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

Chapter II: Literature Review
approach-oriented coping that can be reflected in internal coping (e.g., "I analyze the problem
and think of various possible solutions" [Shulman, Seiffge-Krenke, & Samet, 1987, p. 371], "I
think about the problem and try to find different solutions" [Herman-Stahl et al., 1995, p. 657]),
or reflecting on possible solution (Seiffge-Krenke, 1995). Lazarus (1993) reports that "coping
thoughts and actions under stress must be measured separately from their outcomes in order to
examine, independently, their adaptiveness or maladaptiveness" (p. 235). Hence, in this study,
adolescents' own thinking about needing to talk to someone when depressed was distinguished
as a separate factor in approach-oriented coping.
Compas, Connor-Smith, Saltzman, Harding Thomsen, and Wadsworth (2001) report that
"coping responses refer to intentional physical or mental actions in reaction to a stressor and
directed towards the environment or an internal state. Coping goals are the objectives or intents
of coping responses and reflect the motivational nature of coping" (p. 88-89). These researchers
further elaborate that approach-oriented coping is part of engagement coping (e.g., problem-
focused or problem solving, or seeking social support) which has been found to be associated
with better adjustment (Compas et al., 2001). Coping in terms of problem-solving (e.g., "think
hard about what to do") has also been used to examine children's coping with pain (Walker,
Smith, Garber, & Van Slyke, 1997, p. 398).
Researchers tend to examine access and barriers to mental health services (Samargia,
Saewyc, & Elliot, 2006; Saunders, Resnick, Hoberman, & Blum, 1994). Currently, the accepted
approach to assess who "needs" mental health care in the community has been to provide
prevalence estimates, based on accepted diagnostic criteria for mental disorders. There is
emerging literature on the value of self-perceived need for mental health care (Mojtabai, Olfson,
& Mechanic, 2002; Rabinowitz, Gross, & Feldman, 1999; Sareen, Stein, Campbell, Hassard, &
Menec, 2002; Sareen et al., 2005a; Sareen, Cox, Afifi, Clara, & Yu, 2005b; Sareen, Cox, Afifi,
Yu, & Stein, 2005c) which may connect to internal approach-oriented coping. Asking the
individual to identify and assess his or her own need to talk to someone when depressed as a way
of approach-oriented coping, with or without using DSM criteria, may provide insight into
adolescents' one type of problem-solving for own depressive symptoms. Deciding whether to
seek help is the perception of need (Mojtabai et al., 2002).
In a study examining self-perceived need in 1,792 participants aged 15 to 54 years, who
met the criteria of diagnosis (12-month DSM-III-R mood, anxiety, or substance disorder),
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