

CONCLUSION

The study contributes to understanding the dynamics of adolescent mental health, particularly in the context of Chinese high school students. It underscores the importance of considering family dynamics, personality traits, and mental toughness in developing effective mental health interventions for adolescents.

Perceived Occupational Noise Exposure and Depression in Young Finnish Adults

We investigated the association between perceived occupational noise exposure and depressive symptoms in young Finnish adults and whether noise sensitivity moderates this association. This study was based on an ongoing longitudinal twin study. We included those who had been working daily (n = 521) or weekly (n = 245) during the past 12 months (mean age 22.4, SD 0.7, 53% female). We asked about occupational noise exposure at age 22 and assessed depressive symptoms using the General Behavior Inventory (GBI) at age 17 and 22. Noise sensitivity and covariates were used in linear regression models. Perceived daily occupational noise exposure was associated, as a statistically independent main effect with depressive symptoms at age 22 (beta 1.19; 95% CI 0.09, 2.29) among all, and separately for females (beta 2.22; 95% CI 0.34, 4.09) but not males (beta 0.22; 95% CI -1.08, 1.52). Noise sensitivity was independently associated with depressive symptoms among all (beta 1.35; 95% CI 0.54, 2.17), and separately for males (beta 1.96; 95% CI 0.68, 3.24) but not females (beta 1.05; 95 % CI -0.04, 2.13). Noise sensitivity was independent of perceived occupational noise exposure. Pre-existing depressive symptoms at age 17 were predictive of perceived occupational noise exposure, suggesting complex interactions of noise and depression.

Individual, Peer, and Family Correlates of Depressive Symptoms among College Students in Hong Kong

In this study, an ecological model and developmental psychopathology theory focusing on an ontogenic system (hopelessness) and microsystems (peer alienation and childhood abuse and trauma) was adopted to examine the individual, peer, and family correlates of depressive symptoms among college Chinese students in Hong Kong, China. A cross-sectional survey research design with a convenience sampling procedure was used to examine a sample of college students (n = 786) aged 18 to 21 years old in Hong Kong. Among them, 352 respondents (44.8%) reported having depressive symptoms, with a Beck Depression Inventory-II (BDI-II) score of 14 or above. The results of this study indicated that childhood abuse and trauma, peer alienation, and hopelessness were positively related to depressive symptoms. The underlying arguments and implications were discussed. The study results provided further support for the ecological model and the developmental psychopathology theory on the predictive roles of individual, peer, and family correlates of adolescent depression.

Specific Pathways from Parental Distress Reactions to Adolescent Depressive Symptoms: The Mediating Role of Youths' Reactions to Negative Life Events

The current multimethod longitudinal study examines how parents' distress reactions to adolescents' negative emotions may shape youths' own perceptions of negative life events and subsequent increases in depressive symptomology. Ninety adolescents (41 girls, 49 boys, average age = 16.5 years old) and their parents were assessed over three timepoints. We found that greater parent-reported distress reactions to adolescents' emotions predicted subsequent increase in youths' own self-reported negative reactions to stressful experiences over a two-week period, which in turn predicted steeper increases in youth-reported depressive symptoms across this same two-week period. Moreover, youths' negative reactions mediated the relation between parent emotion socialization and increases in adolescent depressive symptoms. These findings support the use of interventions that simultaneously target parent and child distress to prevent the onset of adolescent depression.

Profiling third-level student mental health: findings from My World Survey 2

OBJECTIVES

This study aimed to identify risk and protective factors for mental health across student cohorts to guide mental health provision.

METHODS

Cross-sectional data from the My World Survey 2-Post Second Level (MWS2-PSL) were used. The sample consisted of N = 9935 students (18-65 years) from 12 third-level institutions (7 out of 7 universities and 5 out of 14 Institute of Technologies (IoTs)) across Ireland. Key outcomes of interest were depression, anxiety and suicidality. Risk factors included drug/alcohol use, risky sexual behaviours and exposure to stressors. Protective factors included coping strategies, help-seeking, resilience, self-esteem, life satisfaction, optimism and social support. These factors were profiled by degree type (undergraduate, postgraduate taught, postgraduate research), access route, and institution type (IoT, university). Chi-square tests of Independence and one-way ANOVAs compared groups on key risk and protective factors.

RESULTS

A total 71% of respondents were female, 85% were aged 23 or under and there was a 2.2% response rate in IoTs versus 10.6% in university students. Undergraduates demonstrated higher levels of depression, anxiety, self-harm and suicidal ideation than postgraduates. Undergraduates showed higher risk and lower protective factors than postgraduates. Students attending Institutes of Technology reported higher levels of depression and anxiety, lower protective and higher risk factors than university students.

CONCLUSION

In this sample of students, undergraduates, especially those attending Institutes of Technology, were at increased risk of mental health difficulties. Findings suggest the need to tailor interventions to meet cohort needs, and consider the differing vulnerabilities and strengths across student cohorts. Due to limitations of this study, such as selection bias, further research is warranted.

Psychological risk and protective factors associated with depression among older adults in mainland China: A systematic review and meta-analysis

BACKGROUND

Although geriatric depression is a public health concern in mainland China, findings about its psychological risk and protective factors have been inconsistent, and its prevention programmes have been deficient. To improve interventions for geriatric depression, we designed a study to systematically estimate the effect size of those factors.

METHODS

To identify psychological risk and protective factors of geriatric depression, we conducted two independent literature searches in English- and Chinese-language databases, and we used a random effects model to analyse effect sizes.

RESULTS

We identified 15 psychological risk and protective factors in 66 studies. The pooled effect sizes between the factors and geriatric depression ranged from 0.129 to 0.567. Self-esteem displayed a large effect size with depression (r = -0.567), whereas medium-to-large effect sizes emerged between geriatric depression and negative perceptions of age (r = 0.452), resilience (r = -0.426), rumination (r = 0.432), neuroticism (r = 0.381), extraversion (r = -0.363), self-efficacy (r = -0.357), sense of control (r = -0.343), and negative coping strategies (r = 0.315). The sample's mean age, the percentage of women sampled, and the research quality of the studies significantly moderated certain associations.

LIMITATIONS

Large heterogeneity, the inexplicability of causal relationships between the factors and geriatric depression, and the lack of generalisability to special groups limit our findings.

CONCLUSIONS

Self-esteem and perceptions of age are potential targets for improving interventions for geriatric depression in mainland China, which should continue to be developed and assessed for their effectiveness.

Randomized Trial of a Single-Session Growth Mind-Set Intervention for Rural Adolescents' Internalizing and Externalizing Problems

Adolescents living in rural regions of the United States face substantial barriers to accessing mental health services, creating needs for more accessible, nonstigmatizing, briefer interventions. Research suggests that single-session "growth mind-set" interventions (GM-SSIs)-which teach the belief that personal traits are malleable through effort-may reduce internalizing and externalizing problems in adolescents. However, GM-SSIs have not been evaluated among rural youth, and their effects on internalizing and externalizing problems have not been assessed within a single trial, rendering their relative benefits for different problem types unclear. We examined whether a computerized GM-SSI could reduce depressive symptoms, social anxiety symptoms, and conduct problems in female adolescents from rural areas of the United States. Tenth-grade female adolescents (N = 222, M age = 15.2, 38% White, 25% Black, 29% Hispanic) from 4 rural, low-income high schools in the southeastern United States were randomized to receive a 45-min GM-SSI or a computer-based active control program, teaching healthy sexual behaviors. Young women self-reported depression symptoms, social anxiety symptoms, and conduct problem behaviors at baseline and 4-month follow-up. Relative to the female students in the control group, the students receiving the GM-SSI reported modest but significantly greater reductions in depressive symptoms (d= .23) and likelihood of reporting elevated depressive symptoms (d= .29) from baseline to follow-up. GM-SSI effects were nonsignificant for social anxiety symptoms, although a small effect size emerged in the hypothesized direction (d= .21), and nonsignificant for change in conduct problems (d= .01). A free-of-charge 45-min GM-SSI may help reduce internalizing distress, especially depression-but not conduct problems-in rural female adolescents.

Reciprocal associations between early adolescent antisocial behavior and depressive symptoms: A longitudinal study in Victoria, Australia and Washington State, United States

PURPOSE

Reciprocal prospective associations between adolescent antisocial behavior and depressive symptoms were examined.

METHODS

Seventh grade students (average age 13 years; N=2,314/2,348) were surveyed (T1), and then followed-up 12 (T2) and 24 months (T3) later, using the same methods in Washington State and Victoria, Australia.

RESULTS

Negative binomial regressions showed antisocial behavior (T1, T2) did not prospectively predict depressive symptoms (T2, T3). T1 multivariate predictors for T2 depressive symptoms included female gender (incident rate ratio [IRR] = 1.70), prior depressive symptoms (IRR = 1.06), alcohol use (IRR = 1.13), family conflict (IRR = 1.13), antisocial peers (IRR = 1.08) and bullying victimization (IRR = 1.06). Depressive symptoms (T1, T2) did not predict antisocial behavior (T2, T3). T1 multivariate predictors for T2 antisocial behavior included female gender (IRR = .96), age (IRR = .97), prior antisocial behavior (IRR = 1.32), alcohol use (IRR = 1.04), antisocial peers (IRR = 1.11) and academic failure (IRR = 1.03).

CONCLUSIONS

Depressive symptoms and antisocial behaviors showed considerable predictive stability in early adolescence but were not reciprocally related. Prevention and intervention strategies in adolescence may benefit by targeting common predictors such as alcohol, peer interactions and early symptoms for depression and antisocial behavior.

Psychosocial Risk and Protective Factors for Depression Among Lesbian, Gay, Bisexual, and Queer Youth: A Systematic Review

Many lesbian, gay, bisexual, or queer (LGBQ) youth suffer from depression. Identifying modifiable risk and protective factors for depression can inform the development of psychosocial interventions. The aim of this review is to evaluate the methodological characteristics and summarize the substantive findings of studies examining psychosocial risk and protective factors for depression among LGBQ youth. Eight bibliographic databases were searched, and 35 studies that met all inclusion criteria were included for review. Results show that prominent risk factors for depression include internalized LGBQ-related oppression, stress from hiding and managing a socially stigmatized identity, maladaptive coping, parental rejection, abuse and other traumatic events, negative interpersonal interactions, negative religious experiences, school bullying victimization, and violence victimization in community settings. Prominent protective factors include a positive LGBQ identity, self-esteem, social support from friends, and family support. LGBQ youth may face an array of threats to their mental health originating from multiple socioecological levels.

Evaluation of a Digital Game-Based Learning Program for Enhancing Youth Mental Health: A Structural Equation Modeling of the Program Effectiveness

BACKGROUND

Digital game-based learning (DGBL) makes use of the entertaining power of digital games for educational purposes. Effectiveness assessment of DGBL programs has been underexplored and no attempt has been made to simultaneously model both important components of DGBL: learning attainment (ie, educational purposes of DGBL) and engagement of users (ie, entertaining power of DGBL) in evaluating program effectiveness.

OBJECTIVE

This study aimed to describe and evaluate an Internet-based DGBL program, Professor Gooley and the Flame of Mind, which promotes mental health to adolescents in a positive youth development approach. In particular, we investigated whether user engagement in the DGBL program could enhance their attainment on each of the learning constructs per DGBL module and subsequently enhance their mental health as measured by psychological well-being.

METHODS

Users were assessed on their attainment on each learning construct, psychological well-being, and engagement in each of the modules. One structural equation model was constructed for each DGBL module to model the effect of users' engagement and attainment on the learning construct on their psychological well-being.

RESULTS

Of the 498 secondary school students that registered and participated from the first module of the DGBL program, 192 completed all 8 modules of the program. Results from structural equation modeling suggested that a higher extent of engagement in the program activities facilitated users' attainment on the learning constructs on most of the modules and in turn enhanced their psychological well-being after controlling for users' initial psychological well-being and initial attainment on the constructs.

CONCLUSIONS

This study provided evidence that Internet intervention for mental health, implemented with the technologies and digital innovations of DGBL, could enhance youth mental health. Structural equation modeling is a promising approach in evaluating the effectiveness of DGBL programs.

Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents

INTRODUCTION AND AIMS

Alcohol misuse and depressed mood are common during early adolescence, and comorbidity of these conditions in adulthood is associated with poorer health and social outcomes, yet little research has examined the co-occurrence of these problems at early adolescence. This study assessed risky and protective characteristics of pre-teens with concurrent depressed mood/early alcohol use in a large school-based sample.

DESIGN AND METHODS

School children aged 10-14 years (n = 7289) from late primary and early secondary school classes in government, Catholic and independent sectors participated with parental consent in the cross-sectional Healthy Neighbourhoods Study. Key measures included depressed mood, recent alcohol use, school mobility, family relationship quality, school engagement and coping style. Multinomial logistic regression analyses were used to identify school and family-related factors that distinguished those with co-occurring drinking and depressive symptoms from those with either single condition. Gender and school-level interactions for each factor were evaluated.

RESULTS

Co-occurring conditions were reported by 5.7% of students [confidence interval (CI)95 5.19, 6.19]. Recent drinkers were more likely than non-drinkers to have symptoms consistent with depression (odds ratio 1.80; CI95 1.58, 2.03). Low school commitment was associated with co-occurring drinking/depressive symptoms (odds ratio 2.86; CI95 2.25, 3.65 compared with null condition). This association appeared to be weaker in the presence of adaptive stress-coping skills (odds ratio 0.18; CI95 0.14, 0.23).

CONCLUSIONS

We have identified factors that distinguish pre-teens with very early co-occurrence of drinking and depressed mood, and protective factors with potential utility for school-based prevention programmes targeting these conditions. [Salom CL, Kelly AB, Alati R, Williams GM, Patton GC, Williams JW. Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents. Drug Alcohol Rev 2016;35:387-396].

Risk and protective factors for depression that adolescents can modify: a systematic review and meta-analysis of longitudinal studies

BACKGROUND

Adolescence is a peak time for the onset of depression, but little is known about what adolescents can do to reduce their own level of risk. To fill this gap, a review was carried out to identify risk and protective factors for depression during adolescence that are modifiable by the young person.

METHODS

Employing the PRISMA method, we conducted a systematic review and meta-analysis of longitudinal studies to identify risk and protective factors during the adolescent period (aged 12-18 years) that are potentially modifiable by the young person without professional intervention or assistance. Stouffer׳s method of combining p values was used to determine whether associations between variables were reliable, and meta-analyses were conducted to estimate the mean effect sizes of associations.

RESULTS

We identified 113 publications which met the inclusion criteria. Putative risk factors implicated in the development of depression for which there is a sound evidence base, and which are potentially modifiable during adolescence without professional intervention, are: substance use (alcohol, tobacco, cannabis, other illicit drugs, and polydrug use); dieting; negative coping strategies; and weight. Modifiable protective factors with a sound evidence base are healthy diet and sleep.

LIMITATIONS

Limitations include not systematically reviewing moderators and mediators, the lack of generalisability across cultures or to younger children or young adults, and the inability to conduct a meta-analysis on all included studies.

CONCLUSIONS

Findings from this review suggest that future health education campaigns or self-help prevention interventions targeting adolescent depression should aim to reduce substance use (alcohol, tobacco, cannabis, other illicit drugs, and polydrug use); dieting; and negative coping strategies; and promote healthy weight; diet; and sleep patterns.

Effects of early adolescent alcohol use on mid-adolescent school performance and connection: a longitudinal study of students in Victoria, Australia and Washington State, United States

BACKGROUND

This article examines the effect of early adolescent alcohol use on mid-adolescent school suspension, truancy, commitment, and academic failure in Washington State, United States, and Victoria, Australia. Also of interest was whether associations remain after statistically controlling for other factors known to predict school outcomes.

METHODS

State-representative student samples were surveyed in 2002 (grade 7; N = 1858) and followed up annually to 2004 (grade 9) in both sites. Students completed a modified version of the Communities That Care survey to report alcohol use, school outcomes, and risk and protective factors. Response rates were above 74% and retention rates exceeded 98% in both places.

RESULTS

Controlling for grade 7 risk factors, grade 7 current alcohol use, and heavy episodic drinking were associated with grade 8 school suspension. Grade 7 current and frequent alcohol use and heavy episodic drinking were linked to grade 9 truancy. In fully adjusted analyses, associations between early alcohol use and academic failure and low school commitment did not remain.

CONCLUSIONS

Although alcohol use is one factor influencing school performance and connection, there are other risk factors that need to be targeted to improve school outcomes.

Protective factors against depression during the transition from adolescence to adulthood: findings from a national Canadian cohort

OBJECTIVE

This study sought to identify factors protective against the onset or recurrence of depression in early adulthood, and to describe their interactions with stressors during this transitional period.

METHODS

1137 members of Canada's National Population Health Survey were followed from ages 12 to 17 in 1994/95 and contacted every two years until 2008/09. Protective factors measured at age 16/17 included social support, physical activity, mastery, self-esteem, and education level. General linear mixed models were used to examine the relationship between the protective factors and five assessments of depression, including interactions between protective factors and four types of stress: stressful life events, and work, financial, and personal stress.

RESULTS

High mastery in adolescence had a significant protective effect against depression in early adulthood. Participants with high social support in adolescence were significantly less likely to become depressed after experiencing work or financial stress, compared to those with low social support. Those who were physically active in adolescence were less likely to become depressed after experiencing work stress, and higher overall education level reduced depression risk following personal stress or major life events.

CONCLUSION

Social support and physical activity may be ideal targets for school-based depression interventions during a potentially stressful transitional period.

Does the absence of a supportive family environment influence the outcome of a universal intervention for the prevention of depression?

To date, universal, school-based interventions have produced limited success in the long-term prevention of depression in young people. This paper examines whether family relationship support moderates the outcomes of a universal, school-based preventive intervention for depression in adolescents. It reports a secondary analysis of data from the beyondblue schools research initiative. Twenty-five matched pairs of secondary schools were randomly assigned to an intervention or control condition (N = 5633 Grade 8 students). The multi-component, school-based intervention was implemented over a 3-year period, with 2 years of follow-up in Grades 11 and 12. For those available at follow-up, small but significantly greater reductions in depressive and anxiety symptoms and improvements in emotional wellbeing were found over time for the intervention group compared to the control among those who experienced low family relationship support in Grade 8. For those who did not experience low family relationship support in Grade 8, no significant effects of the invention were found over the control condition. This pattern of results was also found for the intent-to-treat sample for measures of depression and anxiety. Previous research may have overlooked important moderating variables that influence the outcome of universal approaches to the prevention of depression. The findings raise issues of the relative costs and benefits of universal versus targeted approaches to the prevention of depression.

Psychological distress as a mediator in the relationships between biopsychosocial factors and disordered eating among Malaysian university students

The mechanism linking biopsychosocial factors to disordered eating among university students is not well understood especially among Malaysians. This study aimed to examine the mediating role of psychological distress in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. A self-administered questionnaire measured self-esteem, body image, social pressures to be thin, weight-related teasing, psychological distress, and disordered eating in 584 university students (59.4% females and 40.6% males). Body weight and height were measured. Structural equation modeling analysis revealed that the partial mediation model provided good fit to the data. Specifically, the relationships between self-esteem and weight-related teasing with disordered eating were mediated by psychological distress. In contrast, only direct relationships between body weight status, body image, and social pressures to be thin with disordered eating were found and were not mediated by psychological distress. Furthermore, multigroup analyses indicated that the model was equivalent for both genders but not for ethnic groups. There was a negative relationship between body weight status and psychological distress for Chinese students, whereas this was not the case among Malay students. Intervention and prevention programs on psychological distress may be beneficial in reducing disordered eating among Malaysian university students.

Self-reported internalization symptoms and family factors in indigenous Sami and non-Sami adolescents in North Norway

Through differences in family socialization between indigenous and non-indigenous youth, there may be cultural differences in the impact of family factors on mental health outcome. Using structural equation modelling, this population-based study explored the relationship between symptoms of anxiety and depression and family factors in indigenous Sami and non-Sami boys and girls in North Norway. The findings show that family income was to a lesser degree related to internalization symptoms for Sami youth than non-Sami youth. For all groups except for Sami girls, family conflict and moving was associated with increasing symptoms. Sami boys differed from the other three groups with regard to the relationship between family connectedness and symptom level. These interaction effects were discussed in light of traditional Sami values and gender socialization. The present study has indicated that in the family socialization context, culture may be related to internalization symptoms in youth.

Assessment of Psychopathological Problems in the School Context: The Psychometric Properties of a Portuguese Version of the Adolescent Psychopathology Scale—Short Form

The psychometric properties of a Portuguese version of the Adolescent Psychopathology Scale—Short Form (APS-SF) were studied in a sample of 656 Portuguese adolescents, aged 12 to 19 years, assessed in school context. Also, the aim of the study was to gather data concerning age- and gender-related differences in the expression of psychopathological problems assessed by the APS-SF. Results of the reliability of APS-SF scales are compared with those obtained by Reynolds in the validation studies with the American sample. Factor analysis reproduced the bidimensionality of the original validation studies of the scale. These findings seem to support the use of the APS-SF as a valuable tool for early identification of psychosocial problems in the school context in Portuguese adolescents. Results concerning age- and gender-related differences in the expression of psychopathological problems in the adolescents are discussed.

Neuroticism, life events and negative thoughts in the development of depression in adolescent girls

Theories of depression suggest that cognitive and environmental factors may explain the relationship between personality and depression. This study tested such a model in early adolescence, incorporating neuroticism, stress-generation and negative automatic thoughts in the development of depressive symptoms. Participants (896 girls, mean age 12.3 years) completed measures of personality and depressive symptoms, and 12 months later completed measures of depressive symptoms, recent stressors and negative automatic thoughts. Path analysis supported a model in which neuroticism serves as a distal vulnerability for depression, conferring a risk of experiencing dependent negative events and negative automatic thoughts, which fully mediate the effect of neuroticism on later depression. A second path supported a maintenance model for depression in adolescence, with initial levels of depression predicting dependent negative events, negative automatic thoughts and subsequent depressive symptoms. Unexpectedly, initial depression was also associated with later independent life events. This study establishes potential mechanisms through which personality contributes to the development of depression in adolescent girls.

Life events, coping and depressive symptoms among young adolescents: a one-year prospective study

BACKGROUND

To investigate prospectively over one year, the extent to which greater exposure to negative life events, greater use of more negative coping strategies, and less use of positive coping strategies and an optimistic thinking style, predicts the onset of depressive symptoms among adolescents.

METHODS

A prospective longitudinal study of 5,634 adolescents (Mean Age=13.1, SD=0.5) enrolled in Year 8 at secondary school. Standard questionnaires were used to assess depressive symptoms and the predictor variables.

RESULTS

Over a one-year period, there was an independent and statistically significant relationship between transition to a CES-D score above the recommended cut-off score and i) greater exposure to negative life events and use of negative coping strategies, and ii) less use of positive coping strategies and an optimistic thinking style. Among males who experienced a higher number of negative life events, the impact on depressive symptoms was greater among those who made more use of negative coping strategies.

LIMITATIONS

Self-report questionnaires completed by adolescents were employed to evaluate all the variables in the study. Only two assessment points were available. Ten percent of adolescents did not complete the follow-up assessment.

CONCLUSIONS

Particularly among females, early adolescence is marked by increased susceptibility to depressive symptoms. Helping young adolescents to adopt more positive coping strategies and optimistic thinking styles may reduce their risk for the onset of depressive symptoms. This may be particularly important for young males who experience high levels of adverse life events and utilise negative coping strategies.

Depression in young people: description, assessment and evidence-based treatment

OBJECTIVE

The literature on depression in children and adolescents was reviewed to provide an update for clinicians.

REVIEW PROCESS

Literature of particular relevance to evidence-based practice was selected for critical review. Meta-analyses and controlled trials were prioritized for review along with key assessment instruments.

OUTCOMES

An up-to-date overview of clinical features, epidemiology, prognosis, aetiology, assessment and intervention was provided.

CONCLUSIONS

Depression in children and adolescence is a relatively common, multifactorially determined and recurring problem which often persists into adulthood. Psychometrically robust screening questionnaires and structured interviews facilitate reliable assessment. There is growing evidence for the effectiveness of cognitive behaviour therapy, psychodynamic therapy, interpersonal therapy and family therapy in the treatment of paediatric depression. There is also evidence that SSRIs may be particularly effective for severe depression, although they may carry the risk of increased suicidality.