Adolescent Depression and Risk Factors

Adolescence, Fall, 2001 by Tiffany Field, Miguel Diego, Christopher Sanders

ABSTRACT

Seventy-nine high school seniors were administered the Center for Epidemiological Studies Depression Scale (CES-D), as well as a questionnaire on parent relationships, peer relationships, positive and negative feelings including suicidal thoughts, and lifestyle variables including academic performance, exercise, and drug use. The group of adolescents who scored above the clinical cutoff for depression on the CES-D (n = 29) had poorer relations with parents. Further, the incidence of paternal depression in that group was greater. The depressed adolescents also had less optimal peer relationships, fewer friends, and were less popular. They experienced less happiness and more frequent suicidal thoughts. They spent less time doing homework, had a lower grade point average, and spent less time exercising. The depressed group also reported more use of marijuana and cocaine. A stepwise regression indicated that physical affection with parents, homework, well-being, exercise, happiness, and parent relations explained 55% of the variance.

Approximately 8% to 10% of adolescents score above the cutoff for clinical depression on self-report measures, such as the Center for Epidemiological Studies Depression Scale, and the percentage is increasing (Fombonne, 1998; Lewinsohn et al., 1998). Adolescent depression has been associated with poor psychosocial and academic outcomes and increased risk for substance abuse and suicide (Birmaher et al., 1996).

One of the most frequently studied risk variables is relationships with parents. Parents of depressed adolescents have been reported to be less caring (Rey, 1995), to be more negative (Pike & Plomin, 1996), and to provide less support (Hoffman & Su, 1998). In one study in which parent-adolescent interactions were videotaped, parents of depressed adolescents increased their facilitative behavior in response to their adolescents' depressed behavior, suggesting that these parents may be inadvertently reinforcing depressive behavior (Sheeber et al., 1998). Another frequently studied risk factor is parental depression. In one recent study, a greater proportion of depressed adolescents had depressed mothers (47% vs. 18% in the control group), although the rates of paternal depression did not differ between the two groups (Shiner & Marmorstein, 1998). In another study, parental depression increased the risk for medical problems and hospitalization among depressed adolescents (Kramer et al., 1998).

A less frequently studied risk factor for adolescent depression is peer relations, more specifically, loneliness. In a recent investigation of multiple correlates of adolescent depression, higher levels of depressive symptoms were associated with greater loneliness (r = .65), and loneliness was the first and most significant variable to enter the stepwise regression (Brage et al., 1995).

Invariably, strong relationships are reported between depression and substance use (Aalto-Setaelae et al., 1998; Birmaher et al., 1996). Depression and substance use, in turn, are related to poor academic outcomes (Birmaher, 1996).

The purpose of the present study was to examine frequently explored risk factors for adolescent depression, such as relationships with parents, parental depression, and substance use, as well as less frequently explored factors. The latter were as follows: peer relationships, number of friends, popularity, and dating; feelings of well-being, happiness, and anger; suicidal thoughts; time spent doing homework, working, and exercising; and grade point average.

METHOD

Participants

The participants were 79 high school seniors recruited from a suburban Florida high school. The distribution of participants was 76% Caucasian, 11% Hispanic, 5% Asian, 3% African-American, and 5% other. On average, they were of middle to upper middle socioeconomic status (M = 1.9 on the Hollingshead Two-Factor Index).

Measures

Participants completed a 181-item Likert-type questionnaire that gathered information on multiple behavioral and psychological aspects of adolescent life (Field & Yando, 1991). The questionnaires were completed anonymously within a 45-minute time frame in a large assembly room.

Depression. Scores on the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977) can range from 0 to 60. The CES-D has been standardized for high school populations (Radloff, 1991), with a score of 19 or higher indicating depressed mood. It has demonstrated adequate test-retest reliability, internal consistency, and concurrent validity (Schoenbach, Kaplan, Wagner, Grimson, & Miller, 1983; Wells, Klerman, & Deykin, 1987).

Relationships with parents / friends. Twenty-four questions assessed relationships with mother, father, and best friend (Blyth & FosterClark, 1987). Questions included: "How much do you go to your mother for advice/support?" and "How much does your best friend accept you no matter what you do?" Each question was rated on a 5-point Likert scale ranging from "not at all" to "very much."