Randomized Controlled Trial Testing the Effectiveness of a Depression Prevention Program (‘Op Volle Kracht’) Among Adolescent Girls with Elevated Depressive Symptoms

Depression rates rise dramatically from the early to late adolescence. Especially young adolescent girls with elevated depressive symptoms are at high risk for developing a depression during adolescence or adulthood. Therefore, the prevention of depression is important especially in this high-risk group. The aim of the present study was to examine the effectiveness of the Cognitive Behavioral Therapy (CBT) component of the depression prevention program ‘Op Volle Kracht’ (OVK) among Dutch adolescent girls with elevated depressive symptoms. In total, 102 adolescent girls (11–15 years) in the first and second year of secondary school participated in this study. The girls in the experimental group (n?=?50) followed the eight CBT-lessons of OVK and reported depressive symptoms 1 week prior to the start of the lessons, after every lesson, at one-month and 6-months follow-up. The girls in the control group (n?=?52) exclusively reported depressive symptoms at the same time points. Latent Growth Curve Modeling showed that the decrease in depressive symptoms was significantly larger for girls in the experimental group compared to the girls in the control group. Furthermore, it was found that at 6-months follow-up, the girls in the experimental group had significantly lower levels of depressive symptoms compared to the girls in the control group. These findings indicate that the CBT-component of OVK effectively reduces depressive symptoms in short term and possibly prevents the development of a clinical depression.     

Early Adolescent Growth in Depression and Conduct Problem Symptoms as Predictors of Later Substance Use Impairment

Most studies of adolescent substance use and psychological comorbidity have examined the contributions of conduct problems and depressive symptoms measured only at particular points-in-time. Yet, during adolescence, risk factors such as conduct problems and depression exist within a developmental context, and vary over time. Though internalizing and comorbid pathways to substance use have been theorized (Hussong et al. Psychology of Addictive Behaviors 25:390-404, 2011), the degree to which developmental increases in depressive symptoms and conduct problems elevate risk for substance use impairment among adolescents, in either an additive or potentially a synergistic fashion, is unclear. Using a school-based sample of 521 adolescents, we tested additive and synergistic influences of changes in depressive symptoms and conduct problems from 6th to 9th grade using parallel process growth curve modeling with latent interactions in the prediction of late adolescent (12th grade) substance use impairment, while examining gender as a moderator. We found that the interaction between growth in depression and conduct disorder symptoms uniquely predicted later substance use problems, in addition to main effects of each, across boys and girls. Results indicated that adolescents whose parents reported increases in both depression and conduct disorder symptoms from 6th to 9th grade reported the most substance use-related impairment in 12th grade. The current study demonstrates that patterns of depression and conduct problems (e.g., growth vs. decreasing) are likely more important than the static levels at any particular point-in-time in relation to substance use risk.     

Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms

This study examined the role of both pubertal and social transitions in the emergence of gender differences in depressive symptoms during adolescence. This study generated the following findings: (a) Gender differences in depressive symptoms emerged during 8th grade and remained significant through 12th grade. (b) Pubertal status in 7th grade was related to adolescent depressive symptoms over time. (c) Early-maturing girls represented the group with the highest rate of depressive symptoms. (d) Depressive symptoms measured in 7th grade predicted subsequent symptom levels throughout the secondary school years. (e) Recent stressful life events were associated with increased depressive symptoms. (f) Early-maturing girls with higher levels of initial symptoms and more recent stressful life events were most likely to be depressed subsequently. The findings demonstrate the importance of the interaction between the pubertal transition and psychosocial factors in increasing adolescent vulnerability to depressive experiences.     

Reciprocal Associations Between Depressive Symptoms and Disordered Eating Among Adolescent Girls and Boys: A Multiwave,Prospective Study

Symptoms of depression and eating disorders increase during adolescence, particularly among girls, and they tend to co-occur. Despite this evidence, there is meager research on whether depression increases the risk of future eating pathology, or vice versa, and we do not know whether these processes are different for adolescent girls and boys. Accordingly, this study explored the prospective reciprocal associations between depressive symptoms and disordered eating at different time points from preadolescence to mid-adolescence and tested the moderator effect of gender on these associations. A community-based sample of Spanish youth (N?=?942, 49 % female) was assessed at ages of approximately 10-11 (T1), 12-13 (T2), 14-15 (T3), and 16-17 (T4) years. The bidirectional relationships between depressive symptoms and disordered eating were estimated in an autoregressive cross-lagged model with latent variables. A unidirectional, age-specific association between depressive symptoms at T1 and disordered eating at T2 was found. No other significant cross-lagged effect emerged, but the stability of the constructs was considerable. Gender did not moderate any of the links examined. Regardless of gender, the transition from childhood to adolescence appears to be a key period when depressive symptoms foster the development of disordered eating. These findings suggest that early prevention and treatment of depression targeting both girls and boys may result in lower levels of depressive symptoms and disordered eating in adolescence.     

Pathways From Depressive Symptoms to Low Social Status

This research examined two pathways through which depressive symptoms contribute to low social status (i.e., neglect and rejection) within the peer group over time: (a) depressive symptoms promote socially helpless behavior and consequent neglect by peers; and (b) depressive symptoms promote aggressive behavior and consequent rejection by peers. These pathways were investigated in independent samples of youth at two developmental stages: middle childhood (2nd–4th grade) and early adolescence (5th–7th grade). In both Study 1 (M age?=?7.97, SD?=?0.37; 338 girls, 298 boys) and Study 2 (M age?=?11.74, SD?=?0.68; 305 girls, 300 boys), youth and their teachers completed questionnaires at three waves. Multi-group comparison path analyses were conducted to examine sex differences in the models. Consistent with expectations, two pathways emerged through which depressive symptoms undermined subsequent social status. Support was not found for the reverse direction of effect nor for developmental or sex differences in the pathways with one exception: In early adolescence, neglect directly predicted depressive symptoms. These findings suggest specificity but also heterogeneity in the effects of depressive symptoms on social status, and identify behaviors that may be targeted for preventing the persistence of depression and its interpersonal consequences.     

Le modèle diathèse–stress de la dépression appliqué à une population d’adolescents

This study evaluates the applicability of the depression diathesis-stress theoretical model to an adolescent group. The mediatory and moderating functions of two types of cognitions, (dysfunctional attitudes and automatic negative thoughts) on the relationship between stressful negative life events and depressive symptoms was studied. Research hypotheses made it possible to verify if an individual that shows cognitive vulnerability towards a stressful negative event also shows more risks at developing depressive symptoms. The study was conducted on a sample of 752 participants from 4th, 3rd and 2nd grade, 55% of which were girls and 45% were boys. The study was carried out for 12 months in four Quebec high schools in Canada. The results showed that automatic negative thoughts are partly mediatory in the relationship between stress and depressive symptoms, among girls as well as boys. As for dysfunctional attitudes, the interaction effect between the autonomy schema and performance stress, as well as the interaction effect between the sociotropy schema and relational stress, predicted depressive symptoms only among boys.     

Prospective relations between social support and depression: differential direction of effects for parent and peer support?

The authors tested whether deficits in perceived social support predicted subsequent increases in depression and whether depression predicted subsequent decreases in social support with longitudinal data from adolescent girls (N = 496). Deficits in parental support but not peer support predicted future increases in depressive symptoms and onset of major depression. In contrast, initial depressive symptoms and major depression predicted future decreases in peer support but not parental support. Results are consistent with the theory that support decreases the risk for depression but suggest that this effect may be specific to parental support during early adolescence. Results are also consonant with the claim that depression promotes support erosion but imply that this effect may only occur with peer support during this period.     

Stress,sense of coherence and emotional symptoms in adolescents

This paper aims to investigate the association between the domains of stress, sense of coherence (SOC) and emotional symptoms (depression and anxiety) in adolescents, as well as the potential moderating role of SOC on the relationship between stress and emotional symptoms. The study is based on a cross-sectional sample of 1183 adolescents aged 13–18 who attend public elementary and secondary schools in Mid-Norway. The results showed that girls scored higher than boys on stress related to peer pressure, home life, school performance, school/leisure conflict and emotional symptoms. Conversely, boys reported higher SOC than girls. Results from multiple hierarchical regression analyses showed that for boys, stress related to school performance was positively associated with symptoms of both depression and anxiety, whereas stress from peer pressure was associated with depressive symptoms. For girls, stress from peer pressure, romantic relationships and school was associated with more depressive symptoms. SOC was strongly and inversely associated with emotional symptoms, especially anxiety in girls. SOC also moderated the association between stress related to peer pressure and depressive symptoms in both genders. The study provides evidence of the association of SOC with stress and emotional symptoms during adolescence.     

Preliminary examination of sex differences in depressive symptoms among adolescent psychiatric inpatients: the role of anxious symptoms and generalized negative affect.

Assessed the emerging view that generalized negative affect and anxious symptoms are important in understanding sex differences in depressive symptoms. Sixty-three adolescent psychiatric inpatients (32 boys, 31 girls), ages 12 to 16 (M = 13.87, SD = 1.36), completed measures of positive and negative affect and anxious and depressive symptoms. Results demonstrated, as predicted, that depressive and anxious symptoms were more highly associated in adolescent girls than boys. Furthermore, girls with depressive symptoms were more likely to have comorbid anxious symptoms than boys with depressive symptoms. Sex differences were not found for adolescents with specific depressive symptoms and specific anxious symptoms (i.e., the absence of comorbidity). Our findings supported the possibility that sex differences in pure forms of depression are overestimated and that comorbid internalizing conditions may be more prevalent in adolescent girls than boys.     

Girls�� and Boys�� Disclosure about Problems as a Predictor of Changes in Depressive Symptoms Over Time

Gender differences consistently emerge in adolescents?? friendships, with girls disclosing to friends about troubles and concerns more than boys. Although theories regarding possible emotional benefits of catharsis, as well as everyday assumptions, suggest that talking about problems makes people feel better, research regarding the impact of disclosure about problems on depressive symptoms has not been conclusive. In the current study, 79 early adolescent high school students residing in the Southeastern United States (73% European American) were observed talking about problems with a friend. Of primary interest was whether disclosure to friends predicted changes in self-reported depression over 6 months for girls and boys. Although girls disclosed to friends about problems (especially interpersonal problems) more than did boys, disclosure did not buffer girls from the development of depressive symptoms over time. In contrast, boys?? disclosure predicted their experiencing fewer depressive symptoms 6 months later. Results suggest that talking to friends may not be an especially effective method of coping with problems for girls.     

Maternal Prenatal Stress and Other Developmental Risk Factors for Adolescent Depression: Spotlight on Sex Differences

Maternal stress during pregnancy has been linked to premorbid abnormalities associated with depression (e.g., difficult temperament, cognitive deficits) in offspring. However, few studies have looked across developmental periods to examine maternal stress during pregnancy and offspring depression during adolescence and whether these associations differ by sex. The current study used data from 1711 mother-offspring dyads (offspring sex: 49.8% male) in a longitudinal birth cohort study. Maternal narratives collected during pregnancy were qualitatively coded for stress-related themes by independent raters. Latent class analysis (LCA) identified distinct subgroups of offspring based on exposure to maternal prenatal stress and other developmental factors from the prenatal, childhood, and adolescent periods that have been associated with depression and/or maternal prenatal stress. LCA identified subgroups that were compared to determine whether and to what extent they differed on adolescent depressive symptoms. LCA revealed a subgroup of “high-risk” individuals, characterized by maternal factors during pregnancy (higher ambivalence/negativity and lower positivity towards the pregnancy, higher levels of hassles, lower maternal education and higher maternal age at birth, higher pre-pregnancy BMI) and offspring developmental factors (decreased cognitive functioning during childhood and adolescence, lower perceived parental support during adolescence, and higher levels of maternal depression during adolescence). High-risk females exhibited elevated conduct symptoms and higher birth order, while high-risk males exhibited decreased internalizing symptoms and lower birth order. Both high-risk males and females reported elevated depressive symptoms during adolescence relative to their “low-risk” counterparts.     

Academic, motivational, and emotional correlates of adolescent dating

This study is an examination of the relationship between dating status and academic achievement, academic motivation, depression, and self-esteem; it is an investigation of the differential effects wielded by gender and age (grade level) of the dating adolescent in each of these domains. Participants were a relatively large gender-balanced adolescent group (N = 380) from Grades 8, 10, and 12. Dating status was studied first as a binary variable (frequent versus infrequent dating) and second as a dating spectrum, including steady, frequent, and infrequent dating. Results showed that adolescents who dated frequently (more than once or twice a month), whether they were boys or girls, relatively young (8th grade) or more mature (l0th and 12th grades), exhibited consistently and significantly lower levels of academic achievement and academic motivation and higher levels of depressive symptoms. There were no significant effects of dating status on global self-esteem, but, as hypothesized, subscale analyses revealed important subscale-differentiated effects.     

Developmental epidemiologically based preventive trials: Baseline modeling of early target behaviors and depressive symptoms

Describes a conceptual framework for identifying and targeting developmental antecedents in early childhood that have been shown in previous work to predict delinquency and violent behavior, heavy drug use, depression, and other psychiatric symptoms and possibly disorders in late adolescence and into adulthood. Criteria are described that guided choices of targets for two epidemiologically based, randomized preventive trials carried out in 19 elementary schools in the eastern half of Baltimore, involving more than 2,400 first-grade children over the course of first and second grades. Baseline models derived from the first of two cohorts show the evolving patterns of concurrence among the target antecedents. The central role of concentration problems emerged. From Fall to Spring in first grade, concentration problems led to shy and aggressive behavior and poor achievement in both genders and to depressive symptoms among girls. There was evidence for reciprocal relationships in girls. For example, depressive symptoms led to poor achievement in both girls and boys, whereas poor achievement led to depressive symptoms in girls but not boys, at least over the first-grade year. These results provide important epidemiological data relevant to the developmental paths leading to the problem outcomes and suggest preventive trials.     

Reciprocal, Longitudinal Associations Among Adolescents' Negative Feedback-Seeking, Depressive Symptoms, and Peer Relations

This study examined reciprocal associations among adolescents' negative feedback-seeking, depressive symptoms, perceptions of friendship quality, and peer-reported social preference over an 11-month period. A total of 478 adolescents in grades 6–8 completed measures of negative feedback-seeking, depressive symptoms, friendship quality, global-self-esteem, and social anxiety at two time points. Peer-reported measures of peer status were collected using a sociometric procedure. Consistent with hypotheses, path analyses results suggested that negative feedback-seeking was associated longitudinally with depressive symptoms and perceptions of friendship criticism in girls and with lower social preference scores in boys; however, depressive symptoms were not associated longitudinally with negative feedback-seeking. Implications for interpersonal models of adolescent depression are discussed.     

Latent growth modeling of the relationship between depressive symptoms and substance use during adolescence.

To explicate the nature of the relationship between depressive symptoms and substance use, the authors conducted research that incorporated both individual and group approaches and utilized longitudinal data across development. Multiple-group latent growth curve models were used to assess specific dimensions (cross-sectional and longitudinal correlation, within-individual change, and movement off developmental trajectories) of the relationship between depressive symptoms and substance use during adolescence and how this relationship differs by gender. Annual survey data from 8th through 11th grade were provided by 441 girls and 510 boys in the Raising Healthy Children project (E. C. Brown, R. F. Catalano, C. B. Fleming, K. P. Haggerty, & R. D. Abbott, 2005). Levels of depressive symptoms and substance use in early adolescence were positively associated for alcohol, marijuana, and cigarette use for girls, but only for marijuana use for boys. Individual changes in depressive symptoms and substance use across adolescence were positively associated for each type of substance use. Evidence was also found for positive association between episodic expressions of depressive symptoms and alcohol use that fell outside developmental trajectories. Predictive relationships across constructs were not found, with the exception of higher level of depressive symptoms in early adolescence predicting less increase in alcohol use.     

A multimethod examination of the stability of depressive symptoms in childhood and adolescence

In an 8-wave, 2-cohort longitudinal study, children and adolescents were followed from the fall of 5th grade to the spring of 8th grade. Participants (N = 1,269), their parents, and peers completed reports of depressive symptoms at 6-month intervals. The use of a 2-group latent variable autoregressive model to examine the stability of depressive symptomatology revealed several trends. First, the 6-month stability of depressive symptoms was high for boys and girls. Second, the stability of depressive symptomatology was lower between the spring of 6th grade and the fall of 7th grade than during any other point in the study. Finally, the stability of depressive symptoms did not differ with respect to gender.     

DRD2基因TaqIA多态性与同伴侵害对青少年早期抑郁的交互作用

本研究运用问卷法与DNA分型技术,对1063名青少年(初次测评年龄为12.32±0.47岁,50.3%女生)进行间隔2年的追踪调查,考察DRD2基因TaqIA多态性与同伴身体侵害和关系侵害对青少年早期抑郁的交互作用及其性别差异。结果发现,TaqIA多态性与身体侵害、关系侵害均对男青少年抑郁存在显著的交互作用。在携带A2A2基因型的男生中,身体侵害和关系侵害可以显著正向预测其抑郁水平,而在携带A1等位基因的男生中,同伴侵害对抑郁无预测作用。此外,TaqIA多态性与身体侵害、关系侵害对女生抑郁均无显著交互作用。研究结果提示,同伴侵害是一种重要的候选环境指标,与TaqIA多态性交互影响青少年早期抑郁,并且性别在这一基因×环境交互作用中起到重要的调节效应。     

Body-image and eating disturbances predict onset of depression among female adolescents: a longitudinal study

This study examined data from a 4-year school-based longitudinal study (n = 1,124), to test whether the increase in major depression that occurs among girls during adolescence may be partially explained by the body-image and eating disturbances that emerge after puberty. Elevated body dissatisfaction, dietary restraint, and bulimic symptoms at study entry predicted onset of subsequent depression among initially nondepressed youth in bivariate analyses controlling for initial depressive symptoms. Although the unique effect for body dissatisfaction was not significant in the multivariate model, this set of risk factors was able to fairly accurately foretell which girls would go on to develop major depression. Results were consistent with the assertion that the body-image- and eating-related risk factors that emerge after puberty might contribute to the elevated rates of depression for adolescent girls.     

5-HTTLPR X Stress in Adolescent Depression: Moderation by MAOA and Gender

Depression surges in adolescence, especially among girls. Most evidence indicates that the short allele of a polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) interacts with stress to influence the onset of depression. This effect appears to be less robust in adolescents, particularly among boys, and may be moderated by other genetic polymorphisms. Seeking to explain the adolescent gender difference in depression, this study examined the effects of 5-HTTLPR (rs25531), the monoamine oxidase A-upstream variable number tandem repeat (MAOA-uVNTR), and negative life events (NLE). A community-based longitudinal sample of 309 adolescents reported depressive symptoms and NLE at ages 11, 13, and 15. 5-HTTLPR and MAOA-uVNTR genotypes were ascertained via buccal swabs. A significant four-way interaction of 5-HTTLPR, MAOA-uVNTR, NLE at age 13, and gender predicted depressive symptoms at age 15. Girls were most likely to exhibit elevated depressive symptoms when experiencing NLE if they possessed low-expression MAOA-uVNTR alleles and short 5-HTTLPR alleles, whereas low-expression MAOA-uVNTR alleles but long 5-HTTLPR alleles were implicated in boys. The results indicate that the commonly reported 5-HTTLPR by stress interaction for depression may be limited to individuals with low-expression MAOA-uVNTR alleles. These data also provide new evidence that the short allele of 5-HTTLPR confers susceptibility to stress differently for females compared with males.     

The Interaction Between Pubertal Timing and Peer Popularity for Boys and Girls: An Integration of Biological and Interpersonal Perspectives on Adolescent Depression

The transition to adolescence marks a time of sharply increased vulnerability to the development of depression, particularly among girls. Past research has examined isolated risk factors from individual theoretical models (e.g., biological, interpersonal, and cognitive) of depression, but few have examined integrative models. This study investigated the conjoint effects of early pubertal timing and popularity in the longitudinal prediction of depressive symptoms. A total of 319 girls and 294 boys (ages 11–14) provided information on their pubertal status, depressive symptoms, and the social status (i.e., popularity) of their peers. Adolescents completed a second measure of depressive symptoms 11 months after the initial time point. Findings supported an integrated biological-interpersonal model in explaining the development of depressive symptoms during adolescence. Early pubertal development was associated with increase in depressive symptoms only when accompanied by low levels of popularity. High levels of popularity buffered the association between early pubertal development and later depressive symptoms. Unexpectedly, these results were significant both for girls and boys. Results are discussed in terms of dynamic systems theories.