Adolescent Depression Flashcards
Describe the main features of depression Describe some important aetiological and maintaining factors Describe the outcome and interventions that may ameliorate the problem
What percentage of adults diagnosed with a psychiatric disorder had a previous diagnosis before age 18? (Kim-Cohen et al, 2003)
75%
What is shy, fearful, and easily upset behaviour at age 3 predictive of?
Later depression, suicide attempts, and alcohol misuse
What is impulsive, restless, and distractible behaviour at age 3 predictive of?
Later conduct problems, depression, antisocial behaviour, suicide attempts, and alcohol misuse
What is the concordance rate of depression in monozygotic twins reared together and apart?
76% together, 67% apart
State some environmental risk factors for depression
Parental depression, family discord, maltreatment, peer victimisation, bereavement
Describe the change in depression incidence in males and females through puberty
Before puberty, incidence is the same in males and females. Between ages 11-13, incidence dramatically increases in females but only increases slightly in males. By 15, females are twice as likely to experience a major depressive episode
Give some potential explanations for the gender differences in depression incidence in adolescence
Hormones (testosterone affects social and affective information), rapid growth (change in body shape), circadian rhythm changes
Describe the changes in the prefrontal cortex during adolescence
Grey matter thinning, synaptic pruning, myelination
Describe the influence of the amygdala and prefrontal cortex on depression
Increased amygdala to prefrontal cortex connectivity is associated with an increase in adolescent suicidal ideation and attempts (Alarcon etal, 2019) - but positive parenting is protective, associated with decreased amygdala growth and increased cortical thinning (Whittle et al, 2013)
Describe the cognitive changes which occur during adolescence
Thoughts become more logical with more abstract reasoning
Greater consideration of consequences and ambiguity
Improved memory capacity, including autobiographical memory (sense of self across time)
Describe the emotional changes which occur during adolescence
Increased intensity of mood
Changes to self-regulation
Establishment of identity, including consideration of reputation amongst peers
Describe the social changes which occur during adolescence
Family shift towards autonomy and independence, questioning family rules and values More importance attached to peer relationships Romantic and sexual relationships Increased experimentation (e.g. tobacco, alcohol, drugs)
How is adolescent depressive disorder differentiated from normal teenage angst?
It causes serious suffering and impairment, impacting on the individual, their family, their peers, and their education or work
What are the 3 main domains of depressive disorder?
Low mood and sadness, loss of enjoyment, and loss of energy
Give at least 3 differences between adolescent and adult major depressive disorder
1) Irritability instead of sadness or low mood (especially in boys)
2) Somatic complaints and social withdrawal more common
3) Psychotic symptoms rarer
4) Self-harm more common
