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Protective and vulnerability factors of depression in normal adolescents

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Abstract

The present study investigated the role of various protective and vulnerability factors in the development of depressive symptoms. A sample of normal adolescents (N=373) completed the Children’s Depression Inventory and measures of a negative attributional style, parental rearing behaviour, coping styles, and perceived self-efficacy. In addition to computing the correlations between depression and these protective and vulnerability factors, the present data were also subjected to structural equations modelling to examine the correlational structure of the data. Depression was accompanied by high levels of parental rejection, negative attributions, and passive coping, and by low levels of active coping and self-efficacy. Furthermore, a model in which negative parental rearing behaviour and a negative attributional style featured as the primary sources of depression, while coping styles and self-efficacy played a mediating role in the formation of depressive symptoms, provided a reasonable fit for the data.

Introduction

Depression is common among adolescents. Epidemiological studies have reported prevalence rates of depression in adolescents ranging between 0.4 and 8.3% (e.g., Fleming and Offord, 1990, Lewinsohn et al., 1993). Furthermore, the life time prevalence of depression in adolescents varies between 15 and 20% which is comparable with the life time rate in adults, suggesting that depression frequently has its onset in adolescence (e.g., Lewinsohn, Duncan, Stanton & Hautziner, 1986).

Various psychological and psychosocial factors have been associated with the etiology of depression in adolescents. One important factor that has received considerable research attention is a negative attributional style. The basic idea is that depression occurs in people who attribute the causes of negative events to negative qualities of themselves that are unchanging and pervasive (Abramson, Seligman & Teasdale, 1978). For example, an adolescent who fails an exam but believes that the teacher made this test too difficult will not be depressed, whereas a student who attributes the cause of his failure to low ability (e.g., “I lack intelligence”, i.e., an internal-global-stable attribution) will be depressed. There is abundant evidence that high levels of depression in adolescents are related to internal-global-stable attributions for negative events and that the reverse (i.e., making external-specific-unstable attributions) is true for positive events (Joiner and Wagner, 1995, Gladstone and Kaslow, 1995).

Another factor that might be involved in the etiology of depression is parental rearing behaviour. Evidence for this notion primarily comes from retrospective studies showing that depressed individuals report their parents to be more rejecting and controlling than do non depressed controls (e.g., Crook et al., 1981, Perris et al., 1986). Note in passing that such retrospective reports should be interpreted with caution as studies (e.g., Lewinsohn & Rosenbaum, 1987) have shown that recall of parenting is heavily influenced by current depressive symptomatology. More convincing support for a connection between negative parental rearing behaviour and depression was obtained by Burge and Hammen (1991). These researchers videotaped interactions of mothers and their children while discussing a topic of disagreement. Results showed that children’s depressive symptoms at 6 months after the mother-child discussion were significantly predicted by the affective quality of the interaction: the more negative the interaction, the higher the levels of depressive symptoms. Altogether, certain parental rearing practices, in particular high levels of rejection and low levels of emotional warmth, seem to be positively associated with depression (see for reviews, Gerlsma et al., 1990, Rapee, 1997).

Coping styles are generally considered as a protective factor for mental health. The basic idea is that some coping styles screen the individual from stressful life events, whereas other coping styles enhance the individual’s vulnerability to mental health problems. Direct support for this notion in adolescent populations was provided by two subsequent studies of Herman-Stahl and colleagues (Herman-Stahl et al., 1995, Herman-Stahl and Petersen, 1996). Results indicated that depressive symptomatology is accompanied by higher levels of passive and avoidant coping but lower levels of active and approach coping. Furthermore, evidence coming from the adult literature suggests that depression is negatively associated with problem-focussed coping but positively with emotion-focussed coping (e.g., Turner, King & Tremblay, 1992).

Perceived self-efficacy refers to beliefs in one’s capabilities to produce given attainments (Bandura, 1997). It is well conceivable that individuals with a low sense of self-efficacy are at risk for developing depression. A recent longitudinal study by Bandura, Pastorelli, Barbaranelli and Caprara (1999) tested this idea in an adolescent population. More specifically, the connection between self-efficacy and current depression and depression at one and two years follow-up was examined. Results indicated that low levels of self-efficacy were associated with high levels of concurrent and subsequent depression.

So far, most studies have investigated the potential role of isolated factors in the etiology of adolescent depression. Little is known about the interplay of various protective and vulnerability factors. In the “cognitive diathesis-stress model” of Garber and Hilsman (1992), a negative attributional style plays a key role in the formation of depressive symptoms in adolescents. These authors further assume that children and adolescents develop a negative cognitive style due to modelling of significant others, criticism, rejection, and experiences with uncontrollable stressful life events. When confronted with stressful life events, the negative cognitive style would trigger negative coping styles and a low sense of self-efficacy, ultimately resulting in an increased vulnerability to develop depressive symptoms. In a first test of the cognitive diathesis-stress model, Hilsman and Garber (1995) studied children’s depressive symptoms in response to a stressful event (i.e., receiving unacceptable grades on a report card). Results showed that children with a negative attributional style or lack of academic self-efficacy expressed more distress and higher levels of depressive symptoms after receiving unacceptable grades than did students without these cognitive characteristics. Hilsman and Garber (1995) also studied parental reactions to children’s report cards and found that negative parental reactions enhanced children’s negative mood and depressive symptoms. Furthermore, the negative parental reactions interacted significantly with children’s lack of academic self-efficacy to predict negative affect.

The present study further examined the role of various protective and vulnerability factors in the development of depressive symptoms. A sample of normal adolescents (N=373) completed the Children’s Depression Inventory (Kovacs, 1981) and measures of a negative attributional style, parental rearing behaviour, coping styles, and perceived self-efficacy. Not only correlations between depression and these protective and vulnerability factors were computed, but the present data were also subjected to structural equations modelling to test whether the observed correlational structure was in keeping with Garber and Hilsman’s (1992) suggestions.

Section snippets

Children and procedure

Three-hundred-and-seventy-three children (165 boys and 208 girls; mean age: 15.4 years, SD=1.3, range 13–19 years) were recruited from a regular secondary school in Geleen, The Netherlands. Children were asked to complete the questionnaires (see below) in their classrooms. The teacher and a research assistant were always available to help children if necessary and to ensure confidential and independent responding.

Questionnaires

The Children’s Depression Inventory (CDI; Kovacs, 1981) is a commonly used

Descriptive statistics

Descriptive statistics of the various questionnaires that were used in the current study are shown in Table 1. As can be seen, most questionnaires were found to have sufficient internal consistency. Cronbach’s alphas were 0.83 for CDI, between 0.67 and 0.84 for EMBU-A, 0.77 for NAQ, between 0.42 and 0.82 for UCL-A, and 0.90 for SEQ. Furthermore, t-tests revealed significant gender differences for CDI [t(371)=2, P<0.05], EMBU-A emotional warmth [t(371)=3.2, P<0.005], and the UCL-A scales

Discussion

The current study examined the connections between depression and a number of protective and vulnerability factors in a normal adolescent population. Results of a correlational analysis showed that all protective and vulnerability factors were related to depression in a theoretically meaningful way. That is, depression was accompanied by high levels of parental rejection, negative attributions, and passive coping, and by low levels of active coping and self-efficacy. Furthermore, structural

Acknowledgments

Children, parents, and staff of the Albert Schweitzer Scholengemeenschap (Graaf Huijn College) in Geleen, The Netherlands, are thanked for their participation in the present study.

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