Improving treatment for early adolescent girls with depression by understanding factors that promote the maintenance of treatment effects is an important area of research given the association of depression with functional impairment and negative future outcomes. The effectiveness of CBT for treating depressed youth in the short-term has been well-established. However, limited research exists on the impact of CBT beyond one year post-treatment and on factors that enhance treatment maintenance for children and adolescents with depression. An intervention strategy that may yield the maintenance of treatment effects is the inclusion of primary caregivers. However, there is presently insufficient evidence to ascertain whether including primary caregivers in girls’ depression treatment produces additional benefits because they have rarely been incorporated into clinical trials of depression treatment for youth. This approach warrants study since families of depressed youngsters are often characterized by disturbances in family functioning and because aspects of the family environment are related to the development and maintenance of depressive disorders in youth. The current study addressed gaps in the existing literature about the maintenance of treatment effects for girls with depression by examining the impact of a parent training (PT) component added to a school-based, group-administered CBT intervention on girls’ depressive symptoms and key areas of family functioning (i.e., conflict, cohesion, communication, and family sociability). Participants included 9- to 14-year-old girls with a depressive disorder, one primary caregiver for each girl who completed measures, and caregivers in the parental treatment component. Girls were randomly assigned to a CBT, CBT+PT, or minimal contact control condition. Ratings of girls’ depressive symptoms and the family functioning variables were obtained from girls and primary caregivers at pre-treatment, post-treatment, and annually for up to four years following treatment. Results from growth curve modeling using hierarchical linear models indicated no significant differences in rate of change of girls’ depressive symptoms over time depending on whether they were in the CBT or CBT+PT condition. However, subsequent analyses revealed two significant factors associated with treatment maintenance: child attendance at CBT meetings and parental attendance at PT meetings. Specifically, higher rates of child and parental attendance were generally predictive of a sustained decline in girls’ depressive symptoms over time. In addition, findings supported the positive impact of CBT with PT on aspects of the family environment from pre- to post-treatment, but not from post-treatment through the four years of follow-up assessment. Implications, limitations, and recommendations for further areas of research are discussed. / text

AFRIKAANS: In hierdie studie is die rol van massa-toename in die vroeë-adolessente dogter se belewenis van die self bestudeer. Aspekte uit die literatuur wat ’n betekenisvolle bydrae tot die grondslag van die studie gelê het, is die volgende: • die rol wat massa speel in die vroeë-adolessente dogter se belewenis van die self en die implikasies daarvan op haar kledinggedrag • die rol van ander in die vroeë-adolessente dogter se belewenis van die self en die implikasies daarvan op haar kledinggedrag • die strategieë wat die vroeë-adolessente dogter gebruik om die self in hierdie ontwikkelingsfase te kan handhaaf en die implikasies daarvan op haar kledinggedrag. Die steekproef is saamgestel uit 16 blanke vroeë-adolessente dogters tussen die ouderdom van 11 en 13 jaar, wat in ’n stedelike gebied woonagtig was. ’n Kwalitatiewe navorsingsmetodologie is vir die studie gevolg met ongestruktureerde onderhoude, fokusgroepe en persoonlike dokumentasie wat ook verskeie stimulustegnieke ingesluit het. Verbatim transkripsies van die onderhoude sowel as bekrywings van die onderhoudsituasies is gebruik vir die bespreking en interpretasie van die resultate. Dit is gedoen met inagneming van die breë navorsingsvrae wat die studie gerig het. Vroeë-adolessente dogters ervaar massa-toename verskillend: • Die normale-massa vroeë-adolessente dogter ervaar dat sy deur die fase van ingrypende veranderinge, wat massa-toename insluit, eintlik vet word. Sy is konstant besig met selfmonitering; die self word ’n objek van evaluering. Sy ervaar die emosie van skaamte en poog om haar liggaam te bedek vir ander wat haar voortdurend dophou. • Aan die ander kant beleef die oormassa vroeë-adolessente dogter die ontwikkelingsfase meer ontspanne en is sy nie so bewus van haar liggaam en dit wat ander daarvan sê nie. Sy gee voor om nie so begaan te wees oor die oormassa nie, deur ander te blameer vir die situasie en vir haar voorkoms. Sy blameer selfs vir God dat Hy haar so geskep het. Sy ervaar die emosie van hartseer en deur voor te gee dat sy nie oor die situasie bekommerd is nie, hanteer sy slegs die emosie en nie die situasie nie. • Aan die einde blyk dit egter dat normale-massa en oormassa vroeë-adolessente dogters dieselfde belewenis van die self in die oorgangsfase het. Hulle voel hartseer oor die verlore kinderjare en ervaar dat hulle minder tyd het om te speel maar meer verantwoordelikhede moet dra. Die studie het die volgende bydrae gelewer: • ’n Lewensverloop- en simboliese interaksionistiese perspektief kan as geskik beskou word vir ’n studie waarin ’n ontwikkelingsfase soos vroeë adolessensie ter sprake kom. • Dit blyk dat die vroeë-adolessente dogter in die studie werklik bekommerd is oor haar voorkoms en dit wat ander van haar dink. • Dit blyk ook dat die vroeë-adolessente dogter in hierdie studie, kleding gebruik om haar voorkoms so te bestuur dat dit aan die norm van ideale liggaamsbou wat in die media voorgehou word, kan voldoen, en dat dit haar kan ondersteun in die aanneem van ‘n volwasse vroulike geslagsrol. • Dit blyk dat die normale-massa vroeë-adolessente dogter van probleem-gefokusde handhawingstrategieë gebruik maak soos bedek, wegsteek of self-manipulering van die liggaam. • Die oormassa vroeë-adolessente dogter daarenteë maak van meer emosioneel gefokusde handhawingstrategieë gebruik soos ontkenning, vermyding, kognitiewe her-ontwerp en godsdiens. Die volgende aanbevelings kan gemaak word: • Die kwalitatiewe navorsingstyl kan meer dikwels gebruik word in studies met jonger deelnemers. • Kledingkundiges behoort dit in gedagte te hou dat veral die pas van klere vir die vroeë-adolessente dogter belangrik is en dat kleding wat die liggaam ontbloot, of styf aan die liggaam pas, die liggaam benadruk en die dogter ongemaklik en skaam laat voel. • Daar behoort ook begrip te wees vir die feit dat dit vir die vroeë-adolessente dogter nou belangrik is om met verskillende voorkomsstyle te eksperimenteer ten einde ‘n voorkoms te vind wat nie net by haar veranderde liggaam pas nie, maar ook by die nuwe rol wat sy nou moet aanneem. Daar moet in gedagte gehou word dat die studie uitgevoer is met ’n beperkte aantal deelnemers en daarom kan die gevolgtrekking nie na die breë populasie veralgemeen word nie; dit het slegs betrekking op die 16 deelnemers wat met die toestemming van hul ouers aan die studie deelgeneem het. ENGLISH: In this study the role of weight gain in the early-adolescent girl’s experience of the self was studied. Aspects from the literature that were significant and formed the foundation of the study were: • the role that weight gain plays in the early adolescent girl’s perception of the self and the implication that it may have for her clothing behaviour • the role of others in the early adolescent girl’s perception of the self and the implications that it may have for her clothing behaviour • the strategies that the early-adolescent uses to cope with this development phase and the implications that it may have for her clothing behaviour The study comprises 16 white early-adolescent girls aged between 11 and 13 years who, according to acknowledged criteria, are staying in an urban environment. A qualitative research methodology was selected with unstructured interviews, focus groups, and personal documentation utilising various stimulus techniques. Verbatim transcriptions of the interviews as well as descriptions of the interview situation were used for the discussions and interpretations of the results, taking into account the broad research questions set for the study. The findings were the following: Early-adolescent girls experience weight gain differently: • The normal-weight early-adolescent girl experiences that by going through this phase of rapid change, which includes an increase in her weight, that she is actually becoming fat. She is constantly busy with self monitoring; her self is becoming an object to evaluate. She experiences the emotion of shame and wants to cover her body from people that are constantly looking at her. • On the other hand, the overweight early-adolescent girl’s experience of this phase is more relaxed; she is not so much aware of her body and what other people are saying about her. She pretends not to be worried about being overweight by blaming other people and situations for her appearance. She even blames God for creating her that way. She experiences the emotion of sadness and by pretending not to worry or by avoiding the situation, she only copes with the emotion – but the situation is not handled. • In the end it seems that normal-weight and overweight early-adolescent girls share the same experience of the self. They feel sad about losing their childhood years when they felt less ashamed and had fewer concerns about their body’s appearance. They feel the loss of having less time to play and more responsibilities. The study could make the following contribution to the theory of clothing: • The life course and symbolic interactions perspective would be suitable for studies into a developmental stage such as early adolescence. • It seems that the early-adolescent girl in this study was really concerned with her appearance and about what other people thought of her. • It seems that the early adolescent girl in this study used clothes in appearance management to manipulate her appearance in order to try and fit the ideal body that the mass media hold up as an example as well as for support in her adoption of an adult gender role. • The normal-weight early-adolescent girls in this study made use of problem-focused coping strategies such as hiding and self-manipulation of their bodies. • The overweight early-adolescent girl, on the other hand, made use of more emotionally focused coping strategies such as avoidance, re-appraisal, denial and religion. The following recommendations were made: • The qualitative research methodology could be used more often when studying younger participants. • The early adolescent girl is especially concerned about the fit of her clothes. Tight fitted clothes and clothes that expose her body make her feel uncomfortable and ashamed of herself. • An understanding of the early-adolescent girl’s need to experiment with new styles and various appearances is needed. One should keep in mind that this study was conducted with a limited number of participants and the conclusions reached therefore pertain only to the 16 participants who gave their valuable input willingly and with the consent of their parents. / Thesis (PhD)--University of Pretoria, 2009. / Consumer Science / unrestricted

Early adolescent girls in a private school setting are in a vulnerable state on account of their gender, transitional developmental phase and a combined array of modern-day expectations and challenges. With many private schools expecting a 100% pass rate from their students, issues of competitiveness and achievement pressure may become prevalent. Research has shown that early adolescent girls are more susceptible to psychosocial problems than boys as well as girls of other ages, putting them more at risk of the effects of performance pressure, academic stress, depression and anxiety. Early adolescent girls’ vulnerability due to the impact that puberty has on their self-esteem as well as the fact that they are easily influenced by the opinions of others, causing them to be highly sensitive to the approval of others, may be compounded by pressures of the private school. The purpose and aim of this study was therefore to explore and describe the lived experiences of early adolescent girls in a private school setting so as to gain a deeper understanding of such experiences. In following this it was hoped that the study would offer the girls a ‘voice’ as well as create awareness of how they can be better supported in terms of their psychosocial development and well-being. The study was not viewed from one specific theoretical perspective but rather took into consideration various theories of development while undertaking the literature review, in order to gain a broader orientation of the subject at hand. The current literature with regard to the key concepts of the study formed part of the overview of the study. A qualitative approach was followed so as to understand the unique, true meaning of the girls’ experiences. A case study design allowed for a holistic, in-depth study of the social phenomenon at hand. The participants were ten early adolescent girls in Grade 7 in a private school in Northern Johannesburg who volunteered to take part in the study with the informed consent of their parents. The data obtained were viewed in line with an interpretive descriptive paradigm, which allowed the phenomenon to be studied through a ‘subjective lens’ while allowing for the formation of various realities. A deeper understanding of such realities in terms of the girls’ interpretations of their lived experiences was obtained through the data collection methods of semi-structured in-depth interviews, collages, confidential letters, journal Psychosocial experiences of early adolescent girls in a private school setting entries, field notes and researcher reflective notes. In combination with the researcher’s interpretation, this led to a richer, co-constructed, description of the girls’ experiences. The interpretive description allowed for the emergence of thematic patterns which revealed the findings of the study. The findings confirm that the girls are experiencing pressure to attain and maintain the high standard of the school. The findings further confirm that such pressures are increased by the early adolescent girls’ vulnerable developmental phase which places them in need of greater positive support from teachers, peers and parents to maintain healthy psychosocial development. The findings show that perceived rejection from peers and teachers has a negative effect on the girls’ self-concept. The findings further reveal that in considering the girls’ well-being they should be given a voice and be respected in their authentic uniqueness. Recommendations were made for the school to investigate the establishment of ‘mindfulness workshops’ to be run at the school, with the outcome that parents, teachers and students further develop skills in ways of supporting the girls’ healthy psychosocial development. / Thesis (MA (Psychology))--North-West University, Potchefstroom Campus, 2013.

Early adolescent girls in a private school setting are in a vulnerable state on account of their gender, transitional developmental phase and a combined array of modern-day expectations and challenges. With many private schools expecting a 100% pass rate from their students, issues of competitiveness and achievement pressure may become prevalent. Research has shown that early adolescent girls are more susceptible to psychosocial problems than boys as well as girls of other ages, putting them more at risk of the effects of performance pressure, academic stress, depression and anxiety. Early adolescent girls’ vulnerability due to the impact that puberty has on their self-esteem as well as the fact that they are easily influenced by the opinions of others, causing them to be highly sensitive to the approval of others, may be compounded by pressures of the private school. The purpose and aim of this study was therefore to explore and describe the lived experiences of early adolescent girls in a private school setting so as to gain a deeper understanding of such experiences. In following this it was hoped that the study would offer the girls a ‘voice’ as well as create awareness of how they can be better supported in terms of their psychosocial development and well-being. The study was not viewed from one specific theoretical perspective but rather took into consideration various theories of development while undertaking the literature review, in order to gain a broader orientation of the subject at hand. The current literature with regard to the key concepts of the study formed part of the overview of the study. A qualitative approach was followed so as to understand the unique, true meaning of the girls’ experiences. A case study design allowed for a holistic, in-depth study of the social phenomenon at hand. The participants were ten early adolescent girls in Grade 7 in a private school in Northern Johannesburg who volunteered to take part in the study with the informed consent of their parents. The data obtained were viewed in line with an interpretive descriptive paradigm, which allowed the phenomenon to be studied through a ‘subjective lens’ while allowing for the formation of various realities. A deeper understanding of such realities in terms of the girls’ interpretations of their lived experiences was obtained through the data collection methods of semi-structured in-depth interviews, collages, confidential letters, journal Psychosocial experiences of early adolescent girls in a private school setting entries, field notes and researcher reflective notes. In combination with the researcher’s interpretation, this led to a richer, co-constructed, description of the girls’ experiences. The interpretive description allowed for the emergence of thematic patterns which revealed the findings of the study. The findings confirm that the girls are experiencing pressure to attain and maintain the high standard of the school. The findings further confirm that such pressures are increased by the early adolescent girls’ vulnerable developmental phase which places them in need of greater positive support from teachers, peers and parents to maintain healthy psychosocial development. The findings show that perceived rejection from peers and teachers has a negative effect on the girls’ self-concept. The findings further reveal that in considering the girls’ well-being they should be given a voice and be respected in their authentic uniqueness. Recommendations were made for the school to investigate the establishment of ‘mindfulness workshops’ to be run at the school, with the outcome that parents, teachers and students further develop skills in ways of supporting the girls’ healthy psychosocial development. / Thesis (MA (Psychology))--North-West University, Potchefstroom Campus, 2013.