Monday, December 1, 2014

Depression

Poverty has been linked to a variety of health, learning and behavioral problems, including depressive symptoms for both adults and children (Butler, 2014).  Americans who are in poverty are more likely than those who aren’t to struggle with chronic health problems and depression disproportionately affects those in poverty the most.  According to Brown, about 31% of American in poverty say that have at some point been diagnosed with depression compared with 15.8% of those not in poverty (Brown 2013).  Some of the most common symptoms for both children and adults include feelings of loneliness, sadness, hopelessness, worthlessness, having little interest of pleasure in activities, fatigue, insomnia and thoughts of suicide. 


            The relationship between low socioeconomic status and depression has been well documented in child and adult populations.  About 10-15% of children report a moderate to severe level of depressive symptoms at any given time and between 14% and 15% of children and adolescents will experience at least one episode of major depression before adulthood (Zimmerman, Galea, McCauley,Stoep, 2008).  There are many possible pathways that exist for how living in poverty might lead to elevated symptoms of depression among children.  Therefore, poverty has a direct relation to depression among adolescences. 
The negative association between poverty and mental health is robust (Butler, 2014).   In a study conducted by Lorant et al, they found a meta-analysis of 51 studies, which indicated that adults with low socioeconomic status are 80% more likely to be depressed than are higher socioeconomic adults (Lorant et al., 2003). There are two primary theoretical pathways through which poverty has been proposed to lead to childhood behavioral disorders (Conger & Donnellan, 2007).
One pathway is the family investment model, which implies that poor parents cannot afford to live in safe neighborhoods, send their children to schools in which they will thrive, or provide adequate supervision of their children’s activities. Thus, poor children are more likely to be exposed to harsh and potentially traumatic conditions with lasting emotional repercussions (Butler, 2014).  The environmental experiences in crime-riddenneighborhoods from which the family cannot afford to escape, can create trauma bywitnessing the victimization of other people.
A second pathway is the family stress model, which proposes that poverty affects children’s mental health primarily through its negative effect on parents (Conger et al., 1993).  A number of researchers have used the family stress model to interpret the relationship between economic hardship and depressive symptoms (Butler, 2014). “There is also evidence that certain potentially traumatic events, including emotional abuse and witnessing the victimization of other people are more likely to be experienced by low-income children” (Finkelhor,Ormrod, Turner, & Hamby,2005). Economically pressured parents may perpetrate childhood trauma such as emotional abuse or domestic violence, and so childhood poverty increases the likelihood of depressive symptoms among adolescents (Butler, 2014).
“If poverty leads to depressive symptoms, it may be the experience of poverty might have the strongest impact during early childhood when important developmental tasks, such as attachment, must be negotiated (Bowlby, 1980; Mash & Dozois, 2003)”.  Further more, “depression represents a critical health problem during the developmental stage of adolescence. Adolescent depression is associated with recurrent depression in adulthood, increased risk for suicide, and comorbidity with other psychological problems such as substance abuse” (Compass, Conner, & Wadsworth 1997; Compas, Ey,& Grant, 1993). Depressed mood is recognized as the most commonly occurring taxonomic level of the disorder, affecting 15-40% of the general adolescent population (Compas, Ey et al., 1993).
Research consistently reveals a relationship between socioeconomic status and depressive symptoms among urban African-American youth (Goodman, 1999; Taylor, 1996). Combined with other potential socioeconomic stressors, such as racial discrimination, poverty represents a major risk factor for adverse mental health outcomes for urban African-Americans adolescents (Hammack, 2003)
 However,“In a study in the February 2011 issue of the Journal of Child and AdolescentPsychiatry, researchers from the Rollins School of Public Health at Emory inAtlanta, Georgia analyzed five years of data (2004-2008). This study evaluated a national representative sample of 7,704 adolescents, from 12 to 17 years of age, who were diagnosed with major depression within the past year. Researchers studied the differences in treatment for depression across four racial/ethnic groups of adolescents with major depression (i.e., non-Hispanic whites, blacks, Hispanics, and Asians)” (Elsevier, 2011).  “In their article Dr. Janet R. Cummings and Dr. Benjamin G Druss report that after adjusting for demographics and health status, the percentage of non-Hispanic whites who received any major depression treatment was 40% compared to 32% in blacks, 31% in Hispanics, and 19% in Asians. Black, Hispanic, and Asian adolescents were also significantly less likely than non-Hispanic whites to receive treatment for major depression from medical providers, and to have any mental health outpatient visits, with Asians exhibiting the lowest rate of service use on each measurement” (Elsevier,2011). A short description of professional treatment for depressed adolescentsis given by Dr. David Brent of the University of Pittsburgh.
In conclusion, depression is one of the biggest challenges that face adolescence who live with their poor families and lead both of adolescents and their families to chronic diseases and bad behaviors such as the use of drugs.  However, teenagers and pre-teens don’t deserve to be depressed or led to bad habits because of poverty.  As depressed adolescents grow up with these symptoms, they tend to influence other people around them negatively.  Therefore, governments and other people like those who are rich can play a role in impacting communities’ especially poor communities to practice a good lifestyle.  For instance, better school systems, mandatory charity and counseling services can be provided for poor people by governments and those who can afford it.  Many teenagers need someone who can listen to them effectively.  Once they find the right person that cares about them and can advise them properly, they may start to feel better and behave better. 
In addition, there are some strategies that can be used for preventing depressed adolescents due to poverty.  Many cases of poverty can be decreased if the child has the motivation to work hard and is determined to help itself.  Another solution is to prevent having kids if the adults are considered to be low on the socioeconomic ladder.  Poor couples ought to plan to have kids when they are capable of affording the needs of their children.  Although, having kids is a pleasure, parents should have the sense that they are not easy or cheap to raise.

Roya Afghan, Stephanie Vazquez, Ricardo Rodriguez, Turki Altharaman & Phoenix Toliver

References:

Bowlby, J. (1980). Attachment and Loss: Vol. 3. Loss: Sadness and depression. NY: Basic Books.
Butler, A. C. (2014). Poverty and adolescent depressive symptoms. American Journal of Orthopsychiatry, 84(1), 82 http://dx.doi.org/10.1037/h0098735
Brown, A. (2013, October 30). With Poverty Comes Depression, More Than Other Illnesses. Retrieved November 28, 2014, from http://www.gallup.com/poll/158417/poverty-comes-depression-illness.aspx
Elsevier (2011). Racial and ethnic minority adolescents less likely to receive treatment for major depression February 2011 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP)
Carson NJ. (2011). The Devil You Know: Revealing Racial/Ethnic Disparities in the Treatment of Adolescent Depression. Journal of the American Academy of Child and Adolescent Psychiatry; 50 (2):106-107
Compas,B.E.,Con.P.Gullottanor,J.,&Wadsworth,M.(1997).Prevention of depression.InR.P.Weissberg,T, R. L. Hampton, B. A. Ryan, & G. R. Adams (Eds.),Issues in children’s and families’ lives: Vol. 8. Enhancing children’s wellness
(pp. 129–174). Thousand Oaks, CA: Sage.
Compas, B. E., Ey, S., & Grant, K. E. (1993). Taxonomy, assessment, and diagnosis of depression during adolescence. Psychological Bulletin114, 323–344.
Conger, R. D., Conger, K. J., Elder, G. H., Lorenz, F. O., Simons, R. L., & Whitbeck, L. B. (1993). Family economic stress and adjustment of early adolescent girls. Developmental Psychology, 29, 206-219.
Elsevier. (2011, February 22). Racial and ethnic minority adolescents less likely to receive treatment for major depression, study finds. ScienceDaily. Retrieved November 29, 2014 from www.sciencedaily.com/releases/2011/02/110222092609.htm
Finkelhor, D., Ormrod, R. K., Turner, H., & Hamby, S. L. (2005). The victimization of children and
youth: A comprehensive, national survey. Child Maltreatment, 10, 5-25.
Goodman, E. (1999). The role of socioeconomic status gradients in explaining differences in U.S.adolescents’ health. American Journal of Public Health 89, 1522–1528.
Hammack, P. L. (2003). Toward a uniļ¬ed theory of depression among urban African American adolescents: Integrating socioecologic, cognitive, family stress, and biopsychosocial perspectives.
 Journal of Black Psychology, 29,187–209
Hammack, P. L., Robinson, W. L., Crawford, I., & Li, S. T. (2004). Poverty and depressed mood among urban African-American adolescents: A family stress perspective. Journal of Child and Family Studies, 13(3), 309-323.
Mash, E. J., & Dozois, D. J. A. (2003). Child psychopathology: A developmental-systems perspective. In E. J. Mash & R. A. Barkley (Eds.), Child Psychopathology (2 ed., pp. 3-71). NY: Gilford.
Taylor, R. D. (1996). Adolescents’ perceptions of kinship support and family management practices: Association with adolescent adjustment in African American families.
 DevelopmentalPsychology32, 687–695.
Tracy, M., Zimmerman, F. J., Galea, S., McCauley, E., & Stoep, A. V. (2008). What explains the relation between family poverty and childhood depressive symptoms?. Journal of psychiatric research, 42(14), 1163-1175.

VIDEOS I—IV

VIDEO I
Poverty and Depression
http://youtu.be/f7qYtfyybSM

VIDEO II
Adolescent Depression Intervention : a  description of what goes on during therapy
Sara Reyes (Cute, lively, explained by teenagers).

VIDEO III
The Best Treatment for Adolescent Depression: professional description of what the treatment is about. Dr. David Brent University of Pittsburgh

VIDEO IV
Professional Resources: Evidence-Based Treatment of Depression inAdolescents:Publishedon Jan 11, 2013
https://www.youtube.com/watch?v=UYnojA9qEhI










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