how do adolescents define depression? - cIRcle - University of ...

Chapter V: Discussion
under Depressive Disorders, boredom is also referred to as loss of interest or ability to enjoy.
Although Pessimism is not reported as a criterion for MDE criteria in the DSM-IV-TR (APA,
2000), it is mentioned as a criterion in Dysthymia. However, in adolescents' COAD, Boredom is
distinguished without knowing the individual's previous condition. Hence, it is difficult to
determine whether there is a "loss" of interest or pleasure based on their descriptions, and it is
not known what state precedes the subcategory Unmotivated.
Almost two in five adolescents included Depressed Appearance in their definitions (e.g.,
crying, teary, stop caring about their appearance). The DSM-IV-TR (APA, 2000) refers to facial
expression and demeanor to help determine a diagnosis of MDE, with crying or tearfulness used
as frequent presentations of MDE. In the K-SADS-PL, references are made in how an individual
looks or acts when observations are made in interviews. Davidson et al. (1990) distinguish the
importance of facial expression for the study of emotion, and difficulties in emotion management
have been associated with poor social functioning (Shipman et al., 2003). Recognizing facial
expressions indicate that social cognition or social competence is related to social cues or
competence. The degree and meaning of Depressed Appearance can be important relative to
these characteristics, however careful consideration needs to be made before attaching these
meanings to Depressed Mood because adolescents did not provide that kind of detail in the
subcategory Depressed Appearance.
Adolescents identified Moody in their COAD but this term is not reported under MDE
criteria in the DSM-IV-TR (APA, 2000). However, the DSM-IV-TR (APA, 2000) uses the term
affective lability under Depressive Disorders Not Otherwise Specified, and as emotional under
Dysphoria (Zuckerman, 2005). Deciphering the intended meaning of Moody as adolescents used
it seems complex, but possible references to the environment and irritability may be more useful
attributes to explore.
In this study, adolescents provided one definition of Somatic Symptoms (e.g., difficulty
breathing). This single reference, provided by the adolescents, contrasts with an emphasis that is
put on somatic complaints (e.g., bodily aches, headaches, or joint pain, abdominal pain) in the
DSM-IV-TR (APA, 2000) criteria for depression, rather than feelings of sadness.
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