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

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.
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