Depression and school performance in middle adolescent boys and girls

The study aimed to investigate the associations between different levels of depression with different aspects of school performance. The target population included 2516 7th-9th grade pupils (13-17 years) of whom 90% completed the questionnaire anonymously in the classroom. Of the girls 18.4% and of the boys 11.1% were classified as being depressed (R-Beck Depression Inventory (BDI), the Finnish version of the 13-item BDI). The lower the self-reported grade point average (GPA) or the more the GPA had declined from the previous term, the more commonly the adolescents were depressed. Depression was associated with difficulties in concentration, social relationships, self-reliant school performance and reading and writing as well as perceiving schoolwork as highly loading. The school performance variables had similar associations with depression among both sexes when a wide range of depression was studied but gender differences appeared when studying the severe end of the depression scale. Our study indicates that pupils reporting difficulties in academic performance should be screened for depression.     

Depression,drinking, and substance use among 14- to 16-year-old Finnish adolescents

Our aim was to assess the relationship between self-reported depression, alcohol consumption, and substance use among 14- to 16-year-olds. A school survey was conducted of 16,464 14- to 16-year-olds in two regions of Finland. Alcohol and other substance use were found to be significantly associated with depression. Of girls (boys) who reported drinking weekly, 24% (13%) scored as depressed, compared with 7% (4%) of those not drinking. Of girls (boys) who reported having experimented with substances five times or more, 37% (28%) scored as depressed compared with 8% (5%) of those who reported never having experimented with substances. These associations persisted in multivariate analyses controlling for sociodemographic background. In conclusion, frequent drinking and experimenting with substances indicate a risk for adolescent depressive disorders, and depressive adolescents are at risk for substance use. Health services should pay attention to the identified depressive adolescents to prevent the possibly subsequent substance use problems among them and also pay attention to frequently drinking adolescents and substance experimenters, to increase identification of depressive disorder and possibilities for early interventions.     

A Latent Class Analysis of Suicidal Behaviors in Adolescents

ObjectiveThe purpose of the present study was to identify adolescents’ suicide subgroups using five indicators (depression, anxiety, suicide ideation, and planned and attempted suicide), and explore the distinctive features of each subgroup. MethodsThis study included 2,258 teenagers from four schools. Both adolescents and their parents, who voluntarily agreed to participate in the study, completed a series of self-reported questionnaires on depression, anxiety, suicide, self-harm, self-esteem, impulsivity, childhood maltreatment, and deviant behaviors. The data were analyzed using latent class analysis, a person-centered method. ResultsFour classes were detected: “high risk for suicide without distress,” “high risk for suicide with distress,” “low risk for suicide with distress,” and “healthy.” The “high risk for suicide with distress” class was the most severe on all evaluated psychosocial risk factors, namely, impulsivity, low self-esteem, self-harming behaviours, deviant behaviour problems, and childhood maltreatment, followed by “high risk for suicide without distress.” ConclusionThis study identified two high risk subgroups for adolescent’ suicidality, “high risk for suicide with or without distress.” Both high risk subgroups for suicide showed higher scores for all psychosocial risk factors than low risk subgroups for suicide. Our findings suggest that special attention needs to be paid to the latent class “high risk for suicide without distress,” as this group’s “cry for help” might be relatively difficult to detect. Specific interventions for each group (e.g., distress safety plans for “suicidal potential with or without emotional distress”) need to be developed and implemented.     

The cyclical nature of depressed mood and future risk: Depression,rumination, and deficits in emotional clarity in adolescent girls

Deficits in emotional clarity, the understanding and awareness of one's own emotions and the ability to label them appropriately, are associated with increased depressive symptoms. Surprisingly, few studies have examined factors associated with reduction in emotional clarity for adolescents, such as depressed mood and ruminative response styles. The present study examined rumination as a potential mediator of the relationship between depressive symptoms and changes in emotional clarity, focusing on sex differences. Participants included 223 adolescents (51.60% female, Mean age = 12.39). Controlling for baseline levels of emotional clarity, initial depressive symptoms predicted decreases in emotional clarity. Further, rumination prospectively mediated the relationship between baseline depressive symptoms and follow-up emotional clarity for girls, but not boys. Findings suggest that depressive symptoms may increase girls' tendencies to engage in repetitive, negative thinking, which may reduce the ability to understand and label emotions, a potentially cyclical process that confers vulnerability to future depression.     

School refusal and anxiety in adolescence: non-randomized trial of a developmentally sensitive cognitive behavioral therapy

The main objectives were to evaluate efficacy and acceptability of a developmentally sensitive cognitive behavioral therapy for anxiety-based school refusal in adolescence. Twenty school-refusing adolescents meeting DSM-IV anxiety disorder criteria participated in a non-randomized trial, together with parents and school staff. Outcome was assessed at post-treatment and 2-month follow-up. Treated adolescents showed significant and maintained improvements across primary outcome variables (school attendance; school-related fear; anxiety), with medium to large effect sizes. Half of the adolescents were free of any anxiety disorder at follow-up. Additional improvements were observed across secondary outcome variables (depression; overall functioning; adolescent and parent self-efficacy). The treatment was rated as acceptable by adolescents, parents, and school staff, which may help explain the very low attrition rate. Social anxiety disorder was the most common disorder among adolescents still meeting anxiety disorder criteria at follow-up. Treatment modifications to improve efficacy for school-refusing adolescents presenting with social anxiety disorder are suggested.     

Short Form 36 and Hospital Anxiety and Depression Scale. A comparison based on patients with testicular cancer

BACKGROUND: The aim of this study was to compare the scorings of anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS-A [Anxiety] and HADS-D [Depression]) with the scorings on the eight subscales of Short Form 36 (SF-36) and the Physical (PCS) and Mental Component Summary (MCS) assessed by the same patients. METHOD: In a cross-sectional study 736 long-term survivors after treatment for testicular cancer (TC) completed HADS and SF-36. Pearson's correlation coefficients were calculated on item and scale level to assess the associations between the HADS and the SF-36 scales and, in particular, between HADS and PCS and MCS, respectively. Independent predictors for PCS and MCS were identified by linear regression analysis. RESULTS: HADS-A and HADS-D were significantly associated with the SF-36 summary scales. HADS-A explained 5% of the variance of PCS and 49% of the variance of MCS. The comparable figures for HADS-D were 10% and 45%, respectively. In the multivariate analysis the HADS-D scoring independently predicted the level of PCS together with the patients' educational level, long-lasting working disability and age (variance: 30%). Both HADS-D and HADS-A remained independent parameters for MCS (variance: 58%) together with the patient's civil status. HADS-D item D4 ("slowed down") was similarly associated with both PCS and MCS. CONCLUSION: In univariate analyses HADS-D and HADS-A were statistically associated with PCS and MCS. The highest r values were observed for the associations between HADS and MCS, in particular between HADS-A and MCS. In the multivariate analyses HADS-D, but not HADS-A, contributed to PCS, whereas both HADS-A and HADS-D were associated with MCS. This pattern of different predictions of the summary scales of SF-36 supports a clinical practice that anxiety and depression should be assessed separately. Additional use of a self-rating instrument for depression and anxiety, such as HADS, is recommended when SF-36 is used for quality of life (QL) assessment.     

Assessment of Anxiety and Depression in Adolescents with Mental Retardation

This report examines the concurrent validity of different informant and self-report assessment instruments of psychopathology, both general and specific for anxiety and/or depression, in referred mentally retarded adolescents with a depressive and anxiety disorders, according to DSM IV criteria. A consecutive, unselected sample of 50 mildly and moderate mentally retarded adolescents (29 males and 21 females, aged 11.8 to 18 years, mean age 15.1) were assessed using standardized assessment techniques: Psychopathology Instrument for Mentally Retarded Adults (PIMRA) (informant version) (total score, affective and anxiety subscales), Child Behavior Checklist (CBCL) (informant version) (total score, internalizing and externalizing scores, anxiety-depression scale), Zung Self-Rating Depression Scale and Zung Self-Rating Anxiety Scale. Patterns of correlation among measures were calculated. PIMRA and CBCL total scores were closely intercorrelated. Internalizing and externalizing scores of CBCL were not intercorrelated, but they both correlated with CBCL and PIMRA total scores. Anxiety measures were positively correlated; they correlated with PIMRA and CBCL total scores, as well as with the internalizing score of CBCL. Depression measures were not correlated; their correlation with more general measures of psychopathology was weak. Clinical implications of these findings are discussed.     

When Depression Mediates the Relationship Between Entity Beliefs and Performance

The aim of this study was to determine whether depression can explain the negative relationship between academic performance and the belief that intelligence is a fixed trait, i.e., entity belief. A sample of 353 French volunteer adolescents (age 11–16) completed questionnaires assessing entity theory and depressive symptoms (Children Depression Inventory: CDI). Academic performance was assessed by math performance while controlling for baseline level of math ability. Results of this study revealed that entity theory is a significant negative predictor of academic performance and a significant positive predictor of depression. Importantly, our findings also show that depression plays a significant mediating role between entity theory and academic performance. Our findings indicate that individuals who consider their abilities to be non-malleable are more likely to develop depressive symptoms which, in turn, decrease academic performance. These findings contribute to tailoring specific prevention and treatment programs for childhood and adolescent depression.     

Functioning and quality of life in the Treatment for Adolescents with Depression Study (TADS)

OBJECTIVE: To test whether 12-week treatment of major depression improved the level of functioning, global health, and quality of life of adolescents. METHOD: The Treatment for Adolescents With Depression Study was a multisite, randomized clinical trial of fluoxetine, cognitive-behavioral therapy (CBT), their combination (COMB), or clinical management with placebo in 439 adolescents with major depression. Functioning was measured with the Children's Global Assessment Scale (CGAS), global health with the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), and quality of life with the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Random-effects regression models were applied to the data. RESULTS: Compared with placebo, COMB was effective on the CGAS (p < .0001), HoNOSCA (p < .05), and PQ-LES-Q (p < .001), whereas fluoxetine was superior to placebo on the CGAS only (p < .05). COMB was superior to fluoxetine on the CGAS (p < .05) and PQ-LES-Q (p = .001). Fluoxetine was superior to CBT on the CGAS (p < .01). CBT monotherapy was not statistically different from the placebo group on any of the measures assessed. Treatment effects were mediated by improvement in depressive symptoms measured on the Child Depression Rating Scale-Revised. CONCLUSIONS: The combination of fluoxetine and CBT was effective in improving functioning, global health, and quality of life in depressed adolescents. Fluoxetine monotherapy improved functioning.     

Alteration of Attentional Blink in High Functioning Autism: A Pilot Study

Autism is characterized by deficits in attention. However, no study has investigated the dynamics of attentional processes in autistic patients yet. The attentional blink (AB) paradigm provides information about the temporal dynamics of attention in particular about the allocation and the duration of an attentional episode. We compared 11 high functioning autistic patients with 15 control participants on a classical AB task. Autistic patients exhibited a deficit in rapidly allocated attentional resources. Further investigations such as coupling AB evaluation with neuroimaging data and/or increasing the size of groups, would allow for investigating the neurobiological substrates of these AB alterations in autistic patients.     

The impact of sleep on adolescent depressed mood,alertness and academic performance

The present study developed and tested a theoretical model examining the inter-relationships among sleep duration, sleep quality, and circadian chronotype and their effect on alertness, depression, and academic performance. Participants were 385 adolescents aged 13–18 years (M = 15.6, SD = 1.0; 60% male) were recruited from eight socioeconomically diverse high schools in South Australia. Participants completed a battery of questionnaires during class time and recorded their sleep patterns in a sleep diary for 8 days. A good fit was found between the model and the data (χ²/df = 1.78, CFI = .99, RMSEA = .04). Circadian chronotype showed the largest association with on adolescent functioning, with more evening-typed students reporting worse sleep quality (β = .50, p < .001) and diminished alertness (β = .59, p < .001). Sleep quality was significantly associated with poor outcomes: adolescents with poorer sleep quality reported less sleep on school nights (β = −.28, p < .001), diminished daytime alertness (β = .33, p < .001), and more depressed mood (β = .47, p < .001). Adolescents with poor sleep quality and/or more evening chronotype were also more likely to report worse grades, through the association with depression. Sleep duration showed no direct effect on adolescent functioning. These results identified the importance of two lesser-studied aspects of sleep: circadian chronotype and sleep quality. Easy-to-implement strategies to optimize sleep quality and maintain an adaptive circadian body clock may help to increase daytime alertness, elevate mood, and improve academic performance.     

Patterns of Depression and Resilience in Children and Adolescents Exposed to an Earthquake: A Latent Profile Analysis

Objective Depression and resilience are different psychological outcomes caused by experiencing traumatic events. We aimed to 1) explore heterogeneity patterns of co-occurrence between depression symptoms and resilience among children and adolescents exposed to an earthquake and 2) assess covariates (trauma exposure, sex, age, ethnicity, and sleep quality) in identifying the best fitting solution. Methods Latent profile analysis (LPA) was used to examine patterns of self-reported depression and resilience in an epidemiological sample of 2,887 Chinese youth survivors 1 year after the Lushan earthquake. Results A suitable 3-class model were identified, which are mild depression/high resilience (65.0%), severe depression/high resilience (22.1%), and severe depression/low resilience (12.9%). Trauma exposure, demographic characteristics and sleep state can be used to identify the different latent classes. Conclusion Our results contribute to understanding the heterogeneous coexisting patterns of depression and resilience and provide suggestions for identifying high-risk youth survivors and offering effective interventions.     

Support for Students Exposed to Trauma: A Pilot Study

With high rates of trauma exposure among students, the need for intervention programs is clear. Delivery of such programs in the school setting eliminates key barriers to access, but there are few programs that demonstrate efficacy in this setting. Programs to date have been designed for delivery by clinicians, who are a scarce resource in many schools. This study describes preliminary data from a pilot study of a new program, Support for Students Exposed to Trauma (SSET), adapted from the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program. Because of its “pilot” nature, all results from the study should be viewed as preliminary. Results show that the program can be implemented successfully by teachers and school counselors, with good satisfaction among students and parents. Pilot data show small reductions in symptoms among the students in the SSET program, suggesting that this program shows promise that warrants a full evaluation of effectiveness.

A Validation Study of the Korean-Ruminative Response Scale in Korean Adolescents

Objective

We aimed to evaluate the psychometric properties of Korean version of Ruminative Response Scale (K-RRS) for Korean adolescents.

Methods

A community sample of 1220 adolescents was recruited from middle schools and high schools. Exploratory factor analyses and confirmatory factor analyses were conducted, and additional analyses were performed to assess the reliability and validity of the K-RRS.

Results

An exploratory factor analysis of a sample of adolescents (n=550) yielded a three factor structure: ''depressive rumination'', ''reflective pondering'', and ''brooding''. Confirmatory factor analyses of another sample of adolescents (n=530) supported the three-factor model for the K-RRS. The K-RRS was found to have good internal consistency and construct validity.

Conclusion

Our results suggest that K-RRS is a valid measurement to assess rumination in adolescents, as well as in adults.