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Factors Influencing Teenage Depression

Info: 4411 words (18 pages) Nursing Essay
Published: 3rd Dec 2020

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Introduction

In society, depression is perceived as a phase that is easy to get over if the person tries hard enough, where in fact it is an existing mental health condition that restricts an individual from carrying out daily activities due to a persistent feeling of sadness (Nimh.nih.gov, 2019).Medical organisations such as the Lucile Packard children’s hospital have begun to realise that young children within their childhood have experienced depressive symptoms, proving that depression does not only affect adults (Stanfordchildrens.org, 2019). Depression is of interest when it comes to teenagers as they are prone to isolating themselves and it can be difficult to assess if a certain individual is experiencing the depressive signs and symptoms because they often occur within their minds and body. Having this background information in mind, the main aim of this essay is to explore and analyse the different factors that contribute to teenage depression. As well as this, 6 articles from the CINAHL database will be presented throughout in order to support the discussion. Also, many abbreviations will be used across the assignment such as EBP will be used to refer to Evidence Based Practice, ACEs will refer to Adverse Childhood Experiences and TLEQ is associated to the term Traumatic Life Events questionnaire

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Evidence based practice in a clinical setting is a way of challenging current practices by weaving out the most effective approach to a healthcare problem but it could also mean challenging poor practice by exploring the models that support EBP.(Dang and Dearholt, 2017).The systematic approach allows paediatric nurses to make clinical decisions about their patients by using the best current evidence of treatments and care(Academy of Medical-Surgical Nurses, 2019). It is essential to incorporate evidence based practice within care giving as it indicates that research has be done to plan and individualise care which brings light to new opportunities for the patient as well as the nurse.(Dang and Dearholt, 2017).This leads to the patient receiving care that is valid and relevant to their health, improving their overall quality of life. In children’s nursing, it is important to have age appropriate evidence so that when it is reflected into practice, it has a constructive impact on the child’s health due to them receiving the best possible treatment. In addition to this, EBP models are defined as tools that empower nurses to make the right decisions using critical thinking and the models recognise the creative approaches taken in order to resolve problems (Dang and Dearholt, 2017). Also, the models are designed in a way where patients and their families have the opportunity to be involved with the caregiving process meaning that they have control over their health and wellbeing (England.nhs.uk, 2019). Children’s nurses are encouraged to use EBP models within their own practice to challenge the current evidence they hold. This will support them to explore up-to-date advanced evidence, which is then translated into patient care, equalling in positive health outcomes.

Literature search

In order to explore the influencing factors of teenage depression it is important to have relating journal articles that can provide evidence of points made throughout the discussion. The articles mentioned throughout this assignment have been located by the CINAHL complete database because it was the only database that focused on the nursing and health journals. Also, the database has been programed to update every week which suggests that the current best evidence of teenage depression is offered throughout the articles which links back to evidence based practice where it is important to search for the best research.

The inclusion criteria were the age group of teenagers or young adults which falls in the range of 13-19-year olds and articles that explored other age groups such as infants or adults were not included so this was the exclusion criteria. These 2 criteria’s were made use of due to the research question centralising around teenagers therefore, if other age groups were involved  it would have been a wide spread of different age ranges which would lead to the question being unanswered due to the discussion not being focused on a particular age group. Moreover, some of the articles are not from the UK and have been conducted in a different country such as the U.S due to the UK holding a limited amount of research on teenage depression therefore, expanding out to other countries has had a positive impact on the discussion. 

Firstly, the publication date filter was set to find journals between the years 2010-2019 meaning that CINAHL only present journals that were published within the 9 years which ensured that the articles were up to date. This filter was applied because if the research is valid and updated, it can represent the society when it comes to discussing the issues surrounding depression in teenagers. Also, narrowing the search down to only 9 years allows trends and similar outcomes to be discovered for example, the same recurring symptoms due to the articles being relevant which links back to evidence based practice because they present current findings which is important to answer the question of what influencing factors lead to teenage depression (Evidence-Based Nursing blog, 2019).

Furthermore, the peer-reviewed filter was utilised for all 6 articles as it was important to have literature that was double checked by professionals from a medical board suggesting that the articles presented are of high quality and they adhere to the given standards before being published (Library.sdsu.edu, 2019). Peer reviewing allows the researchers to gain significant feedback on their articles, leading to them looking over their literature and making the necessary adjustments which means the overall discussion would be realistic and accurate (Gcu.ac.uk, 2019).

Moreover, it was essential to make sure that the full text filter was put into place before searching for the literature because the database would then only display the full text articles which illustrates that they are highly effective due to the in depth detail (Lin, 2009). The articles used within this assignment are all available in full text which means that all the crucial evidence is included in complete detail and no information is missing which overall makes the discussion realistic.

To begin with, the search terms Causes OR reasons OR factors AND teenagers OR adolescences OR young adults AND childhood trauma AND depression were used to find the Mental Health, Religion & Culture journal which explained how adverse childhood experiences, spiritual struggles and mental health symptoms were factors involved in teenage depression McCormick et al. (2017).

The search terms Causes OR reasons OR factors AND teenagers OR adolescences OR young adults AND social media AND depression were applied to access 2 different journals with the same concept of social media. The first one was the Depression & Anxiety journal that conveyed the relations between excessive social media use and depression in U.S teenagers Lin et al. (2016) and the second was Computers in Human Behaviour where the symptoms of depression and anxiety were related to the use of multiple social media platforms Primack et al. (2017).

The next set of search terms were Causes OR reasons OR factors AND teenagers OR adolescences OR young adults AND family AND depression which helped to identify the Stress & Health Journal of the international society for the investigation of stress journal which demonstrated how depression in young U.S. adults correlated to a disadvantaged family background that later led to chronic stress and low self-esteem Mossakowski et al. (2015). In addition, this journal article was found by applying the Subject: Major heading filter and selecting depression which led to articles that were relevant. This filter was utilised for the search to be focused around the word depression which would then make it easier to answer the research question that is based on teenage depression.

Another search was produced using the terms Causes OR reasons OR factors AND teenagers OR adolescences OR young adults AND school AND bullying AND depression. This allowed the Journal of Child & Family Studies to be discovered which looked at the pathways between bullying and depression within early adolescents and how their school belonging was affected Davis et al. (2019).

The journal of Child Psychology & Psychiatry was discovered through the search terms Causes OR influencing AND factors AND teenagers OR adolescences AND depression. The journal is a national cohort study that uncovered the link between depression and parental death during childhood in younger adults Berg et al. (2016). Also, during the search for this article, the geography filter of the UK and Ireland was used in order to narrow down the search because without the filter the articles presented were in a different language and were conducted in many different countries. Furthermore, the key articles within my assignment were identified by selecting ones that linked back to the overall research question and the 6 articles did contribute towards answering the question as each is based around a factor of teenage depression.

Discussion

Adverse childhood experiences, religious struggles and mental health symptoms

The “Adverse childhood experiences, religious/spiritual struggles and mental health symptoms: Examination of mediation models” article explored the relationship between ACEs and different religious struggles and how they linked to depression in younger adults. According to McCormick et al. (2017), adverse childhood experiences are when a child undergoes any type of physical, sexual or emotional abuse as well as neglect but it can also be seen as young adults experiencing household dysfunction where their parental figure has a mental health condition or is incarcerated. It was suggested that if a child had higher exposure to ACEs, they would find it difficult to associate themselves with a certain religion or belief. The reason for this is that childhood trauma can be severe at times and children begin to realise that the situation they are facing of abuse clashes against their religious beliefs of god not wanting them to suffer, leading them to disbelieve in religion once they become younger adults McCormick et al. (2017).

A study was constructed where the underlying effects of religious struggles and adverse childhood experiences were compared to the common symptoms of depression in a sample of younger adults. The aim was to discover if there was a correlation between the 2 variables. The procedures and measures involved within the study were accepted by the institutional board before it could be carried out which suggests that the study was valid and reliable as it had been reviewed by a professional authorised body. Furthermore, the study specifically included people that volunteered to participate, from the psychology department within a university and in total there were exactly 512 undergraduate students participating but this was narrowed down to a sample of 458 participants due to the missing data of 54 students. It was important to accurately measure the number of ACEs and TLEs the participants sustained before the age of 18 so a range of assessment materials and tools were utilised for an indication to be shown as to how severely they were exposed. The ACEs were presented through closed questions which required a yes or no answer from the participants whereas the TLEQ stated different scenarios that could later lead to trauma and these were assessed through McCormick et al.’s (2017, p.1046) six point scale where 0 was “never” and 6 was “more than 5 times” Moreover, a religious and spiritual struggles scale was used to assess the participants struggles with religious faith in the past few months, potentially to see if the ACEs and trauma had any impact towards their views and beliefs about religion. This type of assessment was measured through written statements of feelings where the participants had to use a five-point scale to identify if the statement applied to them and specially this assessment was narrowed down to the last few months, equalling in the overall studying being credible. Finally, to bring the study together, depressive symptoms were assessed through the eight-item patient health questionnaire where the common indication of depression were stated and participants had to use a four-point scale to mark how often they felt that specific symptom in the last month.

According to McCormick et al.’s (2017) statistics, 22.2% of the participants had experienced at least 1 ACE, 14.8% had 2 ACEs and 21.6% had reported to have 3 or more ACEs. In terms of traumatic life events, the study discovered that 80.2% of participants sustained trauma from natural disasters and 68.4% participants experienced trauma due to a loved one passing away unexpectedly. Also, the results of the patient health questionnaire indicated that 37.65 participants had a score of 15 or more, meaning that they displayed a severe level of depressive symptoms McCormick et al. (2017). Looking at these statistics, it is clear to see the direct link between ACEs/ TLE and depression because the more ACEs and TLE the participant had endured, the higher their depressive symptoms would be. This links back to the religious and spiritual struggles amongst participants who have had a high occurrence of ACEs and trauma in the past as McCormick et al. (2017) suggested that these individuals would experience distress and conflict against multiple religions due to their adverse and traumatic encounters. The reason for this could be due to the participants experience leading them to doubt their religion and faith as it has been highlighted that ACEs and TLE have an influence over a person’s meaning of life in relation to their beliefs. McCormick et al. (2017) demonstrates that ACEs and religious struggles have a considerable amount of effect on a person’s mental health which can lead to depression later in life. 

Examining pathways between bully victim’s depression and school belonging among early adolescents

  • What were the studies about?

Davis et al. (2019) distinguished the connection between depression and victims of bullying within adolescents whilst making links as to how this affected their sense of belonging inside a school environment. The link between depression and being a victim of bullying is that it can bring about emotional, academic and social challenges which can be difficult to overcome for adolescences due to the symptoms of depression being intensified. Davis et al. (2019) pointed out the significance of understanding the underlying factors of depression as statistics show a high prevalence of 13% among teenagers with the major factor of bully victimisation. Although, depression is bound to develop within teenagers who have experienced bullying, Davis et al. (2019) identified protective factors such as supportive parenting and high-quality relationships that have proven to reduce the occurrence of depression due to the nurturing value. Moreover, it has been said that adolescences seek acceptance and respect whist being in a school environment as they want to be included by their peers (Davis et al. 2019). Adding on to this, if there is no sense of school belonging throughout the teenager’s education life, it can result to feelings of sadness as they have not been successful in building rapport with others. This can then lead to aggression and symptoms of depression as Davis et al. (2019) has discussed these to be the implications of not having any interpersonal relationships within school.

  • How were they conducted?

Davis et al. (2019) decided to conduct a study that looked at 3 main pieces of theoretical frameworks which were the interpersonal risk model, symptom driven model and the transactional model that would help to comprehend the main aim of discovering the connections between depression and bully victimisations, along with the positive effects of school belonging. To provide a background, the 3 frameworks were explained where the interpersonal risk model indicated that unsupportive and disagreeing social interactions can influence the symptoms of depression to occur. The symptom driven model explained that teenagers who have behavioural issues are more inclined to symptoms of depression and anxiety as they have a higher chance of being peer victimised. The transactional framework looks at the influences of different negative peer interactions and how the symptoms of depression can develop as it leads to social isolation. To begin the study, Davis et al. (2019) included 2,177 students from 4 different midwestern middle schools to participate but only 98% of those students took part in the study as the rest of the students did not gain consent from their parents to participate. The study’s data was collected through surveys that each student completed within their school hours where questions about bully victimisation, depression and school belonging were presented so that Davis et al. (2019) could have a clear overview about the exposure to these factors. Moving on, bully victimisation was measured through a four-item scale that listed particular statements for the students to rate as to how often they had experienced them within the last 30 days. Similarly, depression was assessed using the six-item orpinas modified depression scale that outlined different statements and the participants had to score how frequently they felt a certain way according to the statements. Finally, school belonging was evaluated through a 5-point response scale where again the participants were given a range of statements in which they were asked how much they agree with each.

  • What did they find?

Davis et al. (2019) brought the study together through the results and found that teenagers that had a high score of bully victimisation also had a higher chance of developing depressive symptoms but Davis et al. (2019) connected this to having a low score on school belonging. Looking at the depression results, those that scored higher had reported lower for their sense of school belonging, therefore, again Davis et al. (2019) found a correlation between the 2 variables. Also, whilst conducting the study, Davis et al. (2019) realised that protective factors such as a positive school belonging proved to ease the symptoms of depression that are mostly led by bully victimization as they promote peer acceptance. Overall, it is said that teenagers who have repeatedly experienced bully victimisation, often are used to having a low school belonging, but it is also lower than any other teenager who has not experienced bullying at all.

Parental death during childhood and depression in young adults

What were the studies about?

Berg et al. (2016) completed a study

How were they conducted?

What did they find?

Use different research terms- https://libguides.usc.edu/writingguide/researchglossary

 

Use of multiple social media platforms and symptoms of depression and anxiety

  • Social media- (comparing self to others and being critical of self too much)

What were the studies about?

How were they conducted?

What did they find?

Use different research terms- https://libguides.usc.edu/writingguide/researchglossary

Sexual orientation and depressive symptoms in adolescents

What was the study about?

How was it conducted?

What was found?

Conclusion

Not having a strong base of self- esteem means the teenager doesn’t have a valuable psychological resource that they can utilise. Self-esteem is a strong motivational “force” that can be used to reduce stress meaning that mental health is protected so less likely to become depressed

Within the 5 articles, there were some occurring limitations such as the articles only focusing on one region of a specific country where the study was carried out. This means that the study is not representative of teenagers in the whole country and this can include demographics as well due to the articles narrowing down to only specific demographics but

Did not look at other connecting protective factors that could lower the affect of depression such as family or school activities as these could potentially change the outcomes of the studies and

All of the studies confirm that teenagers can experience long lasting affects if exposed to depressive symptoms

All of the findings from each of the studies can be comparable as they all look at depression but state different factors that can lead to depressive symptoms.

Changes need to be made in terms of

Further research and prevention techniques should be put into place so that teenagers are not going through depression alone and will know that they have someone who they feel comfortable talking to. Reacher could help understand depression to the core and what factors other than the ones outlined can cause depressive symptoms to arise.

Reference list-

  1. https://www.nimh.nih.gov/health/publications/teen-depression/index.shtml
  2. https://www.stanfordchildrens.org/en/topic/default?id=understanding-teenage-depression-1-2220
  3. https://www.amsn.org/practice-resources/evidence-based-practice
  4. https://www.england.nhs.uk/wp-content/uploads/2017/04/ppp-involving-people-health-care-guidance.pdf
  5. https://blogs.bmj.com/ebn/2013/09/26/when-is-the-evidence-too-old/
  6. https://library.sdsu.edu/reference/news/what-does-peer-review-mean
  7. https://www.gcu.ac.uk/library/pilot/publication/peerreview/advantagesanddisadvantages/
  8. https://www.dictionary.com/browse/socioeconomic-status
  9. Lin, J. (2009). Is searching full text more effective than searching abstracts? BMC Bioinformatics, 10(1).  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695361/
  10.  

Database Searched

Date searched

Search strategy used

Limits

Number of results

Notes

CINAHL complete

14/10/19

Causes OR influencing AND factors AND teenagers OR adolescences AND depression

Country and language

66

  • Geography- UK and Ireland
  • Year = 2010-2019
  • Full text
  • Peer reviewed

CINAHL complete

17/10/19

Causes OR reasons OR factors AND teenagers OR adolescences OR young adults AND social media AND depression

PDF format only

115

  • Full text
  • Year = 2010-2019
  • Peer reviewed

CINAHL complete

17/10/19

Causes OR reasons OR factors AND teenagers OR adolescences OR young adults AND family AND depression

Vague

849

  • Full text
  • Year = 2010-2019
  • Subject: Major heading of depression
  • Peer reviewed

CINAHL complete

21/10/19

Causes OR reasons OR factors AND teenagers OR adolescences OR young adults AND school AND bullying AND depression

Country

173

  • Full text
  • Year = 2010-2019
  • Peer reviewed

CINAHL complete

21/10/19

Causes OR reasons OR factors AND teenagers OR adolescences OR young adults AND childhood trauma AND depression

HTML and PDF text only

188

  • Full text
  • Peer reviewed
  • Year = 2010-2019

Appendices-

 

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