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Trajectories of individual depressive symptoms in adolescents: gender and family relationships as predictors.

ABSTRACT: Depressive syndrome and disorders increase substantially during adolescence. Little is known, however, about how individual symptoms of depression change over the course of this developmental period. The present study examined within-person changes in symptom severity of each individual symptom of depression, utilizing longitudinal data collected across 6 years of adolescence. Adolescent gender and family relationship variables were tested as predictors of the symptom trajectories (i.e., intercept and slope). Adolescents and their mothers (N = 240) were first evaluated when youth were in Grade 6 (M = 11.86 years old, SD = 0.56, 54% female) and then annually through Grade 12. Individual symptoms of depression were assessed by a clinical interviewer using the Children's Depression Rating Scale-Revised (CDRS-R). Mothers and youth also completed measures about their relationship on the Children's Report of Parent Behavior Inventory and the Family Environment Scale. Results showed that all depressive symptoms increased linearly over time except psychomotor disturbances and problems with concentration and decision making, which were best represented by a quadratic growth model. Sex differences were found such that significantly more rapid increases in worthlessness/guilt were found for girls than boys, and concentration/decision making problems significantly changed for boys, but not girls. Poor family relationship quality (mother-reported) predicted a significantly faster rate of increase in adolescents' symptoms of anhedonia, appetite/weight changes, and fatigue. High maternal psychological control (youth-reported) also predicted a faster rate of increase in anhedonia. Study limitations, future research directions, and clinical implications of the findings are discussed.

SUBMITTER: Kouros CD

PROVIDER: S-EPMC4591045 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Trajectories of individual depressive symptoms in adolescents: gender and family relationships as predictors.

Kouros Chrystyna D CD Garber Judy J

Developmental psychology 20141020 12

Depressive syndrome and disorders increase substantially during adolescence. Little is known, however, about how individual symptoms of depression change over the course of this developmental period. The present study examined within-person changes in symptom severity of each individual symptom of depression, utilizing longitudinal data collected across 6 years of adolescence. Adolescent gender and family relationship variables were tested as predictors of the symptom trajectories (i.e., interce ...[more]

PMID: 25329553

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Project description:ImportanceConcerns about the mental health of youths going through gender identity transitions have received increased attention. There is a need for empirical evidence to understand how transitions in self-reported gender identity are associated with mental health.ObjectiveTo examine whether and how often youths changed self-reported gender identities in a longitudinal sample of sexual and gender minority (SGM) youths, and whether trajectories of gender identity were associated with depressive symptoms.Design, setting, and participantsThis cohort study used data from 4 waves (every 9 months) of a longitudinal community-based study collected in 2 large cities in the US (1 in the Northeast and 1 in the Southwest) between November 2011 and June 2015. Eligible participants included youths who self-identified as SGM from community-based agencies and college groups for SGM youths. Data analysis occurred from September 2022 to June 2023.ExposureGender identity trajectories and gender identity variability.Main outcomes and measuresThe Beck Depression Inventory for Youth (BDI-Y) assessed depressive symptoms. Gender identity variability was measured as the number of times participants' gender identity changed. Hierarchical linear models investigated gender identity trajectories and whether gender identity variability was associated with depressive symptoms over time.ResultsAmong the 366 SGM youths included in the study (mean [SD] age, 18.61 [1.71] years; 181 [49.4%] assigned male at birth and 185 [50.6%] assigned female at birth), 4 gender identity trajectory groups were identified: (1) cisgender across all waves (274 participants ), (2) transgender or gender diverse (TGD) across all waves (32 participants), (3) initially cisgender but TGD by wave 4 (ie, cisgender to TGD [28 participants]), and (4) initially TGD but cisgender by wave 4 (ie, TGD to cisgender [32 participants]). One in 5 youths (18.3%) reported a different gender identity over a period of approximately 3.5 years; 28 youths varied gender identity more than twice. The cisgender to TGD group reported higher levels of depression compared with the cisgender group at baseline (Β = 4.66; SE = 2.10; P = .03), but there was no statistical difference once exposure to lesbian, gay, bisexual, and transgender violence was taken into account (Β = 3.31; SE = 2.36; P = .16). Gender identity variability was not associated with within-person change in depressive symptoms (Β = 0.23; SE = 0.74; P = .75) or the level of depressive symptoms (Β = 2.43; SE = 2.51; P = .33).ConclusionsThese findings suggest that gender identity can evolve among SGM youths across time and that changes in gender identity are not associated with changes in depressive symptoms. Further longitudinal work should explore gender identity variability and adolescent and adult health.

Project description:BackgroundThere are gaps in understanding longitudinal patterns and predictors of perinatal depressive symptoms in sub-Saharan Africa. This study aimed to explore trajectories of depressive symptoms and associated factors from pregnancy to 9 months post partum among Kenyan women.MethodsIn this prospective cohort study, we analysed data from the PrEP Implementation for Mothers in Antenatal Care (PrIMA) study in which HIV-negative women were enrolled in pregnancy and followed up to 9 months post partum in 20 public sector maternal-child health clinics in western Kenya. Pregnant women were eligible for enrolment if they were not infected with HIV, aged 15 years or older, and were able to provide consent. Eligible participants were screened and enrolled between Jan 15, 2018, and July 31, 2019, and followed up to 9 months post partum, with the last participant study visit conducted on Jan 15, 2021. Study nurses serially assessed depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CESD-10), intimate partner violence with the Hurt, Insult, Threaten, Scream scale, and social support with the Medical Outcomes Study scale. Generalised estimating equations were used to identify correlates of moderate-to-severe depressive symptoms (CESD-10 score ≥10) and group-based trajectory modelling identified discrete trajectories of perinatal depressive symptoms.FindingsAmong 4447 participants in the main PrIMA study, 3555 had complete depressive symptom data in pregnancy and depressive symptom data post partum and were included in the primary analysis. Median age was 24·0 years (IQR 21·0-28·7), 1330 (38%) participants had low social support, and 278 (8%) reported intimate partner violence in pregnancy. All participants (100%) were female and all (100%) were of African Kenyan ethnicity. Prevalence of moderate-to-severe depressive symptoms was higher in pregnancy than post partum (870 [24·5%; 95% CI 23·1-25·9] vs 597 [6·8%; 15·6-18·1]; p<0·0001). Five patterns of depressive symptoms were identified; persistent moderate-to-severe depressive symptoms in pregnancy and post partum (295 [8·3%]), moderate-to-severe depressive symptoms in pregnancy that resolved post partum (139 [3·9%]), moderate-to-severe depressive symptoms that emerged post partum (40 [1·1%]), chronically mild symptoms (2709 [76·2%]), and no depressive symptoms (372 [10·5%]). Emergent moderate-to-severe depressive symptoms were associated with older age. Emergent, persistent, and resolving moderate-to-severe depressive symptoms were associated with intimate partner violence during pregnancy; and persistent and resolving moderate-to-severe depressive symptoms were associated with low social support and high HIV risk (all p<0·05). Moderate-to-severe depressive symptom risk was significantly increased with intimate partner violence (adjusted odds ratio 2·07 [95% CI 1·81-2·31]; p<0·0001), low social support (1·74 [1·56-1·95]; p<0·0001), and partner HIV-positive status (1·48 [1·22-1·78]; p<0·0001). 23·34% (95% CI 18·77-27·65) of cases of perinatal moderate-to-severe depressive symptoms were attributable to low social support.InterpretationOne third of women had perinatal moderate-to-severe depressive symptoms; nearly half of these had higher severity phenotypes of resolving, persistent, and emerging moderate-to-severe depressive symptoms that might require tailored interventions. Perinatal women with comorbid psychosocial stressors such as intimate partner violence and previous pregnancy loss should be prioritised for mental health services that augment social support within routine maternal-child health care.FundingNational Institutes of Health.TranslationFor the Kiswahili translation of the abstract see Supplementary Materials section.

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Trajectories of individual depressive symptoms in adolescents: gender and family relationships as predictors.

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Trajectories of individual depressive symptoms in adolescents: gender and family relationships as predictors.

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