long-term sequelae of sub-clinical depressive symptoms in early adolescence joe allen joanna chango...
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Long-term Sequelae of Sub-clinicalDepressive Symptoms in Early Adolescence
Joe AllenJoanna ChangoDavid SzwedoMegan Schad
University of Virginia
Copies of related papers are available at:WWW.TEENRESEARCH.ORG
Collaborators:Maryfrances Porter, Ph.D.Kathleen McElhaney, Ph.D.F. Christy McFarland, Ph.D.Ann Spilker
Farah Williams, Ph.D.Jill Antonishak, Ph.D.Joanna ChangoCaroline White
Elie HesselEmily Marston, Ph.D.Glenda Insabella, Ph.D.Erin Miga, Ph.D.Amanda Hare, Ph.D.
Depressive Symptoms as Uniquely Problematic in
Adolescence
Social Relationship Quality:Why Teens Care/ Why We Care
Links to numerous adult mental health indices• Anxiety, Depression, Antisocial Personality Disorder, etc.
Links to physical health• Self-care
• Cardiovascular reactivity to Stress
• Immune Functioning
• Weight/obesity Links to Survival
There’s a reason teens care so desperately about their peer relationships.
Adolescence as Sensitive Period for Developing Relationship Competence
Development of Neural Structures• Prefrontal and Parietal Cortex
Development of Sophisticated Social Perspective-taking Capacity
First experience with True Adult-like Relationships
Early Adolescent Depressive Symptoms
Concurrent Effects:
• Reduced Energy for Developmental Tasks
• Negative Bias Regarding Relationships/Hopelessness
• Self-fulfilling nature/vicious cycle
Impairment at a critical point in social development?
Primary Question
How Are Adolescent Depressive SymptomsLinked to Future Social Functioning?
Sample 184 Adolescents, their Parents, Best Friends, Other Friends,
Romantic Partners
Intensive Interviews and Observations with all parties (Total N over first 13 years ~ 3200).
Equal numbers of Males and Females
Socio-economically Diverse (Median Family Income= $40- $60K)
31% African American; 69% European American
Very Low Attrition (98% participation rate in current phase)
Depressive Symptoms
Adolescence: Childhood Depression Inventory (Kovacs & Beck, 1977)
27-items based on the Beck Depression Inventory• Screening Cutoffs – For possible depression
• Clinical Cutoffs – For likely depression
• Aggregated Scores across 3 assessments (ages 14,15, 16)
Adulthood: Beck Depression Inventory (Beck & Steer, 1987) 21-items
assessing concurrent symptoms.• Aggregated Scores Across Ages 23, 24
Functioning with Peers
Adolescence: Inventory of Parent and Peer Attachment (Armsden &
Greenberg, 1987) 21-item inventory summing Communication, Trust, and Alienation (reverse-scored)• Aggregated from three assessments (Age 14, 15, & 16)
Adulthood: UCLA Loneliness Scale (Russell et al., 1980) 20 -item
inventory• linked to long-term mental and physical health risks
• Aggregated from two assessments (Age 23 & 24)
Depressive Symptoms
Loneliness.52***
Simple Prediction of Future Loneliness(Correlations)
Ages 14-16 Age 23-24
Depressive Symptoms
Loneliness.41***
Simple Prediction of Future Loneliness*(Correlations)
Ages 14-16 Age 23-24
• Excluding most severely depressed adolescents (10% of sample)
Long-term Links are Found Even Among those with very mild levels of Depressive Symptoms
Depressive Symptoms
Loneliness.34***
Predicting Loneliness Over and Above Covariates
Peer Attachment
-.11+
Concurrent Depression
.43***
Ages 14-16 Age 23-24
Predictions Even After Accounting forBaseline Functioning & Concurrent
Depression
Gender & Income
Depressive Symptoms Predicting Loneliness (Categorical Description)
Loneliness (Age 23-24)
Depressive Symptoms (Age 14-16)
Below Median
Above Median
Below Screening Cutoff
Above Cutoff
Depressive Symptoms Predicting Loneliness (Categorical Description)
Loneliness (Age 23-24)
Depressive Symptoms (Age 14-16)
Below Median
Above Median
Below Screening Cutoff
80 68
Above Cutoff
Depressive Symptoms Predicting Loneliness (Categorical Description)
Loneliness (Age 23-24)
Depressive Symptoms (Age 14-16)
Below Median
Above Median
Below Screening Cutoff
80 68
Above Cutoff
24
Depressive Symptoms Predicting Loneliness (Categorical Description)
Loneliness (Age 23-24)
Depressive Symptoms (Age 14-16)
Below Median
Above Median
Below Screening Cutoff
80 68
Above Cutoff
0!! 24
EVERY Teen who was even mildly depressed in adolescence was above the median in adult loneliness.
Limitations
All Based on Teen Self-Report
Need to Begin to Explore Possible Mediators of Long-term Links
Maternal Relationship Quality
Adolescence: Inventory of Parent and Peer Attachment (Armsden &
Greenberg, 1987) 21-item inventory summing Communication, Trust and Alienation (reverse-scored)• Early adolescence: Aggregated from Age 14, 15, & 16
• Late adolescence: Aggregated from Age 18, 19, & 20
Adulthood: Maternal Report: Network of Relationships Inventory
(Furman & Buhrmester, 1985) Total positivity (Six 3-item scales)• Age 23
Depressive Symptoms
Maternal Relationship
Quality
-.30***
Simple Continuity(Correlations)
Ages 14-16 Age 23
-.31***
Simple Continuity *(Correlations)
Ages 14-16
• Excluding most severely depressed adolescents (10% of sample)
Age 23
Long-term Effects are Found Even Among those with very mild levels of Depressive Symptoms
Depressive Symptoms
Maternal Relationship
Quality
-.39***
Predicting Maternal Relationship Quality Over and Above Covariates
Maternal Attachment
-.03
Concurrent Depression
.18*
Ages 14-16 Age 23
Depressive Symptoms
Maternal Relationship
Quality
Gender & Income
Even Mild Adolescent Depressive Symptoms Have Clear Long-term Sequelae
Key Question: Mediating Pathways?
Potential Peer Pathway:
Avoidance?
Social Avoidance Peers
Late Adolescence:
Social Avoidance Social Anxiety Scale for Adolescents (La Greca & Lopez, 1998) 14-item inventory.
Aggregated from 3 assessments (Ages 19, 20, & 21)
Attachment to Peers
Depressive Symptoms
Avoidance of Peers
Loneliness
Early AdolescentPredictors
(Age 14-16)
Late-Adolescent Intervening Variables
(Age 18-20)
Early Adult Outcomes
(Age 23-24)
.25***-.18**
.25***
Depressive Symptoms
.39***.41***
.30***
Gender & Income
Attachment to Peers
Depressive Symptoms
Avoidance of Peers
Loneliness
Early AdolescentPredictors
(Age 14-16)
Late-Adolescent Intervening Variables
(Age 18-20)
Early Adult Outcomes
(Age 23-24)
.25***-.18**
.25***
Depressive Symptoms
.41***
.30***
Gender & Income
.39***
Attachment to Peers
Depressive Symptoms
Avoidance of Peers
Loneliness
Early AdolescentPredictors
(Age 14-16)
Late-Adolescent Intervening Variables
(Age 18-20)
Early Adult Outcomes
(Age 23-24)
.25***-.18**
.25***
Depressive Symptoms
.41***
.30***
Direct and Indirect Effects on Future Loneliness
Gender & Income
.39***
Potential Parent Pathway:
Disrupted Relationship
Depressive Symptoms
Attachment to Mother
Attachment to Mother
Maternal Relat. Quality
Early AdolescentPredictors
(Age 14-16)
Late-Adolescent Intervening Variables
(Age 18-20)
Early Adult Outcomes
(Age 23-24)
-.14**
.53*** .35***
-.29***
Depressive Symptoms
.22**
.30***
Gender & Income
Depressive Symptoms
Attachment to Mother
Attachment to Mother
Maternal Relat. Quality
Early AdolescentPredictors
(Age 14-16)
Late-Adolescent Intervening Variables
(Age 18-20)
Early Adult Outcomes
(Age 23-24)
-.14**
.53*** .35***
-.29***
Depressive Symptoms
.22**
.30***
Gender & Income
Depressive Symptoms
Attachment to Mother
Attachment to Mother
Maternal Relat. Quality
Early AdolescentPredictors
(Age 14-16)
Late-Adolescent Intervening Variables
(Age 18-20)
Early Adult Outcomes
(Age 23-24)
-.14**
.53*** .35***
-.29***
Depressive Symptoms
.22**
.30***
Direct and Indirect Effects on Maternal Relationship Quality
Gender & Income
Attachment to Peers
Depressive Symptoms
Attachment to Mother
Attachment to Mother
Avoidance of Peers
Loneliness
Maternal Relat. Quality
Early Adolescent(Age 14-16)
Late-Adolescent (Age 18-20)
Early Adult (Age 23-24)
.25***-.18**
.18**
-.14**
.53*** .35***
-.29***
.25***
Depressive Symptoms
.39***
.22**
.41***
-.19*.30***
The Multiple Sequelae of Adolescent Depression
Limitations
Correlational not Causal
Very Preliminary Understanding of Mediating Processes
NOT based on diagnostic/clinical interviews
Copies of related papers are available at:
www.TeenResearch.org
Conclusions
Importance of even MILD Depressive Symptoms
Effects Beyond Simple Symptom Continuity
Interference with Relationship Formation/Maintenance – A Sensitive Period?
Intervention Implications
Copies of related papers are available at:
www.TeenResearch.org