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

Chapter V: Discussion
does not readily equate with Social Impairment. Disconnecting from someone can be viewed in
two lights, both positively and as an impairment. The element of change is also important. A
normally shy person is not necessarily depressed, but an outgoing person who starts to exhibit
this behavior may be. Hence, dimensional, contextual, and critically subjective factors attached
to this quality need to be considered before social disconnection (e.g., behavioral or perceived) is
addressed as an impairment.
Social Impairment can be linked to Social Perspective Coordination, a core component of
social competencies. Individuals can be vulnerable to outcomes of social risks if they do not have
a mature perspective on what those risks mean to them personally (Selman, 2003). Even if they
do have the maturity to understand social competencies as defined in Social Perspective
Coordination, something else can occur that may entail their level of emotion understanding,
and/or context, and/or other underlying physical dynamics that interconnect with each other.
Other Categories Defined by Adolescents
At least one in five adolescents contributed definitions in each of the categories Low
Self-Worth/Guilt, Suicidal, Anxiety Symptoms, and Contextual/Causal. This study's category
Low Self-Worth/Guilt (e.g., worthlessness, lack of self-esteem, guilt, ashamed, insecure) is
defined as a criterion for MDE in the DSM-IV-TR (APA, 2000), and by other researchers who
link low self-worth with depressive symptomatology (Kreuger, 2002; Loehlin, 1992; Lykken &
Tellegen, 1996). In the Suicidal category (e.g., thinks of death, attempts suicide, hurt themselves,
suicidal) adolescents' COAD used descriptions similar to those found in the DSM-IV-TR (APA,
2000); the literature is rich in linking suicide with depression.
Adolescents' COAD in the category Anxiety Symptoms (e.g., fear, feel scared, stressed,
always worry, anxiety) were similar to the descriptions of anxiety in the DSM-IV-TR (APA,
2000). Although anxiety is not a criterion for the diagnosis of MDE, the DSM-IV-TR (APA,
2000) mentions that adolescents with MDE frequently present with anxiety disorders (e.g.,
complain of feeling anxious, stressed, fear, worry). The literature shows that anxiety typically
first begins in childhood and precedes the onset of adolescent MDD (Rutter et al., 2006), and
adult MDD is most likely to be preceded by adolescent overanxious disorder (Pine et al., 1998).
Other findings in the literature indicate that anxiety disorder often accompanies depressive
symptomatology (Compas & Oppedisano, 2000; Compas et al., 1997; Rivas-Vazquez, Saffa-
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