Social problem-solving among adolescents treated for depression

Studies suggest that deficits in social problem-solving may be associated with increased risk of depression and suicidality in children and adolescents. It is unclear, however, which specific dimensions of social problem-solving are related to depression and suicidality among youth. Moreover, rational problem-solving strategies and problem-solving motivation may moderate or predict change in depression and suicidality among children and adolescents receiving treatment. The effect of social problem-solving on acute treatment outcomes were explored in a randomized controlled trial of 439 clinically depressed adolescents enrolled in the Treatment for Adolescents with Depression Study (TADS). Measures included the Children's Depression Rating Scale-Revised (CDRS-R), the Suicidal Ideation Questionnaire - Grades 7-9 (SIQ-Jr), and the Social Problem-Solving Inventory-Revised (SPSI-R). A random coefficients regression model was conducted to examine main and interaction effects of treatment and SPSI-R subscale scores on outcomes during the 12-week acute treatment stage. Negative problem orientation, positive problem orientation, and avoidant problem-solving style were non-specific predictors of depression severity. In terms of suicidality, avoidant problem-solving style and impulsiveness/carelessness style were predictors, whereas negative problem orientation and positive problem orientation were moderators of treatment outcome. Implications of these findings, limitations, and directions for future research are discussed.     

Peer interactions of conduct-disordered,anxious-withdrawn,and well-adjusted black adolescents

The relationship between behavior problems and adolescent peer relations was examined in 30 black male adolescents divided into three equal-sized groups on the basis of individual psychosocial functioning (conduct-disordered, anxious-withdrawn, well-adjusted). Groups were matched on age, IQ, and father absence. An observational method was used to evaluate dominance, conflict, affect, and social competence manifested with a friend and with a well-adjusted stranger. Conduct-disordered and anxious-withdrawn adolescents displayed less social competence and less positive affect than well-adjusted adolescents when interacting with both friends and strangers. Anxious-withdrawn adolescents evidenced more personal apprehension than their well-adjusted counterparts. All groups showed greater leadership ability, talked more, and showed less personal apprehension with friends than with strangers. The findings support the role of peer relations in the maintenance and exacerbation of adolescent psychosocial difficulties.This research was supported by funding to the Department of Psychology at Memphis State University granted through the Centers of Excellence Program of the State of Tennessee. This article is based on a master's thesis submitted by the first author to the Department of Psychology at Memphis State University.     

Dominance hierarchies in normal and conduct-disordered children

Two groups of conduct-disordered children in day treatment and two groups of normal matched controls were observed over eight sessions in a free-play situation. The purpose of the study was to examine whether disturbed children formed dominance hierarchies, and to compare the power relations among disturbed children to those of normal peers. Results indicated that the hospitalized children did form dominance hierarchies, although their hierarchies were not as stable as those of their normal peers. Moreover, an inverse relation was noted between intragroup conflict and the hierarchy's stability. In addition, the pattern of targeting differed between the normal and disturbed youngsters. Conflict among the children in both control groups tended to be concentrated among members of adjacent ranks. The disturbed children, on the other hand, were less discriminating as to their target's rank, exhibited greater intragroup conflict, and lost more frequently in their agonistic encounters.     

Gender differences in coping and daily stress in conduct-disordered and non-conduct-disordered adolescents

Research shows that conduct disorder (CD) manifests differently in boys and girls, yet little is known about specific characteristics of girls with CD. This study examined gender differences in stress and coping in both CD (n = 69) and non-conduct-disordered (NCD) adolescents (n = 64). Results indicated similar patterns of gender differences in stress and coping, although CD adolescents reported a higher frequency of stress and maladaptive coping strategies than NCDs. Girls reported more daily stress and greater use of coping associated with both social relationships and emotional venting. A significant interaction effect distinguished girls with CD from other groups by their higher level of daily stress, more frequent use of self-injurious behavior and emotion-focused coping, and deficits in active coping.     

Utility of the SCL-90-R with depressed and conduct-disordered adolescent inpatients.

We assessed the diagnostic utility of the Symptom Checklist-90-Revised (SCL-90-R) in a sample of adolescent inpatients. In Part 1 (n = 79), convergent and discriminant validity were demonstrated for SCL-90-R scales measuring depression and paranoid ideation. Canonical correlation showed that SCL-90-R scales tapped two dimensions of adolescent psychopathology, a primary dimension of dysphoria and a secondary dimension of anger and mistrust. In Part 2 (n = 50), adolescents diagnosed as having major depression showed significant elevations on scales measuring depression, anxiety, and obsessive-compulsive features. Although several scales had high diagnostic specificity for major depression and conduct disorder, sensitivity was low.     

Contribution of ADHD symptoms to substance problems and delinquency in conduct-disordered adolescents

We examined adolescents with conduct disorder (CD) and substance problems to determine if those with attention deficit hyperactivity disorder (ADHD) symptomatology had more severe delinquency and substance involvement. ADHD symptomatology was assessed in two ways: (1) by self-reports using the Diagnostic Interview Schedule for Children (DISC) and (2) by use of DISC plus reports of others (parents, program staff, and program teacher). We divided boys into three ADHD groups based on DISC: those who met criteria, those who reported at least eight current symptoms, and those who reported fewer than eight symptoms. We also divided the same boys into two groups: those with reports of ADHD by two or more sources and those without this multisource ADHD. Examining these definitions of ADHD revealed that boys with either self- or multisource ADHD had more CD symptoms, earlier age of CD onset, more substance dependence diagnoses, and more comorbid depression and anxiety.This investigation was supported by the National Institute on Drug Abuse Grant No. DAO6941.     

Social problem-solving in dual diagnosis patients

Social problem-solving skills among dual-diagnosis patients were compared to two control groups: psychiatric patients without substance abuse problems and community volunteers. A standardized, behavioral role-play test consisting of four scenarios representing interpersonal problems yielded two reliable dependent variables: (a) specificity, or elaboration, of the problem-solving response and (b) overall effectiveness of the response. Analyses of covariance (using a measure of intellectual function as the covariate) indicated that both dual-diagnosis patients and psychiatric controls were significantly poorer problem-solvers than were community controls. The overall pattern of the results indicated that deficits observed in a dual-diagnosis sample are not necessarily compounded due to the presence of the coexisting disorders. Implications of these findings, strengths and limitations of this study, and suggestions for future research are discussed.This research was supported in part by Grant DA04593-01 from the National Institute on Drug Abuse.Portions of this article were presented at the 22nd Annual Meeting of the Association for the Advancement of Behavior Therapy during November 1988 in New York.     

Eastern Caribbean family psychology with conduct-disordered adolescents from the Virgin Islands

Family psychology is a new and relatively undeveloped discipline in much of the English-speaking Caribbean, particularly in the U.S. Virgin Islands. Family structure and youth behavior in the region have changed dramatically over the past few decades. Given the family-oriented nature of the culture, it is posited that the use of family psychology as an approach to research and intervention may prove to be a rich method to address this cultural metamorphosis. This article examines the potential effectiveness of interventions at the family level when mental health providers are working with youth with conduct disorder in the Virgin Islands. This article is offered as a microcosm of the global changes in family structure and the youth culture that are occurring particularly in the developing world, in part due to the rapid development of telecommunications. Possible roles of the family psychologist in this global transformation are presented.     

A Rorschach study of attachment and anxiety in inpatient conduct-disordered and dysthymic adolescents.

We investigated the constructs of attachment and anxiety in inpatient conduct-disordered and dysthymic adolescents. Texture, diffuse shading, and pure human content (Exner, 1986) Rorschach indices were compared between 48 subjects who met the criteria for conduct disorder and 30 subjects who met the criteria for dysthymia, according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987). We also compared mild, moderate, and severe conduct-disorder groups on the three selected Rorschach variables and investigated certain family characteristics for the two groups. We found a lower frequency of texture and pure human content responses in conduct-disordered subjects and a greater frequency of diffuse shading responses in the dysthymic subjects. The conduct-disordered subjects also came from homes in which the mother figure was significantly less present. Our psychometric findings of lessened attachment and diminished anxiety in the conduct-disordered adolescents are similar to adult psychopaths. We urge that an attachment or socialization disturbance criterion be reintroduced into the forthcoming DSM-IV conduct-disorder diagnosis.     

Sex differences in anger expression,depressed mood,and aggression in children and adolescents

The current study examined anger expression styles and their relationship to levels of depressed mood and aggressive behavior in male and female children and adolescents. Measures of anger, anger expression, and depressed mood were collected from both children and their parents. Hierarchical multiple regressions revealed that anger expression significantly predicted sadness but not aggression for females, after accounting for age and anger level. Among males, anger expression was important in predicting aggression but not sadness, whereas age and anger level best predicted sadness. These results suggest that age, anger level, and anger expression may be risk factors for depression and aggression among children and adolescents. Sex appears to be an important factor in anger expression styles and related depression and aggressive behavior.     

Gender differences in the social problem-solving performance of adolescents

Compared to other cognitive measures, social problem solving has received little attention in research on gender differences. In the present study, the Means-Ends Problem-Solving Procedure and the Personal Attributes Questionnaire (PAQ) were administered to 207 adolescents to examine social problem-solving skills as a function of subject gender, PAQ type, and gender of protagonist. Hypotheses were that superior problem solving would occur (a) for androgynous and masculine PAQ types and (b) when subject gender and/or PAQ type corresponded with protagonist gender. Results failed to corroborate these patterns, but indicated a clear overall advantage for females over males. A follow-up multiple-regression analysis showed this effect to be stable after controlling for English level. In a supplementary analysis, PAQ breakdowns were compared for the present sample and for one tested in a different region seven years earlier. Overall, the research findings imply that fewer adolescents today are likely to identify with traditional feminine roles, and that sex-related personality traits have, in general, a relatively limited impact on social problem-solving skills.     

Recognition of emotional facial expressions in depressed children and adolescents

Of the neurobiological models of children's and adolescents' depression, the neuropsychological one is considered here. Experimental and clinical evidence has allowed us to identify a lateralization of emotional functions from the very beginning of development, and a right hemisphere dominance for emotions is by now well-known. Many studies have also correlated depression with a right hemisphere dysfunction in patients of different ages. The aim of our study was to analyze recognition of different facial emotions by a group of depressed children and adolescents. Patients affected by Major Depressive Disorder recognized less fear in six fundamental emotions than a group of healthy controls, and Dysthymic subjects recognized less anger. The group of patients' failure to recognize negative-aroused facial expressions could indicate a subtle right hemisphere dysfunction in depressed children and adolescents.     

A data-based typology of depressed adolescents.

To develop a data-based classification of depressive adolescents, a face valid depression scale for adolescents was applied to MMPI protocols of 212 adolescent psychiatric patients of ages 12 to 18, to identify a depressive subsample which turned out to have 36 females and 10 males. Complete linkage cluster analysis was applied to this subsample and three hierachically organized depressive groups were obtained: "Restless" and "Socially Frustrated", which joined into a higher order group, and "Endogenous". Discriminant function analysis was applied for differentiating and cross-validating the obtained groups.     

Correlates of depressed mood in normal children

Two instruments which have been proposed as measures of clinical depression in children and an ad hoc teacher rating were given to a group of 109 normal children. The Children's Depression Inventory (CDI), the Peer Nomination Inventory for Depression (PNID), and a teacher rating of depression were given along with the Conner s Teacher Rating Scale (TRS), teacher ratings of somatic complaints, peer popularity, and absenteeism, and peer ratings of popularity to examine the behavioral correlates of depressed mood in normal children. While few sex differences were found on mean depression scores, different patterns of correlations were found for the two sexes. For males, there were no significant correlations among the three depression measures, but all three depression measures were correlated with unpopularity and conduct problem ratings on the TRS. For females, the three depression measures were adequately intercorrelated. The teacher rating of depression was correlated with general deviance as measured by the TRS, but the CDI and PNID were correlated with TRS ratings of conduct problems, with peer ratings of unpopularity, and with teacher ratings of somatic complaints. Implications for the issue of the possible existence of a clinical syndrome of depression in children were discussed.     

Secondary enuresis in institutionalized conduct-disordered children

The incidence of secondary enuresis in 16 institutionalized conduct-disordered children was examined. In contrast to a control group of 16 noninstitutionalized conduct-disordered children, the former showed significantly more enuretic behaviour. Also, enuresis began within 6 mo. of the children's separation from their families, suggesting this problem is very likely related to the emotional trauma surrounding the change in living conditions. However, the small number of subjects limits further interpretation of the findings.     

Social problem-solving skills in boys with conduct and oppositional defiant disorders

The current study compared the social problem-solving skills of a clinic-based sample of 30 boys diagnosed with conduct disorder (CD) and 25 boys diagnosed with oppositional defiant disorder (ODD). Past research has indicated that contextual factors influence children's social problem-solving; thus, three hypothetical conflict situations (i.e., child-child, teacher-child, and parent-child) and situations which differed by degree of negative intent of the provocateur (i.e., hostile vs. Ambiguous intent) were examined. Problem-solving strategies were aggregated into three broad dimensions: 1) aggressive/antisocial solutions; 2) nonverbal-nonaggressive solutions; and 3) verbal-nonaggressive solutions. Compared to ODD boys, CD boys proposed more aggressive/antisocial solutions in parent-child conflicts when parental intent was ambiguous and in teacher-child conflicts regardless of intent. Compared to ODD boys, CD boys proposed fewer verbal-nonaggressive solutions in child-child conflicts. The implications of these findings for treatment intervention with CD and ODD boys were discussed. Aggr. Behav. 23:457–469, 1997. © 1997 Wiley-Liss, Inc.     

Untangling developmental relations between depressed mood and delinquency in male adolescents

Relations between depressed mood and delinquency were investigated in a longitudinal sample of 506 urban adolescent males across ages 13.5–17.5, while adjusting for common risk factors. Adolescents provided yearly reports of their delinquent activities and depressed mood, as well as reports of peer delinquency at age 13.5 (i.e., baseline). Primary caregivers and teachers provided reports of risk factors for depressed mood and delinquency such as aggressive behavior problems and low academic achievement. Two-level hierarchical generalized linear models of concurrent relations indicated that depressed mood predicted concurrent variety of delinquent acts, and more variety of delinquent acts predicted concurrent depressed mood, even after controlling common risk factors. Longitudinal analyses indicated that after controlling for common risk factors, depressed mood had a more robust effect on delinquency variety trajectories than delinquency variety had on depressed mood trajectories. Time-averaged depressed mood significantly predicted a more positive rate of change in delinquency variety across time. Baseline delinquency variety predicted baseline depressed mood and time-averaged delinquency variety predicted a more positive rate of change in depressed mood; however, both effects were marginally significant. Implications of the results for theory and intervention are discussed.