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

Chapter II: Literature Review
et al., 1996b; Pataki & Carlson, 1995; Rutter, 2000). However, several studies reveal that some
depressive symptomatology in adolescents do reflect diagnostic criteria according to the DSM or
the ICD-10 (Patton, Coffey, Posterino, Carlin, & Wolfe, 2000; Roberts, Lewinsohn, & Seeley,
1995).
Several central concepts and guiding assumptions underpin our current understanding of
adolescent depression. These assumptions are based on the premise that depression arises from
complex, multi-layered interactions within the adolescent (including biological and genetic
factors), the adolescents' environment (including family members, peers, neighbors, school,
community, and the larger social-cultural context), and the inter-relationship of these factors
(Frankish, Veenstra, & Moulton, 1999; US Department of Health and Human Services, 1999).
Developmental changes within the adolescent and in the environment are also important to
discern as both undergo changes.
Factors Associated with Depression in Adolescents
During adolescence, there is a rise in mortality due to suicides, increased tobacco,
alcohol, and drug use, and a dramatic increase in the incidence of eating disorders (Angold,
Costello, Farmer, Burns, & Erkanli, 1999; Canadian Council on Social Development, 2001;
Hankin & Abramson, 2001; Kessler et al., 2001; Kessler & Walters, 1998; Lewinsohn et al.,
2000a; Newman & Bland, 1998; Parker & Roy, 2001; Patton, Coffey, & Sawyer, 2003; Rutter,
2000; Shaffer, Gould, Fisher, & Trautman, 1996; Stewart, Manion, & Davidson, 2002; WHO,
2003; Windle & Davies, 1999). Stressful life events and psychosocial influences are associated
with depression (Goldberg & Huxley, 1993; Rutter, 2000; Rutter & Sroufe, 2000). In a study
with more than 1,500 participants in grades 9 to 12, Lewinsohn et al. (1999) found that dysphoric
mood and symptoms, dysfunctional thinking, and psychosocial stress appeared to be the
predictors of first onset of depression in adolescence. Life events, especially their number and
timing, may provoke the onset of depression in adolescence (Rutter, 2000) and may be mediated
by the individual's response and interpretation of depression. Further, research indicates that
depression in general often presents itself along with another disorder (Kreuger, 1999; Reynolds
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