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

Social Impairment
Chapter V: Discussion
More than two in three adolescents provided descriptions of depression in the category
Social Impairment. Three out of its four subcategories, Behavioral Disconnection (e.g., hardly
socializes), Perceived Disconnection (e.g., feeling misunderstood), and Lonely, had at least 20
percent of adolescents contribute definitions in each of these constructs, extending the previous
literature. In the DSM-IV-TR, no rules or distinctions specifically refer to social impairment as
requirement criteria for a diagnosis for MDE, rather a general functioning impairment is tied in
with symptoms causing distress, social, occupational, functional, or other important areas of
functioning. Others must observe the functioning impairment (that includes social impairment) to
account for its presence in the affected individual. References in the literature allude to social
impairment as being linked with depression; however, they are labeled as generalizations in
association with depressive symptomatology. Some of these findings link depression with:
individuals who are rejected by others (Joiner, 2000), loneliness (Brage & Meredith, 1994),
alienation (Gjerde et al., 1988), lack of self-belonging (Stanard, 2000), maladaptive coping
patterns (Kreuger, 2002), behavioral inhibition and shyness (Cherny et al., 1994), social
information processing deficit (Crick & Dodge, 1994), and peer difficulties (Hankin &
Abramson, 2001; Nolen-Hoeksema, Girgus, & Seligman, 1992; Petersen et al., 1991).
In defining depression, most adolescents are saying in their COAD that rather than a
general functioning impairment, it is more specifically about Social Impairment. Individuals
seem to recognize Social Impairment in themselves and in others. Another critical factor is that
adolescents recognize Social Impairment in terms of overt or behavioral disconnection,
perceived disconnection from others, subjective feelings of loneliness, and in aggressiveness or
bullying. As described in the DSM-IV-TR (APA, 2000; Criteria C in Table 5 in the Methodology
chapter), functioning impairment must be overt and accompany depressive symptomatology to
make a diagnosis in MDE. However, adolescents are defining Social Impairment in terms of both
overt and covert terms, and reinforce this area as an integral part of depression definition.
The Importance of Social Impairment.
The importance of Social Impairment can be broadened in scale by linking it with other
categories and subcategories generated by adolescents' COAD and the related descriptions
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