UNIVERSITY OF THE PUNJAB, LAHORE
FINAL PROGRESS / COMPLETION REPORT OF THE RESEARCH PROJECT For Fiscal Year 2007-2008 SUMMARY Name and Designation of the Researcher: Ms Shazia Khalid (Lecturer)
Department: PSYCHOLOGY & APPLIED PSYCHOLOGY, UNIVERSITY OF THE PUNJAB, LAHORE. Title of the Project: Incidence and Consequences of Adolescent Depression Total grant allocated: 100,000/Total grant released: 100,000/Total expenditure and balance available: Expenditure Completed Signature: Balance Nil
Date: 4th December 2008
UNIVERSITY OF THE PUNJAB, LAHORE
DETAILED REPORT Name and Designation of the Researcher: Ms Shazia Khalid (Lecturer) Funding Year: 2007-2008 Title of the Project: Incidence and Consequences of Adolescent Depression Objectives of the Approved Project: The current research purports to explore incidence of depression among adolescents and the aftermaths that it produces in their academic, social and academic life or more generally speaking on their overall life circumstances. The primary objective of this research was to explore the prevalence or incidence of depression among adolescents who seem to be attending
their schools as normal children but who harbor in them the poor quality of mental health and the debilitated states which they cannot make their elders and parents be known. The adolescent depression has grown so prevalent that it goes unnoticed in adolescence due to the fact that the parents assume the affect related changes in adolescence as the out product of hormonal changes in their bodies. Whatever the claim there may be for neglecting this phenomenon, a harsh fact is that such adolescents are forced to stifle their psychological and emotional health and they have to behave as other children do and the result is lower self-esteem, shattering of confidence and production of the states of utter dismay and distress in them. Secondary objective of this research stems from this and that is the review of the possible setbacks and problems these adolescents suffer due to states of depression. Since children at this transitional phase of development are not so expressive, they suffer in their selves and souls the dejected state of depression. In essence, the propagation of the awareness of this harsh reality that depression can positively appear in the phase of adolescence on one hand and exposition of the consequences of depression on the other hand is the main focuss of the current research.
UNIVERSITY OF THE PUNJAB, LAHORE
Details of the research work done: Abstract The present study purports to investigate the incidence and consequences or cost of depression in the sensitive and crucial phase of life known as. The primal objective is to develop this insight that depression can essentially exist during different phases of childhood. The study included a sample of 300 school children going through the stage of storm and stress and that is adolescence. Purposive sampling was used with due consideration to the inclusion/ exclusion criterion. Only those adolescents were selected who scored scores above the cut off point. Children depression Inventory with due permission from its author was used for screening students for possible incidence of depression. The Questionnaire for assessing outcomes of depression on the life of adolescents were developed and executed extensively like they were inquired on such issues as their health status, risk behaviors, and school performance so on and so forth. Respondent demographic and socioeconomic information was also reported. This included age, sex, race, region, urban or suburban residence, and family financial status. Cronbach’s alpha for these two measures revealed reliability of α .87 and α .71 respectively. Inferential analyses were conducted by means of
and t tests for bivariate relationships between
depression, incomes, factors, and problem indicators. Multivariate logistic and linear regressions were used in order to assess multivariate relationships. The prevalence of major depression in adolescents has been examined in limited population. It has been observed by Herrington that the prevalence in the community is approximately 5%, although there is variability across studies, depending on the stringency of the applied impairment threshold and the measure used to make the diagnosis. The current findings provide direction to health professionals especially to
UNIVERSITY OF THE PUNJAB, LAHORE
psychologists to work on spreading awareness to parents and professional community about presence of depression among adolescence and also to devise effective strategies for handling it since therapeutic implications towards it could be starkly different from the adult measures. Timely intervention last but not the least is the crux idea that this research wants to disseminate.
Introduction Incidence and Outcomes of Adolescent Depression Adolescent depression is a phenomenon that has been overlooked in all societies under the impression that this phase of human development is marked as a phase of turbulence (Santrock. Depression may affect their whole well-being. Adolescence has been termed by many health psychologists as a phase of mystery and turbulence. Such adolescents turn out to be school dropouts who occasionally end up in self-destructive behaviors and that would be as horrible as taking away of their own or others’ lives (Anderson. This has been so because at this crucial phase of life. siblings health professionals and their educational institutes. 2008). adolescents behave like adults while they have not completely left the childhood immaturity. If we review the relics of history. the reality vividly comes out that the adolescents and teens were not admitted as
. Due to this limitation and inability to detect it. If we review the research literature in the recent past about depression. we come to know that children and adolescents were not considered candidates for depression lately (Whitley. significant others. The stage of human development. 1980). 2008). Freud spread the notions about the unconscious conflicts and childhood based suppressed urges that find their way out to conscious level in forms of psychosomatic complaints or as in states of depression (Bolger.UNIVERSITY OF THE PUNJAB. known as adolescence entails massive psychophysical changes and consequently in this scenario. massive
problems are created not only for adolescents but also this turns out to be a major issue for those who confront its aftermaths like the parents. mood instability is nothing but a normal aspect of this development. 1996). They experience more behavioral and emotional disturbances and may also fall a prey to infectious diseases or may suffer from plenty of psychosomatic disorder.
” Depression has been considered to be the major psychiatric disease of the 20th century evident in children and teens that has been amply ignored due to lack of awareness or due to rigid patterns towards its acknowledgement. "It is easy for parents to identify their child's physical needs: nutritious food. A hard reality about adolescent depression is that such individuals hardly report their sufferings with others rather they are at the behest of other like parents. teachers or of other
. bedtime at a reasonable hour. The hormonal upheaval was generally associated with the phasic changes in affect and moods. The parents successfully fulfill physical needs and demands of the children whereas the
mental health is usually ignored. 2008). a child's mental and emotional needs may not be as obvious. They also don’t realize and admit that depression is not just the occurrence of bad mood rather it is a prevalent pattern and something different from occasional tantrums. However this understanding has been expanded and today. 1993). LAHORE
having or ever in experiencing the depression in their developing years of life. Childhood and adolescent depression is no longer viewed as a mask to phasic changes in physical states due to hormonal alterations rather its presence due to various psychosocial factors has been accepted (Cohen. However. They neglect this fact that occasional bad moods in seclusion or at the other end acting out must not become habitual (Goodyer. 1988).UNIVERSITY OF THE PUNJAB. People with these notions forget that if adolescent was really a period of chaos then how comes few cope with it in a befitting manner (Dubois. Large this problem of ignoring the adolescent depression occurs because people rely on prevalent misconceptions that adolescent and teen years are problematic years. According to the National Mental Health Association (NMHA). warm clothes when it's cold. childhood and adolescent depression is widely recognized and health professionals see depression as a serious condition effecting both adolescents and young children (Bird. 1996).
Depressive illness in children and teens is defined when the feelings of depression is carried on beyond a certain time span and specifically when it interferes with a child or adolescent's ability
. writes that depression may often be detected in somatic complaints such as allergies. Gould (1998) considers that ‘in children and adolescents. sleep and eating disorders and hyperactivity’.UNIVERSITY OF THE PUNJAB. but it also can refer to a mental illness. Fritz (1995). In order to understand the exact limits of the concept adolescent depression. sleep disorders or persistent boredom. depression may often be mistaken for other conditions such as attention deficit disorder. separation anxiety disorder. physical illness. 1994). impulsivities and with emotional reactions that are more intense. aggressiveness. LAHORE
caregivers who could eventually identify or recognize their problems so that some timely management is sought. somatic complaints and behavior problems. 1993). Children may not have the vocabulary to talk about such feelings and so may express their feelings through behavior (Ferguson. Still other writers prefer to move past the philosophy of masked depression and view adolescent depressive symptoms as similar to those of adults (Jaskulski. this can be referred to as a mental health illness. digestive problem. 2003). Recent research findings indicate that Younger individuals with depression are more likely to show phobias. frequent and lasting than a typical adolescent moody episode. its literal definitions can be reviewed. The term "depression" connotates a normal human emotion but in some cases depending on its intensity and extensity. The term "depression" can be fiddly as this narrates a normal human emotion as experienced almost by all as a low down state.
Adolescents express it with the behavior oddities. Many writers view adult depression as being systematically different from adolescent and children depression. Although depression in children may be confused with attention deficit hyperactivity disorder (ADHD). ADHD must begin before the age of 7 (Garber.
However. It has been put forward by Klein (1997) as Adolescent depression is a disorder occurring during the teenage years marked by persistent sadness. discouragement. LAHORE
to function (Johnson. the criteria for childhood and adult Major Depression are the same. Adolescent depression is a disorder occurring during the teenage years marked by persistent sadness.. and problems with friends. He/she may say negative things about himself and may be self-destructive. Older elementary school through adolescence comes out with different semblence of depression (Rende. this child may show these states spontaneously. 1977. and loss of interest in usual activities. somatic complaints and behavior problems. and loss of interest in usual activities. The major characteristics of adolescent depression could be quite varied across the cases but generally speaking they are the symptoms quite similar to those of adult depression. Sometimes one can also see aggressive behavior. Older adolescents and adults with psychotic depression are more likely to have delusions. He or she might be less bouncy or spontaneous. (Delusions require more advanced cognitive functioning than simple hallucinations). While other children would become tearful or irritable when
frustrated. disruptive behavior. 1987). 1999). This is very important to distinguish a typical adolescence moody episode
. The parent may say that the adolescent hates himself and everything else. one might observe the following external signs in a depressed child or adolescent ( Lewis. 1997). irritability and suicidal talk (Cshoen. Thus the young elementary age a child might look serious or vaguely sick. Children may not have the vocabulary to talk about such feelings and so may express their feelings through behavior (Kapphahn. separation anxiety disorder. Here one can assess adolescent depression through academic decline. discouragement. loss of selfworth.UNIVERSITY OF THE PUNJAB. Younger individuals with depression are more likely to show phobias. In the DSM-IV. 1999). loss of self-worth. 1997).
inability to experience pleasure. it has increased markedly in past forty years. (Similar to adult rate) Adolescence is an unsettling time especially for girls. al (1999) In children and adolescents. However if careful analysis of the reported data is carried on. Major depression affects 3 to 5 percent of children and adolescents. or bored mood and difficulty with familial relationships. school. psychosocial changes that accompany this stage of life. sad. a major depressive episode lasts an average of eight months (Shaffer. At least 20 percent of those with early-onset depressive disorders (those beginning in childhood or adolescence) are at risk for bipolar disorder. rather its age of onset has also fallen greatly in past two decades. particularly if they have a family history of
from adolescent depression. it is reported that between 3 and 40% of adolescents present anxio-depressive symptoms” (Tamplin. Researchers have tended to record the statistics concerning the prevalence of depressive disorders among adolescents but the output findings have been rare and imprecise (Kashani et al 1987). boredom. In the absence of treatment. 1996). 1999). Depression is a chronic. During childhood the number of boys and girls affected are almost equal. with the many physical. depression is not always characterized by sadness. the severity of depressive symptoms is hard to evaluate (Garrison et al 1998). The average age of onset has fallen. “In the United States. but depression is characterized by a persistent irritable. In adolescence. Any child can be sad. recurrent. 1998). twice as many girls as boys are diagnosed.UNIVERSITY OF THE PUNJAB. Not just this. and work (Schraedeley. emotional. In addition to this. According to Hayward et. As far as the incidence and prevalence of adolescent depression is concerned. the findings are revealed that a predominance of girls suffering from it is always prominent. and often familial illness that frequently first occurs in childhood or adolescence. but instead by irritability. The risk of recurrence is approximately 40 percent at two years and 72 percent at five years (Jaskulski1993).
Well over half of depressed adolescents have a recurrence within seven years. school performance. Depression is more common in persons with chronic illnesses such as diabetes and epilepsy and after stressful life events such as the loss of a friend. Repeated episodes of depression can take a great toll on a young mind (Zima. psychotic symptoms. Children with Major Depression have an increased incidence of Bipolar Disorder and recurrent Major Depression. abuse. parent. or a manic response to antidepressant treatment. Alterations in central serotonergic and noradrenergic neurotransmission are associated with and may antedate childhood depression. LAHORE
bipolar disorder. Current research data however gives us a partial and derisory picture and the literature is still not so transparent about incidence of adolescent depression due to certain factors and these are the evaluations modes are inadequate and insufficient that measure adolescence depression and secondly the difference between temporary depressive symptoms and persistent depressive syndrome is difficult issue to be tackled. may be a precursor of depression. be a star athlete. As far as the co morbid patterns are concerned. Also significant is the matter that the frequency of depression in adolescence is so varied that its hard to chalk out a clear picture. or from peers can result in adolescent or teenage depression. depression is very widespread in teenagers. 1996). Stress from the pressure to have good grades. Depression negatively impacts growth and development. Multitude factors may contribute to adolescent depression. Biomedical and
. and neglect increase the risk of depression. particularly social phobia.UNIVERSITY OF THE PUNJAB. or sibling. It is difficult to assess the consequences of depressive symptoms since depression in adolescents is often associated with many other factors that raise the risk of undesirable behaviors and outcomes. Parent–child discord. Anxiety. and peer or family relationships and may lead to suicide.
such as alcohol and drug use. depression may raise the risk of suicide in children and adolescents. including costs of juvenile justice and educational programs. and smoking. but estimates for youth younger than 19 years that include all related costs. adolescents may lose earnings in the future. and chronic illness(Williamson. one half currently use alcohol. smoking cigarettes and having a mother who suffers from depression. and more than one fourth currently use marijuana. Second. Two factors relatively common in adolescence. both increase the adolescent's own susceptibility to depression. There is also a suggestion that adolescent depression affects susceptibility to infectious disease. Further. Such effects could occur through a connection between depression and dangerous behaviors. According to data from the Youth Risk
. just as such symptoms reduce work performance among adults. bingeing.UNIVERSITY OF THE PUNJAB. 1995). stressful life events. LAHORE
psychosocial risk factors include a family history of depression. Data from the 1999 Youth Risk Behavior Surveillance Survey indicate that more than one third of youth in grades 9 through 12 currently smoke cigarettes. Risky behaviors are quite prevalent among youth. Depression may inhibit school performance of children and adolescents. depression may affect other aspects of well-being. Education is a critical determinant of adult earnings. First. female sex. have ranged as high as $20 billion. as it does in adults. Depression in adolescence might also generate important nonmedical costs in several ways. so if school attendance and performance are substantially affected by depression. depression may lead girls and boys to miss school or to fall behind in school. Children with emotional and behavioral disorders in general are significantly more likely to experience substance use and are at higher risk of involvement with the juvenile justice system. childhood abuse or neglect. THE DIRECT COSTS of medical care utilization and the morbidity and mortality costs of mental health problems for children younger than 15 years has been estimated at $2 billion in 1985.
Furthermore. family studies suggest that the prevalence of depression is higher among adolescents from families that include a parent with depression. and children subjected to physical or sexual abuse. the findings are limited by the nature of the generally nonrepresentative samples in most studies. from singleparent families. children who are homeless. and these children may be at risk for other poor outcomes as well. Mental health problems in adolescents tend to be concentrated in the most disadvantaged groups—children from minority groups. It is difficult to assess the consequences of depressive symptoms
because depression in adolescents is often associated with many other factors that also raise the risk of undesirable behaviors and outcomes. Adolescent depression may also be associated with environmental adversity. the findings are limited by the referred nature of these samples. The relationship between depression and extreme stress has been demonstrated in children subjected to natural disasters. This relationship has been examined in 3 epidemiological samples.UNIVERSITY OF THE PUNJAB. with each study noting a consistent relationship between the 2 constructs. LAHORE
Behavior Surveillance Survey. nearly 20% of youth seriously considered attempting suicide during the preceding year. We then turn to the consequences of depression in adolescence: the degree to which depressive symptoms are correlated with school performance and with dangerous behaviors. In this article. We examine the
. While these studies consistently note an association between life events and adolescent depression. While these studies consistently note associations between depression and extreme adversity. The relationship between adolescent depression and other. we examine the prevalence and incidence of depressive symptoms among children and adolescents. and from low-income families. less extreme life events has been examined primarily in clinic-based samples. particularly alcohol and drug use and eating problems.
extent to which these negative outcomes associated with depression persist after controlling for sociodemographics and other risk factors that are associated with both higher rates of depression and higher risk of problem indicators. This analysis broadens the range of behaviors considered to include school performance as well as a range of unhealthy behaviors. such as excessive alcohol use. Keeping into consideration the brevity of the contents. such as life events and abuse. This would be extremely beneficial for such individuals will be extremely beneficial for reduction of the impact and economic burden of treatment that they have to pay in adult life. some correlates of adolescent depression. Previous research has shown associations between depression and some of these risk behaviors. Timely psychological interventions can help improve the quality of life in adolescents with depression.UNIVERSITY OF THE PUNJAB. such as abuse or adverse life circumstances.
. Moreover. Ultimate focus as expounded by the current research is effective management of adolescent depression so that the toll that the adolescents have to pay heavily through impaired patterns of their life could be decreased. It describes these associations in a large community sample. This research study has explored various hypotheses and multiple research questions. Otherwise its severity could get coupled with other psychiatric or psychosomatic diseases by the age such children step on the ladder of the adulthood. Assessing the relationship between depression and adverse outcomes is complicated by the fact that depression is also correlated with other factors that raise the risk of adverse outcomes. some of them are mentioned on the following page. may carry independent risks for adverse consequences.
METHOD Research design The current research employs ex-post facto research design as the characteristics of the population to be studied were already present. Hypotheses: Hypothesis 1: There are gender differences in adolescent depression. Those who responded to the symptoms of depression significantly were included in the sample.UNIVERSITY OF THE PUNJAB. Sample A total of 360 adolescents were screened and examined by the researcher out of a sample of 950 that were found to be having moderate to severe depression. LAHORE
Following hypotheses are proposed. The assent and consent of the respondents was also sought carefully and those who refused to cooperate and extend their opinions or who refused to share data about their family was excluded from the final sample. Sampling strategy In the current research.
. purposive sampling was used due to the fact that the sample to be taken had to be having certain characteristics and there was specific inclusion and exclusion criterion. Those who were taking some medication due to asthma like medical problems were excluded from the sample with the reservation that their medication might have produced a particular affect state. Hypothesis 3: Adolescent depression causes multiple physical and psychosocial consequences. The remaining samples that fulfilled al the requisites consisted of 300 respondents. Hypothesis 2: There are age differences in severity of adolescent depression.
and school performance. There were no exact standardized measures available on assessment of the consequences of depression. urban or suburban residence. risk behaviors. This included age. occasionally. The survey
. or never. These questions rate current depressive symptoms that had been present during the preceding 2 weeks. from absent to definitely present. sex. Family finances were assessed on the basis of whether the family had money problems frequently. LAHORE
Measures The current research study has used Depressive symptoms with Children's Depression Inventory (CDI) with due permission of the author. The measure exhibits satisfactory internal reliability and test-retest reliability. race. rarely. region. with the 10-item version being used to screen for major depression. as well as satisfactory predictive validity for the clinical diagnosis of major depression in children (Carlson & Cantwell.UNIVERSITY OF THE PUNJAB. Respondent demographic and socioeconomic information was also sought. One question was also asked concerning parental history of depression.87 and α . It was only through indicator determination that the questionnaire to assess possible problems of adolescents with depression was devised. for which an adolescent marks one of the statements most consistent with his or her current mental state. This allows a rating of depressive symptoms to be made on a 3-point scale. 1980). The questionnaire consists of a series of forced-choice items. The questionnaire asked adolescents extensive questions about their health status. Cronbach’s alpha for these two measures revealed reliability of α .71 respectively. Kovacs (1985) originally developed this selfreport questionnaire in 1985 as a screening measure for the diagnosis of major depression in children. The CDI exists as both a 26-item and a 10-item questionnaire. and family financial status.
The format of the questions was multiple choice. Not only the institutional permission was taken rather the students were individually questioned about their willingness to participate and written consent of this was received from their parents.UNIVERSITY OF THE PUNJAB. We used the information on age and grade to assess whether the child was
below the age-appropriate grade level. Data obtained through these measures was analyzed by using SPSS version 14. The screening of depressive symptoms was done in class administered Survey oriented Questionnaire since in our traditional school set ups.
Procedure Institutional consent from six major reputed schools was duly sought. how many days of school they missed because of illness in the preceding month. The survey also asked adolescents whether they engaged in risk behaviors when experiencing stress. schools from private and public sectors were deliberately selected.constructed questionnaire to assess problems caused due to their depressive symptoms was also administered in school settings. Out of this three schools were from private sectors while the other three were from government sector. LAHORE
asked adolescents whether they engaged in risk behaviors (overeating. and drinking alcohol). with responses grouped into categories. This was done individually so that the information sought was complete and accurate. The Self. mental health of the children has never been the area of concern. and their grade level. The children who manifested mild to moderate symptoms were excluded from the sample. Demographic information was also take after the sample has been short listed on the basis of the incidence of symptoms of depression from moderate to severe. In order to access students from all financial status. smoking.
. the findings have been displayed below followed by its analyses in discussion section.
. although there is variability across studies. factors. LAHORE
Analysis Statistical Package for Social Sciences Version 14 was used to analyze the data conducted the analysis with Software for Statistical Analysis of Survey Data.UNIVERSITY OF THE PUNJAB. depending on the stringency of the applied impairment threshold and the measure used to make the diagnosis. incomes. The prevalence of major depression in children and adolescents has been examined in many relatively large surveys that have relied on standardized interviews. and problem indicators were used. As reviewed by Sohail and Shaw (2004) the prevalence in the community is approximately 5%.
and t tests for
bivariate relationships between depression.
Results Demographic Characteristics of the sample (N= 300) Table 1 Descriptive Features Important in the Findings
_____________________________________________________________________________ _ Variable N Percentage
_____________________________________________________________________________ _ (I) Age 9-11 12-14 Total (11) Gender Male Female Total 150 150 300 50% 50% 100% 150 150 300 50% 50% 100%
(11I) Type of Institution with reference to number of students taken Private sector Government sector Total (IV) Education/ Grade 150 150 300 50% 50% 100%
.UNIVERSITY OF THE PUNJAB.
66% 26% 100% 23.UNIVERSITY OF THE PUNJAB. LAHORE
Class 5 Class 6 Class 7 Class8 Total 80 78 300 70 72 26.3% 24%
(V) Socioeconomic status Lower Class (income range 5000-8000) Middle Class (income range 10000-25000) Upper Class (income range 26000-50000) Total 120 130 50 300 40% 43% 17% 100%
08 0. LAHORE
Table 2 Prevalence of Depression across Socioeconomic Characteristics _____________________________________________________________________________ _ Prevalence Boys-------------------------Girls _____________________________________________________________________________ _ Family Type Single Parent Both Parents Divorced Family History of Depression Yes No Income No Money Problems Few Money Problems Scanty Money 0.05 0.04 0.17 0.16
∗Bold figures clearly show marked differences across Male and Females
.07 0.09 0.06 0.07 0.03 0.UNIVERSITY OF THE PUNJAB.02 0.03 0.04 0.05 0.08 0.06 0.
06 22. LAHORE
Table 3 Mean difference of the Gender on Depression _____________________________________________________________________________ _ N Mean Sd df t p
_____________________________________________________________________________ _ Male Female 150 150 6.05.80 3.UNIVERSITY OF THE PUNJAB.00
_____________________________________________________________________________ Results are significant since p < .
.05. So second research hypothesis is also supported.462. Table 3 represents the results from independent sample t-test.7 2. This shows that there is greater likelihood for girls to suffer from severity of depression symptomology as compared to boys.95 299 4. indicating that there is significant difference in depression between both of the gender. p < .76 0. t (58) = -7.
1 0. Problems Outcomes and Depression ________________________________________________________________________ Boys with Depression Girls with Depression
_____________________________________________________________________________ Days Missed from school Binging Smoking Poor grade performance Suicidal thoughts 7.4 0.76 0.9
.UNIVERSITY OF THE PUNJAB.7 0.3 8.9 0. LAHORE
Table 4.2 0.7 o.60 0.
_____________________________________________________________________________ Results are significant at p < . LAHORE
Table 5 Two age groups were compared using independent sample t-tests. So first research hypothesis is supported.97 299 4.05.05. This clearly represents that the as children are advancing in years in terms of adolescent phases. Table 4 represents the results from independent sample t-test.81 0. t (299) = 3. Results are shown in table below. p < .193 3. indicating that there is significant difference in depression between the two age groups adolescents with depression. Mean difference between the two age groups on Depression _____________________________________________________________________________ _ N Mean SD df t p
_____________________________________________________________________________ 9-11 years 12-14years 150 150 20.
. the depression increases.95 3.UNIVERSITY OF THE PUNJAB.03 24.818.
.78 1.11 1. LAHORE
Table 6 Problems Indicators and Consequences of Depression _____________________________________________________________________________ _ Days of School missed (n=300) Behind grad (n=300) Smoking Suicidal (n=300)
_____________________________________________________________________________ _ Depressed Family History Sexual Abuse Physical Abuse Life tragedies/ loss/death Aggression/ violence 0.12 1.62 2.87 1.05 1.02 1.03 15.UNIVERSITY OF THE PUNJAB.09 2.97 1.06 0.03 1.92 2.35 1.10 0.18 1.64 0.43 1.88 0.69 1.12 1.14 1.09 1.
UNIVERSITY OF THE PUNJAB. Previous studies have shown higher rates of mental health problems among children from divorced or single-parent families. In these data there was an increased prevalence of depression
. and family income. In these data. Table 1 provides prevalence rates for boys and girls by race. LAHORE
Discussion The Prevalence of Depression has significantly been found to be higher among girls as compared to the boys during adolescence phase. Anderson reports the prevalence of depression in boys was 5%. rates were quite low among 10-yearold girls and boys. family history of depression. Rates for girls rapidly rose above those for boys and were much higher by age 14 years. As expected. family structure. rates of depression do not vary substantively or significantly among grades though this difference becomes prominent when ages are considered by ignoring grades. whereas that in girls was 9%.
. girls and boys who had experienced severe life stresses in the year before the interview were much more likely to meet criteria for depression than were those whose lives had been less stressful. LAHORE
in boys with divorced parents. Adolescents from such families were much more likely to meet criteria for depression than were those who did not report a family history of depression. This finding suggests that environmental factors may contribute to depression risk. rates of depression were much higher half of the time higher in girls and boys in very-low-income families than among girls and boys in high-income families. In order to explore phenomenon. The relationship between life events and depression was positive in both girls and boys. The correlations between depressive symptoms and problem indicators has been found to be high.UNIVERSITY OF THE PUNJAB. About one fourth of girls and boys reported this high level of violence. For both girls and boys. As far as the prevalence rates for depression in girls and boys is concerned. and by the number of life events experienced in the preceding year. Indeed. Again. 2 measures of school performance: days of school missed because of illness and whether a child was in the expected grade level (age minus 6). For convenience. a history of sexual or physical abuse was strongly related to depressive symptoms. the report for quartiles of life events. by history of physical or sexual abuse. almost one fourth of girls with a history of either type of abuse met criteria for depression. Nearly 20% of girls and 8% of boys in the sample reported a history of sexual abuse. 23% of girls and 7% of boys in the sample reported a history of physical abuse. a history of violence was strongly and significantly related to depression in both girls and boys. Among those who responded to the question (three fourths of the full sample). Consistent with previous studies. The survey asked whether violence at home had ever been so serious that an adolescent contemplated leaving home. nearly one third reported that a family member had had depression. Finally.
smoking. be a consequence of socioeconomic disadvantage or of environmental risk factors. For example. Risk behaviors that are associated with depression may. Both girls and boys who were depressed reported much higher rates of use of alcohol. girls and boys who are doing badly at school may become depressed in consequence. Indeed. and depression. those who use drugs or cigarettes or engage in self-destructive behavior may also be depressed. Depressed girls were more likely than
. smoking. suicidal thoughts are a marker of depression (so that the relationship between depression and suicidal thoughts cannot be separated).UNIVERSITY OF THE PUNJAB. these negative outcomes. Finally. Final Comments While depression may increase the risk of any or all of these negative outcomes. the outcomes themselves may place adolescents at risk of depression. LAHORE
examined the measure of problem behaviors including alcohol use. Finally. suicidal ideation was substantially more frequent among depressed adolescents than among those who were not depressed. more than 75% of depressed girls and boys engaged in at least 1 of these risk behaviors. Alternatively. depression is correlated with environmental risk factors that occur disproportionately in families that are also socioeconomically disadvantaged. drugs. Finally. As e noted already. and bingeing. it was examined whether a girl or boy reported suicidal ideation. Depressed adolescent girls were also almost twice as likely to be behind a grade in school as those who were not depressed. instead. may be a consequence of other underlying problems. For example. and
bingeing etc were used. Depression was correlated with a significant increase in the number of school days missed. reports rates of these problem indicators and behaviors among depressed and nondepressed adolescent girls and boys. drug use.
Depressed adolescents are at much higher risk of poor performance at school. We cannot exclude the possible effects of reverse causality on the current results. The present study draws on observational cross-sectional data. of using drugs or smoking and of bingeing. Together. Thus. raise the risk of engaging in high-risk behaviors. Adolescents may become depressed because they are performing poorly in school or are using drugs. This means that they smoked when stressed. and suicidal ideation are significantly correlated with depression. in turn. studies show that
. This has been reflected clearly from the current research that the adolescents who have been subject to traumatic life events and to abuse (sexual or physical) are at significantly higher risk of depression. bingeing. Both depressed girls and depressed boys were more likely than their nondepressed counterparts to report that they stopped eating when stressed. these findings suggest that depression is an especially serious problem among children who live in risky environments and that depression is. The results of this study show that school attendance. it is too haphazard that the correlations observed herein are necessarily causal. Information about these indicators and behaviors as well as the presence of traumatic life events could be powerful tools for physicians in the difficult task of identifying adolescent depression and initiating treatment. LAHORE
nondepressed girls to report that they ate when stressed.UNIVERSITY OF THE PUNJAB.
CONCLUSIONS There are multiple significant findings that have been divulged from the current study. These results suggest that depression does. Overall. These results hold equally well for both girls and boys. associated with other serious risks. smoking. indeed.
about 1 in 20 adolescents currently suffer from depression. engaged in bingeing. suggesting that routine screening for depression has considerable merit. depressive symptoms are correlated with missing school. Assessing the relationship between depression and adverse outcomes is complicated by the fact that depression is also correlated with other factors that raise the risk of adverse outcomes. so we were able to control for these factors. this research study has shown valuable findings. smoking.
. rates of elevated depressive symptoms were more than twice as high. bingeing. Thus in determining the predictors for adolescent depression and in outlining the possible outcomes of depression. and life events. smoked. and suicidal ideation. after controlling for these factors. such as life events and abuse. abuse. This study used data collected through main streamed schools and not on the clinical population since the population at clinics is stigmatized. In this study. What This Study Adds to existing findings? Previous research has documented the high prevalence of depression among adolescents without highlighting the factors that become nurturing grounds for depression. We found evidence that. among adolescents who missed more than 10 days of school in the preceding month.UNIVERSITY OF THE PUNJAB. or had suicidal thoughts. The data also contained measures of family background.
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The study objectives have prospectively been achieved. Children in the middle adolescent phase seem to be more depressed than the beginning phase that suggests that the depression if not properly attended and acknowledged increases with the time span. awareness campaigns cum programs could be devised with the collaboration of school counselors to save such children from malady of depression. On the basis of findings of the current study. morbidity are not only the ultimate outcomes of adolescent depression rater many other achievement related aspect of individuals suffer and their life is affected badly psychologically. the Objectives of the Proposed Research have been achieved? The results of the study have pointed in the horizon of exploring the dynamics of adolescent depression in a large sample. Chronicity. LAHORE
To what extent. socially and emotionally.UNIVERSITY OF THE PUNJAB. Environmental risk factors can be
Research Grant allocation made and the expenditure incurred Total grant allocated: 100.UNIVERSITY OF THE PUNJAB.000/-
controlled for such individuals who appear to be the possible victims of depression in the advancing age.000/Total expenditure: 100. This could also save a large part of psychiatric population to be identified at a
younger age due to which their management plans and recovery picture would become strongly optimistic.