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

Chapter I: Introduction
expected to continue to rise. Better means of communication with young people, early detection,
early intervention, and treatment would greatly reduce overall costs.
Adolescents' Understanding of Depression
Despite the plethora of research examining the emergence, course, and treatment of
adolescent depression, one area in which there exists a paucity of research is in regards to
obtaining information from the adolescents themselves with respect to how they understand and
define depression. Studies that focus on adolescents' perceptions of their health concerns show
that mental health is prominent among them (Goodman et al., 1997; Millstein & Litt, 1990;
Tonkin, 2001). Virtually all research and practice on adolescent depression is bound by the
DSM-IV-TR (APA, 2000) or the International Classification of Diseases (ICD-10) (WHO, 1992)
criteria for depression, yet research on adolescents' understanding of depression is unexplored.
There exist three ways in which our understanding of adolescent depression could be
furthered. First, insight into the roots of adolescent depression may be found by examining
adolescents' conceptions of depression — that is, how they define "depression." It is well
documented that the stage of adolescence is marked by rapid physical and social changes,
increased cognitive capacity, and the development of differentiated and abstract cognitive
abilities (Chapman, 1988; Inhelder & Piaget, 1958). The present study provides a first step in our
efforts to understand how adolescents "define" depression and how their conceptions vary by age
and gender.
A second important factor that could expand our understanding of depression in
adolescents may be found by assessing whether or not adolescents can recognize depression in
themselves — that is, their self-diagnosis. Adolescents' conceptions of depression can be
intertwined with their understanding of their vulnerability. The ability to recognize depression
may be influenced by the adolescents' interpretations and processing of information by capacities
and competencies in their emotional growth, in their social relationships, in their conceptions and
reasoning regarding their social world, and changes in their environment. Adolescents' tendency
to initiate or experiment with different forms of behavior that are harmful to their health may be
linked to adolescents' understanding of their own vulnerability to depression intertwined with
their emotional, cognitive, social capacities, and experiences. The immense disparity between the
epidemiological findings of adolescent depression and adolescents' help-seeking and access to
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