1. Depression Goals: What it is how its diagnosed prevention/interventions Depression Goals: -What depression is -How it can be diagnosed -Preventions/interventions By: Danielle Bange

2. Introduction Depression - a prototypical multifactor disorder that profoundly affects individuals’ emotions, thought and sense of self, behaviors, interpersonal relations, physical functioning, biological processes, work productivity, and overall life satisfaction  Most commonly occurring of all major psychiatric disorders  Depression has been recognized to begin in adolescence  Ranked the fourth leading cause of disability and premature death worldwide

3. Diagnostic Criteria/classification issues  Depression can be diagnosed through the same symptoms in childhood, adolescence and adulthood  Such as a patients changes in sleep, appetite, and feelings of worthlessness  Tools to access: questionnaires that are valid and brief  The syndrome and predominant symptoms of depression may differ as a function of age and development; given the cognitive, social, emotional, biological changes that transpire over time through childhood and adolescence

4. Diagnostic criteria  Symptoms that make up depression and influence its phenomenological manifestation may differ developmentally for many reasons…  younger children may not have developed the requisite cognitive, social, emotional, or biological capacities to experience certain typical depressive symptoms  Young preschoolers tend not to report depressed mood or hopelessness/younger children are more likely to describe somatic symptoms of depression

5. Diagnostic Criteria Continued…  Issues of classification  Whether the latent structure of depression is best considered as a category or dimension  When viewed as a dimension, it differs quantitatively by degree  When viewed as categorical, depression is said to differ in kind in a qualitatively distinct way  Research shows that the structure of depression is dimensional from childhood to adulthood

6. Stressful negative events in life  Negative life events play a substantial role in the development of depression from childhood through adulthood  Most all individuals who have a depressive disorder have encountered at least one significant negative life event in the month prior to the onset of depression  Only 20-50% of individuals who experience severe, major negative life events develop clinically significant levels of depression

7. Genetic Vulnerability  One of the strongest predictors of depression in youth is having a parent with a history of depression  It increases the persons risk of depression by 2 or 3 times more (20-30% versus 10% of an average person)  Etiological risk factors of the disorder are moderately heritable  Liability to experience negative events is partially heritable

8. Personality/temperament vulnerability  Depression has been linked with personality traits subsumed under negative emotionality/and are considered moderately heritable  Neuroticism, or negative emotionality reflects the extent to which an individual perceives and experiences the world as threatening or distressing  Strongest predictors of a major depressive episode among adults were negative life events, genetic factors, and neuroticism

9. Cognitive vulnerability  Cognitive theories of depression are concerned with the relationship between human mental activity and the experience of depression  Four cognitive factors received the most attention:  Negative inferential styles about causes, consequences, and the self  Dysfunctional attitudes  The tendency to ruminate in response to depressed mood  Self-criticism

10. Cognitive Vulnerability Continued…..  Depression emerges only during the transition from late childhood to early adolescence when children acquire the ability to engage in abstract reasoning and formal operational thought  Developmental hypothesis- children lack the cognitive capacities to think abstractly about their self and future

11. Interpersonal Vulnerability  Adolescent depression is linked to lower levels of family support and lower levels of social support from friends  Adolescents’ perception of low parental support predicted future depression  According the Bowlby’s attachment theory, insecure attachment patterns have been posited to serves as vulnerability to a diversity of psychological problems including depression  Results from a study that was done showed that children who exhibited high levels of negative attachment patterns reported greater elevations in depressive symptoms following elevations in their parents’ level of depressive symptoms.

12. Interventions for depression  Depression in adolescents can be improved through:  individual psychotherapies  1.) Cognitive-behavioral therapy (CBT)  2.) Interpersonal psychotherapy (IPT)  Antidepressants  Severe clinical depression in adolescence can be treated most efficiently by the combination of antidepressants and CBT  These are said to reduce suicidality

13. Facts  Psychological preventions were effective when aimed at targeted or at-risk youth  Universal prevention programs were not effective  Adolescents with epilepsy are more likely to experience depression  Diagnosed clinical levels of depression show that the rates of depression are generally low in children and increase to near-adult prevalence levels in adolescence  Twice as many women are depressed as men (adulthood)  Depression affects 17 million people every year

14. Conclusion  Depression is a prevalent mental illness with significant burden and costs that may affect the patient and those related to them socially, educationally, interpersonally, economically, and may also impair future developmental outcomes  Many factors increase the risk of adolescents experiencing depression  There are many treatments that can be used to help those who are clinically depressed and prevention efforts can be applied to those identified as “at-risk”

15. Conclusion Continued  A patient with mild to moderate depression, psychotherapy may be all that is needed  Patients with major depression, a combination of medication and psychotherapy may be the most effective

16. References  Hankin, B. L. (2006). Epilepsy & Behavior. Adolescent depression: Description, causes, and interventions, 8(1), 102-114. Retrieved from http://http://www.sciencedirect.com.ezaccess.libr aries.psu.edu/science/article/pii/S15255050050040 02  Understanding Depression. (2013). Retrieved December 1, 2013, from http://kidshealth.org/parent/emotions/feelings/un derstanding_depression.html http://kidshealth.org/parent/emotions/feelings/un derstanding_depression.html  What is depression? What causes depression? - Medical News Today. (2009, April 7). Retrieved December 1, 2013, from http://www.medicalnewstoday.com/articles/8933. php

17. Five Multiple Choice questions and answers  1. Which of the following affects an individual with depression?  A.) emotions  B.) Thoughts and sense of self  C.) physical functioning  D.) work productivity  E.) All of the above  2. Depression affects how many people each year?  A.) 14 million  B.) 19 billion  C.) 17 million  D.) 13 billion

18. Multiple Choice Questions continued….  3.) Which intervention is said to decrease suicidiality?  A.) Antidepressants  B.) Cognitive-behavioral therapy  C.) Cognitive-behavioral therapy (CBT) and antidepressants  D.) Interpersonal psychotherapy  4.) Depression has ranked what number in the leading cause of disability and premature death?  A.) First  B.) Tenth  C.) Ninth  D.) Fourth  5.) Which sex is more depressed?  A.) Female  B. Male

19. Short answers questions  1.) Genetics increase a persons risk of depression by what percentage? 20-30%  2.) How can depression be diagnosed? through a person sleep changes, appetite changes, and feelings of worthlessness  3.) What percentage of individuals experience severe and major life events? 20-50%  4.)What is one of the strongest predictors of depression? Having a parent with history of it  5.) According to past research, what is the structure of depression from childhood- adulthood? Dimensional