Psychological correlates of adolescent depression

Cultural Dimensions Moderate the Association between Loneliness and Mental Health during Adolescence and Younger Adulthood: A Systematic Review and Meta-Analysis

Cultural factors, such as country or continent, influence the relationship between loneliness and mental health. However, less is known about how cultural dimensions moderate this relationship during adolescence and younger adulthood, even if these dimensions manifest as country or continent differences. This study aims to examine the potential influence of Hofstede's cultural dimensions on this relationship using a three-level meta-analysis approach. A total of 292 studies with 291,946 participants aged 10 to 24 were included in this study. The results indicate that cultural dimensions, such as individualism vs. collectivism, indulgence vs. restraint, power distance, and long-term vs. short-term orientation, moderated the associations between loneliness and social anxiety, stress, Internet overuse, and negative affect. The association between loneliness and mental health was not moderated by cultural dimensions, such as masculinity and uncertainty avoidance. These findings suggest that culture's influence on the association between loneliness and mental health is based on a domain-specific mechanism.

Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19

OBJECTIVE

Disease containment of COVID-19 has necessitated widespread social isolation. We aimed to establish what is known about how loneliness and disease containment measures impact on the mental health in children and adolescents.

METHOD

For this rapid review, we searched MEDLINE, PsycInfo, and Web of Science for articles published between January 1, 1946, and March 29, 2020. Of the articles, 20% were double screened using predefined criteria, and 20% of data was double extracted for quality assurance.

RESULTS

A total of 83 articles (80 studies) met inclusion criteria. Of these, 63 studies reported on the impact of social isolation and loneliness on the mental health of previously healthy children and adolescents (n = 51,576; mean age 15.3 years). In all, 61 studies were observational, 18 were longitudinal, and 43 were cross-sectional studies assessing self-reported loneliness in healthy children and adolescents. One of these studies was a retrospective investigation after a pandemic. Two studies evaluated interventions. Studies had a high risk of bias, although longitudinal studies were of better methodological quality. Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time at which loneliness was measured and between 0.25 and 9 years later. Duration of loneliness was more strongly correlated with mental health symptoms than intensity of loneliness.

CONCLUSION

Children and adolescents are probably more likely to experience high rates of depression and most likely anxiety during and after enforced isolation ends. This may increase as enforced isolation continues. Clinical services should offer preventive support and early intervention where possible and be prepared for an increase in mental health problems.

Bidirectional predictions between Internet addiction and probable depression among Chinese adolescents

BACKGROUND AND AIMS

The aim of the study is to investigate (a) whether probable depression status assessed at baseline prospectively predicted new incidence of Internet addiction (IA) at the 12-month follow-up and (b) whether IA status assessed at baseline prospectively predicted new incidence of probable depression at follow-up.

METHODS

We conducted a 12-month cohort study (n = 8,286) among Hong Kong secondary students, and derived two subsamples. The first subsample (n = 6,954) included students who were non-IA at baseline, using the Chen Internet Addiction Scale (≤63), and another included non-depressed cases at baseline (n = 3,589), using the Center for Epidemiological Studies Depression Scale (<16).

RESULTS

In the first subsample, 11.5% of the non-IA cases developed IA during follow-up, and probable depression status at baseline significantly predicted new incidence of IA [severe depression: adjusted odds ratio (ORa) = 2.50, 95% CI = 2.07, 3.01; moderate: ORa = 1.82, 95% CI = 1.45, 2.28; mild: ORa = 1.65, 95% CI = 1.32, 2.05; reference: non-depressed], after adjusting for sociodemographic factors. In the second subsample, 38.9% of those non-depressed participants developed probable depression during follow-up. Adjusted analysis showed that baseline IA status also significantly predicted new incidence of probable depression (ORa = 1.57, 95% CI = 1.18, 2.09).

DISCUSSION AND CONCLUSIONS

The high incidence of probable depression is a concern that warrants interventions, as depression has lasting harmful effects in adolescents. Baseline probable depression predicted IA at follow-up and vice versa, among those who were free from IA/probable depression at baseline. Healthcare workers, teachers, and parents need to be made aware of this bidirectional finding. Interventions, both IA and depression prevention, should thus take both problems into consideration.

Hopelessness and Loneliness Among Suicide Attempters in School-Based Samples of Taiwanese, Philippine and Thai Adolescents

The aim of this study was to assess the level of suicide attempts in three school-based samples of Southeast Asian adolescents (Taipei, Taiwan; the Philippines; Chiang Mai, Thailand) and determine whether adolescent suicide attempters score higher on measures of hopelessness and loneliness relative to nonattempters. It was hypothesized that hopelessness and loneliness would be related to suicide attempts, and that hopelessness would continue to be associated with suicide attempts when controlling for loneliness. The prevalence of suicide attempts across the three samples of Asian youth were not consistent with Taiwanese girls and boys as the most likely to have ever attempted suicide. As expected, results showed that suicide attempters (in past 12 months and ever) scored higher on hopelessness and loneliness than nonattempters across all three samples and for both genders. However, the statistical control of loneliness demonstrably weakened the association between suicide attempt behaviour and hopelessness across the samples and for both genders, and resulted in nonsignificant ANCOVA tests for some of the sample-gender groups. These results attest to the need for more research investigating connections between youth suicide attempts, hopelessness and loneliness in adolescent populations. Loneliness should be included as a potential determinant of youth suicidal behaviour in future research.

[Cigarette smoking initiation among Tunisian adolescents: Risk and protective factors]

BACKGROUND

Since smoking is a major public health problem among Tunisian teenagers, it is important to identify the underlying risk and protective factors associated with initiation of this behavior.

METHODS

A cross-sectional, school-based survey of students was conducted by the Tunisian Ministry of Health among a nationally representative sample of 4172 adolescents aged between 12 and 20 years attending public, private, and professional secondary schools across Tunisia who participated in the Survey of the Health of Tunisian adolescents in 2000. For data analysis, we first calculated crude odds ratios (OR) followed by calculating adjusted OR after using multivariate logistic regression models.

RESULTS

Almost one-third of respondents had already started smoking at an average age of 13 years, 6.4% among them smoked daily. Demographic vulnerabilities to smoking behavior were gender (boys more than girls), age and residence in urban areas and particularly in Greater Tunis and the North East. Familial and school factors were parental divorce, poor relationship with parents, poor integration into the peer group, and poor school investment. Psychological and behavioral factors were low self-esteem level and the occurrence of stressful life events, risk taking and alcohol consumption when there was no association with the depression, anxiety and body image. Protective factors against the experimental cigarettes were mainly sports and reading.

CONCLUSION

There are many factors associated with smoking behavior among adolescents. All of these predictors need to be considered in smoking prevention among Tunisian teenagers.

Intolerance of uncertainty in adolescents: correlations with worry, social anxiety, and depression

The current study examined Intolerance of Uncertainty (IU)-the tendency to react negatively to situations that are uncertain-in psychological problems among adolescents. Using data from 191 adolescents, aged 14 to 18, we examined (a) the dimensionality of IU as tapped by the Intolerance of Uncertainty Scale short-form (IUS-12), (b) the relationship of IU with worry, social anxiety, and depression, (c) the specificity of IU to these variables, and (d) the role of IU as a mediator of the linkages between negative affectivity (NA) and worry, social anxiety, and depression. Results showed that the IUS-12 encompassed 2 components of IU, named Prospective Anxiety and Inhibitory Anxiety. Furthermore, IU was specifically related with worry and social anxiety, but not depression, when controlling the shared variance between these variables and NA, age, and gender. Finally, IU and its 2 components were found to mediate the linkages of NA with worry and social anxiety.

Quality of life, depressed mood, and self-esteem in adolescents with heart disease

OBJECTIVE

To assess health-related quality of life (HRQoL), depressed mood, and self-esteem in adolescents with heart disease and compare them with age-matched healthy adolescents (control group).

METHODS

Ninety adolescents (aged 12 to 18 years with congenital or acquired heart disease) and 87 controls completed the HRQoL (TAAQOL-CHD), Center for Epidemiologic Studies Depression scale, and Rosenberg self-esteem questionnaires. Relevant medical details were collected. The patients and their parents were asked to rate their perceived severity of heart disease.

RESULTS

Adolescents with severe heart disease reported higher levels of depressed mood and lower self-esteem than did adolescents with moderate and mild heart disease and age-matched healthy controls. Adolescents with severe heart disease also reported worse HRQoL than those with moderate and mild disease. According to the multiple regression analysis, 44% of variance of HRQoL was explained by the study variables. Disease severity alone explained 11% of the variance, but when entered with the other study variables, depressed mood, self-esteem, and adolescents' perceived severity of disease were the only significant contributors to the explained variance of HRQoL. An exploratory mediation analysis, using the Sobel test, was therefore applied, and it showed that depressed mood and perceived disease severity, but not self-esteem, mediated the relationship between disease severity and HRQoL.

CONCLUSIONS

Lower HRQoL was found in adolescents with severe heart disease. Psychosocial factors have a significant effect on the psychological state of adolescents, and they should be addressed and treated.

Characteristics of adolescent depression

Depression is a common psychiatric disorder that is acknowledged to be increasing in disease burden. The rates of adolescent depression is particularly concerning as they continue to increase. The seriousness and pervasive effects of depression on young people's lives supports the view that research that extends the knowledge in this area is vital. This is a descriptive study of the characteristics of depression in a sample of 121 adolescents attending an outpatient specialist adolescent mental health service in New Zealand. The adolescents were required to complete two self-report measures to assess presence of depressive symptoms, severity of depression, and particular characteristics of the depression. The findings revealed that irritability was the most common characteristic along with other interpersonal and thought processing symptoms. It is important that mental health nurses are able to identify the specific characteristics of adolescent depression that may differ from adult depression in order to manage this patient population effectively.

Depressive Symptoms in Adolescents Living in Rural America

PURPOSE

The purposes of this pilot study were to examine prevalence of depressive symptoms among rural adolescents and identify related social and environmental variables.

METHODS

A convenience sample of 299 14- to 18-year-old agriculture class students at 5 rural high schools in Kentucky and Iowa completed a survey that included demographic information, family farm history, experience with suicide, perception of school environment, and indicators of farm injuries and risky behaviors. Participants also completed the Center for Epidemiologic Studies Depression Scale (CES-D) as well as scales to assess the number of major life events in the last year, active coping use, and family closeness.

FINDINGS

The prevalence of a high level of depressive symptoms (CES-D > or = 16) in this sample was 34%. Nine percent had seriously considered suicide in the last year. Unlike previous reports, boys reported as many depressive symptoms as girls. Although the literature reports that engaging in risky behavior is associated with depressive symptoms, the only risky behavior linked with depressive symptoms in this sample was operating a 4-wheel all-terrain vehicle. Other predictors of depressive symptoms included poor family relationships and poor active coping.

CONCLUSIONS

Interventions to identify and prevent depressive symptoms in rural adolescents are needed. Boosting active coping and improving family function may also prevent the development of clinical depression in rural adolescents.

Depression in children with cancer

In this study, children with cancer and healthy students between the ages of 9 and 13 were investigated in terms of depression status. A demographic data form and the Children's Depression Inventory were given to both groups. The research group consisted of 50 children with cancer who were followed up in pediatric hematology and oncology outpatient clinics at Ankara University. The control group was comprised of 50 healthy students who attended Türközü Timur Primary School. It was found that there were significant differences between depression scores of children with cancer and children that are healthy. Children with cancer have higher depression scores than healthy students.

Adolescent depression: important facts that matter

PURPOSE

To determine if there are differences in adolescent depression using variables of age, gender, smoking, and alcohol use.

METHODS

A comparative, descriptive survey design was used. The adolescents (N = 217) completed either the Beck Depression Inventory or the Children's Depression Inventory and a demographic questionnaire.

FINDINGS

The 15- to 16-year-olds (p = .016), females (p = .003), and smokers (p = .001) scored significantly higher than the 12- to 14-year-olds on depression. The 15- to 16-year-olds who used alcohol were found to be twice as depressed as the nonusers (p = .002). No significant differences were found in the 17- to 19-year-old age group.

CONCLUSIONS

This study confirmed depression increased with age, in females, and with smokers. Nurses are in a unique position to provide interventions to promote healthy lifestyles and reduce the likelihood of depression and alcohol and nicotine abuse in adolescents.

Screening and predicting adolescent depressive symptoms in rural settings

Adolescent depression with related suicidal behavior is a serious health problem. This article describes depressive symptoms, reported life events, and demographic risk factors in 846 rural adolescents. The results indicate that self-reported depressive symptoms in rural adolescents is significantly (p < .05) related to gender, death in the family, and the perceived positive and negative impact of life events, as well as the specific events of losing a close friend, an increase in number of arguments with parents, trouble with classmates, and trouble with police. The type of school program and trouble with siblings was marginally significant (p < .10). These demographic factors and life events may assist health-care professionals in identifying adolescents at risk for depressive symptoms.

Responding to Healthy People 2000: depression in our youth, common yet misunderstood

Pediatric health care providers are concerned with the physical health, growth, and development of youth. The U.S. Public Health Service has recommended that children's mental status be reviewed during routine assessments, and the promotion of mental health is one of the priorities set by Healthy People 2000. Pediatric nurses must be able to assess mental status, including depression, in children and adolescents, and to identify pathology early. This paper presents an overview of depression, historical perspectives, risk factors, a developmental approach to assessment, common treatment regimens, and nursing implications for this mental health concern in children and adolescents.