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Ecological Correlates of Depression and Self-Esteem in Rural Youth

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Abstract

The current study examines individual-, social-, and school-level characteristics influencing symptoms of depression and self-esteem among a large sample (N = 4,321) of U.S. youth living in two rural counties in the South. Survey data for this sample of middle-school students (Grade 6 to Grade 8) were part of the Rural Adaptation Project. Data were analyzed using ordered logistic regression. Results show that being female, having a low income, and having negative relationships with parents and peers are risk factors that increase the probability of reporting high levels of depressive symptoms and low levels of self-esteem. In contrast, supportive relationships with parents and peers, high religious orientation, ethnic identity, and school satisfaction increased the probability of reporting low levels of depressive symptoms and high levels of self-esteem. There were few school-level characteristics associated with levels of depressive symptoms and self-esteem. Implications are discussed.

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References

  1. Erickson EH (1963) Childhood and society, 2nd edn. WW Norton, New york

    Google Scholar 

  2. Hankin BL (2006) Adolescent depression: Description, causes and interventions. Epilepsy Behav 8:102–114. Company, INC: New York, NY

    Google Scholar 

  3. Knopf D, Park MJ, Mulye TP (2008) The mental health of adolescents: a national profile, 2008. National Adolescent Health Information Center, University of California, San Francisco, San Francisco

    Google Scholar 

  4. U.S. Department of Health and Human Services (2011) The National survey on drug use and health: major depressive episode and treatment among adolescents-2009. Retrieved from http://oas.samhsa.gov/2k11/009/AdolescentDepressionHTML.pdf

  5. Birmaher B, Ryan ND, Willamson DE, Brent DA, Kaufman J, Dahl RE, Nelson B (1996) Childhood and adolescent depression: a review of the past 10 years (part I). J Am Acad Child Adolesc Psychiatry 35:1427–1439

    Article  PubMed  Google Scholar 

  6. Derdikman-Eiron R, Indredavik MS, Bratberg GH, Taraldsen G, Bakken IJ, Colton M (2011) Gender differences in subjective well-being, self-esteem, and psychosocial functioning in adolescents with symptoms of anxiety and depression: Findings from the Nord-Trøndelag health study. Scand J Psychol 52:261–267

    Article  PubMed  Google Scholar 

  7. Glendinning A (1998) Family life, health, and lifestyles in rural areas: the role of self-esteem. Health Educ 98:59–68

    Article  Google Scholar 

  8. Millings A, Buck R, Montgomery A, Spears M, Stallard P (2012) School connectedness, peer attachments, and self-esteem as predictors of adolescent depression. Manuscript submitted for publication. J Adolesc XXX:1–7

    Google Scholar 

  9. Donnellan MB, Trzesniewski KH, Robins RW, Moffitt TE, Caspi A (2005) Low self-esteem is related to aggression, antisocial behavior, and delinquency. Psychol Sci 16:328–335

    Article  PubMed  Google Scholar 

  10. Trzesniewski KH, Donnellan MB, Moffitt TE, Robins RW, Poulton R, Caspi A (2006) Low self-esteem during adolescence predicts poor health, criminal behavior, and limited economic prospects during adulthood. Dev Psychol 42:381–390

    Article  PubMed  Google Scholar 

  11. Grama JL (2000) Women forgotten: difficulties faced by rural victims of domestic violence. Am J Fam Law 14:173–189

    Google Scholar 

  12. Bronfrenbrenner U (1979) The ecology of human development: Experiments by nature and design. Harvard University Press, Cambridge

    Google Scholar 

  13. Bronfrenbrenner U (1994) Ecological models of human development. In: International encyclopedia of education, vol. 3, 2nd edn. Elsevier, Oxford. Reprinted in Gauvain M, Cole M (eds) (1993) Readings on the development of children, 2nd edn. Freeman, NY, pp 37–43

  14. Maas HS (1986) From crib to crypt: Social development and responsive environments as professional focus. Rutgers University Press, New Brunswick

    Google Scholar 

  15. Smokowski PR, Cotter KL, Robertson CIB, Guo S (2013) Anxiety and aggression in rural youth: baseline results from the Rural Adaptation Project. Child Psych Human Dev 44:479–492

  16. U.S. Department of Justice, Office for Victims of Crime, Office of Justice Programs (2001) Rural victim assistance: A victim/witness guide for rural prosecutors (NCJ No. 21106). Retrieved from http://www.ojp.usdoj.gov/ovc/publications/infores/rural_victim_assistance/pfv.html

  17. Eberhardt MS, Pamuk ER (2004) The importance of place of residence: examining health in rural areas. Am J Pub Health 94:1682–1686

    Article  Google Scholar 

  18. Probst JC, Laditka SB, Moore CG, Harun N, Powell P, Baxley EG (2006) Rural-urban differences in depression prevalence: implications for family medicine. Health Services Res 38:653–660

    Google Scholar 

  19. Atav S, Spencer GA (2002) Health risk behaviors among adolescents attending rural, suburban, and urban schools: a comparative study. Fam Community Health 17:53–64

    Article  Google Scholar 

  20. Provasnik S, Ramani AK, Coleman MM, Gilbertson L, Herring W, Xie Q (2007) Status of education in rural America (NCES 2007-040). National Center for Education Statistics, Washington, DC

    Google Scholar 

  21. Witherspoon D, Ennett S (2011) Stability and change in rural youths’ educational outcomes through the middle and high school years. J Youth Adolesc 40:1077–1090

    Article  PubMed  PubMed Central  Google Scholar 

  22. Carlson KT (2006) Poverty and youth violence exposure: experiences in rural communities. Child Sch 28:87–96

    Article  Google Scholar 

  23. Dawkins J, Hill P (1995) Bullying: Another form of abuse. In: David TJ (ed) Recent advances in pediatrics. Edinburgh, Livingstone, pp 103–122

    Google Scholar 

  24. Robbins V, Dollard N, Armstrong BJ, Kutash K, Vergon KS (2008) Mental health needs of poor suburban and rural children and their families. J Loss Trauma 13:94–122

    Article  Google Scholar 

  25. Spoth R, Goldberg C, Neppl T, Trudeau L, Ramisetty-Mikler S (2001) Rural-urban differences in the distribution of parent-reported risk factors for substance use among young adolescents. J Subst Abuse 13:609–623

    Article  PubMed  Google Scholar 

  26. Angold A, Erkanli A, Farmer EMZ, Fairbank JA, Burns BJ, Keeler G, Costello EJ (2002) Psychiatric disorder, impairment, and service use in rural African American and White youth. Arch Gen Psychiatry 59:893–901

    Article  PubMed  Google Scholar 

  27. Roberts R, Attkisson C, Rossenblatt A (1998) Prevalence of psychopathology among children and adolescents. Am J Psychiatry 155:715–725

    PubMed  Google Scholar 

  28. O’Regan M (1994) Self-esteem, depression and hostility in Irish adolescents. J Adolesc 17:565–577

    Article  Google Scholar 

  29. Parikh SV, Wasylenki D, Goering P, Wong J (1996) Mood disorders: rural/urban differences in prevalence, health care utilization, and disability in Ontario. J Affect Disord 38:57–65

    Article  PubMed  Google Scholar 

  30. Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S et al (1994) Life time and 12-month prevalence of DSM-III-R psychiatric disorders in the Unites States: results from the National Comorbidity Survey. Arch Gen Psychiatry 41:8–19

    Article  Google Scholar 

  31. Negriff S, Susman EJ (2011) Pubertal timing, depression, and externalizing problems: a framework, review, and examination of gender differences. J Res Adoles 21:717–746

    Article  Google Scholar 

  32. Puskar KR, Bernardo LM, Ren D, Haley TM, Tark KH, Switala J et al (2010) Self-esteem and optimism is rural youth: gender differences. Contemp Nurse 34:190–198

    Article  PubMed  Google Scholar 

  33. Behnke AO, Plunkett SW, Sands T, Bamaca-Colber MY (2011) The relationship between adolescents’ perceptions of discrimination, neighborhood risk, and parenting on self-esteem and depressive symptoms. J Cross Cult Psychol 42:1179–1197

    Article  Google Scholar 

  34. Goodman E, Huang B, Wade TJ, Kahn RS (2003) A multilevel analysis of the relation of socioeconomic status to adolescent depressive symptoms: does school context matter? J Peds 143:451–456

    Article  Google Scholar 

  35. Goodman E, Slap GB, Huang B (2003) The public health impact of socioeconomic status on adolescent depression and obesity. Adolesc Health 93:1844–1850

    Google Scholar 

  36. Twenge JM, Campbell WK (2002) Self-esteem and socioeconomic status: a meta-analytic review. Pers Soc Psychol Rev 6:59–71

    Article  Google Scholar 

  37. Twenge JM, Nolen-Hoeksema S (2002) Gender, race, socioeconomic status, and birth cohort differences on children’s depression inventory: a meta-analysis. J Abnorm Psychol 111:578–588

    Article  PubMed  Google Scholar 

  38. Mullins AK, Mullins RL, Normandin D (1992) Cross-sectional and longitudinal comparisons of adolescent self-esteem. Adolesc 27:51–61

    Google Scholar 

  39. Wiltfang GL, Scarbecz M (1990) Social class and adolescents’ self-esteem: another look. Social Psychol Q 53:174–183

    Article  Google Scholar 

  40. Brooks-Gunn J, Duncan GJ (1997) The effects of poverty on children. Future Child 7:55–71

    Article  PubMed  Google Scholar 

  41. Bracken BA, Reintjes C (2010) Age, race, and gender differences in depressive symptoms: a lifespan developmental investigation. J Psychol Assess 28:40–53

    Article  Google Scholar 

  42. Roberts RE, Sobhan M (1992) Symptoms of depression in adolescence: a comparison of Anglo, African, and Hispanic Americans. J Youth Adolesc 21:639–651

    Article  PubMed  Google Scholar 

  43. Roberts RE, Roberts CR, Chen YR (1997) Ethnocultural differences in the prevalence of adolescent depression. Am J Comm Psychol 25:95–110

    Article  Google Scholar 

  44. Twenge JM, Crocker J (2002) Race and self-esteem: meta-analyses comparing Whites, Blacks, Hispanics, Asians, and American Indians and comment on Gray-Little and Hafdahl (2000). Psychol Bull 128:371–408

    Article  PubMed  Google Scholar 

  45. Bachman JG, O’Malley PM, Freedman-Doan P, Trzesniewski KH, Donnellan MB (2011) Adolescent self-esteem: differences by race/ethnicity, gender, and age. Self Identity 10:445–473

    Article  PubMed  PubMed Central  Google Scholar 

  46. Center for Disease Control and Prevention (2011) School connectedness. Retrieved from http://www.cdc.gov/healthyyouth/adolescenthealth/connectedness.htm

  47. Resnick MD, Bearman PS, Blum RW, Bauman KE, Harris KM, Jones J, Udry (1997) Protecting adolescents from harm: findings from the National Longitudinal Study on Adolescent Health. JAMA 278:823–832

    Article  PubMed  Google Scholar 

  48. Eamon MK (2002) Influences and mediators of the effects of poverty on young adolescent depressive symptoms. J Youth Adolesc 31:231–242

    Article  Google Scholar 

  49. Witherspoon D, Schotland M, Way N, Hughes D (2009) Connecting the dots: how connectedness to multiple contexts influences the psychological and academic adjustment of urban youth. Appl Dev Sci 13(4):199–216

    Article  Google Scholar 

  50. Huebner ES, Gilman R (2006) Students who like and dislike school. App Res Qual Life 1:139–150

    Article  Google Scholar 

  51. Kiang L, Witkow MR, Champagne MC (2012) Normative changes in ethnic and American identities and links with adjustment among Asian American adolescents. Advance online publication, Dev Psychol

    Google Scholar 

  52. Kenyon DB, Carter JS (2011) Ethnic identity, sense of community, and psychological well-being among northern plains American Indian youth. J Community Psychol 39:1–9

    Article  Google Scholar 

  53. Blash RR, Unger DG (1995) Self-concept of African-American male youth: self-esteem and ethnic identity. J Child Fam Stud 4:359–373

    Article  Google Scholar 

  54. Corenblum B, Armstrong HD (2012) Racial-ethnic identity development in children in a racial-ethnic minority group. Can J Behav Sci 44:124–137

    Article  Google Scholar 

  55. Phinney JS, Chaviara V (1992) Ethnic identity and self-esteem: an exploratory longitudinal study. J Adolesc 15:271–281

    Article  PubMed  Google Scholar 

  56. Phinney JS, Horenczyk G, Liebkind K, Vedder P (2001) Ethnic identity, immigration, and well-being: an interactional perspective. J Soc Issues 57:493–510

    Article  Google Scholar 

  57. Umaña-Taylor AJ, Updegraff KA (2007) Latino adolescents’ mental health: exploring the interrelations among discrimination, ethnic identity, cultural orientation, self-esteem, and depressive symptoms. J Adolesc 30:549–567

    Article  PubMed  Google Scholar 

  58. White CL, Burke PJ (1987) Ethnic role identity among black and white college students: an interactionist approach. Sociol Pers 30:310–331

    Article  Google Scholar 

  59. Le TN, Tov W, Taylor J (2007) Religiousness and depressive symptoms in five ethnic adolescent groups. Int J Psychol Relig 17:209–232

    Article  Google Scholar 

  60. Rasic D, Kisely S, Langille DB (2011) Protective associations of importance of religion and frequency service attendance with depression risk, suicidal behaviours and substance use in adolescents in Nova Scotia, Canada. J Affect Disord 132:389–395

    Article  PubMed  Google Scholar 

  61. Wong YJ, Rew L, Slaikeu KD (2006) A systematic review of recent research on adolescent religiosity/spirituality and mental health. Issues Ment Health Nurs 27:161–183

    Article  PubMed  Google Scholar 

  62. Bagley C, Mallick K (1997) Self-esteem and religiosity: comparison of 13- to 15-year-old students in Catholic and public junior high schools. Can Soc Study Educ 22:89–92

    Google Scholar 

  63. Smith CB, Weigert AJ, Thomas DL (1979) Self-esteem and religiosity: an analysis of Catholic adolescents from five cultures. J Sci Study Relig 18:51–60

    Article  Google Scholar 

  64. Donahue MJ (1995) Religion and well-being of adolescents. J Soc Issues 51:145–160

    Article  Google Scholar 

  65. Hunsberger B, Pratt M, Pancer M (2001) Religious versus nonreligious socialization: does religious background have implications for adjustment? Int J Psychol Relig 11:105–128

    Article  Google Scholar 

  66. Boutelle K, Eisenberg ME, Gregory ML, Neumark-Sztainer D (2009) The reciprocal relationship between parent-child connectedness and adolescent emotional functioning over 5 years. J Psychosoma Res 66:309–316

    Article  Google Scholar 

  67. Mallery CJ (2011) The effects of neighborhood context and parenting factors on adolescent mental

  68. Laible DJ, Carlo G, Roesch SC (2004) Pathways to self-esteem in late adolescence: the role of parent and peer attachment, empathy, and social behaviours. J Adolesc 27: 703–716. Health: a multilevel investigation. Diss Abstr Int 1819

    Google Scholar 

  69. Arslan C (2009) Anger, self-esteem, and perceived social support in adolescence. Soc Pers 37:555–564

    Article  Google Scholar 

  70. Martin AI, Marsh HW, McInerney DM, Green J, Dowson M (2007) Getting along with teachers and parents: the yields of good relationships for students’ achievement motivation and self-esteem. Aust J Guidance Counsel 17:109–125

    Article  Google Scholar 

  71. Stevenson HC (1998) Raising safe villages: cultural-ecological factors that influence the emotional adjustment of adolescents. J Black Psychol 24:44–59

    Article  Google Scholar 

  72. Lai L, Zhehg G, Liu F (2008) The effect of peer relationship on self-esteem of middle school students. Chinese J Clin Psychol 16:74–76

    Google Scholar 

  73. Smokowski PR, Bacallao M, Buchanan R (in press) Mediation pathways from acculturation stressors to adolescent internalizing problems: an ecological structural model for Latino youth. J Comm Psychol

  74. Sheeber LB, Davis B, Leve C, Hops H, Tildesley E (2008) Adolescents’ relationships with their mothers and fathers: associations with depressive disorder and subdiagnostic symptomatology. J Abnormal Psychol 116:144–154

    Article  Google Scholar 

  75. Sigfusdottir ID, Asgeirsdottir BB, Sigurdsson JF, Gudjonsson GH (2011) Physical activity buffers the effects of family conflict on depressed mood: a study on adolescent girls and boys. J Adolesc 34:895–902

    Article  PubMed  Google Scholar 

  76. Holtzman RJ, Roberts MC (2012) The role of family conflict in the relation between exposure to community violence and depressive symptoms. J Community Psychol 40:264–275

    Article  Google Scholar 

  77. La Greca AM, Harrison HM (2005) Adolescent peer relations, friendships, and romantic relationships: do they predict social anxiety and depression? J Clin Child Adolesc Psychol 34:49–61

    Article  PubMed  Google Scholar 

  78. Armsden GC, McCauley E, Greenberg MT, Burke PM, Mitchell JR (1990) Parent and peer attachment in early adolescent depression. J Abnorm Child Psychol 18:683–697

    Article  PubMed  Google Scholar 

  79. Keefe K, Berndt TJ (1996) Relations of friendship quality to self-esteem in early adolescence. J Early Adolesc 16:110–129

    Article  Google Scholar 

  80. Brody GH, Murry VM, Ge X, Simons RL, Gibbons FX, Gerrard M, Cutrona CE (2006) Perceived discrimination and the adjustment of African American youths: a five-year longitudinal analysis with contextual moderation effects. Child Dev 77:1170–1189

    Article  PubMed  Google Scholar 

  81. Gibbons FX, Gerrard M, Cleveland MJ, Wills TA, Brody G (2004) Perceived discrimination and substance use in African American parents and their children: a panel study. J Pers Soc Psychol 86:517–529

    Article  PubMed  Google Scholar 

  82. Fisher CB, Wallace SA, Fenton RE (2000) Discrimination distress during adolescence. J Youth Adol 29:679–695

    Article  Google Scholar 

  83. Harris-Britt A, Valrie CR, Kurtz-Costes B, Rowley SJ (2007) Perceived racial discrimination and self-esteem in African American youth: racial socialization as a protective factor. J Res Adolesc 17:669–682

    Article  PubMed  PubMed Central  Google Scholar 

  84. Szalacha LA, Erkut S, Coll CG, Alarcón O, Fields JP, Ceder I (2003) Discrimination and Puerto Rican children’s and adolescents’ mental health. Cult Divers Ethnic Minor Psychol 9:141–155

    Article  Google Scholar 

  85. Greene ML, Way N, Paul K (2006) Trajectories of perceived adult and peer discrimination among Black, Latino, and Asian American Adolescents: patterns and psychological correlates. Dev Psychol 42:218–238

    Article  PubMed  Google Scholar 

  86. Irvin MJ, Meece JL, Byun S, Farmer TW, Hutchins BC (2011) Relationship of school context to rural youth’s educational achievement and aspirations. J Youth Adolesc 40:1225–1242

    Article  PubMed  Google Scholar 

  87. Walsemann KM, Bell BA, Maitra D (2011) The intersection of school racial composition and student race/ethnicity on adolescent depressive and somatic symptoms. Soc Sci Med 72:1873–1883

    Article  PubMed  Google Scholar 

  88. Farrell L, Sijbenga A, Barrett P (2009) An examination of childhood anxiety, depression and self-esteem across socioeconomic groups: a comparison study between high and low socioeconomic status school communities. Adv Soc Mental Health Prom 2:5–19

    Article  Google Scholar 

  89. Lleras C (2008) Hostile school climates: explaining differential risk of student exposure to disruptive learning environments in high school. J Sch Violence 7:105–135

    Article  Google Scholar 

  90. Ferris JS, West EG (2004) Economies of scale, school violence, and the optimal size of schools. Appl Econ 36:1677–1684

    Article  Google Scholar 

  91. Chen G (2008) Communities, students, schools, and school crime: a confirmatory study of crime in U.S. high schools. Urban Educ 43:301–318

    Article  Google Scholar 

  92. Walker HM, Gresham FM (1997) Making schools safer and violence free. Interv Sch Clin 32:199–204

    Article  Google Scholar 

  93. Cronsoe R, Johnson MK, Elder GH (2004) School size and the interpersonal side of education: an examination of race/ethnicity and organizational context. Soc Sci Q 85:1259–1274

    Article  Google Scholar 

  94. U.S. Census Bureau (2010) Population, housing units, area, and density: 2010 County Subdivision and place. Retrieved from http://www.census.gov/prod/cen2010/doc/sf1.pdf

  95. Heisler EJ (2012) The U.S. infant mortality rate: International comparisons, underlying factors, federal programs. Congressional Research Service. Retrieved from http://www.fas.org/sgp/crs/misc/R41378.pdf

  96. Bureau of Labor Statistics (2012) Local area unemployment statistics map. Retrieved from http://data.bls.gov/map/MapToolServlet

  97. Bowen GL, Richman JM (2008) The school success profile. University of North Carolina, Chapel Hill

    Google Scholar 

  98. Bowen GL, Rose RA, Bowen NK (2005) The reliability and validity of the school success profile. Xlibris Corporation, Philadelphia

    Google Scholar 

  99. Rosenberg M (1965) Society and the adolescent self-image Princeton University Press: Princeton, NJ

  100. Phinney J, Ong AD (2007) Conceptualization and measurement of ethnic identity: current status and future directions. J Counsel Psychol 54:271–281

    Article  Google Scholar 

  101. Prinz RJ, Foster S, Kent RN, O’Leary KD (1979) Multivariate assessment of conflict in distressed and nondistresssed mother-adolescent dyads. J Appl Behav Anal 12:691–700

    Article  PubMed  PubMed Central  Google Scholar 

  102. Phinney JS, Ong AD (2007) Conceptualization and measurement of ethnic identity: current status and future directions. J Counsel Psychol 54:271–281

    Article  Google Scholar 

  103. Gil AG, Vega WA, Dimas JM (1994) Acculturative stress and personal adjustment among Hispanic adolescent boys. J Community Psychol 22:43–54

    Article  Google Scholar 

  104. Gil AG, Wagner EF, Vega WA (2000) Acculturation, familism, and alcohol use among Latino adolescent males: longitudinal relations. J Community Psychol 28:443–458

    Article  Google Scholar 

  105. Gil AG, Vega WA (1996) Two different worlds: acculturation stress and adaptation among Cuban and Nicaraguan families. J Soc Pers Relat 13:435–456

    Article  Google Scholar 

  106. Robin AL, Foster SL (1989) Negotiating parent-adolescent conflict. Guilford Press, New York

    Google Scholar 

  107. Raudenbush SW, Bryk AS (2002) Hierarchical linear models: Applications and data analysis methods, 2nd edn. Thousand Oaks, CA, Sage

    Google Scholar 

  108. Long JS (1997) Regression models for categorical and limited dependent variables. Sage Publications, Inc, Thousand Oaks

    Google Scholar 

  109. Allison P (2002) Missing data. Sage, Thousand Oaks

    Google Scholar 

  110. Little J, Panelli R (2003) Gender research in rural geography. Gender Place Cult 10:281–289

    Article  Google Scholar 

  111. Lott B (2001) Low-income parents and the public schools. J Soc Issues 57:247–259

    Article  Google Scholar 

  112. Farkas G, Grobe RP, Sheehan D, Shaun Y (1990) Cultural resources and school success: gender, ethnicity, and poverty groups with in an urban school district. Am Sociol Rev 55:127–142

    Article  Google Scholar 

  113. Ross LE (1995) School environment, self-esteem, and delinquency. J Crim Justice 23:555–567

    Article  Google Scholar 

  114. Gaines SO, Marelich WD, Bledsoe KL, Steers WN, Henderson MC, Granrose CS et al (1997) Links between race/ethnicity and cultural values as mediated by racial/ethnic identity and moderated by gender. J Pers Soc Psychol 72:1460–1476

    Article  PubMed  Google Scholar 

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Acknowledgments

Funding for this research was provided through a cooperative agreement with the U.S. Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control (5 U01 CE001948-03).

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Correspondence to Caroline B. R. Evans.

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Smokowski, P.R., Evans, C.B.R., Cotter, K.L. et al. Ecological Correlates of Depression and Self-Esteem in Rural Youth. Child Psychiatry Hum Dev 45, 500–518 (2014). https://doi.org/10.1007/s10578-013-0420-8

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