ABSTRACT It is not uncommon for new mothers to experience depression. However, depression after the arrival of a child is not limited to biological mothers. The term Post-Adoption Depression Syndrome (PADS) was created to capture the unique type of depression that may occur after adopting a child. The nature and prevalence of depression after adoption is still largely unknown since there is little published research exploring the experiences of mothers in the first year after adopting a child. The characteristics of this disorder are reportedly comparable to postpartum depression in a biological mother. A review of postpartum literature reveals risk factors unrelated to biology. The experiences of adoptive mothers were explored focusing on the psychosocial and psychological risk factors of postpartum depression and challenges specific to adoptive parenting were also considered. Quantitative data were collected through an on-line survey. Findings revealed that 25% of adoptive mothers experienced depressive symptoms after adoption. Lack of support and increased fatigue were the most significant predictors of post-adoption depression. Other factors related to increased depression were found, such as infant temperament and marital status. Additionally, in-depth interviews with adoptive mothers were conducted that illustrate the experiences and challenges specific to adoptive parenting that may contribute to post-adoption depression. Implications for social work practice, adoption agencies and adoption professionals are discussed. Improved assessment strategies are suggested.

published_or_final_version / Nursing Studies / Master / Master of Nursing

Depression has become a medical condition that affects more and more of the aged Hong Kong population, yet this condition is often overlooked. Depression is a treatable condition. Nevertheless, the current practice in Hong Kong relies heavily on medication and cognitive-behavioural therapy. The effectiveness of these two types of therapy is limited by the side-effects of the medications and the accessibility to medical facilities for cognitive-behavioural therapy. Physical activity is suggested by many studies to be effective in managing depressive symptoms in the population. Physical exercise is a relatively economic and convenient activity that can be self-administered for health. Some studies have suggested that physical activity is effective for managing depression, yet the number of theses on this topic for the aged population is limited. In this thesis, studies related to the effectiveness of physical activity on depressive symptoms alleviation among older adults were reviewed and critically appraised. The potential to apply the findings of these studies to the aged Chinese population in Hong Kong is discussed and presented. Studies were searched using the databases Pubmed and CINAHL, and a total of 15 relevant studies were found. The 15 studies were analyzed and listed as tables of evidence and appraised with the SIGN checklist for their quality. The results of these studies and the quality of the papers were summarized. Regarding the physical activity types examined in these studies, aerobic exercise involving controlled-breathing or deep-breathing (e.g. TaiChi) and activities to promote posture including flexibility and balance (e.g. Yoga) were found to be effective for alleviating depressive symptoms among the aged population. The feasibility and transferability of the desired intervention to the target population and setting were discussed. An evidence-based guideline with 8 recommendations was also developed. Finally, a plan for communication with different parties (e.g., administrators, users and staff) to administer the intervention was devised. A pilot test was also planned, with and evaluation plan for the pilot test to allow for adjustments to the intervention. This thesis discussed an alternative to treatment of depressive symptoms among the aged population. With the practice of physical activity effective in managing depressive symptoms in this population, it gave rise to the possibility that to promote the innovation to all of this population. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Early adolescence is a period marked by increases in internalizing problems, particularly depression. In childhood, the rates of depressive symptomatology are between .6% and 1.7%, but by adolescence, rates rise to 8.0%. Two key correlates of adolescent depression are behavioral inhibition and poor peer relations. Yet, it is unclear whether these factors simply co-occur with depressive symptoms or are instrumental across development in regulating them. In this study, using data from the NICHD Study of Early Child Care, we examine whether increases in inhibition in late childhood may undermine peer relationships in predicting increases in adolescent depressive symptoms. Specifically, we test whether inhibition promotes depressive symptoms by undermining two aspects of peer relationships – popularity and friendship quality. Findings revealed that increases in inhibition from childhood to adolescence lead to increases in adolescent depressive symptoms. Decreases in popularity mediated the relation of inhibition, friendship quality and increases in adolescent depressive symptoms. / text

This study used a qualitative methodology to examine treatment outcome and mechanisms of change from the perspective of the participants in a group cognitivebehavioral therapy intervention for depressed girls (i.e., the ACTION program). Data were collected from seventeen participants using semi-structured interviews. Seventeen initial and seven follow-up interviews were conducted. Interviews were transcribed and analyzed using the grounded theory approach. A theoretical model emerged from the data that explained mechanisms of change in relation to treatment outcome and evaluation. Prior to treatment, all participants were diagnosed with a depressive disorder. At post-treatment, approximately 88% of the sample no longer met criteria for depression. Thus, the ACTION program demonstrated a high rate of efficacy. Additionally, all of the participants described treatment as helpful. Level of helpfulness varied from high to low, with most participants rating treatment as very helpful, and depended on the ways in which the intervention produced positive change in the following areas: stressors, stressor management strategies, emotions, cognitions, and social support. Participants evidenced high levels of pre-treatment stressors, particularly in the interpersonal domain, and low levels of social support. Passive, emotion-focused strategies were used to manage these difficulties; however, they were largely ineffective. Not being able to resolve stressors successfully led participants to experience unpleasant emotions and negative ways of thinking. Together, these variables resulted in high levels depression prior to treatment. At post-treatment, most participants experienced several positive changes, including decreased stressors, increased effectiveness of stressor management strategies, elevated mood, and a more positive outlook. These changes were attributed to the acquisition and application of the core treatment components by the majority of participants. Some participants also experienced an increase in social support, which was associated with characteristics of the treatment structure. Thus, the two most important variables in relation to treatment outcome and evaluation were specific mechanisms of change (i.e., treatment components) and non-specific therapeutic factors (i.e., treatment structure). In addition, treatment outcome was also influenced by participant characteristics. Participants that held unrealistic expectations, were not ready for change, or engaged in limited problem-sharing experienced fewer positive changes over the course of treatment.

No description available.

Depression is a significant problem, which is often related to stressful life events. Individual responses to life stress can vary depending on vulnerability factors, such as ability to regulate emotions. Studies have demonstrated that emotion regulation involves executive functioning abilities. Executive functioning is not only associated with cognition, but also emotional and behavioral control. Difficulty with executive function is sometimes associated with depression. Though there is an established relationship in the literature between life stress and depression, the moderating effects of executive functioning on the relationship between life stress and depression remains unknown. This study will use multiple linear regression to test whether executive functioning moderates the influence of life stress on depression. / text

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

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences