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Long-term Sequelae of Sub-clinical Depressive Symptoms in Early Adolescence Joe Allen Joanna Chango David Szwedo Megan Schad University of Virginia. Farah Williams, Ph.D. Jill Antonishak , Ph.D . Joanna Chango Caroline White . Elie Hessel Emily Marston, Ph.D. Glenda Insabella, Ph.D.

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  1. Long-term Sequelae of Sub-clinicalDepressive Symptoms in Early AdolescenceJoe AllenJoanna ChangoDavid SzwedoMegan SchadUniversity of Virginia Farah Williams, Ph.D. Jill Antonishak, Ph.D. Joanna Chango Caroline White ElieHessel Emily Marston, Ph.D. Glenda Insabella, Ph.D. Erin Miga, Ph.D. Amanda Hare, Ph.D. Collaborators: Maryfrances Porter, Ph.D. Kathleen McElhaney, Ph.D. F. Christy McFarland, Ph.D. Ann Spilker Copies of related papers are available at:WWW.TEENRESEARCH.ORG

  2. Depressive Symptoms as Uniquely Problematic in Adolescence

  3. Social Relationship Quality:Why Teens Care/ Why We Care • Links to numerous adult mental health indices • Anxiety, Depression, Antisocial Personality Disorder, etc. • Links to physical health • Self-care • Cardiovascular reactivity to Stress • Immune Functioning • Weight/obesity • Links to Survival There’s a reason teens care so desperately about their peer relationships.

  4. Adolescence asSensitive Period for Developing Relationship Competence • Development of Neural Structures • Prefrontal and Parietal Cortex • Development of Sophisticated Social Perspective-taking Capacity • First experience with True Adult-like Relationships

  5. Early Adolescent Depressive Symptoms • Concurrent Effects: • Reduced Energy for Developmental Tasks • Negative Bias Regarding Relationships/Hopelessness • Self-fulfilling nature/vicious cycle • Impairment at a critical point in social development?

  6. Primary QuestionHow Are Adolescent Depressive SymptomsLinked to Future Social Functioning?

  7. Sample • 184 Adolescents, their Parents, Best Friends, Other Friends, Romantic Partners • Intensive Interviews and Observations with all parties (Total N over first 13 years ~ 3200). • Equal numbers of Males and Females • Socio-economically Diverse (Median Family Income= $40- $60K) • 31% African American; 69% European American • Very Low Attrition (98% participation rate in current phase)

  8. Depressive Symptoms Adolescence: • Childhood Depression Inventory (Kovacs & Beck, 1977) 27-items based on the Beck Depression Inventory • Screening Cutoffs – For possible depression • Clinical Cutoffs – For likely depression • Aggregated Scores across 3 assessments (ages 14,15, 16) Adulthood: • Beck Depression Inventory (Beck & Steer, 1987) 21-items assessing concurrent symptoms. • Aggregated Scores Across Ages 23, 24

  9. Functioning with Peers Adolescence: • Inventory of Parent and Peer Attachment (Armsden & Greenberg, 1987) 21-item inventory summing Communication, Trust, and Alienation (reverse-scored) • Aggregated from three assessments (Age 14, 15, & 16) Adulthood: • UCLA Loneliness Scale (Russell et al., 1980) 20 -item inventory • linked to long-term mental and physical health risks • Aggregated from two assessments (Age 23 & 24)

  10. Simple Prediction of Future Loneliness(Correlations) Ages 14-16 Age 23-24 Loneliness Depressive Symptoms .52***

  11. Simple Prediction of Future Loneliness*(Correlations) Ages 14-16 Age 23-24 Loneliness Depressive Symptoms .41*** • Excluding most severely depressed adolescents • (10% of sample) Long-term Links are Found Even Among those with very mild levels of Depressive Symptoms

  12. Predicting Loneliness Over and Above Covariates Ages 14-16 Age 23-24 Loneliness Depressive Symptoms .34*** -.11+ Peer Attachment Gender & Income .43*** Concurrent Depression Predictions Even After Accounting for Baseline Functioning & Concurrent Depression

  13. Depressive Symptoms Predicting Loneliness (Categorical Description)

  14. Depressive Symptoms Predicting Loneliness (Categorical Description)

  15. Depressive Symptoms Predicting Loneliness (Categorical Description)

  16. Depressive Symptoms Predicting Loneliness (Categorical Description) EVERY Teen who was even mildly depressed in adolescence was above the median in adult loneliness.

  17. Limitations • All Based on Teen Self-Report • Need to Begin to Explore Possible Mediators of Long-term Links

  18. Maternal Relationship Quality Adolescence: • Inventory of Parent and Peer Attachment (Armsden & Greenberg, 1987) 21-item inventory summing Communication, Trust and Alienation (reverse-scored) • Early adolescence: Aggregated from Age 14, 15, & 16 • Late adolescence: Aggregated from Age 18, 19, & 20 Adulthood: • MaternalReport: Network of Relationships Inventory (Furman & Buhrmester, 1985) Total positivity (Six 3-item scales) • Age 23

  19. Simple Continuity(Correlations) Ages 14-16 Age 23 Maternal Relationship Quality Depressive Symptoms -.30***

  20. Simple Continuity *(Correlations) Ages 14-16 Age 23 Maternal Relationship Quality Depressive Symptoms -.31*** • Excluding most severely depressed adolescents • (10% of sample) Long-term Effects are Found Even Among those with very mild levels of Depressive Symptoms

  21. Predicting Maternal Relationship Quality Over and Above Covariates Ages 14-16 Age 23 Maternal Relationship Quality Depressive Symptoms -.39*** -.03 Gender & Income Maternal Attachment .18* Concurrent Depression

  22. Even Mild Adolescent Depressive Symptoms Have Clear Long-term Sequelae • Key Question: Mediating Pathways?

  23. Potential Peer Pathway:Avoidance?

  24. Social Avoidance Peers Late Adolescence: • Social AvoidanceSocial Anxiety Scale for Adolescents (La Greca & Lopez, 1998) 14-item inventory. • Aggregated from 3 assessments (Ages 19, 20, & 21)

  25. Early Adolescent Predictors (Age 14-16) Late-Adolescent Intervening Variables (Age 18-20) Early Adult Outcomes (Age 23-24) Attachment to Peers Avoidance of Peers Loneliness .25*** -.18** .41*** .39*** .25*** .30*** Depressive Symptoms Depressive Symptoms Gender & Income

  26. Early Adolescent Predictors (Age 14-16) Late-Adolescent Intervening Variables (Age 18-20) Early Adult Outcomes (Age 23-24) Attachment to Peers Avoidance of Peers Loneliness -.18** .25*** .41*** .39*** .25*** .30*** Depressive Symptoms Depressive Symptoms Gender & Income

  27. Early Adolescent Predictors (Age 14-16) Late-Adolescent Intervening Variables (Age 18-20) Early Adult Outcomes (Age 23-24) Attachment to Peers Avoidance of Peers Loneliness -.18** .25*** .41*** .39*** .25*** .30*** Depressive Symptoms Depressive Symptoms Gender & Income Direct and Indirect Effects on Future Loneliness

  28. Potential Parent Pathway:Disrupted Relationship

  29. Early Adolescent Predictors (Age 14-16) Late-Adolescent Intervening Variables (Age 18-20) Early Adult Outcomes (Age 23-24) .30*** Depressive Symptoms Depressive Symptoms -.29*** .22** -.14** Gender & Income Attachment to Mother Attachment to Mother Maternal Relat. Quality .53*** .35***

  30. Early Adolescent Predictors (Age 14-16) Late-Adolescent Intervening Variables (Age 18-20) Early Adult Outcomes (Age 23-24) .30*** Depressive Symptoms Depressive Symptoms -.29*** .22** -.14** Gender & Income Attachment to Mother Attachment to Mother Maternal Relat. Quality .53*** .35***

  31. Early Adolescent Predictors (Age 14-16) Late-Adolescent Intervening Variables (Age 18-20) Early Adult Outcomes (Age 23-24) .30*** Depressive Symptoms Depressive Symptoms -.29*** .22** -.14** Gender & Income Attachment to Mother Attachment to Mother Maternal Relat. Quality .53*** .35*** Direct and Indirect Effects on Maternal Relationship Quality

  32. The Multiple Sequelae of Adolescent Depression Early Adolescent (Age 14-16) Late-Adolescent (Age 18-20) Early Adult (Age 23-24) Attachment to Peers Avoidance of Peers Loneliness -.18** .25*** .41*** .18** .39*** .25*** .30*** Depressive Symptoms Depressive Symptoms -.19* -.29*** .22** -.14** Attachment to Mother Attachment to Mother Maternal Relat. Quality .53*** .35***

  33. Limitations • Correlational not Causal • Very Preliminary Understanding of Mediating Processes • NOT based on diagnostic/clinical interviews Copies of related papers are available at:www.TeenResearch.org

  34. Conclusions • Importance of even MILD Depressive Symptoms • Effects Beyond Simple Symptom Continuity • Interference with Relationship Formation/Maintenance – A Sensitive Period? • Intervention Implications Copies of related papers are available at:www.TeenResearch.org

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