Depression in Adolescents 3

Depression in AdolescentsWhat are the environmental and biological factors that contribute to depression in adolescents?

Cynthia Ho0277- Extended Essay in IB PsychologyB. PattonMay 2015Word Count: 4000

Table of ContentsTitle Page.........................................................................................................................................1Abstract..........................................................................................................................................(2)Table of Contents.............................................................................................................................2Introduction......................................................................................................................................3Environmental factors...............................................................................................................3, 4, 5Environmental factors concerning gender ........................................................................3,4Environmental factors concerning race...............................................................................5Poverty and socio-economic standing.................................................................................5Family environment.............................................................................................................5School environment.............................................................................................................5Biological factors.............................................................................................................................6Hormones and neurotransmitters.........................................................................................6Brain structures....................................................................................................................6Genetic factors.....................................................................................................................6Comorbidity with other disorders........................................................................................6Treatment methods..........................................................................................................................6Conclusion.......................................................................................................................................7References....................................................................................................................................7, 8Appendices.......................................................................................................................................8

OutlineIntroductionWhat is depressionMood disorder that causes emotions of persistent sadness and loss of interestMay cause suicidal ideationThoughts about how to kill oneselfAlso known as major depressive disorder, or MDDDiagnostic criteria of depression according to the DSM-VEnvironmental FactorsEnvironmental Factors Concerning Gender According to several researchers such as Hankin et al. (1998), Dweck and Bush (1976), and Koenig and Juhasz (1991), there is a gender difference in depression in adolescents. Unassertiveness is a risk factor for depression, and many females are conditioned to be unassertive by societal and family values. Hankin et al. (1998) noted that depression was consistently found to increase during adolescence, especially in females (p. 135). Girgus and Nolen-Hoeksema (1994) explained this occurrence through the gender intensification theory. The gender intensification theory describes that the increasing gender differentiation in adolescent depression is due to socio-cultural pressures, pressuring adolescent males and females to adopt personality traits which are appropriate for their gender (Girgus & Nolen-Hoeksema, 1994, p. 426). Some personality characteristics in the female gender role, like unassertiveness and an increased emotional dependence on others, may become risk factors for depression (Cyranowski et al, 2000). Another socio-cultural influence on gender differences in adolescent depression is negative body image. According to Rierdan et al.s 1987 study, there is a relationship between body image and depression in adolescents, and depressed adolescent females were often less satisfied with their bodies (Rierdan et al, 1987). This could also relate to Carol Dwecks and Ellen Bushs 1976 study about sex differences in learned helplessness. They concluded that preadolescent girls are more self-defeating than preadolescent boys (Dweck & Bush, 1976). Negative body image and a lower self-esteem can be intensified by ruminative coping, which means to focus on a distress, and the causes and consequences of the distress. In the 1991 study by Koenig and Juhasz, it is observed that adolescent females use ruminative coping more often than their male counterparts (Koenig & Juhasz, 1991). The use of ruminative coping applies to victims of abuse, and people with a history of sexual abuse have an increased rate of depression (Weiss et al., 1999). Cutler and Nolen-Hoeksema observed that there is a greater increase of sexual abuse in the adolescent years for females than in males (Cutler & Nolen-Hoeksema, 1991). The 1984 study conducted by Carmen et al. further supports this statement, concluding that abuse is associated with depression in both genders, but this association is stronger in females than in males. Furthermore, abuse experiences are detrimental to an adolescents self-esteem and self-perception (Zahn & Waxler, 2000). The gender difference is only apparent in adolescence, though, Petersen et al. (1991) studied depressive symptoms in children and adolescents aged eleven to eighteen in a longitudinal study and found that there were no gender differences in depression in those younger than thirteen (Petersen et al., 1991). The researchers found that gender differences in depression generally emerged during adolescence, and by the time the subjects were eighteen, it was clear that the females reported depressive symptoms than males. Acknowledging these gender differences in adolescent depression could mean using different approaches in treatment, such as in cognitive-behavioural therapy, to cater to this demographic. There is a clear relation between gender and depression, specifically the link between depression and adolescent females. Word count: 500Environmental Factors Concerning RaceWalsemann et al, 2011Racial disparities in depressive symptoms during early adulthood may have origins in adolescenceMisaki et al., 2007Racial discrimination contributes to young adult mental health problems.Wickrama, 2007Day-to-day discrimination experienced by minorities generates depressive feelingsPoverty and Socio-Economic Standing (SES)Lower SES youth are at greater risk for maltreatment and disengagement from schoolDisengagement from school is an experience that has been found to influence depressive symptomsLower SES individuals possess fewer familial, social, and psychological resources; experience more stressful life eventsContributes to poorer mental healthBhasin et al., 2007Studied depression, anxiety and stress among adolescents of higher SESConger et al., 2002Economic hardship was shown to be directly associated with adolescent emotional distressFamily environmentMoon & Rao, 2010Youths good relationship with family is associated with lower depressive symptomsThienemann & Steiner, 1993Strong relationship between the level of depression and a negative report of family environment, in a study conducted with adolescents and their familiesPosnanski et al., 1976Depressed children are likely to have parents who are unaffectionate and abusive.School environmentMoon & Rao, 2010Low school connectedness is significantly associated with negative emotional health and depressive symptoms.Negative perception of school environment may be linked with adolescent depressionWickrama & Vzsonyi, 2011Stress associated with maltreatment by schoolteachers and low attachment to school may have generated depressive symptoms in adolescentsBiological FactorsHormones and neurotransmittersToo much cortisol released into the bloodstream may create a vulnerability for depressionCortisol is a stress hormoneSleep onset mechanism is impaired in depressed adolescents, by decreasing growth hormone secretionIncreases cortisolDahl et al., 1991Depressed children and adolescents tend to secrete less cortisolBrain structuresA dysfunction in the hypothalamus and the pituitary glands, responsible for stress response, may render one vulnerable to depression. Brain structures that are abnormal in those with depressionAmygdalaResponsible for the emotion of fear and anxietyMesolimbic dopamine systemInvolved in the feelings of reward and pleasurePrefrontal cortexInvolved in approach and withdrawal systemsGenetic factorsDepression is found to be moderately heritableTwin researchDepressive symptoms are heritable starting from adolescenceIdentical twins more likely than fraternal twins to show a concordance for depressionComorbidity with other disordersDefinitionThe presence of two disorders in a patientComorbidity of depression and anxiety disorders is at 30% to 70% (Kovacs, 1990)Comorbidity of depression and conduct disorders (such as ADHD) also high in adolescents (Egger, 2005)Children/early adolescents likely to have separation anxiety and depressionOlder adolescents likely to have comorbid eating disorders/substance abuse and depression. Treatment methodsEvans et al., 2005Depression in adolescents can be treated using psychotherapies such as cognitive-behavioural therapy (CBT), interpersonal psychotherapy and antidepressantsMarch et al., 2004Adolescents with moderate to severe clinical depression are best treated with a combination of antidepressants and CBT ConclusionReferencesBeek, Y. V., Hessen, D. J., Hutteman, R., Verhulp, E. E., & Leuven, M. V. (2012). Age and gender differences in depression across adolescence: real or bias. Journal of Child Psychology and Psychiatry, 53(9), 973-985.Bhasin, S. K., Sharma, R., & Saini, N. K. (2010). Depression, anxiety and stress among adolescent students belonging to affluent families: A school-based study. The Indian Journal of Pediatrics, 77(2), 161-165.Hankin, B. L. (2006). Adolescent Depression: Description, Causes, And Interventions. Epilepsy & Behavior, 8(1), 102-114.Moon, S. S., & Rao, U. (2010). Youth-Family, Youth-School Relationship, And Depression. Child and Adolescent Social Work Journal, 27(2), 115-131.Nolen-Hoeksema, S., & Girgus, J. S. (1994). The Emergence Of Gender Differences In Depression During Adolescence. Psychological Bulletin, 115(3), 424-443.Petersen, A. C., Compas, B. E., Brooks-Gunn, J., Stemmler, M., Ey, S., & Grant, K. E. (1993). Depression in adolescence. American Psychologist, 48(2), 155-168.Rierdan, J., Koff, E., & Stubbs, M. L. (1989). A Longitudinal Analysis of Body Image as a Predictor of the Onset and Persistence of Adolescent Girls' Depression. The Journal of Early Adolescence, 9(4), 454-466.Thienemann, M., & Steiner, H. (1993). Family environment of eating disordered and depressed adolescents. International Journal of Eating Disorders, 14(1), 43-48.Walsemann, K. M., Bell, B. A., & Goosby, B. J. (2011). Effect of School Racial Composition on Trajectories of Depressive Symptoms from Adolescence Through Early Adulthood. Race and Social Problems, 3(3), 131-145.Wickrama, T., & Vazsonyi, A. T. (2011). School contextual experiences and longitudinal changes in depressive symptoms from adolescence to young adulthood. Journal of Community Psychology, 39(5), 566-575.

AppendicesIntended: Brain scans depicting brains with Depression Comorbid disorders with depression, such as ADHD and anxiety Graphs, tables and charts from the studies mentioned in the outline Questionnaire samples from the studies Diagnostic criteria for depression and other comorbid disorders from the DSM-V Samples from different personality inventories used in the above-mentioned studiesConcluding Notes1. I am not writing an Extended Essay in Psychology. 2. My IA topic is Loftus and Palmer, 1976.3. I will double space my Extended Essay.