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

Chapter V: Discussion
discussed in the DSM-IV-TR (APA, 2000) and in the literature. In this study, the subcategory
Quiet (e.g., quiet, silent) is just one of these constructs that can belong to both its presently
assigned category Retardation/Agitation and to Social Impairment. Recall that almost all of
adolescents' COAD Table 12 in Results chapter) identified subcategory Quiet in the category
Retardation/Agitation. In the DSM-IV-TR (APA, 2000), Retardation includes definitions such as
speech that is decreased in volume, inflection, amount, slowed down in thinking (or slowed
down in speech in the K-SADS-PL), or muteness, as one of the symptoms others observe that is
used as a criterion for MDE. Hence, symptoms of Retardation (Criteria A-5 in the DSM-IV-TR;
APA, 2000; Table 5) can exclude these individuals from also having a functional impairment
(e.g., quiet, silent as overt criteria in Criteria C in the DSM-IV-TR; APA, 2000; see Table 5) in
making the diagnosis for MDE. However, when social relational withdrawal (e.g., being quiet or
silent) is observed, the individual may be slowed down in their thinking or retardation (overt
evidence); they cannot talk because they cannot think. Keeping adolescents' COAD units in one
category Retardation/Agitation lessened the impact of the Social Impairment category, already
an important area as defined by adolescents and the possible missing link when and if
impairment changed from a previous state.
Other categories and subcategories may represent social indicators and link with Social
Impairment. Some of the features of Irritability seem to connect with discontent with one's
environment or relationships (e.g., are angry, blaming others, frustration). These features involve
interpersonal factors and may contribute to Social Impairment. Further categories that can be
socially construed and linked with Social Impairment are: Low Self-Worth, Masking/Stigma,
Escaping Reality, or Feel Trapped. For example, in Low Self-Worth, comparisons are made
about an individual's perceptions of himself or herself in relation to others. Masking/Stigma, too,
is socially constructed, where an individual places importance on their understanding, privacy,
expectations, and own actions in relation to others. Escaping Reality and Feel Trapped also have
social relational bases. The importance of Social Impairment is critical when other constructs are
examined in combination.
Differentiating Qualities of Social Impairment.
In further exploring Social Impairment as a link to depressive symptomatology,
researchers need to exercise caution: being alone does not equate with lonely, and feeling lonely
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