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

Chapter II: Literature Review
Early intervention has not occurred for adolescents with mental disorders (Patel, Flisher,
Hetrick, & McGorry, 2006; Patton et al., 2007; Viner & Barker, 2005). Studies show that about
two out of three adolescents with mental disorders do not receive services (Burns et al., 1995;
Cauce et al., 2002; Keller, Lavori, Beardslee, Wunder, & Ryan, 1991; Offer et al., 1991; Patton
et al., 2007; Quine et al., 2003; Romans-Clarkson, Walton, Dons, & Mullen, 1990; Samargia et
al., 2006; Sareen et al., 2005c). In a paper about the Great Smoky Mountains Study, based on a
cohort of 1,420 adolescents, Costello, Copeland, Cowell, and Keeler (2007) report that one out
of three young adolescents in need of mental health support received some form of intervention
but that most of the support existed outside traditional mental health services. An explanation for
the high drop-out rate or failure to keep the first appointment may be that adolescents rarely
make the referrals themselves. Another factor may be that their adaptive social capacity and
coping styles are affected by depressive symptomatology. A study differentiating help-seeking
for mental health services in adolescents looked at two groups, a group with minor depression
(mDEP) and a group with major depressive disorder (MDD). The study found that the mDEP
group used more mental health services than the MDD group (Gonzalez-Tejera et al., 2005). The
immense disparity between adolescents' modest use of support services and epidemiological
findings of adolescent depression in the community confirms that we need to pay more attention
to what adolescents are saying about depression and how their conceptions of depression fit with
their approach-oriented coping, specifically via their own need to talk to someone and actually
talking to someone when feeling depressed.
Social Cognition
The theoretical roots of social-cognitive development stem from the cognitive theory of
Piaget (Inhelder & Piaget, 1958) and can be differentiated in their relationships to affectivity,
individual differences, and personal meanings (Noam et al., 1995). Social cognition is the
merging of the cognitive and social development theories. Social cognition is a complex system,
consisting of related, interwoven processes enabling the individual to understand others and the
personal relationships with them (Schultz & Selman, 2000b).
It has only been in the past 15 years that the relation between the social-cognitive
developmental perspective and depression received any consideration (Noam et al., 1995). Noam
et al. (1995) report that social-cognitive theory is not only intrapsychic but interactive and there
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