Depression

The incidence of depression is rare in children through age 6 and low prior to puberty; it increases as young people reach adolescence, with 5 percent of adolescents in a given year experiencing clinical depression and as many as 20 percent having had a clinical episode sometime during their adolescence, rates similar to those found in young adults (Angold and Costello, 2001). Around age 13, depression becomes about twice as common among girls than boys (Angold and Costello, 2001). This changing picture means that prevention programs need to be appropriate for specific developmental periods, taking into account age and gender differences in the mechanisms leading to depression.

Interventions to prevent depression in young people have primarily focused on three risk factors: parents with mood disorders, a depressogenic cognitive style, and elevated levels of depressive symptoms or a history of depression. Across studies, the rates of depression in adolescents with a depressed parent are three to four times higher than rates in those with non-depressed parents (Beardslee, Versage, and Gladstone, 1998). The mechanism is not understood but is likely to involve a combination of genetic and psychosocial influences, including poor parenting, high family stress, and conflict (Garber, 2006; Riley, Valdez, et al., 2008).

For children of depressed parents, preventive interventions have been developed to promote multiple family-level protective processes and to help children cope effectively (Beardslee, Gladstone, et al., 2003). Beardslee and Podorefsky (1988) specifically examined resilience in this population and identified three characteristics in the children: the capacity to accomplish age-appropriate developmental tasks, the capacity to be deeply engaged in relationships, and the capacity for self-reflection and self-understanding. Specifically, the youngsters understood that their parents had an illness, that they were not to blame and were not responsible for it, and that they were free to go on with their own lives. Correspondingly, the researchers found that a commitment to parenting despite depression characterized the parents of resilient children. These resilience characteristics were built into their preventive intervention strategy, illustrating the connection between understanding risk and resilience and developing preventive interventions.

A depressogenic cognitive style is marked by a tendency to ruminate and to see the world without optimism and as not in one’s control (Abramson, Alloy, et al., 2002; Kaslow, Abramson, and Collins, 2000). The results of intervention trials to modify depressogenic cognitive styles have been promising in terms of reducing depressive symptoms and disorder. In some cases, improvement in depressive cognitive mediators accounted for program effects to reduce depression (Clarke, Hornbrook, et al., 2001; Gilham,



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