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

Chapter V: Discussion
Remaining Categories and Subcategories in Descending Order of Percentages as Defined by
Adolescents' COAD
Adolescents provided definitions of depression in several categories reported and not
mentioned in the DSM-IV-TR (APA, 2000). The categories generated by adolescents' COAD
and corresponding to findings in the DSM-IV-TR (APA, 2000) criteria for depression (e.g.,
Retardation/Agitation, Loss of Interest or Pleasure, Indecisiveness/Impaired Concentration and
Attention, and Appetite/Weight/Eat/Sleep Changes), will not be elaborated on. In the following
paragraphs, I discuss only the categories defined by adolescents that were not described in the
DSM-IV-TR (APA, 2000). I also discuss the category Functional Impairment/Distress because
the adolescents' COAD differentiated it from the general functioning impairment described in
the DSM-IV-TR (APA, 2000).
In the DSM-IV-TR (APA, 2000), Functional Impairment (e.g., their marks might drop,
thinking there is no use in school, distressed) is part of a general criterion (as is Social
Impairment) that includes distress, social, occupational, or other important areas of functioning
impairment (e.g., truancy, school failure, activities decline, distress), where overt evidence is
needed for a diagnosis of MDE. For example, when an individual has lost interest (e.g., lose
interest in school), the evidence of Functional Impairment could be that his or her marks might
drop or truancy occurs (as defined in the DSM-IV-TR [APA, 2000]). In this study, Functional
Impairment/Distress covers the remaining impairments after Social Impairment is distinguished
in its own category. Adolescents' COAD revealed that Functional Impairment/Distress was
considerably less important in defining depression.
This paragraph discusses the remaining categories that were defined by adolescents'
COAD but were not found in the DSM-IV-TR (APA, 2000) as criteria for depression. Although
each category was minor in terms of its frequency compared to other more prominent constructs,
adolescents contributed important information about them. The category Masking/Stigma (e.g.,
too scared to tell anyone about their own depression, false outgoingness; see Table 8 in
Methodology chapter) implies that adolescents placed importance on their perceived image or
identity in relation with others. This construct seems to reflect adolescents' inner conflicts in
their emotions, perceived expectations, and privacy issues. Adolescents seem to be saying that
stigma occurs, and that it is part of depression. The category Feel Trapped (e.g., being trapped in
your life) may represent a point of hopelessness where there is no way out of their difficult or
148