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Dedicated to my daughters, Maiya and Rebecca thank you for helping me in keeping awake the sense of wonder in the world xvi
CHAPTER I: INTRODUCTION Chapter I: Introduction Depression in adolescents is a ubiquitous mental health problem presenting ambiguities, uncertainties, and diverse challenges in its conceptualization, presentation, detection, and treatment (American Academy of Child and Adolescent Psychiatry [AACAP], 1998; Birmaher et al., 2007; Cicchetti & Toth, 1998; Good & Kleinman, 1985; Kazdin, 2001, 2002; Olfson, Gameroff, Marcus, & Waslick, 2003; Rounsaville, Andrews, & Kendall, 2002). At present, the diagnosis of adolescent depression in North America is based on adult depression criteria found in the Diagnostic and Statistical Manual of Mental Disorders - fourth edition - Text Revision (DSM-IV-TR) (American Psychiatric Association [APA], 2000). There is a plethora of research suggesting that depression often begins in adolescence and can recur in adulthood (Birmaher, Ryan, Williamson, Brent, & Kaufman, 1996a; Costello, Foley, & Angold, 2006; Kim-Cohen et al., 2003; Lewinsohn, Rohde, Seeley, Klein, & Gotlib, 2000a; Pine, Cohen, Gurley, Brook, & Ma, 1998). Research examining the prevalence of mental disorders in community-based samples in the US and Canada indicates that about one in five adolescents in the community exhibits mental disorders (Health Canada, 2002; Michalak, Goldner, Jones, Oetter, & Lam, 2002; Schonert-Reichl & Offer, 1992). Goldberg and Goodyer (2005) report that depressive disorders markedly increase in prevalence between the ages of 13 and 16 years, and continue to rise during adolescence into young adult life. Depression is increasing in prevalence in developed countries (World Health Organization [WHO], 2001) and poses a significant societal concern (Waddell, Offord, Shepherd, Hua, & McEwan, 2002; Waddell & Shepherd, 2002; WHO, 2003). Young people who experience depression demonstrate an increased risk of suicide and injury and are more likely to engage in harmful behaviors, such as disordered eating, the use of tobacco, alcohol, and drugs or controlled substances (Birmaher et al., 2007; Patton et al., 1998; Rutter, 2000). Moreover, the risk of depression also increases in the absence of social support (Brown & Harris, 1978; Kandel & Davies, 1986; Wong & Wiest, 1999), and individuals with depression exhibit social isolation (Kandel & Davies, 1986). Taken together, researchers are in accord in suggesting that depression in adolescence has both short-and long-term consequences for the adolescent and society as a whole. 1
Page 1 and 2: HOW DO ADOLESCENTS DEFINE DEPRESSIO
Page 3 and 4: understanding to guide future resea
Page 5 and 6: Introduction^ 29 Adolescents' Self-
Page 7 and 8: Remaining Significant Categories an
Page 9 and 10: APPENDIX F: Self-Recognition of Ado
Page 11 and 12: LIST OF TABLES Table 1 Developmenta
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Page 15: ACKNOWLEDGEMENTS There are many ind
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Chapter III: Methodology As can be
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Chapter III: Methodology interactio
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Emotion Regulation: Sadness Chapter
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Chapter III: Methodology for Anger
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Chapter III: Methodology of death (
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Content Analysis of Participants '
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Chapter III: Methodology using cont
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Chapter III: Methodology Some categ
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Chapter III: Methodology these unit
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Chapter III: Methodology A total of
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Table 7 Chapter III: Methodology Ca
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Chapter III: Methodology #^Category
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Chapter III: Methodology Category ^
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Chapter III: Methodology to partici
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Chapter III: Methodology pamphlets
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CHAPTER IV: RESULTS Chapter IV: Res
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Chapter IV: Results category and su
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Chapter IV: Results the Methodology
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Table 12 Chapter IV: Results Freque
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Category/Subcategory Defined Units
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Category/Subcategory Defined Units
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Chapter IV: Results lower percentag
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Chapter IV: Results COAD unit in th
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Chapter IV: Results than 5% of part
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Chapter IV: Results presented in pa
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Chapter IV: Results Appendix Al for
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Table 18 Percentages, Significant a
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Table 19 Chapter IV: Results Percen
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Chapter IV: Results significant ass
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Chapter IV: Results variable contai
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Chapter IV: Results Association bet
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ecognition groups, generated COAD u
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Chapter IV: Results More than 80% o
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Chapter IV: Results same variables.
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Category / Subcategory Fatigue/Loss
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Chapter IV: Results Association of
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Chapter IV: Results were screened a
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Chapter 1V: Results girls (n = 67),
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Chapter IV: Results inhibition; wer
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Chapter IV: Results correlated with
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Chapter IV: Results model now with
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Hierarchical Regression Analysis fo
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CHAPTER V: DISCUSSION Depression: A
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Chapter V: Discussion depression in
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Chapter V: Discussion reported more
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Depressed Mood Chapter V: Discussio
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Chapter V: Discussion under Depress
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Chapter V: Discussion discussed in
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Chapter V: Discussion Biller, Ruiz,
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Chapter V: Discussion impossible co
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Association of Categories and Subca
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constructs reflect overt characteri
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Chapter V: Discussion definitions i
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Chapter V: Discussion Association o
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Chapter V: Discussion Lifetime Self
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Chapter V: Discussion Social Perspe
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Chapter V: Discussion symptomatolog
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Study Strengths and Limitations Stu
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along with their family's permissio
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Chapter V: Discussion sectional stu
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Chapter V: Discussion development,
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Chapter V: Discussion which include
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Chapter V: Discussion not wait for
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REFERENCES References Achenbach, T.
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Beck, A. T., Rush, A. J., Shaw, B.
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References Byrnes, J. P. (1988). Fo
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school adolescents: A randomized tr
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References Compton, S. N., Burns, B
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References Eisenberg, N., Fabes, R.
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Fombonne, E., Wostear, G., Cooper,
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References Glasersfeld, E. von (197
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Hall, G. S. (1904). Adolescence its
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References Jackson, S. W. (1986). M
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References Keating, D. P. (1988). B
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Kurt, M. D., & Crowley, S. L. (2002
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References Mechanic, D. (1978). Sex
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National Institute of Mental Health
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References Patton, G. C., Hetrick,
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References Reynolds, W. M. (1986a).
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Rutter, M., Kim-Cohen, J., & Maugha
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References Schultz, L. H., & Selman
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Southam-Gerow, M. A. & Kendall, P.
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References Taylor, M. (1996). A the
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References Wentzel, K. R. &, Erdley
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APPENDIX A: Parental or Guardian Co
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APPENDIX B: Student Assent Form UNI
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APPENDIX C: Demographic Information
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APPENDIX E: Conceptions of Adolesce
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APPENDIX G: Thought About Own Need
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Appendices APPENDIX I: Access Colum
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APPENDIX K: Photo Example of Sheet
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APPENDIX M: Intercoder Sheet With R
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Pilot Study APPENDIX 0: Pilot Study
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Appendices UBC is Dr. Kimberly Scho
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APPENDIX Q: Parent or Guardian Info
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Appendices An honorarium of $70 wil
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Appendices It is important for you
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Name: ^ School: ^ Date Your home po
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Appendices * Gab Youth Services (at
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APPENDIX U: Protocol For Referral F
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APPENDIX V: Protocol for Referral f
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Appendices further follow-up. We al
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APPENDIX W: Parental Letter Informi
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Appendices APPENDIX Y: Table Y-2: F
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Appendices APPENDIX Al: Table Al-4:
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APPENDIX Cl: Table C1-6: Percentage
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Appendices APPENDIX El: Table El-8:
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APPENDIX G1: Self-Recognition of De
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Appendices APPENDIX Il: Table I1-11
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Category Subcategory Grade x 2 (1,
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APPENDIX K!: Table K1-13: Associati
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APPENDIX Ml: UBC Ethics Approval fo
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