Understanding adolescents' experiences of their own depressive disorders and related psychosocial difficulties.

This study examined clinically depressed adolescents' subjective experiences of their own depressive disorders. The main objective was to learn how adolescents experience depression and its related difficulties as impacting their lives. Using a within- and between-groups cross-sectional design, this study assessed which phenomena related to their depressive disorders, including depressive symptomotology and psychosocial difficulties in social, academic, and self-perception domains, adolescents perceived as least and most distressing to them. A second aim was to determine if within a sample of clinically depressed youth there were smaller subgroups with differentiated patterns of strengths and weaknesses in psychosocial and depressive functioning. The final study aim was to determine if difficulties experienced by depressed youth were specific to adolescents suffering depression or were also related to normative concerns of adolescence. A two-stage screening methodology was used to identify 42 subjects with a depressive disorder and 15 normal comparison subjects from a community sample of 431 adolescents. Q methodology developed by the present researcher was employed to determine how adolescents perceived difficulties in their lives related to their depressive disorders. Other interview and self-report measures were administered to subjects and one parent to determine adolescent psychological and psychosocial impairment, and to test the validity of the Depression Q-sort. As a group, depressed youth experienced depressive symptomotology as more problematic than other psychosocial difficulties typically associated with depressive disorders. However, within the current sample, four subgroups of depressed youth emerged with distinct patterns in subjective experiences of significant psychosocial difficulties along with substantial depressive symptoms. Specifically, one subgroup of depressed youth identified detached and uninvolved fathers as the largest source of distress in their lives, while another indicated that difficulties associated with comorbid substance use caused them the most difficulty. A third subgroup of depressed youth reported social isolation or withdrawal from peers as most distressing, and the last subgroup identified intense conflict with family members as the biggest source of personal distress. Finally, important differences related to internalized negative cognition distinguished depressed from normal control adolescents' subjective experiences of difficulties in their lives.PhDClinical psychologyPsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/132070/2/9959700.pd