Depression, depressive symptoms, and depressed mood among a community sample of adolescents

Using a structured interview, the authors found that the prevalence of major depression and dysthymic disorder was 4.7% and 3.3%, respectively, in a community sample of 150 adolescents. All of the adolescents who met the criteria for major depression and dysthymic disorder had other psychiatric disorders as well; anxiety was the most frequent accompanying DSM-III diagnosis.     

Psychotic-like experiences and depressive symptoms in a community sample of adolescents

Purpose

Studies of psychotic-like experiences (PLEs) within community samples of adolescents have explored predominantly positive experiences. There is a paucity of research examining the prevalence and correlates of negative PLEs, and whether particular subtypes of negative PLEs can be identified among the general population of adolescents. This study examined the association of both positive and negative PLEs with depressive symptoms, including detailed analysis of subtypes of positive and negative psychosis dimensions.

Method

A community sample of 777 adolescents (50.9% girls: mean age 14.4 years) completed a questionnaire assessing positive and negative PLEs and depressive symptoms.

Results

Principal component factor analysis identified four factors of positive symptoms (persecutory ideation, grandiose thinking, first-rank/hallucinatory experiences and self-referential thinking), and three factors of negative symptoms (social withdrawal, affective flattening, and avolition). Depressive symptoms were associated positively with persecutory ideation, first-rank/hallucinatory experiences, social withdrawal, and avolition, whereas grandiose thinking related negatively with depressive symptoms. Neither self-referential thinking nor affective flattening related to self-reported depression.

Conclusions

These findings support the view that not all types of positive and negative PLEs in adolescence are associated with depression and, therefore, they may not confer the same vulnerability for psychotic disorders.     

Self-reported depressive symptoms among Chinese adolescents

Previous reports on the prevalence and features of depression among adolescents have been inconsistent. The purpose of the current study was to estimate the prevalence of depression among Chinese adolescents with a standardized instrument. A total of 2462 students, aged 13–22, were sampled from the Shandong province of China. The Zung Self-Rating Depression Scale (SDS) was administered to the subjects in their classrooms. It was shown that the mean SDS score was 44.8 (SD 9.9) and it decreased significantly from the age of 18 upward (F = 31.73, df = 9, P < 0.01). No significant difference was found between males and females (t = 0.70, P > 0.05). Taking 55 as a cut-off score, the prevalence rate of depression was 16.9% (95% CI = 15.4–18.4%). Logistic regression showed that increasing age appeared to decrease the risk for depression. Most of the individual items differed between ages, except for weight loss and constipation. Principal components factor analysis revealed that the characteristics of adolescent depression were depressive/anxious mood, psychomotor retardation, loss of self-esteem, somatic symptoms and decreased appetite and libido. Although the study was based on a large sample using an established instrument, the sample was not from a general adolescent population and case ascertainment was not by clinical diagnosis. Accepted: 25 May 1998     

Self-reported depressive symptoms in a school sample of Italian children and adolescents

This study reports on self-reported depressive symptoms, assessed with the Children's Depression Inventory (CDI), in a school sample of 685 Italian students. The participants were 254 males and 431 females, the age range of the subjects was 8 to 17 years (mean age 13.0 ± 2.8 years). The CDI mean score was 10.49 ± 2.76. According to our data, about 10% of the subjects scored higher than the clinical threshold of 20. More than 1/3 of the students reported thoughts of death, but only 2.2% had explicit suicidal ideation. Girls scored higher than boys, and young adolescents (11–13 years) scored lower than pre-pubertal children and older adolescents, and showed fewer thoughts of death. Factorial analysis yielded seven factors, a general factor with no predominant theme, two factors related to academic self-image and body image, and four related to anhedonia-withdrawal, hypocondria-asthenia, irritability-opposition, and loss of appetite.     

Disgust sensitivity and obsessive-compulsive symptoms in a non-clinical sample

Disgust sensitivity has been posited to play a role in the etiology and/or maintenance of obsessive-compulsive disorder (OCD); however, results of studies in this area have been mixed. We examined the relationship between specific domains of disgust sensitivity and specific OCD symptom patterns. One thousand and five undergraduate volunteers completed an internet battery of questionnaires including measures of OCD symptoms, depression, anxiety, and disgust sensitivity. Results indicated that even when controlling for depression and anxiety, several OCD symptom groups (checking, ordering, and washing) were associated with disgust sensitivity. Analysis of residuals, in which we controlled for every other OCD and disgust sensitivity domain for each paired comparison, indicated that the clearest relationship was between washing symptoms of OCD and disgust sensitivity toward hygiene-related stimuli. Examination of these items, however, raises questions about whether commonly accepted measures of disgust sensitivity might confound disgust with other forms of aversion. We discuss possible strategies for clarifying the degree to which fear and disgust are involved in OCD symptoms.     

Parenting and depressive symptoms among adolescents in four Caribbean societies

Background  

The purpose of this study was to gain knowledge about the circumstances related to suicide among children and adolescents 15 years and younger.     

Self-image and parental attachment among late adolescents in Belize

This study investigated the relationship of ethnicity, parental education, gender, and parental attachment to multiple dimensions of self-image among 285 (161 female and 124 male) late adolescent Belizean students. Student ratings of self-image were unrelated to paternal education and student ethnicity. For maternal education, ethnic identity was higher for students whose mothers were high school graduates than for those whose mothers had completed college or a graduate degree. Female students reported more positive self-images than males in vocational attitudes. Favourable self-images were associated with secure ratings of parental attachment.     

Comparing three measures of depressive symptoms among American Indian adolescents

This study examined the measurement of depressive symptoms among American Indian adolescents as assessed by the Center for Epidemiologic Studies Depression Scale (CES-D), Youth Self Report (YSR), and the Tri-Ethnic Center's for Prevention Research Depression Scale (TEDS). This analysis demonstrated that the TEDS had good internal consistency, demonstrated construct validity, and shared a commonality with the other two measures, but had limited predictive validity. The YSR had strong predictive validity but, like the CES-D, showed weakness in construct validity. Unexpectedly, the CES-D and YSR revealed enculturated youth were at risk of depressive symptoms. These findings do not generate unequivocal support for any one measure, but suggest that their strengths and potential shortcomings should be taken into account when assessing depressive symptoms among American Indian youth.     

Prevalence and correlates of depressive symptoms among in-school adolescents in a rural district in southwest Nigeria

This study was conducted to assess the prevalence and correlates of depressive symptoms among in-school adolescents in a rural district in southwest Nigeria. A cross-sectional survey involving 1713 adolescents from four private and three public secondary schools were selected using a stratified cluster sampling technique. Patient Health Questionnaire (PHQ)-9, with a maximum score of 27, was used to assess the presence (score ≥ 5) and severity (score ≥ 15) of the symptoms of depression. Multiple logistic regression was used to identify the correlates. The prevalence was 21.2%; 5.1% of the respondents had moderately severe to severe depression. Significant predictors included “not living with parents” (OR = 1.69; 95%CI, 1.14–2.38), not participating in sports (OR = 1.45; 95%CI; 1.11–1.92), a large number of siblings (OR = 1.69; 95%CI; 1.11–2.63), and a change in place of residence (OR = 1.46; 95%CI, 1.13–1.88). A need exists to plan and implement health education measures to reduce the burden of the disease.     

Validation of a classification system of obsessive-compulsive spectrum disorder symptoms in a non-clinical sample

Little is known about which risk factors longitudinally predict non-suicidal self-injury (NSSI) during adolescence, a period when these self-injurious behaviors become alarmingly prevalent. We prospectively studied the rates, course, and longitudinal prediction of NSSI from early through middle adolescence with a community sample of 103 youth (ages 11-14) who were assessed for NSSI at baseline and 2 ½ years later (94% retention; final N = 97). Multiple risk factors (temperament, cognitive and interpersonal vulnerabilities, stressors; youths' and mothers' depression) were examined as prospective predictors of NSSI over the 2½ year follow-up. Analyses showed that 18% of youth engaged in NSSI over the 2½-year follow-up; 14% for the first time. Distal risks (assessed at baseline) that differentiated youth who engaged in NSSI from those who did not included negative cognitive style and mothers' prior depression. Proximal factors (assessed 2 years after baseline) that differentiated NSSI from non-NSSI youth included stressors, depressive symptoms, poor relationship quality, excessive reassurance seeking, and mothers' onset of depression. Several of these factors predicted new engagement of NSSI over 2½ years.     

School factors and the emergence of depressive symptoms among young Norwegian adolescents

Abstract The aims of this study were to examine correlates of self-reported depressive symptoms within the school area, and possible predictors of change in depressive symptom levels over a 1-year period in a large representative sample of 12 to 15-year-old adolescents in central Norway. The school variables were: school stress, class wellbeing, teacher support, and grades. Possible confounding factors were age, SES, ethnicity, and parental divorce. We also examined the strengths of these relationships. In the cross-sectional multivariate analyses of the whole sample, at time-point one (T₁), all four school factors were independently associated with depressive symptom levels at small to moderate levels. In the longitudinal multivariate analyses of the whole sample, self-reported depressive symptom levels at time-point two (T₂) were predicted by depressive symptom levels at T₁, gender and teacher support. For girls, three of the school variables significantly predicted depressive symptom levels at T₂, while this was not the case for boys. Prevention in schools might be of importance.     

Schizotypal traits and depressive symptoms in nonclinical adolescents

The main goal of this study was to examine the relationship between schizotypal personality traits and depressive symptoms in a sample of nonclinical adolescents. The Schizotypal Personality Questionnaire-Brief (J Personal Disord 1995;9:346-355) and the Reynolds Depression Adolescent Scale (Reynolds WM. Reynolds Adolescent Depression Scale. Professional Manual. Odessa: Psychological Assessment Resources, Inc; 1987) were administered. The sample was made up of 1384 adolescents (48.6% boys), with a mean (SD) age of 15.7 (1.0) years. The results of the study indicate a high degree of overlap between schizotypal experiences and depressive symptoms at a nonclinical level. Canonical correlation between the Schizotypal Personality Questionnaire-Brief scales and the Reynolds Adolescent Depression Scale scales was 0.63, which represents 39.69% of the associated variance between the 2 sets of variables. Confirmatory factor analysis showed that the 4-dimensional model made up of the Positive, Interpersonal, Disorganized, and Depressive dimensions was that which best fit the data. Moreover, the dimensional structure underlying the schizotypal traits and depressive symptoms was found to be invariant across sex and age. These findings converge with data found in previous studies of both patients with schizophrenia and nonclinical adults and suggest that affective dysregulation is also present at a subclinical level. Future research should continue to make progress in the early detection of participants at risk of developing schizophrenia-spectrum disorders based on the early identification of these types of subclinical traits.     

Epidemiology of depressive symptoms in young adolescents

Center for Epidemiologic Studies Depression Scales, completed by 677 junior high school students, were used to investigate the significance and measurement of depressive symptoms in young adolescents. Responses differentiated transient and more persistent symptoms. Few students noted the most persistent symptoms (less than 15% for any one item). Minority race, lower social economic status, lower school grade, family constellation, and poorer school progress were associated with higher depressive symptom scores. Findings from this study suggest that high persistent depressive symptomatology is not a universal adolescent experience and that persistent depressive symptoms may be associated with other adverse events.     

Contributions of parental and social influences to cannabis use in a non-clinical sample of adolescents

OBJECTIVE: The aim of the study was to evaluate the relative contributions of peers and parental influences and adolescents' own beliefs about use, in the prediction of cannabis use. METHOD: Participants were 559 high-school and secondary school students (275 girls, mean age=15.4+/-1; 274 boys, mean age=15.5+/-0.9) who completed questionnaires assessing cannabis use frequency, the number of peers using cannabis, the number of peers opposed to cannabis use, parental attitude toward cannabis use, parental present or past cannabis use and participants' expectations toward use. Parents' opinion of cannabis use was assessed using a ten-point scale ranging from zero (highly opposed to cannabis use) to 10 (highly in favour of cannabis use). The participants' opinion of cannabis use was assessed using a self-report questionnaire which was generated from a preliminary qualitative study on a convenient sample of ten adolescents who agreed to participate in a semistructured interview assessing their perceptions of the effects of cannabis use. Interviewers drew up a list of all the reported perceptions. One rater eliminated redundant responses and combined similar instances into more general terms. Responses were reworded concisely to be appropriate for a close-ended questionnaire. The final questionnaire consisted of 29 items. Items were scored on a 7-point Likert scale, ranging from 1=disagree strongly to 7=agree strongly. RESULTS: In the total sample (n=559), 22% of girls (n=61) and 28% of boys (n=76) reported having used cannabis once during the last six months (p=0.05); 4% of girls and 9% of boys used cannabis at least 3-4 times per week; water pipe or bong was used by 31% of boys and 28% of girls used cannabis. Cannabis users reported that 49% of their fathers were using or had used cannabis versus 10% of non-users. Cannabis users reported that 39% of their mothers were using or had used cannabis versus 22% of non-users. An exploratory factorial analysis of the cannabis use expectations questionnaire was conducted. The eigenvalue curve suggested either a two-factor solution explaining 46% of the variance. These factors were called 'positive expectancies' (eigenvalue=9.0; explained variance=29%, Cronbach's alpha=0.86) and 'negative expectancies' (eigenvalue=4.0; explained variance=17%; Cronbach's alpha=0.93). The correlation of factors was negative and moderate (Pearson's r=-0.29). Cannabis users were characterised by a higher number of peers using cannabis, a lower number of peers opposed to use, a lower level of negative opinion of parents, a higher level of positive expectancies and a lower level of negative expectancies. It is to be noted that both users and non-users tended to perceive their parents as highly opposed to use. A logistic regression analysis predicting cannabis use versus non-use was performed entering sex, the number of peers opposed to cannabis use, the number of peers using cannabis, the opinion of parents, parental present or past cannabis use and positive and negative expectations factor scores. A test of the full model with all predictors against a constant-only model was statistically reliable: the predictors reliably distinguished between users and non-users (chi(2) (8)=153.9; p<0.0001). The variance in cannabis use accounted for was high, with McFadden rho(2)=0.39. Prediction success was satisfactory, with 94% of non-users and 59% of users correctly predicted. The number of peers opposed to cannabis use (B=-0.08; t-ratio=3.9; p=0.04), the number of peers using cannabis (B=0.06; t-ratio=7.9, p=0.01), the positive expectations score (B=0.94; t-ratio=26.6; p<0.0001) and negative expectations scores (B=-0.50; t-ratio=11.8; p=0.0006) and father's present or past cannabis use (B=1.17; t-ratio=8.2; p=0.004) were significant independent predictors of cannabis use. These results indicated that the higher the number of peers using cannabis and the positive expectations, the higher the risk for initiation of cannabis use. The regression coefficient of the number of peers opposed to cannabis use and of the negative expectations score were negative. These results indicated that the less the number of peers opposed to cannabis use and the lower the negative expectations, the higher the risk for initiation of use. Parental attitudes toward use and mother's present or past cannabis use were not significant independent predictors of use. DISCUSSION: As our sample was non-clinical, a first limitation of our findings is that they may not be transposable to patient populations. Another limitation of our study is linked to its cross-sectional design, which prevents the attribution of causal explanations for the associations found. One of the study's strengths is that it assesses potentially important variables not evaluated in previous studies, such as the number of peers opposed to cannabis use and positive and negative expectations of use. The results of the present study suggested that the number of peers using cannabis, father's present or past cannabis use and participants' positive expectations of cannabis use were risk factors for use, whereas the number of peers opposed to cannabis use and the negative expectations of use were protective factors. Parental attitudes toward use did not appear to influence adolescents' cannabis use. In conclusion, our results may have some implications for prevention interventions. They add weight to the view that normalisation of non-use by peers facilitates abstinence. The absence of influence of parental attitudes toward use suggests that parental disapproval of use is not effective in preventing use, whereas the example of father's use or non-use influences adolescent use. The quite low correlation between positive and negative expectancies suggests that prevention interventions presenting information concerning the effects of cannabis use should focus on both reducing positive expectancies and enhancing negative expectancies.     

Developmental perspectives in child and adolescent depressive symptoms in a community sample

This developmental study provides some normative data on the distribution of depressive symptoms in 210 children and adolescents in three different age groups (8, 12, and 17 years) from a nonclinically referred sample. The Child Assessment Schedule and other instruments were used. Studying depression from a dimensional point of view, the authors found withdrawal, pessimism, horrible dreams, and suicidal ideation and tendency in the different age groups to be closely related to depressive symptoms.     

Expression of depressive symptoms in a nonclinical Brazilian adolescent sample.

OBJECTIVE: This study aimed to detect the prevalence of depressive symptomatology and its expression in a nonclinical Brazilian adolescent student sample. METHOD: A sample of students from private and public schools (n = 1555, aged 13 to 17 years) answered the Beck Depression Inventory (BDI). We performed factor analysis of the BDI as an indicator of the expression of depressive symptomatology. The following cut-off scores defined nonclinical subgroups: "nondepressed," BDI < 15; "dysphoria," BDI 16 to 20; and "depressed," BDI > 20. We used discriminant analysis to test whether these subgroups could be separated by the depression-specific and nonspecific items. RESULTS: The point prevalence of depression was 7.6%, according to the BDI cut-off of 20. Girls had higher scores than boys in several items. Scores increased with age. Students from public schools had higher scores than did private school students. Factor analysis showed 2 common factors for the total sample and for each sex: the cognitive affective dimension and the somatic nonspecific dimension. In the adolescents showing clinical depression, items related to self-depreciation, sense of failure, guilty feelings, self-dislike, suicidal wishes, and distortion of body image were common components of BDI factors. Discriminant analysis showed that the BDI highly discriminates depressive symptomatology in adolescent students and also measures specific aspects of depression. CONCLUSIONS: The BDI is useful as a measure of specific aspects of depression in nonclinical adolescent samples; it was able to detect depression in approximately 7% of the surveyed population. The expression of depressive symptoms in a Brazilian adolescent population is compatible with international studies in this age group. Detecting depressive symptoms in a school population is a critical preventive strategy; to avoid damage to the learning process, it should be followed with further referral to treatment when needed.     

The relation between sleep and pain among a non-clinical sample of young adults

Poor sleep is linked to poorer daily functioning and increased risk of psychiatric symptoms. With respect to pain, the relation is bi-directional; poor sleep exacerbates pain, while greater pain adversely affects sleep. Moreover, perception of pain is subject to cognitive-emotional processes. Surprisingly, no data are available from non-clinical samples of young adults. The aim of the present study was therefore to investigate the relation between sleep and pain as a function of quality of life and depressive symptoms in young adults. The direction of influence between sleep and pain was statistically tested with two different structural equation models (SEMs). A total of 862 participants (639 women, 223 men; mean age: 24.67; SD = 5.91) completed a series of validated self-report questionnaires assessing sleep, quality of life, depressive symptoms and cognitive-emotional elaboration of pain. Sleep, pain, quality of life, and depressive symptoms were interrelated. The first SEM suggested both a direct and an indirect influence of pain on sleep, whereas the second SEM suggested that sleep had only an indirect influence on pain. Irrespective of the SEM, the relation between sleep and cognitive-emotional elaboration of pain was mediated by quality of life and depressive symptoms. For a non-clinical sample of young adults, findings did support the bi-directional relation between poor sleep and increased cognitive-emotional elaboration of pain, though other cognitive-emotional processes such as depressive symptoms and quality of life should be taken into account.