This dissertation investigates the social nature of the gender difference in teen depression by studying its association with social integration at the institutional, group, and personal levels. Taking a developmentally appropriate approach to social integration, I focus on fit within the normative high school context, friendship group position, and involvement in romantic relationships. Based on a conceptual model derived from the strong theoretical assumptions of past literature, the starting point of this research is that the depression of girls, compared to boys, will be more reactive to social integration in positive and negative ways (social integration is conceptualized as a moderator). However, competing viewpoints are also considered to determine whether this traditional assumption masks greater reactivity for boys at these three distinct levels. The quantitative analyses utilize Waves I and II of the National Longitudinal Study of Adolescent Health (Add Health). Results indicate that boys are actually more reactive to a lack of social integration into the normative context of the school. Boys and girls' depression is equally sensitive to integration within the friendship group. Additionally, girls' depression is more reactive to aspects of romantic relationship break-ups. To better explain the gender differences in teen depression, in-depth interviews of students from an Austin Independent School District high school are analyzed to identify the social and psychological mechanisms through which the elements of social integration are associated with depression. Qualitative results support key elements of the proposed conceptual model indicating social comparison and social feedback as the main mechanisms through which social integration is associated with psychological well-being for girls and boys, respectively. / text

The majority of adolescents diagnosed with Major Depressive Disorder (MDD) and admitted to a psychiatric hospital in Gauteng complained of being tired of 1'talk therapy" . This study used imagery as a technique in the treatment of two adolescents suffering from MDD. The initial identification was based on the results of the Beck Depression Inventory (BDI). After a number of sessions of implementing imagery techniques, the BDI was readministered. To determine the long-term effectiveness of imagery, the BDI was again administered a month-and-a-half after completion of the sessions. The results before and after indicate a reduction in the severity of depression. The results at the month-and-a-half follow-up session indicated a further reduction in the level of depression in both cases. This indicates the long-tenn effectiveness of imagery in treating depression. Further research is required, but there are significant indications that imagery may be an effective technique in the treatment of depressed adolescents under psychiatric supervision. / Educational studies / M.Ed (Guidance and Counseling)

This thesis is an investigation of social problem-solving skills, psychological distress, and supportive relationships among three distinct samples. The research groups comprise a) 25 depressed inpatients and a matched comparison group; b) 50 hospital admissions following an act of suicidal behaviour; and c) 5 sub-groups of incarcerated young offenders (inmates on Strict Suicidal Supervision, inmates on protection, victims of bullying, identified bullies, comparison group) with 25 inmates in each group. Data was collected by structured interviews, standardised psychometric measures of mood states (e.g. Hospital Anxiety and Depression Scale, Beck Hopelessness Scale), problem-solving ability (e.g. Means-Ends Problem-Solving Procedure) and supportive relationships (e.g. Significant Others Scale). Data were analysed by means of parametric statistical techniques (e.g. analyses of variance and multiple regression analyses). Eight cross-sectional studies are reported. Depressed patients demonstrated problem-solving difficulties, which were related to the level of psychological distress experienced. Clinically depressed patients were also found to differ from a comparison group in their autobiographical memory recall and concentration ability - both of which were related to their impoverished problem-solving ability. Deficits in problem-solving ability in the depressed patients were not an artefact of their verbal IQ. Regression analyses of the data relating to suicidal community inpatients illustrated that social support variables were the prime predictors of suicidal intent, depression and hopelessness. Social problem-solving variables also emerged as significant predictors of psychological distress, albeit to a lesser extent. Social support and problem-solving variables were also important moderator variables in the relationship between stress and suicidality. The studies conducted with young offenders illustrated a hierarchy of problem-solving deficits and psychological distress among the inmate groups. Problem-solving ability was not an artefact of verbal IQ. The value of using problem-solving interventions with vulnerable offenders is discussed. The importance of prison relationships in the experience of stress by inmates was also highlighted. Similarly, parental relationships were related to the levels of distress experienced while incarcerated. The results of each study are discussed in relation to the relevant literature, practical implications for clinical interventions with each group, and suggestions for future research. The findings of the thesis are discussed in relationship to transactional, stress-hopelessness-distress models of psychological illness and distress.

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

Adolescence is a developmental period during which boys and girls are at high risk of developing major or minor depression. Increases in fitness have been associated with lower levels of depressive symptomatology and improvements in psychological well-being, yet the mechanisms that underlie this relationship have not been thoroughly examined. Three such psychosocial variables (i.e. body satisfaction, social physique anxiety, and physical activity self-efficacy) have been identified as possible mechanisms and although they have theoretical support, additional research is needed to demonstrate empirically the potential effects of these variables. Self-report measures were used to assess the psychosocial variables and the Progressive Aerobic Cardiovascular Endurance Run (PACER) in conjunction with age, Body Mass Index [BMI], and sex was used to determine an estimate of aerobic capacity (VO2max). Path analyses were used to test the proposed model using version 6.2 EQS Multivariate Software. Results of study revealed that the boys’ and girls’ depressive scores were determined based on the extent that their fitness levels improved their satisfaction with their bodies and lowered the anxiety they experience in relation to real or imagined judgments of their physique. Although all pathways in the model were significant, with the exception of physical activity self-efficacy to depression, differences emerged between the boys and girls in terms of the strength of some of the relations amongst the variables. Limitations include restricted generalizability, self-report measures, and cross-sectional design. Results have implications for individuals in a context intended to improve physical and psychosocial well-being of adolescents.

by Cola S.L. Lo. / Includes questionarires in Chinese. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1994. / Includes bibliographical references (leaves 62-79). / ABSTRACT --- p.ii / ACKNOWLEDGEMENTS --- p.iv / TABLE OF CONTENTS --- p.v / LIST OF TABLES --- p.vi / LIST OF APPENDICES --- p.vii / Chapter CHAPTER I - --- LITERATURE REVIEW AND RATIONALE / The relation between self-report anxiety and depression --- p.1 / Mood Dimensions: Negative and Positive Affectivity Model --- p.5 / Personality Dimensions: Neuroticism and Extraversion --- p.11 / Structural convergence of Affective and Personality Dimensions --- p.13 / Rationale and hypotheses of the present study --- p.16 / Chapter CHAPTER II - --- METHOD / Subjects --- p.19 / Instruments --- p.19 / Procedure --- p.25 / Chapter CHAPTER III - --- RESULTS / Instrument reliabilities --- p.26 / "Mean and standard deviation of the symptoms, emotionality and personality measures" --- p.28 / "Correlations of the symptoms, emotionality and personality measures" --- p.30 / Canonical Correlation Analyses --- p.35 / Hierarchical Regression Analyses --- p.41 / Chapter CHAPTER IV - --- DISCUSSION --- p.51 / REFERENCES --- p.62 / APPENDICES --- p.80

Depressed mood is one of the most common of all psychiatric symptoms occurring in children and adolescents. Population studies suggest a point prevalence of between 10 to 15% of children and adolescents having symptoms of depression. Further, depressed adolescents are also significantly more apt to demonstrate suicidal ideation accompanied by a concomitant sense of helplessness and hopelessness. The overall aim of the study was to identify and characterize profiles of depression and suicidal behavior within the adolescents of the USA in the past 10 years. This study utilized epidemiological, cross-sectional, data from the Youth Risk Behavior Surveillance System (YRBSS), a biennial census that monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth. Latent classes of the indicators were generated utilizing latent class regression modeling. Predictors were then regressed on class membership in a multinomial logistic regression simultaneously to assess significance. Finally, a juxtaposition of the profiles and significant predictors followed to allow for observation of differences in number of profiles and other qualities (i.e., proportions of sample in each class, etc.) as well as to visualize and note “carryover” predictors across the past 10 years. Findings revealed a relatively stable pattern of profiles and predictors over the years with the exception of 2015. In the analysis of demographic variables, membership of the “low- risk non-depressed” class was consistently or more frequently associated with being male, older, not of an ethnic minority, and non-ethnically bi-or multiracial, across all time points. Three clusters of behaviors and factors emerged as significant predictors of depressed mood and suicidality. The first cluster consisted of typical adolescent risk behaviors that includes delinquent behaviors (i.e., fight, weapon carrying, or use of over-the-counter drugs), smoking, alcohol use, as well as consensual (non-violent) sexual activity. The second cluster of predictors that was significant consisted of experiences of traumatic events such as bullying, sexual assault, and intimate partner violence. Finally, a third cluster that showed significance consisted of self destructive behavior such as the use of illicit or hard drugs and maladaptive dieting, restricting or purging behavior. Several protective factors such as having sufficient physical activity and getting at least 8 hours of sleep daily also emerged as significant. Limitations to the YRBS and this study were discussed, and recommendations that tie to the implications of the findings were proposed. Future directions for research were also presented in light of the limitations of the study.

Background: Dissemination of evidence-based mental health clinical practice guidelines had not been studied in Australia prior to the National General Practice Guideline Implementation Program. This naturalistic research reports ten national interventions designed to disseminate the NHMRC 1997 Clinical Practice Guideline Depression in Young People for GPs (GDIYP-GP) through 123 Divisions of General Practice. The guideline covered depression and suicide in young people aged 13 to 20 years. Aim: To evaluate a 'coordinated link agent' and 'enhanced packaged approach' for disseminating a national guideline by engaging 20 Divisions in using 5 dissemination models and to measure Divisions' capacities in performing unfunded local dissemination to GPs. Method: An Implementation Kit was the main national intervention, housing the guidelines and 5 models: Education by the Division; Education by an external provider; 3) Clinical Audit; 4) Segmented Formats and 5) Appraisal. Five studies are reported: 1) an organisational census on guideline-related practices in all topics; 2) a Case Study Database of 3 consecutive interviews of 51 participating Divisions; 3) a Guideline Appraisal study of 9 cohorts of doctors; 4) a Clinical Audit study of 54 doctors involving 1200 patients; and 5) a 'Segmented Formats' documentary analysis of Division communications on GDIYP-GP. Results: Prior dissemination by most Divisions was administrative mail outs rather than planned programs. In all, 70 instead of the pilot 20 organisations participated (57% of the sector) using 10,000 guidelines: 45 participated by 7 weeks and 71 by 35 weeks and the majority used multiple active strategies showing fidelity to the Kit. Education by the Division, Segmented Formats and Appraisal were the most adopted models. GDIYP-GP was acceptable and relevant to the majority of Divisions and to 9 samples of doctors. Conclusion: Divisions are one appropriate system through which evidence-based mental health guidelines can be disseminated to general practitioners. Uptake can be rapid using a flexible enhanced package approach with link-agent support. 3-6 months is needed for organisations to begin effective interventions. Divisions reorient their approach with guidance toward evidence-based dissemination but Division and practice barriers

This study explores the intrapersonal and interpersonal ecological factors that influence adolescent females' perceptions of sex and the extent to which their perceptions of sex impact onset of sexual intercourse as they mature. Particular attention is given to how depression influences individual, personal and social factors in an adolescent female's life, to shape her attitudes towards sex, and determine her engagement in sex as she reaches young adulthood. Ecological Systems Theory is used to examine the extent to which individual, family, and social factors impact adolescent females' perceptions of sex and onset of sexual intercourse. Data are from the National Longitudinal Study of Adolescent Health. Multinomial logistic regression reveals that the factors associated with less positive perceptions of sex are age, self-esteem, sexual intercourse, religiosity and connection to mother and peers, as well as, depression in combination with religiosity and connection to one's peers. More positive perceptions of sex are linked with depression, connection to one's school, as well as, depression in conjunction with aging and sexual intercourse. Results from the logistic regression analysis determines that less positive perceptions of sex delay onset of sexual intercourse among adolescent females; however, adolescent females' attitudes towards sex vary greatly in determining onset of sexual intercourse as they mature. Furthermore, there is no association between depression and adolescent females' perceptions of sex in predicting onset of sexual intercourse as they progress into young adulthood. The findings from this study suggest that programs focused on shaping attitudes toward sex should assist young women in forming a definite opinion about their decision to have sexual intercourse or abstain from engagement in sexual intercourse. A female's age, sense of self-worth, emotional state, and religiosity as well as the strength of her relationships with parents, peers and school must be considered when addressing her sexual health. This investigation supports the use of Ecological Systems Theory as a useful theoretical framework for examining the factors that influence adolescent females' perceptions of sex and engagement in sexual intercourse. A more cognitive investigation of the relationship between depression and the factors in an adolescent female's life that influence her attitudes towards sex and how depression affects an adolescent female's perception of sex and her decision to engage in sexual intercourse is warranted as this study finds only minor support for the use of Ecological Systems Theory when exploring the association between depression and adolescent female sexual health. / Graduation date: 2006