1 / 21

depression

depression. in adolescence. Readings. Wenar, C. & Kerig, P. (2000)“ Disorders in the depressive spectrum and child and adolescent suicide in Developmental Psychopathology (pp. 143-159). Singapore: McGraw-Hill. Lecture Questions.

spence
Download Presentation

depression

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. depression in adolescence

  2. Readings • Wenar, C. & Kerig, P. (2000)“ Disorders in the depressive spectrum and child and adolescent suicide in Developmental Psychopathology (pp. 143-159). Singapore: McGraw-Hill

  3. Lecture Questions • Where is the line between ‘normal’ adolescent depression and ‘abnormal’? • Why is adolescence a time of vulnerability to depression? • What does depression look like in adolescence? • What are the risk and protective factors for adolescent depression and youth suicide?

  4. What’s ‘normal’? • Worrying • ‘Moodiness’ • ‘Puberty blues’ • Underdiagnosis related to ‘normal’ aspects of adolescence

  5. Adolescent vulnerability Cognitive factors • Egocentricity • Black and white thinking • Emotional reasoning • Personal fable- uniqueness • Increased capacity for self awareness

  6. Adolescent vulnerability • Adolescent ‘turmoil’ • Changing bodies, changing parental relationships • Sexual identities • Relationships • Academic pressures • Peer pressures • Balancing work and school

  7. How common is it? • One of the three most common mental health problems in young people • First onset of a major depression often occurs in mid-late adolescence (15 mean age) • Rise in depression ages 13-15, peak ages 17-18, decline to adult levels • Depression is a significant problem for young people in custody or living on the streets • Episode in adolescence risk factor for episode in adulthood (Patton)

  8. NZ prevalence • Fergusson & Horwood • 16-18 year old young women 30.2% rate • 18 plus 10.8% • 16-18 year old young men 13.7% • 18 plus 3.4%

  9. Gender patterns • Onset of menarche significant for girls (around age 12) • Equal prevalence boys and girls til 15 then greater prevalence amongst girls (around twice as likely) • Girls’ depression predictor of subsequent episodes • Speculative differences in way depression differently expressed by girls and boys • Role of constructions of gender, pressures to conform with approach to adulthood

  10. Adolescent presentation • Depressed mood Fatigue • Decreased concentration Insomnia • Social withdrawal Guilt • Negative self-image Anorexia • Anger/irritability Hopelessness • Suicidality Depression feels like falling out of a plane without a parachute I was often impatient with my friends. They didn’t want to be around me any more There aren’t any words to express the confusion of feelings

  11. DSM Criteria • Persistent depressed mood • Loss of pleasure or interest in activities • Weight loss or gain • Insomnia • Restlessness • Fatigue • Feelings of worthlessness • Impairment in concentration, making decisions • Recurrent thoughts of death • 5 plus, two weeks at least 1 symptom (1) or (2)

  12. Comorbidity • Substance abuse- Patton’s research on cannabis use • Anxiety disorders (60-70% in children) • Conduct disorder (boys) • Age patterns- preschoolers separation anxiety, school age children conduct disorder and adolescents eating disorders or substance abuse

  13. Precipitating factors Relationship losses: • Girl/boyfriend • Family member • Close friend Failure to achieve a goal • Sports/leisure • Academic

  14. Risk factors- young person • Biological changes • Physical illness • Poor nutrition • Alcohol or drug abuse • Negative self evaluation beliefs • External locus of control

  15. Risk factors- family • Family history of depression • Early loss experiences • Exposure to non-optimal parenting experiences, especially focus on child’s failures or neglectful parenting • Lack of connectedness with family (Resnick et al.)

  16. Risk factors-social • Stresses from e.g., sexuality issues, academic pressures, peer pressure, friendship/relationship problems, identitiy issues • Lack of connectedness with school (Resnick et al.)

  17. Protective Factors • Resnick et al. “Protecting adolescents from harm” • Connectedness with family, other adults, or school • Religiosity • Feeling safe at school • Coping skills • Feelings of self-esteem and belonging • Secure cultural identity

  18. Help-seeking Most young people don’t seek help: • Use informal versus formal help • Bullet proof-think they can handle it • Don’t know what’s available • Negative about what is available • Effects of depression itself • Psychosocial- levels of stress, confidence and social support

  19. Youth Suicide • 1995 NZ worst rate of 13 OECD countries • 1998-140 deaths • 1999-120 deaths • 2000-96 deaths • Females attempt at twice the rate • Males higher ‘success’ • Maori males highest rate (numbers of suicides divided by population that age)

  20. Key risk factors • High emotional distress • Previous attempts • Family/friend suicide attempt • Involvement in violence perpetration • Victim of violence • Substance abuse • Easy access to suicide ‘tools’

  21. Protective factors • As for depression Resnick et al study: • No protective factors: 1 in 5 boys and 1 in 3 girls attempt • 3 protective and 3 risk factors: probability 4% boys, 8% girls • No risk factors, probability < 1% • Prevention + decrease risks and increae protective

More Related