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

Chapter II: Literature Review
This approach highlights the philosophy of this investigation to move from reliant research and
practice assumptions about adolescent depression towards greater collaboration with the
adolescents themselves from adolescents' understanding of depression. An extensive review of
the extant literature reveals that adolescents' definitions or conceptions of depression are
unexplored. This section includes previous research on the history, definitions, classification,
epidemiology, assessment, treatment, developmental findings, and other factors associated with
adolescent depression, which may inform adolescents' understanding of the condition.
History of Adolescent Depression
In the mid-twentieth century, the definition of depression was mostly posited by
psychoanalytic theorists who maintained that depression was the product of a persecutory
superego (Rie, 1966). 2 According to this theory, the superego lacked maturity in childhood and
emerged during adolescence as a discrete and uncommon phenomenon (Angold, 1988a;
Cicchetti & Toth, 1998), hence adolescent depression was considered rare. Adolescence was
seen as a period of emotional upheaval, but significant, persisting mental health problems were
thought to be uncommon in this age group (Offer, 1969; Petersen et al., 1993). It was also in the
twentieth century that certain observed, unusual mental states began to be recognized as
depression in general and treated on a more consistent basis (Jackson, 1986). For example, Adolf
Meyer (1957) redefined the constituents and terminology of melancholia, nominating the
terminology of depression instead (as cited in Jackson, 1986). In the seventeenth century and
before, with the exception of its occasional use, when depression was applied to signify the
lowering of spirits or dejection, melancholia was the term most often used to describe
depression, in fact, descriptions by Hippocrates date back about 2500 years (Jackson, 1986).
A watershed in the evolution of depression as a diagnostic classification occurred in
1971. The theme of the Fourth Congress of Paedopsychiatrists was "Depressive States in
Childhood and Adolescence," where it was concluded that depression was a significant and
relatively large-scale disorder in this population (Weller, Weller, & Fristad, 1984). A subsequent
conference on childhood depression sponsored by the Center for Studies of Child and Family
Mental Health at the National Institutes of Mental Health (NIMH) expanded the awareness of
2 Psychoanalytic theorists stressed the importance of adolescent's unconscious thoughts.
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