Abstract
This study examined risk and protective factors associated with depression among adolescents in the United States. A sample of 11,738 participants with current or past depression who were between 12 and 17 years was selected from the 2019 National Survey of Children’s Health. Two multivariable logistic regression models examined the relationship between six predictors (being bullied, bullied others, difficulties making or keeping friends, family communication, school engagement, and involvement in extracurricular activities) and outcome variables (past or current depression). Results showed that being bullied or bullying others increased the likelihood of past and current depression. Having little or no difficulties making or keeping friends and engagement in school and extracurricular activities reduced the odds of having past or current depression. Frequent family communication reduced the likelihood of current, but not past depression. Results were significant beyond the associations between covariates (sex, age levels, race, and federal poverty levels) and dependent variables. Caregivers and health professionals should encourage positive social connections with family and peers as well as participation in school and extracurricular activities to protect adolescents from depression.
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Data availability
The dataset analyzed in the current study is available in the Child and Adolescent Health Measurement Initiative repository (https://www.childhealthdata.org/help/dataset).
References
Aronson, O., & Bergh, D. (2021). Adolescents who feel depressed are rejected but do not withdraw: a longitudinal study of ethnically diverse friendship networks in England, Sweden, and Germany. SSM-Population Health, 15, 100889. https://doi.org/10.1016/j.ssmph.2021.100889
Babaee, E., Nojomi, M., Asadi-Aliabadi, M., & Eshrati, B. (2021). Bullying and being bullied; how much can it increase the risk of depression and anxiety in students? A multilevel fixed-effect model analysis. Iranian Journal of Psychiatry and Behavioral Sciences, 15(2).
Baldessarini, R. J., Innamorati, M., Erbuto, D., Serafini, G., Fiorillo, A., Amore, M., Girardi, P., & Pompili, M. (2017). Differential associations of affective temperaments and diagnosis of major affective disorders with suicidal behavior. Journal of Affective Disorders, 210, 19–21. https://doi.org/10.1016/j.jad.2016.12.003
Blumberg, H. P., Kaufman, J., Martin, A., Charney, D. S., Krystal, J. H., & Peterson, B. S. (2004). Significance of adolescent neurodevelopment for the neural circuitry of bipolar disorder. Annals of the New York Academy of Sciences, 1021, 376–383. https://doi.org/10.1196/annals.1308.048
Call, J. B., & Shafer, K. (2018). Gendered manifestations of depression and help-seeking among men. American Journal of Men’s Health, 12(1), 41–51. https://doi.org/10.1177/1557988315623993
Center for Behavioral Health Statistics and Quality. (2011). The NSDUH report: major depressive episode and treatment among adolescents: 2009. Rockville, MD.
Child and Adolescent Health Measurement Initiative (CAHMI) (2021). “2019 National Survey of Children’s Health, Sampling and Survey Administration.” Data Resource Center for Child and Adolescent Health, supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved November 20, 2021, from https://www.childhealthdata.org/docs/default-source/nsch-docs/2019-nsch-sampling-administration_cahmi_10-2-20.pdf?sfvrsn=7b7b5f17_2
Chen, P., & Harris, K. M. (2019). Association of positive family relationships with mental health trajectories from adolescence to midlife. JAMA Pediatrics, 173(12), e193336–e193336. https://doi.org/10.1001/jamapediatrics.2019.3336
Da Silva, M. A., Gonzalez, J. C., Person, G. L., & Martins, S. S. (2020). Bidirectional association between bullying perpetration and internalizing problems among youth. Journal of Adolescent Health, 66(3), 315–322. https://doi.org/10.1016/j.jadohealth.2019.09.022
Evans, C. B., Smokowski, P. R., Rose, R. A., Mercado, M. C., & Marshall, K. J. (2019). Cumulative bullying experiences, adolescent behavioral and mental health, and academic achievement: an integrative model of perpetration, victimization, and bystander behavior. Journal of Child and Family Studies, 28(9), 2415–2428. https://doi.org/10.1007/s10826-018-1078-4
Falci, C., & McNeely, C. (2009). Too many friends: social integration, network cohesion, and adolescent depressive symptoms. Social Forces, 87(4), 2031–2061. https://doi.org/10.1353/sof.0.0189
Fredricks, J. A., & Eccles, J. S. (2008). Participation in extracurricular activities in the middle school years: are there developmental benefits for african american and european american youth? Journal of Youth and Adolescence, 37(9), 1029–2043. https://doi.org/10.1111/j.1532-7795.2009.00627.x
Fullchange, A., & Furlong, M. J. (2016). An exploration of effects of bullying victimization from a complete mental health perspective. Sage Open, 6(1), 2158244015623593. https://doi.org/10.1177/2F2158244015623593
Geçer, E., & Yıldırım, M. (2021). Family communication and psychological distress in the era of COVID-19 pandemic: mediating role of coping. Journal of Family Issues, 1–7. https://doi.org/10.1177/0192513X211044489
Ghazavi, Z., Feshangchi, S., Alavi, M., & Keshvari, M. (2016). Effect of a family-oriented communication skills training program on depression, anxiety, and stress in older adults: a randomized clinical trial. Nursing and Midwifery Studies, 5(1), e28550. https://doi.org/10.17795/nmsjournal28550
Health and Human Services (2014, September 16). Does depression increase the risk for suicide? Retrieved February 26, 2022, from https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-depression-increase-risk-of-suicide/index.html
Jessor, R. (1991). Risk behavior in adolescence: a psychosocial framework for understanding and action. Journal of Adolescent Health, 12(8), 597–605. https://doi.org/10.1016/1054-139X(91)90007-K
John, R. L., & Antai-Otong, D. (2016). Contemporary treatment approaches to major depression and bipolar disorders. Nursing Clinics of North America, 51(2), 335–351. https://doi.org/10.1016/j.cnur.2016.01.015
Joyce, H. D., & Early, T. J. (2014). The impact of school connectedness and teacher support on depressive symptoms in adolescents: a multilevel analysis. Children and Youth Services Review, 39, 101–107. https://doi.org/10.1016/j.childyouth.2014.02.005
Kaminer, Y., Connor, D. F., & Curry, J. F. (2007). Comorbid adolescent substance use and major depressive disorders: a review. Psychiatry (Edgmont (Pa : Township), 4(12), 32–43.
Kang, S. Y., Lee, J. A., & Kim, Y. S. (2019). Impact of family communication on self-rated health of couples who visited primary care physicians: a cross-sectional analysis of Family Cohort Study in Primary Care. PloS One, 14(3), e0213427. https://doi.org/10.1371/journal.pone.0213427
KavehFarsani, Z., Kelishadi, R., & Beshlideh, K. (2020). Study of the effect of family communication and function, and satisfaction with body image, on the psychological well-being of obese girls: the mediating role of self-esteem and depression. Child and Adolescent Psychiatry and Mental Health, 14(1), 1–10. https://doi.org/10.1186/s13034-020-00345-3
Kim-Cohen, J., Caspi, A., Moffitt, T. E., Harrington, H., Milne, B. J., & Poulton, R. (2003). Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Archives of General Psychiatry, 60(7), 709–717. https://doi.org/10.1001/archpsyc.60.7.709
Klomek, A. B., Marrocco, F., Kleinman, M., Schonfeld, I. S., & Gould, M. S. (2007). Bullying, depression, and suicidality in adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 46(1), 40–49. https://doi.org/10.1097/01.chi.0000242237.84925.18
Knifesend, C. A., & Graham, S. (2012). Too much of a good thing? How breadth of extracurricular participation relates to school-related affect and academic outcomes during adolescence. Journal of Youth and Adolescence, 41(3), 379–389. https://doi.org/10.1007/s10964-011-9737-4
Kumpulainen, K., Räsänen, E., & Puura, K. (2001). Psychiatric disorders and the use of mental health services among children involved in bullying. Aggressive Behavior, 27(2), 102–110. https://doi.org/10.1002/ab.3
Litwack, S. D., Aikins, J. W., & Cillessen, A. H. (2012). The distinct roles of sociometric and perceived popularity in friendship: implications for adolescent depressive affect and self-esteem. Journal of Early Adolescence, 32(2), 226–251. https://doi.org/10.1177/0272431610387142
Luukkonen, A. H., Räsänen, P., Hakko, H., Riala, K., & STUDY-70 Workgroup. (2010). Bullying behavior in relation to psychiatric disorders and physical health among adolescents: a clinical cohort of 508 underage inpatient adolescents in Northern Finland. Psychiatry Research, 178(1), 166–170. https://doi.org/10.1016/j.psychres.2010.04.022
McKinley, C. E., Boel-Studt, S., Renner, L. M., & Figley, C. R. (2021). Risk and protective factors for symptoms of depression and anxiety among american Indians: understanding the roles of resilience and trauma. Psychological Trauma, 13(1), 16–25. https://doi.org/10.1037/tra0000950
Mei, S., Hu, Y., Sun, M., Fei, J., Li, C., Liang, L., & Hu, Y. (2021). Association between bullying victimization and symptoms of depression among adolescents: a moderated mediation analysis. International Journal of Environmental Research and Public Health, 18(6), 3316. https://doi.org/10.3390/ijerph18063316
Melton, T. H., Croarkin, P. E., Strawn, J. R., & McClintock, S. M. (2016). Comorbid anxiety and depressive symptoms in children and adolescents: a systematic review and analysis. Journal of Psychiatric Practice, 22(2), 84–98. https://doi.org/10.1097/PRA.0000000000000132
Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey replication-adolescent supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989. https://doi.org/10.1016/j.jaac.2010.05.017
National Institute of Mental Health (2022, January). Major depression Retrieved March 18, 2022, from https://www.nimh.nih.gov/health/statistics/major-depression
Oberle, E., Ji, X. R., Kerai, S., Guhn, M., Schonert-Reichl, K. A., & Gadermann, A. M. (2020). Screen time and extracurricular activities as risk and protective factors for mental health in adolescence: a population-level study. Preventive Medicine, 141, 106291. https://doi.org/10.1016/j.ypmed.2020.106291
Rivers, A. S., Russon, J., Winston-Lindeboom, P., Ruan-Iu, L., & Diamond, G. (2022). Family and peer relationships in a residential youth sample: exploring unique, non-linear, and interactive associations with depressive symptoms and suicide risk. Journal of Youth and Adolescence, 51(6), 1062–1073. https://doi.org/10.1007/s10964-021-01524-x
Ruvalcaba, N. A., Gallegos, J., Borges, A., & Gonzalez, N. (2017). Extracurricular activities and group belonging as a protective factor in adolescence. Psicología Educativa, 23(1), 45–51. https://doi.org/10.1016/j.pse.2016.09.001
Sakyi, K. S., Surkan, P. J., Fombonne, E., Chollet, A., & Melchior, M. (2015). Childhood friendships and psychological difficulties in young adulthood: an 18-year follow-up study. European Child & Adolescent Psychiatry, 24(7), 815–826. https://doi.org/10.1007/s00787-014-0626-8
Sancassiani, F., Pintus, E., Holte, A., Paulus, P., Moro, M. F., Cossu, G., Angermeyer, M. C., Carta, M. G., & Lindert, J. (2015). Enhancing the emotional and social skills of the youth to promote their wellbeing and positive development: a systematic review of universal school-based randomized controlled trials. Clinical Practice and Epidemiology in Mental Health, 11(Suppl 1 M2), S21–S40. https://doi.org/10.2174/1745017901511010021
Serafini, G., Pompili, M., Borgwardt, S., Houenou, J., Geoffroy, P. A., Jardri, R., Girardi, P., & Amore, M. (2014). Brain changes in early-onset bipolar and unipolar depressive disorders: a systematic review in children and adolescents. European Child & Adolescent psychiatry, 23(11), 1023–1041. https://doi.org/10.1007/s00787-014-0614-z
Smith, D. T., Mouzon, D. M., & Elliott, M. (2018). Reviewing the assumptions about men’s mental health: an exploration of the gender binary. American Journal of Men’s Health, 12(1), 78–89. https://doi.org/10.1177/1557988316630953
Tracy, M., Zimmerman, F. J., Galea, S., McCauley, E., & Vander Stoep, A. (2008). What explains the relation between family poverty and childhood depressive symptoms? Journal of Psychiatric Research, 42(14), 1163–1175. https://doi.org/10.1016/j.jpsychires.2008.01.011
Ueno, K. (2005). The effects of friendship networks on adolescent depressive symptoms. Social Science Research, 34(3), 484–510. https://doi.org/10.1016/j.ssresearch.2004.03.002
van Harmelen, A. L., Kievit, R. A., Ioannidis, K., Neufeld, S., Jones, P. B., Bullmore, E., Dolan, R., Consortium, N. S. P. N., Fonagy, P., & Goodyer, I. (2017). Adolescent friendships predict later resilient functioning across psychosocial domains in a healthy community cohort. Psychological Medicine, 47(13), 2312–2322. https://doi.org/10.1017/S0033291717000836
van Harmelen, A. L., Gibson, J. L., Clair, S., Owens, M. C., Brodbeck, M., Dunn, J., Lewis, V., Croudace, G., Jones, T., Kievit, P. B., R. A., & Goodyer, I. M. (2016). Friendships and family support reduce subsequent depressive symptoms in at-risk adolescents. PloS One, 11(5). https://doi.org/10.1371/journal.pone.0153715
Venta, A., Bailey, C., Muñoz, C., Godinez, E., Colin, Y., Arreola, A., Abate, A., Camins, J., Rivas, M., & Lawlace, S. (2019). Contribution of schools to mental health and resilience in recently immigrated youth. School Psychology, 34(2), 138–147. https://doi.org/10.1037/spq0000271
Wang, M. T., & Peck, S. C. (2013). Adolescent educational success and mental health vary across school engagement profiles. Developmental Psychology, 49(7), 1266–1276. https://doi.org/10.1037/a0030028
Zarnaghash, M., Zarnaghash, M., & Zarnaghash, N. (2013). The relationship between family communication patterns and mental health. Procedia-Social and Behavioral Sciences, 84, 405–410. https://doi.org/10.1016/j.sbspro.2013.06.575
Zhang, Q., Pan, Y., Zhang, L., & Lu, H. (2021). Parent-adolescent communication and early adolescent depressive symptoms: the roles of gender and adolescents’ age. Frontiers in Psychology, 12, 647596, 12. https://doi.org/10.3389/fpsyg.2021.647596
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Adabla, S., Nabors, L.A. Risk and protective factors associated with depression among adolescents. Curr Psychol 42, 31024–31034 (2023). https://doi.org/10.1007/s12144-022-04075-x
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DOI: https://doi.org/10.1007/s12144-022-04075-x